The majority of our substance abuse counselees come to biblical counseling having been in a secular treatment program. In those programs, they are told they have a disease and they are given “treatment” according to the medical model. When a person has been down that road with no lasting success, he must understand that before he can change what he habitually does (abuse drugs and alcohol), he must change how he thinks and what he thinks about addiction.

Understanding how the person has been indoctrinated into the disease model is helpful in knowing where to make inroads into this way of thinking. Our initial goal is to reorient their understanding to the biblical model: What society calls addiction is biblically called the sin of drunkenness or idolatry (1 Timothy 3:3; Gal. 5:21).

Our thoughts and beliefs make up how we “see” sin. If someone believes addiction is biological or genetic, then the best the addict can do is get behavioral therapy, attend 12 Step groups, or take a pill to feel better. The addict is “diseased” and in the medical model that is a forever diagnosis. The best he can hope for is “recovery.” With that mindset, the addict sees his behavior as not being his fault, and he believes that he is helpless before his impulses, thoughts, and drives.

A counselee who is struggling with an addiction needs, more than anything, to know there is hope for him to break out of this lifestyle. It is not simplistic, as some people claim, to say that Jesus Christ is the way out of addiction. He came to set the captives free (1 John 1:9).

Freedom begins with changing the terminology from the medical model to the biblical or moral model. “Addiction” must be explained biblically; the alcoholic is a drunkard (Deut. 21:20; Prov. 23:21; 26:9; 1 Cor. 5:11). He must be taught that the Scriptures speak directly to the unacceptability of these behaviors (Eph. 5:18) and because they are called sinful, they must be put off (Eph. 4:22-24). The “addict” can be taught that these behaviors are idolatrous.

Because he is so indoctrinated with the world’s viewpoint on heart issues, the counselee must develop a biblical view of the heart. Once he understands that biblically, heart means soul and not strictly feelings and emotions, we can then teach him that following your heart is a foolish way to live because of what the Bible says about the condition of the heart (Jer. 17:9; Mark 7:21).

This is an excellent opening for presenting the gospel to the unregenerate counselee. The Bible teaches us that since Adam, all men and women are sinners by nature and by choice. The inner man is not “basically good” but basically depraved, seriously flawed, and utterly corrupt and without the grace of God, will remain so. (Rom. 3:9-18, 23; 5:10-12). This will help him understand part of the reason he is tempted to sin with drugs and alcohol.

The immaterial man is fully impacted by the activities of the heart. There is no aspect of our being that is untouched or unperverted by the sinfulness and wickedness that lurks within us. Even in Christ the Christian still is plagued by the sinful aspects of the heart. While we have been redeemed and given a heart of flesh to replace the heart of stone, we are not sinless; there is a constant battle going on inside all of us according to Galatians 5:17. The Spirit and the flesh are locked in a life-long battle because of the thoughts, beliefs, and desires of the heart. At conversion, we were enabled not to sin, but this does not mean we are perfected. Progressive sanctification is the process of biblical change. It is the process of changing our thoughts, beliefs, and desires through the teaching of the Word of God and the Spirit of God applying that Word to our hearts.

When someone with an addiction of any kind comes to us, we help them to see that what they are really dealing with is an issue of idolatry. This gives them hope right from the start because we are not telling them they have a medical disease that cannot be cured or something they need a pill or some sort of treatment for. They have a sin problem!

We are always quick to remind them that Jesus died for sin, even theirs. Addiction is not an unforgivable sin, and while some of their activities have been very unsavory, their sins are not beyond the grace of Jesus Christ. The addict must have a heart that is affected by the gospel for change to take place. Before he can change what he does, he has to come to believe or think differently; that requires a renewing of the mind or in essence, a change of heart (Rom. 12:1-2). These truths are life-giving and hope giving!

Every biblical counselor must have a competent understanding of this issue as we are encountering increasing numbers of people who have been diagnosed as alcoholics, drug addicts, sex addicts, gambling addicts, and so on. Mastering this aspect of biblical counseling can and must be a part of every biblical counselor’s skill set.