Drug Abuse and the Church: Are the Blind Leading the Blind?

by Stephen P. Apthorp

Stephen P. Apthorp is associate rector of Christ the King Episcopal Church and director of Alcohol and Substance Abuse Prevention in Tucson, Arizona.

This article appeared in the Christian Century, November 9, 1988, p. 1010. Copyright by the Christian Century Foundation and used by permission. Current articles and subscription information can be found at www.christiancentury.org. This material was prepared for Religion Online by Ted & Winnie Brock.


The church and its leaders are among the afflicted, if not the addicted. Turning to the church for help, people affected by substance abuse have often put their trust in dysfunctional people and places.

This Sunday, when ministers survey their I flocks, they will be looking at congregations consisting mostly of people who have been or are being drastically harmed by alcoholism or drug abuse. Most will not even be able to hear the gospel message, much less respond to it. This fact will probably be lost on the preachers, however, because in most cases they also will have come from a dysfunctional family -- one in which expression of emotions is discouraged or repressed, usually through compulsive substance abuse. It will be a case of the blind leading the blind.

If these statements sound inflammatory, consider the following:

• One of eight adults in America is suffering from some form of chemical dependency. One dependent person has a harmful impact on five to eight other people, including all family members.

• About 17 million people suffer from alcoholism; 25 percent of these are teenagers.

• Nearly half (47 percent, or 81 million) of the adults in the United States have at some point, to some degree, suffered physical, psychological or social harm as a result of someone else’s drinking; 21 million say they have suffered greatly.

• One in three children coming to school for the first time is crucially impaired by someone’s alcoholism or drug abuse. The same can be said of children attending church school.

These data mean that many church members are so sick from chemical dependency -- their own or that of a friend or relative -- that they are incapable of helping themselves. They don’t even realize how much they have been hurt.

The number of ministers scarred by substance abuse who are seeking to help parishioners who bear the same scars is alarming. In regional training seminars I’ve conducted for denominational clergy and lay leaders, a show of hands has indicated that 80 percent of clergy present have come from families debilitated by substance abuse, and they were aware that it had drastically harmed them. For many this history was a determining factor in the decision to enter the ministry -- "hope of the Lord’s salvation," as it were.

A show of hands among the lay leaders has revealed a similar percentage. These lay leaders said they looked to their churches and clergy for help, support and God’s affirming love. Ironically, in so doing they often put their trust in dysfunctional people and places. Still another disturbing fact, well known among chemical dependency counselors, is that people who grew up in dysfunctional families attract and are drawn to others who grew up in such families. Therefore, impaired pastors often collect impaired parishioners. No wonder that the church at large, and the clergy in particular, have difficulty recognizing and dealing with today’s epidemic affliction of addiction. The church and its leaders are clearly among the afflicted, if not the addicted. A minister recently wrote the editors of Changes, a magazine for adult children of alcoholics, to confess, "I have realized that throughout my ministry I have accepted calls to congregations that replicate the dynamics of the alcoholic family in which I was raised. This insight . . . has helped me discover why my career has been so chaotic" (January-February 1988, p. 78)

Because dysfunction begets dysfunction, denial is a primary symptom. In fact, society still considers substance abuse a laughing matter. For example, large audiences are enjoying the Walt Disney movie Who Framed Roger Rabbit, in which at one point Roger gets super strength from a shot of booze -- giving viewers, particularly children, the message that alcohol can give one power. Even though alcoholism ranks as one of the country’s three major health problems, along with cancer and heart disease; even though it accounts for approximately 98,000 deaths every year; even though it is the root cause of most pastoral-care crises (suicides, auto fatalities, child abuse, divorces, hospital admissions, accidental deaths and home violence) ; even though it costs the nation $120 billion annually in terms of lost work time, health and welfare benefits, property damage, medical expenses, insurance and lost wages; and even though its effects impair the educational process of every child in every classroom, still the church acts as though alcoholism does not exist. With some exceptions, such as the Lutheran and Presbyterian churches, both of which have developed chemical-dependency health programs and educational materials, most denominations do almost nothing in response to alcohol and drug abuse. Except for an independent organization called the National Episcopal Coalition on Alcoholism and Drugs, a handful of diocesan, councils that promote conferences on alcohol and drugs, and approximately a dozen concerned and courageous bishops who require clergy training in the subjects, the Episcopal Church, in which I am a priest, would have no focused program on chemical dependency at all, save one day a year called Alcohol Awareness Sunday. Many congregations do not observe that one consciousness-raising Sunday. often because their priests deny the need. In those churches that do promote it, many of the members who have been affected by some substance abuse are not able to understand the one-shot message, much less discern how to help themselves. The cycle of denial continued uninterrupted.

What lawmakers don’t acknowledge in these approaches is that chemical dependency is a medical illness, as the American Medical Association defined it in a 1956 statement. It is a biochemical, genetic disease with identifiable and progressive symptoms. Like Tay-Sachs disease, sickle-cell anemia and diabetes, it is passed from one generation to another. In the case of chemical dependency, it comes in the form of addiction-prone body chemistry and dysfunctional and aberrant behavior patterns. It also renders its victims incapable of knowing they are sick. If untreated it leads to mental and emotional damage, physical deterioration, spiritual bankruptcy and in many cases early death. The medical definition of chemical dependency describes it as a primary disease with its own symptomatology; it is not a symptom of some other serious problem. It is a progressive disease in that the physical, spiritual and emotional symptoms become worse. The victim must abstain from mood-altering chemicals in order to maintain recovery. (Consequently, abstainers are always "recovering" but never "recovered.") It is a chronic disease, for which there is no known cure. The victim is always vulnerable to pathological chemical use. Chemical dependency is also a fatal disease -- it is terminal unless the chemical use is permanently stopped.

While the government argues over law enforcement versus prevention education and spends $8 billion a year on its futile but politically rewarding programs and arrests, and while politicians, scholars, jurists, police officers and doctors argue over prohibition versus decriminalization, the church continues to argue over whether alcohol and drug abuse is a sin or a sickness, and over how the sin -- if it is seen as a sin -- relates to the sickness. In the April 1988 issue of Alcoholism and Addiction magazine, Billy Graham questions the concept of alcoholism as disease and suggests it is more a matter of disgrace. "Man’s heart without God is like a vacuum," he says. "In our self-sufficiency we try to make it alone. When we refuse to turn to God, who has promised to be a ‘present help in trouble,’ we resort to all sorts of things -- pleasure, lust, drunkenness, revelings, and Wantonness. And drunkenness, as far as Graham is concerned, "is one of the oldest sins."

Underlying Graham’s. moralistic judgment is the mistaken assumption that drunkenness is a matter of choice. Graham’s naïveté is reminiscent of the government’s "Just say No!" campaign. Both invoke the gospel of abstinence in an attempt to save those who do not need saving. Neither Graham nor the government’s program helps the high-risk population: those millions whose body chemistry makes them addicted to any central nervous system depressant or stimulant. Clearly, drinking alcohol can lead to alcoholism, but it is also clear that most alcoholics have this predisposition from birth, waiting for the first dropper of alcohol-based cough syrup or spoonful of narcotic croup remedy. The alcoholic tendency is often activated by a caring parent or physician well before the high-risk child can "just say No!" If any sin or immorality is rampant in the realm of substance use and abuse, it is the willful disregard of those who need care by those who are committed to caring.

The Supreme Court added to public misunderstanding of the disease of alcoholism in its April finding in Traynor v. Turnage and McKelvey v. Turnage. By a narrow 4 to 3 vote it decided that the Veterans Administration could deny benefits to two alcoholic veterans. Giving a broad interpretation to a Prohibition-era regulation that calls alcoholism the result of "willful misconduct," it ruled that the VA was within its rights to refuse the plaintiffs an extension of their educational benefits.

Confusion over the court’s decision was as epidemic as chemical dependency; many people concluded that the court had defined the cause of alcoholism. In fact, the court did not rule on whether alcoholism is a disease or willful misconduct. It based its finding on whether the plaintiffs were eligible for benefits on an interpretation of the federal Rehabilitation Act, which does not deal with the etiology of the illness. However, the court’s majority opinion fueled public perception that medical evidence does not conclusively establish that alcoholism is a disease -- even though the medical community and the entire health profession at large overwhelmingly agree that it is.

The first identifiable role is that of the Enabler, who is usually a spouse, the one most responsible for picking up the pieces for the deteriorating alcoholic. By protecting the chemically dependent person from the consequences of his or her behavior, the Enabler actually helps the illness progress. The other roles are usually filled by the children and usually cast according to birth order. The Hero, most often the firstborn, strives to hold things together and mediate the family chaos, filling in for the absence of appropriate parenting. This child is forced into adulthood before she or he is mature enough for it. The Scapegoat, usually the second child, gains identity by misbehaving in ways that will attract attention. His or her role is to draw the focus away from the alcoholic. The cost to the Scapegoat, however, is the pain of living life as the family lightning rod, absorbing tension for everyone. The third youngster often becomes a Lost Child. While others act and react to the alcoholic, this youngster seeks to stay out of harm’s way by hiding, isolating herself, and fading into the woodwork. This results in abject loneliness and lack of loving consideration. Finally, there’s the Mascot, the family pet, the comic relief. This member’s role is to relieve the intense pressure of this sick household by acting like a clown. This person has a deep hunger for affirmation and appreciation that is never satisfied.

Playing roles does not allow children to grow and develop. They never get the modeling and freedom needed to function in a healthy way. Many of these people grow up to be church leaders. Changes’ letter-writer notes that "almost without exception, members of congregations who are prone to controlling and manipulating are ACOAs [adult children of alcoholics]." In my seminars I’ve learned that most clergy and lay leaders are Hero types, oriented more toward task and achievement than toward care and compassion. Whatever the role, however, all members of a substance-abusing household lose their potential, free will and choices.

Some churches are beginning to recognize the destructive effects of chemical abuse on the clergy and on congregations. They are coming to understand the spiritual dimensions of chemical dependency, co-dependency, treatment and recovery, and are offering training workshops, educational seminars and prevention programs. But considering the vast number of churches that do not acknowledge the problem, it seems that most denominational bodies and local congregations are in denial -- the primary symptom of a dysfunctional person, organization or system -- even though one substance-abusing minister can sicken, dishearten and dispirit an entire church just as one alcoholic can infect an entire household. What can -- and ought -- the church do?

Impetus to confront addiction in the parish must come from those who are healthy enough to insist on confrontation. My seminars have indicated to me that the religious organizations that address the issue of alcohol and drug abuse usually are prodded to do so by one person who is convinced of the need and will not take No for an answer. More often than not such people start small -- for example, they call the Educational Materials Department of the Hazelden Foundation (800-238-9000) ; a reputable treatment center, and order its catalog, which includes excellent materials for churches. Another helpful organization is the Johnson Institute (800-231-5165) , which specializes in training seminars. Health Communications, Inc. (800-851-9100) , carries a full line of material on dysfunctional families, co-dependents, adult children of alcoholics, spirituality, treatment and recovery. A church can start facing the issue by gathering and displaying educational materials, by asking the preacher to address it in a sermon, or by organizing workshops, seminars, retreats, or perhaps even a national meeting. My book Alcohol and Substance Abuse: A Clergy Handbook (Morehouse-Barlow, 1985) includes a detailed appendix listing resource material and organizations, and sample sermon outlines, giving churches specific suggestions on how to start addressing the problem. Concerned churchgoers should begin however they can, despite the ignorance, denial, resistance or refusal the congregation might express.

If the church is in the business of redeeming lives, it must minister to, and not shun or accuse, alcoholics and drug abusers. A disturbing number of members of the two fastest growing self-help groups in America, Alcoholics Anonymous and Adult Children of Alcoholics, describe having been ignored, disregarded and discarded by their minister and congregation. They feel they have been treated as lepers and expunged. Even after they have begun to recover, they find that they are not welcomed back into their church -- some even say their minister and congregation have actively sought to keep them out of church.

This explains why so many people seek spiritual nurture from AA’s Twelve-Step recovery programs rather than the church, and why these programs are the fastest growing "religion" of the day. While a person often is expected to exhibit certain virtues in order to be welcomed in many congregations, in the fellowships of AA and related groups such as Al-Anon, Ala-Teen and Narcotics Anonymous, participants are accepted and loved as they are. AA suggests a program of 12 steps that include elements found in the spiritual teachings of many faiths. These 12 steps focus not on pathology but rather on achieving sobriety and maintaining serenity.

This is not to say that the church does not have something unique to offer. The church is the only care-giving, helping institution that has access to half of all American families each weekend. Gallup polls taken from 1976 to 1983 revealed that Americans rank the clergy highest in terms of honesty and observing ethical standards. This puts the church on the forefront of being able to address the problems of alcohol and drug abuse and puts the clergy in a position to lead the way.

When ministering to addicts and co-dependents, pastors should see themselves as shepherds, not veterinarians. They are not trained to deal with the care and counseling of alcohol and drug addicts. They can be most effective as problem-solving therapists and referral agents. Ministers’ close contact with parish families each week affords them the opportunity to observe chemical dependency’s destruction of individuals and families. The pastor is in the unique position to help not by counseling but by assessing the extent of the chemical dependency and co-dependency and then becoming a resource for referral.

Pastors can also set up and promote chemical health education programs. They can invite AA and related groups to use their meeting rooms. They can educate themselves by taking advantage of the vast number of training programs available. In all, the clergy’s role is to create an environment of hope and redemption.

The church should be a community in which people can learn not only to trust in God but to dare to trust one another. The success of the church should be gauged not by the number in attendance, but by the lives redeemed. When we accept our members in their weakness, illness and dysfunction, and offer them strength and the opportunity for health and hope, we proclaim our faith in God’s redeeming power and establish a basis for faith in each other. Then, even where wounded parishioners listen to a wounded pastor, the light of God’s love and grace will not be dimmed.