IDENTIFICATION

The effects of a drug or alcohol addiction can be devastating to family members and friends, as well as to those with an addiction. Sometimes we do not know what signs and symptoms to look for or what kinds of effects the drug can have on an individual. Specifically, this article will examine the problem of addiction as it exists in society and the church, describe some of the more common addictions seen among Adventists, discuss why people become addicted, suggest new ways of approaching addictions within the church, explore the effects of addiction on the family, and offer some suggestions for how to dealing with an addicted person. The chapter concludes with recommendations on where to go for help in dealing with addiction. (For a discussion on the signs and symptoms of drug or alcohol use in teens, as well as how to prevent drug and alcohol use in adolescents, see the article titled "Kids and Drugs.")
 
PROBLEM OVERVIEW
•    Addiction in Society: Addiction to alcohol and drugs, both legal and illegal, is a serious problem in the United States (although tobacco kills the most people in the United States each year – around 500,000 – we do not deal with this addiction in this article). The National Household Survey on Drug Use and Health revealed that approximately 129 million Americans ages 12 and older were alcohol users (51.6 % of the population). More seriously, 58.1 million (23.3%) had engaged in binge drinking (5 or more drinks in one sitting) at least once in the 30 days prior to the survey, with heavy drinking reported by 17.3 million (6.9%) Americans. Alcohol alone is linked to roughly half of all accidents, homicides, and child and domestic violence cases in the U. S. each year.

Around 20 million people used illegal drugs within the past month, with 15 million of that total using marijuana alone or along with other illegal drugs in the past month. Finally, 6.2 million (2.5% of the population) used prescription drugs for non-medical reasons. (Substance Abuse and Mental Health Services Administration (SAMHSA), 2009).

 
•    Addiction in the Church: While Adventist church leaders would sometimes like to deny that alcohol and drugs are a problem in local churches, the facts say otherwise. In 1988, the North American Division (NAD) and the American Health and Temperance Society commissioned the first study of the Adventist church on addictions among its adult members (McBride, Mutch, Dudley, Julian, Beaven, et al 1989). The study found that 14.1% of Adventist adults agreed with the statement “In my congregation, using alcohol is socially acceptable” (p. 12). Over 12% of those surveyed said that they had used alcohol (mostly wine) in the past year. Of those Adventists who did drink wine, 64% used it one to three times a month, with an additional 15.2% using it weekly; 7.6% indicated near daily use.

In the same NAD survey, over 66% of the respondents were concerned that youth in their church were drinking alcohol. This concern has some basis in reality: a 1996 survey conducted by the Institute for Prevention of Addictions, a General Conference-sponsored research and education organization, found that almost 40% of students in a cross-section of eight Adventist colleges and universities had used alcohol within the past year; almost 10% had used marijuana during that same time period (Hernandez&Mutch, 1996). Of even greater concern is the rate of alcohol or drug use during the 30 days prior to the date the students took the surveywhich amounted to 24% using alcohol and 5% marijuana in that period. The 30-day rate is a much better indicator of who may be more heavily using alcohol or drugs. While these rates are about half of what is found in secular colleges and universities around the nation, they provide sobering evidence of the extent of alcohol and drug use within Adventist communities.

However, while substance use and abuse is present to some degree in Adventist colleges and universities, a more recent study (Helm, Lien, McBride,&Bell, 2009) comparing the use of alcohol and other drug use trends between an Adventist university and national data sets reveals two pieces of good news. First, researchers found that although attending an Adventist university does not prevent substance use and abuse, the rates of alcohol use were less than half of those found at secular colleges and universities. Other rates of drug use were similar by comparison. Second, the rates of drug and alcohol use in at least one of the universities in the study had remained roughly steady over 10 years, leading researchers to conclude that college students at that school had not increased their use of alcohol. Analyses showed that religious beliefs and behaviors, combined with the prohibition of alcohol on campus, contributed greatly to the lower rates of substance abuse in Adventist schools and colleges.

 
Why Do People Abuse Alcohol and Drugs?

Individuals who abuse alcohol or drugs often begin using these substances in their pre-teen or teen years. They may start using for a variety of reasons: they want to fit in with their peers; they feel pressured by others to try the substance; they want to experiment with so-called adult behaviors; they want to rebel against adult rules; or, they are curious about what alcohol or drugs taste or feel like. These pressures and desires can often be quite powerful and may push individuals into using these substances more heavily than they originally planned. People who become addicted to alcohol and drugs will tell you they never intended to become an alcoholic or an addict, but they discovered, for various reasons, that they were unable to quit on their own. 

So why do people become addicted? There are four primary reasons why addiction occurs. The first and simplest reason is that people use alcohol and drugs because they want to feel good. Drugs and alcohol are powerfully reinforcing because they offer pleasure both quickly and effectively. Since people tend to repeat those behaviors which make them feel good, the behaviors become more natural and consistent when they are repeated. Over time, people develop a need to use more and more of the substance in order to get the same good feelings. After awhile, they are no longer using the alcohol or drugs in order to feel good, but rather to keep from feeling bad when they don’t have the substance in their body. At this point the individual will keep using because he or she is trying to avoid the pain of the physical and psychological withdrawal from the substance.
 
A second reason people may become addicted is heredity.  Researchers have found a good deal of evidence which suggests that some alcoholics have an inherited biological tendency toward addiction. Quite simply, addiction tends to run in families. This tendency is passed down through generations, so that a person could be predisposed to becoming addicted even when members of the immediate family do not use these substances. For example, studies have shown that adopted children have rates of alcoholism closer to those of their natural parents than to those of their adoptive parents. Other researchers believe that alcoholics metabolize or process the alcohol or drugs differently in their body, causing them to become powerfully addicted in ways that others do not. 

The third major reason for addiction is found in a person’s environment. When friends or relatives use alcohol or drugs it becomes easier to begin use and to continue using. Over time, the person develops patterns of use which are rewarded by his or her friends or associates. This social reward system makes it more difficult to stop using the substance, especially when many of the people in that person’s social circle also use the substance. On the other hand, being involved with a group that discourages drug or alcohol use is likely to discourage use of those substances. 
 
A final major reason for addiction can be found in the psychological makeup of the person who is addicted. Researchers have found that risk-taking and unconventional personalities are more likely to use alcohol and drugs than more conventional individuals. Some individuals may find that alcohol gives them more courage (alcoholics often call alcohol “liquid courage”) in social situations. They may also feel that other people like them better when they have had a few drinks. Others may feel a need to escape from emotional pain and they find that drugs help them to feel better. Still others may have a so-called addictive personality, which leads them to do everything to excess, including the use of alcohol or drugs. Finally, some people feel emotionally and spiritually empty and are searching for fulfillment through alcohol and drugs.


DEFINITIONS
Some have argued that it is possible to get addicted to anything, including gambling, love, religion, chocolate, and exercise. While there are some elements of an addiction which apply to areas like our relationships or our food, it is not possible to address the emotional and psychological elements of addiction in this article. Rather, addiction will here be more carefully defined as a continued involvement with a mood-altering substance in spite of harmful consequences. Addiction is usually associated with increasing tolerance to the drug, meaning that it takes larger and larger doses of the substance in order to create the same effect on the person. Addiction also involves withdrawal, which includes a series of temporary physical or psychological symptoms that happen when the addict abruptly quits using the drug or alcohol. Another defining feature of addiction is loss of control, in which an addict becomes unable to accurately predict whether any use of the alcohol or drug will lead to unhealthy or damaging behaviors. A final major feature of addiction is negative consequences which result from the misuse of the drug. This might include physical damage, legal trouble, financial problems, academic failure, family conflict or other severe problems associated with the use of the substance.

While it is beyond the scope of this article to include information on all types of addictive substances, the following section will briefly discuss possible physical and/or psychological effects of the use of several major categories of drugs,  and some symptoms of misuse and withdrawal.

•    Alcohol: Alcohol can be distilled from fermented fruits (wine and wine coolers), grains (beer and whiskey), and vegetables (vodka). It can be used as a solvent, an antiseptic, or a sedative. It is typically used to help people feel more relaxed and is often used at social occasions to reduce anxiety and help participants to feel good. It continues to be the most abused of all addictive substances, in part because it is cheap, legal, and widely available. Whether one drinks a 12-ounce can of beer, a shot (1.5 ounces) of distilled spirits, or a 5-ounce glass of wine, the amount of pure alcohol per drink is about the same - one-half ounce.

While many people can drink alcohol in moderation, as little as two beers or drinks can impair coordination and thinking. Possible effects can include intoxication, changes in the way one perceives the world, and reductions in anxiety. You can usually tell if someone has been drinking heavily when they show the following familiar symptoms: staggering or loss of coordination, odor of alcohol on breath, slurred speech, dilated pupils, and drowsiness or unconsciousness (passing out).  

More severe symptoms may include: confusion, disorientation, loss of motor nerve control, convulsions, shock, shallow breathing, involuntary defecation, and possible death. If abused over a long period of time, alcohol use can result in nerve, brain, kidney, pancreas and liver damage. When people are withdrawing from heavy alcohol use they can show symptoms such as sweating, tremors, changes in perceptions, fear, psychosis (loss of touch with reality accompanied by bizarre behaviors), and auditory hallucinations.
 
•    Marijuana: Marijuana (also known as pot, grass, joints, roaches, reefer, weed, and Mary Jane) is a common weed which is easily grown in most locations, although cultivation is illegal. The potency of this plant has increased over time (more than 275% over the last decade) as growers breed the plants to produce more powerful versions of the drug. Marijuana is usually smoked, but is also sometimes baked into brownies. Most people use marijuana because it gives them a sense of relaxation and euphoria. Many argue that since marijuana has not been proven to be physically addictive, no harm can come from smoking it. In addition, some physicians have used marijuana in constructive ways to help cancer patients develop an appetite and reduce nausea levels. However, the consequences of regular marijuana use are well known and can be quite destructive. Many teenagers who end up in drug treatment programs began using marijuana at a young age.
 
Possible effects from normal marijuana use include euphoria followed by relaxation; loss of appetite; a more vivid sense of taste, smell, sight, and hearing; and, impaired short-term memory, concentration, and knowledge retention. Mood changes occur with the first use. Dilated pupils and bloodshot eyes are also common. Driving while under the influence of marijuana can be especially dangerous because of a shortened attention span, delayed reflexes and/or loss of coordination. There is growing concern about how marijuana use by children and adolescents may affect both their short- and long-term development. Some researchers have found increased apathy, loss of ambition, loss of effectiveness, a lowered ability to carry out long-term plans, and a decline in school and work performance (National Clearinghouse for Alcohol and Drug Information, 1999).

Strong doses of marijuana can cause mood swings, fragmentary thoughts, or disoriented behavior while extensive use may result in signs of fatigue, lack of coordination, paranoia, or even psychosis.The user may also become more animated and talk loudly, followed by sleepiness. Depth and time perceptions may be distorted and hallucinations may occur. Over longer periods of time, it may cause irritation to the lungs and respiratory system or cancer. A person who is withdrawing from marijuana may have trouble sleeping (insomnia), become hyperactive, and sometimes experience a decreased appetite.

•    Prescription Drugs: Because of a strong health message, Adventists have a long tradition of educating medical professionals and relying on those professionals during times of pain and crisis. Unfortunately, some individuals have used doctors to get more prescription drugs than their physical condition indicates. Extended use of some of these drugs can result in both physical and psychological addiction.

•    Depressants - Depressants are probably the most commonly abused prescription drug. Both barbiturates (such as Amytal, Seconal, or Phenobarbital) and tranquilizers (such as Xanax, Valium, Dalmane, Ativan, or various sleeping pills) are used to relieve anxiety, irritability, and tension. This class of drugs can produce a state of intoxication similar to that of alcohol and the potential for abuse is high as tolerance to the drug can develop quite rapidly so that more of the drug is needed to get the same effect.  
 
While small amounts can cause calmness and relaxed muscles, larger amounts of depressants can create slurred speech, impaired judgment, and loss of motor coordination, including staggering and stumbling (the behaviors are similar to those of alcohol intoxication). A person may also have difficulty concentrating or fall asleep while at work. Symptoms of an overdose can include shallow breathing, clammy skin, dilated pupils, weak and rapid pulse, and, in more severe cases, coma or even death. 

A person who is withdrawing from the drug might experience anxiety, sleeplessness, muscle tremors, or loss of appetite. A person who abruptly stopped using the drug or who reduced a high dose might go through convulsions, delirium, and even death.

•    Stimulants - Prescription stimulants are used to increase alertness, relieve tiredness, and help people feel stronger and more decisive, in short, stimulants make people feel energetic and more positive about life. Amphetamines are the primary type of drugs in this category. Common amphetamines include Dexedrine, Biphetamine, or Desoxyn. Some stimulants are also prescribed to reduce appetite and control weight (Preludin is the primary drug trade name for prescription weight control). Ritalin is a stimulant for adults, however, for some unknown reason, it has a calming effect on hyperactive children.
 
Stimulants have a number of unintended effects, including increased heart and breathing rates, elevated blood pressure, dilated pupils and decreased appetite. Signs of possible misuse include excessive activity, talkativeness, irritability, argumentativeness, nervousness, or  long periods without eating or sleeping. High doses can cause rapid or irregular heartbeat, loss of coordination, or collapse. Stimulants may also cause perspiration, blurred vision, dizziness, a feeling of restlessness, anxiety, or delusions. A person who has overdosed on stimulants may show agitation, an increase in body temperature, hallucinations, convulsions, or possible death.

Individuals who are withdrawing from stimulants might feel like nothing matters and/or become depressed. They might sleep for long periods or be irritable or disoriented.
 
INTERVENTION

STRATEGIES
When a pastor or church leader is faced with the knowledge that a member has a substance abuse problem, it is difficult to know exactly what to do. How would the pastor know if the allegation is true? Should the member be confronted, should they be placed under discipline, has any harm come to the family, church community, or community at large due to the addiction problem? Knowing how to proceed, what to say, what to do, and what not to do is a great challenge that requires much prayer and guidance by the Holy Spirit. Therefore, before the church board or other church committees are contacted, please consider the following thoughts and suggestions.

A NEW APPROACH TO ADDICTIONS IN THE CHURCH
 
Most Adventists have maintained the predominant historical view that the addicted individual is a morally weak person who could stop drinking or using drugs if he or she were really motivated to quit. Further, the addicted person has been accused of having a poor relationship with God. This person has traditionally been counseled that if their will to quit were stronger and their relationship with God were strengthened through prayer and Bible study, they could be delivered from their addiction. But while this approach has worked for a small number of those who struggle with drugs or alcohol, the vast majority of those who are deeply addicted have found that they need to get help from experts who are familiar with ways to overcome this difficult condition.

Most medical experts affiliated with the American Medical Association (including most many Adventist physicians) ) now agree that a person who is addicted to drugs or alcohol suffers from a medical problem rather than from any moral failing (American Medical Association, 1997). Researchers have found that people who have problems with these substances usually have overwhelming urges to drink or smoke which may be passed through their genes and are powerfully reinforced by chemical changes in their brains (Azar, 1995; National Institute of Drug Abuse (NIDA), 1999). Consequently, the vast majority of all physicians have concluded that physical addictions are often best treated in medical settings under a doctor’s care (NIDA, 2000).
 
While medical findings on addiction have drastically changed the way people think about addictive behaviors, it is increasingly clear that a person’s biology is not the only factor which drives addictive behaviors: biological, psychological, social, and cultural factors all combine to make people more vulnerable to substance use and to keep people hooked once they start. Such growing evidence has led addictions experts within the Adventist church to update their views on drug and alcohol addiction, with the conclusion that more than prayer and willpower are needed to break the chains of addiction. Researchers and treatment professionals have concluded that a combination of medical, psychological, and spiritual treatment approaches can best meet the complex needs of a person who is caught in the grips of an addiction (NIDA, 1999). The suggestions which are discussed below can provide some guidelines on how to interact with a person who is struggling with a substance abuse problem.
 
SPIRITUAL ENCOURAGEMENT
Prayer is certainly the first place to start when trying to help a family member of friend with a substance abuse problem. It is important to ask God for patience and wisdom in dealing with a loved one’s addiction. However, prayer must be followed by careful words and actions which have been proven to be effective with concerned friends and family members. Intervening with a family member or friend can be very difficult and hurtful. The person with the problem is likely to deny that they have a problem and will often try to put the accusing person on the defensive - “I thought you loved me. Are you calling me a drunk?” Or, “Why don’t you mind your own business; I should know if I have a problem”. In cases like this, what you don’t do is as important as what you should do:

• Don’t cover up or make excuses for the person;
• Don’t take over his or her responsibilities, which will leave the person with no sense of importance or dignity;
• Avoid emotional appeals, which may only increase feelings of guilt and anger, and result in a desire to drink or use drugs;
• Don’t hide or dump bottles of alcohol or drugs;
• Don’t shelter your loved ones from situations where alcohol or drugs are present;
• Don’t argue with the person when he or she is under the influence of drugs or alcohol;
• Above all, don’t accept responsibility for the person’s actions nor guilt for his or her drinking or drug abuse.

 
Attitudes and behaviors which you should avoid include:

• Sarcastic;
• Accusatory;    
• Stigmatizing;
• Sympathy seeking for yourself;
• Self-blaming.

There are, however, some important things which you can do to deal more effectively with someone who has a drug or alcohol problem. You should try to be:

Firm - explain why you feel use of alcohol or other drugs can be harmful, causing problems which require counseling or treatment.
Understanding - listen to the reasons why he or she uses or abuses alcohol or other drugs. This can be difficult to do, but it  is important if you want to maintain a level of trust and convey a sense of acceptance.
Supportive - assist the user in finding help and provide moral support through tough times ahead.

Scriptures to share
Matthew 19:26; Psalm 18:1-19; Ephesians 3:14-21; Colossians 1:13; 1 John 5:3-5
 
FURTHER UNDERSTANDING

COMMON PROFESSIONAL INTERVENTIONS
Drug and alcohol problems are extremely difficult to overcome without community or professional intervention. This is because, for most people, the psychological and physical addiction can be more powerful than willpower, words of encouragement, or even prayer. While everyone has heard stories of the problem drinker who prayed and God took away their desire to drink, the vast majority of addicts need the help and support of people who understand the difficulties of the addict and are trained to intervene in the addiction process. In essence, these professionals and community groups are used by God to help the person in overcoming their addiction. The vast majority of all substance abuse treatment professionals and settings use the highly spiritual 12 Step approach found in Alcoholics Anonymous. This method shows that the professionals are sensitive to spiritual issues and integrate spiritual principles into the recovery process.  
 
Alcoholics Anonymous (AA), and its siblings, Narcotics Anonymous and Cocaine Anonymous, have helped millions of people get sober and stay sober (there are many other “anonymous” groups, including Overeaters Anonymous, Emotions Anonymous, and Gamblers Anonymous). The only requirement for admission is a desire to stop drinking or using drugs. The 12 Steps are the foundation of the recovery process. These steps are tools used by the addict to change attitudes, behaviors, and values. Each step has a parallel passage which can be found in scripture, and, directly follows the Biblical steps in the conversion process, including a step which requires the person to turn their will and life over to God. Parallels to these steps can also be found in each chapter of Ellen White’s book Steps to Christ. One of the most significant and effective aspects of 12 Step groups is the powerful support from other members who have experienced similar circumstances and emotions. Since there are over two million AA members nationwide, local chapters of Alcoholics Anonymous can be found in every telephone directory. Those wishing to read more about the Biblical foundations of this program might benefit from the book,  A Hunger for Healing: The Twelve Steps as a Classic Model for Christian Spiritual Growth (c. 1991 - New York: Harper San Francisco). Keith Miller, a well-known Christian writer, describes his own experience with the 12 Steps and explores the close Biblical parallels found in this recovery approach.

Family members and friends often find that coping with a loved one who has an addiction problem can be discouraging, embarrassing, and draining. For that reason, a companion group to AA has been created for family members. This group called Al-Anon is perhaps the best community resource available for helping family members and friends cope with the pain and problems created by the addict. Al-Anon uses a spiritual approach to help family members lovingly detach from the addict while still showing support and understanding of the addict’s problems. Al-Anon locations can be found in virtually any telephone directory by contacting the local Alcoholics Anonymous office.
 
Some people find that just attending Alcoholics Anonymous meetings is not enough to help them overcome an alcohol or drug addiction. For those individuals, professional addictions treatment specialists are a crucial part of the recovery process. If you are not familiar with the substance abuse treatment services in your area, contact the National Institute on Drug Abuse Information and Referral Line (1-800-622-HELP). This organization has a national listing of all reputable drug and alcohol treatment facilities in each state and can help you contact these organizations. Professionals in these facilities are able to assess your unique situation and make recommendations on various treatment options. 

There are several traditional treatment options. The most intense is inpatient treatment, which places the individual in a hospital-like setting and addresses the addict’s problems for a one- to two-week period. The addict is usually discharged into an outpatient setting where treatment continues during the evenings and Alcoholics Anonymous meetings are attended as well. Sometimes addicts are referred to intensive outpatient settings where they attend treatment sessions during four to five hour blocks each day. This allows them to continue working and living at home. For less difficult cases it is possible to attend weekly counseling sessions with a trained therapist in order to deal with an addiction problem. It is important that this counselor be trained in addictions issues since assisting an individual to overcome a drug or alcohol problem requires specialized training.
 
There are a number of Christian treatment centers across the nation. Some of the organizations recommended by the Institute for Prevention of Addictions, a General Conference sponsored organization which is dedicated to helping the church deal with its addictions problems, are administered by Adventists who know and understand the psychological, social, and spiritual issues of other Adventists (see Resources section below).

Sometimes Christians who become involved with recovery are accused of forsaking the Bible for “secular solutions” to their problems. The Internet has a number of web sites which address this issues. This resource has the potential of becoming a positive and powerful recovery resource for Christians. Web sites can link Christians who are struggling with an addiction or dealing with an addicted loved one without having to travel outside the home (see Resources section below for web-based resources). While not all resources will meet each person’s recovery needs, it is possible to find many Christian Internet organizations that provide a strong ministry to people who have been affected by addictions.

CASE EXAMPLE
 
Jan is a newly baptized member of the Seventh-day Adventist Church. She is a housewife who has been drinking daily in her home for the past two years. She tries to hide her drinking behaviors from her family and other church members. Knowing the church’s position on alcohol, Jan did not tell her pastor about her drinking before her baptism six months earlier. She has tried repeatedly on her own to stop her drinking but has been unable to stop for more than two or three days at a time. She admits to her husband to having periods of up to six hours where she doesn’t remember what she did or where she went. She also admits to using tranquilizers on occasions when her doctor will prescribe them to her. When she drinks she becomes depressed and sometimes combative with her family. Her husband isn’t a church member but has tried to protect her from the consequences of her behavior by canceling social occasions, running errands and excusing her to church members who call. Other family members “cover” for her by doing cleaning, cooking, or other household tasks. Jan sometimes argues that her drinking is not a “serious” problem because she only drinks after three p.m. and only drinks wine on a regular basis. Yet she feels she should quit because of her membership in the church. Her family wants to be supportive but doesn’t know how.

 
STAGES OF ADDICTION
Not all people who use drugs or alcohol become dependent on them. For this reason, it is helpful to understand how an addiction might develop and progress over time.    

Many individuals become concerned when a loved one or friend begins to show obvious signs of drug or alcohol use. In many cases, however, the warning signs are not very obvious, partly because of an extremely common characteristic of substance abusers - denial that a problem exists. Denial allows the user to believe that he or she can control their use of the substance. This belief can make attempts to stop the alcohol use very difficult. For these reasons it is helpful to understand the progression of problems and symptoms which a person might show at different points in their addiction. While it is difficult to explain the development of all problem drinkers, researchers have discovered some major changes and phases which seem to be quite consistent, particularly for male alcohol drinkers.

The first phase - the Pre-alcoholic Symptomatic Phase - is characterized by:

• the individual beginning to drink occasionally and then more regularly;
• drinking as a way of dealing with stress or tension, termed "relief drinking";
• drinking for relief from hangovers and other side effects of the alcohol;
• the user shows a need for larger amounts of alcohol in order to bring the same degree of relief from stress or tension.

The second phase - the Prodromal Phase - is characterized by:

• the onset of memory blackouts, periods of time when the person does not remember what they have done or where they have been; (blackout can vary from minutes to hours in length, with  the person appearing "normal" and remaining fully conscious throughout the blackout period);  
• making up stories to cover for their memory lapse;
• attempts to hide the drinking;
• preoccupation with alcohol;
• gulping the first drinks;
• avoiding any discussions about alcohol;
• feelings of guilt about drinking;  

(In Adventist settings where alcohol use is typically already taboo, these symptoms may be even more deeply hidden than usual).

The third phase - the Crucial Phase - is characterized by:

• the beginning of a loss of control on the part of the alcohol abuser;
• changes becoming quite obvious; 
• loss of self-esteem; 
• a desire to be isolated, especially from family and friends;
• possible aggressive behaviors; 
• persistent feelings of remorse and self-pity; 
• periods when the individual does not drink; 
• changes in the choice of beverage and time of day when drinking occurs; 
• uncharacteristic resentments and jealousy; 
• decreased sexual drive and poor nutrition;  
• attempting to rationalize the drinking away.

The final phase - the Chronic Phase - is characterized by:

• periods of obsessive drinking and prolonged intoxication;
• vague religious desires and undefined fears;
• tremors, or uncontrollable shaking;
• loss of tolerance for the alcohol (it takes less alcohol for the drinker to become intoxicated because the liver and kidneys are failing to filter the toxins out of the body); 
• impaired thinking and alcoholic psychosis (the person begins to see hallucinations and loses contact with objective reality while intoxicated);
• the alcoholic "hitting bottom" and either making necessary changes to deal with the addiction or dying.

It is important to note that, while it is not a good idea to begin drinking alcoholic beverages, most people who drink alcohol on an occasional basis never become problem drinkers. Further, these stages are offered as guidelines for understanding the progression of alcohol dependency, but not all who develop problem drinking behaviors will go through the stages listed above. Finally, the stages for addiction to other drugs, such as prescription drugs, marijuana, cocaine, or heroin are different, in a number of ways, from those listed above.  
 
Certain common behaviors are likely to be found in all people who abuse alcohol or use other drugs, regardless of age [for a more detailed list of drug use warning signs for teenagers, see the article titled “Kids and Drugs".  These warning behaviors include:

• an abrupt change in mood or attitudes;
• associating with a new group of friends, especially with those who drink or use drugs;
• sudden or continuing decline in attendance or performance at work or in school
• heightened secrecy about actions and possessions;
• stealing from the home, at school, or in the workplace;
• increased amount and frequency of borrowing money from family and friends;
• unusual flares of temper;
• impaired relationships with family members or friends;
• sudden and continuing resistance to discipline at home, work, or school.

 
EFFECTS OF ADDICTION ON THE FAMILY
While the addiction can have a powerful impact on the person who is addicted, the consequences to the family can often be equally devastating. Spouses are often the most seriously affected, and marital problems are so common among alcoholic families that questions about these troubles are routinely included in screening procedures and diagnostic criteria for substance abuse. Common complaints include poor communication, a lack of trust, role reversals, sexual problems, financial irresponsibility, conflict, and aggressive behavior. Given these problems, it is not surprising that families with alcohol problems have high rates of divorce and separation.

Typically, as alcohol causes more and more problems in the home, the non-drinking spouse begins to “cover” for the alcoholic’s irresponsible and inappropriate behaviors. This behavior, termed enabling, occurs when a person knowingly does something that makes it possible for another person to continue to use drugs or alcohol without having to pay the natural consequences of their behaviors. A spouse might, for example, make excuses to the boss for her husband’s work absence, or she might cancel an appointment because the husband is too sick from a hangover to attend the appointment. Enabling is not limited to spouses -- co-workers, employers, teachers, pastors, and others can enable the alcoholic under the mistaken belief that they are helping the person out.  Unfortunately, enabling actually makes it possible for the alcoholic to continue drinking much longer than they would have without being shielded from the consequences of their mistakes.  
 
Children can also suffer heavily from the consequences of a parent’s drug or alcohol use. Mood changes, memory “blackouts”, and aggressive behaviors usually impair the parent from providing the child with a consistent, dependable relationship. The alcohol or drug using parent’s self-centeredness and withdrawal from the family often make him or her unwilling or unable to provide the child with emotional support. Other problems, such as financial difficulties, marital conflict, the alcoholic’s medical complications from drinking, social isolation due to embarrassment over parental drinking, and lack of rules or inconsistent discipline mean that children do not develop confidence and a sense that they have any control over their lives. Children often have difficulty expressing how they feel or even being able to understand how to ask for things which they need. In many homes, children end up assuming adult roles because the parents fail to live up to their responsibilities. Children carry many of these consequences and roles with them into their adult lives, resulting in continuing generations of addicted and dysfunctional households.

Because people often only give up addictions when they face the consequences of losing the things which are most important to them, it is critical for families to seek help from substance abuse professionals before these losses occur. Addictions counselors can help families effectively intervene in the addict’s life through use of an “intervention”, a term used to describe a counselor-led confrontation with the addicted individual which generally results in that person agreeing to receive treatment.  
 
CONCLUSION
Christians who suffer from problems with addictions need caring, committed family members, friends, clergy, and professionals to help them deal with the overwhelming difficulties associated with this problem. In addition to prayer, many Christian resources are available to help both the person with the addiction as well as caring family members and friends. With the proper help and assistance, addicted persons can find healing and recovery for their problems.
  
RESOURCES

Public or Government Resources

1-800-559-9503
AddictionSearch.com
Free 24-hour addiction helpline with more than 70,000 drug rehabs, alcohol rehabs, addiction treatment and drug treatment recovery programs and centers from all over the United States.
http://www.addictionsearch.com/treatment_facilities.html

1-800-729-6686
US Dept of Health&Human Services and SAMHSA’s National Clearinghouse for Alcohol&Drug Information
7 days a week, 24 hours a day
http://ncadi.samhsa.gov/

1-800-NODRUGS (663-7847)
Cocaine Hotline
7 days a week, 8:00 a.m. - 9:00 p.m.
http://www.cocainehotline.com/

1-877-622-2674 (877-NBAC-ORG)
National Black Alcoholism and Addictions Council (NBAC)
5104 N Orange Blossom Trail Ste 111
Orlando FL 32810-1013
http://www.nbacinc.org/

1-866-783-2645 (1-866-SU FAMILIA)
National Alliance for Hispanic Health
1501 16th Street NW
Washington DC 20036-1401
202-387-5000
http://www.hispanichealth.org/sufamilia/

National Families in Action
2957 Clairmont Road NE Ste 150
Atlanta GA 30329-1647
404-248-9676
http://www.nationalfamilies.org/

1-800-668-9277
PRIDE Youth Programs
4 W Oak Street
Fremont MI 49412-1522
http://www.prideyouthprograms.org/

1-800-705-8997
National Family Partnership
Informed Families' Education Center
2490 Coral Way Ste 501
Miami FL 33145-3430
http://www.nfp.org/

Private organizations, Civic groups, Religious organizations

Adult Children of Alcoholics (AcoA)
PO Box 3216
Torrance, CA 90510-3216
310-534-1815 (message only)
http://www.adultchildren.org/

1-800-344-2666
Al- Anon/Alateen
1600 Corporate Landing Parkway
Virginia Beach VA 23454-5617
Capital Corporate Centre
9 Antares Drive Ste 245
Ottawa ON K2E 7V5
CANADA
http://www.al-anon.alateen.org/

Alcoholics Anonymous (AA)
PO Box 459 NY NY 10163-0459
AA World Services, Inc. 11th Floor
475 Riverside Drive at W 120th Street
New York NY 10115
212-870-3400
http://www.aa.org/

1-800-736-9805
Families Anonymous, Inc.
PO Box 3475
Culver City CA 90231-3475
http://www.familiesanonymous.org/

Adventist Resources

Adventist Recovery Ministries
http://www.adventistrecovery.org
Adventist Recovery Ministries is a fellowship of men and women who share their strength, hope and experience in weekly support settings. Recovery is suggested by working a 12-step program. A spiritual program suggesting prayer, Bible references for the 12 steps, sponsorship, and weekly meetings are the tools for recovery. Their primary purpose is recovery from compulsive-addictive behavior and its dysfunction, and to help others seek recovery.

Journey to Wholeness Complete Set
http://www.adventsource.org/as30/store-productDetails.aspx?ID=36924
By Jackie Bishop&Shelley Curtis (AdventSource)
Journey to Wholeness is a support system for people of any faith (or lack thereof) who are struggling with things that are hurting them or the people they love. It presents a 12-step model for understanding God and ourselves as God’s creation. This program is for anyone who finds him or herself in the grip of unhealthy dependence upon substances or other destructive behaviors. This complete set includes a facilitators guide and a series of four participant guides.

1-800-253-2874 x3558
Institute for Prevention of Addictions
8338 W Campus Circle Drive
Berrien Springs, MI 49104-0211
http://www.andrews.edu/ipa/

1-877-866-8661
The Bridge to Recovery
1745  Logsdon Road
Bowling Green KY 42101-8531
Tel:  502 777 1094
http://www.thebridgetorecovery.com/
Seventh-day Adventist inpatient recovery for codependency, with substance abuse, compulsive behavior, sexual abuse, and alcoholic relapse services (18 years or older).

Project PATCH
2404 E Mill Plain Boulevard #A
Vancouver, WA 98661-4334
360-690-8495
http://www.projectpatch.org/
A Seventh-day Adventist organization that seeks to provide preventive help for children ages 12-17. This program deals with all types of crises.

Advent Home Learning Center (AHLC)
900 County Road 950
Calhoun TN  37309-5150
423 336 5052
http://www.adventhome.org/
A residential counseling program for 12-18 year old boys within grades 6-12. They specialize in working with boys who have behavior, attitude and academic problems. This is an ASI member organization. The program publishes a newsletter 3 times a year called "Advent Update," to keep supporters informed of the needs and growth of this youth ministry.
 
1-800-752-5999
Loma Linda University Behavioral Medicine Center
1710 Barton Road
Redlands CA 92373-5304
909-558-9200
http://lomalindahealth.org/behavioral-medicine-center/index.html
Loma Linda University Behavioral Medicine Center has been serving its community for over 17 years. Our mental health and addiction programs focus on whole person care addressing the complexities of the mind, body, and spirit. Inpatient and outpatient services are designed to meet the unique needs of seniors, adults, adolescents and children. For an assessment, please call 1-800-752-5999 or 909-558-9275.

Glendale Adventist Alcohol&Drug Services
1509 Wilson Terrace
Glendale CA 91206
818-409-8000
http://www.glendaleadventist.com/body.cfm?id=65
If you think your child might be using drugs but don't know for sure, the Alcohol and Drug Services programs at Glendale Adventist Medical Center can help. Inpatient and out patient rehab is provided. For a free slide guide that helps you identify a drug problem in your child, call 24 hours a day. Also there is a psychiatric inpatient facility.

1-800-784-1094
Drug Alternative Program
11868 Arliss Drive
Grand Terrace CA 92313-5102
http://www.drugalternativeprogram.com/
Inpatient and outpatient support for drug and alcohol abuse (18-65 years of age). Adventist In House Drug Rehabilitation Program. Cliff and Freddie also present seminars and initiate support groups.

Castle Alcoholism and Addiction Program
Castle Medical Center
640 Ulukahiki Street
Kailua HI  96734-4454
808-263-5400
Alcohol/Addiction treatment program
http://www.castlemed.com/bhs.htm

1-800-548-8700
The Health Connection
55 W Oak Ridge Drive
Hagerstown MD 21740-7390
http://www.healthconnection.org
Slides, videos, books on nutrition, health violence prevention, drug prevention, counseling, conflict resolution&anger, AIDS, alcohol, tobacco, wellness, displays and aids for health fair use, puppets and dolls with music and soundtracks are all available.

Health Works
885 Kilauea Avenue
Hilo, HI 96720-4214
808-934-7837
http://healthworksutb.org/
Programs are available to anyone wanting to stop any self-destructive substance or behavior. We include support for those wanting to reverse obesity and eating disorders; and for those wanting to end dependency to pharmaceutical drugs and illegal 'street drugs' like methamphetamine.

Christian online resources
Christians In Recovery  http://christians-in-recovery.org/

Secular online resources
Addiction Research Foundation. http://www.arf.org/
National Clearinghouse for Alcohol and Drug Information. http://www.health.org/

REFERENCES

Alzar, Beth (1995, May). “Several genetic traits linked to alcoholism”. APA Monitor. American Medical Association (1995). [Policy 95.983, 420.970]. AMA Policy Compendium, Spring 1995.

Helm, H.W., Jr., Lien, L.M., McBride, D.C.,&Bell, B. (2009). Comparison of alcohol and other drug use trends between a prohibitionist university and national data sets. Journal of Research on Christian Education, 18, 190-205.

Hernandez, W. & Mutch, P.B. (1996).  “Alcohol and drug use in North American Division Colleges and Universities”.  Institute for Prevention of Addictions, Andrews University, Berrien Springs, Michigan.

McBride, D.C., Mutch, P.B., Dudley, R.L., Julian, A.G.,&Beaven, W.H. (1989).  “Adventists, drugs, and a changing church”.  Adventist Review, June 1, 1989.

National Clearinghouse for Alcohol and Drug Information (1999).  Retrieved from the World Wide Web on August 5, 1999.  URL:  http://www.health.org

National Institute of Health (1999).  Principles of Drug Addiction Treatment. (NIH Publication No. 99-4180).  Washington, D.C.: National Institute of Health.

National Institute on Drug Abuse (1999).  Drug Abuse and Addiciton Research: 25 years of discovery to advance the health of the public. (NIH Publication).  Rockville, MD: Author.

Substance Abuse and Mental Health Services Administration. (2009). Results from the 2008 National Survey on Drug Use and Health National Findings (Office of Applied Studies, NSDUH Series H-36, HHS Publication No. SMA 09-4434). Rockville, MD.

Curtis VanderWaal, MSW, Ph.D., is Chair and Professor of Social Work at Andrews University, where he has taught since 1990.  He is also Associate Director of the Center for Policy Research at the Institute for Prevention of Addictions.

Reprinted and Resources updated with the author's permission.