In continuing our journey toward compassionate person-first language, it’s crucial that we examine Substance Use Disorder (SUD) for what it truly is: a complex, chronic disease. This is in contrast to what many see addiction as being simple, repetitive choices. We must grasp this concept as a faith community in order to approach, support, and speak about those who struggle with addiction. Understanding SUD as a disease—rather than a mere “choice” or moral failing—is key. It shifts our perspective; it deepens our empathy. What I am proposing here is a shift that is supported by both scientific and theological insights, inviting us to extend the same grace and compassion to those with SUD as we would to anyone managing a chronic illness.
Defining Substance Use Disorder (SUD)
At its core, SUD is a medical condition affecting the brain, behavior, and, ultimately, the entire life of a person. SAMHSA defines SUD as a condition in which the “recurrent use of alcohol and/or drugs causes clinically significant impairment,” impacting health, responsibilities, and relationships. Unlike occasional or social use, SUD disrupts a person’s ability to control their substance intake despite adverse effects on their physical, emotional, and social well-being. Diagnosing SUD typically involves a comprehensive assessment, often incorporating criteria such as the inability to limit use, increased tolerance, and, most significantly, interference with one’s daily life.
This distinction matters. By understanding that SUD is not merely excessive use but a disorder with measurable clinical implications, we’re better equipped to see beyond stereotypes. Ashford’s study notes, “Terms like ‘addict’ or ‘substance abuser’ reinforce stereotypes and elicit greater negative bias” (Ashford et al., 2018, p. 133). Using person-first language, such as “person with a substance use disorder,” acknowledges the humanity before the disease, highlighting the reality of the struggle while preserving the person’s dignity.
SUD as a Chronic Disease: The Science Behind the Model
The medical and scientific communities increasingly recognize SUD as a chronic disease—one influenced by a combination of genetic, neurological, psychological, and environmental factors. This disease model reveals that SUD, like other chronic conditions such as diabetes or heart disease, fundamentally alters the brain’s structure and function. These changes disrupt critical areas involved in decision-making, impulse control, and reward processing, making it extremely difficult for individuals to stop using substances even when they sincerely desire to do so.
Understanding SUD through the lens of the disease model changes our approach in significant ways. Just as we provide ongoing treatment, understanding, and accommodations for someone with diabetes, so too should we approach individuals with SUD with patience, treatment support, and empathy. Ashford’s research reminds us that shifting away from judgmental terminology could open doors to support systems and reduce the stigma that often prevents individuals from seeking help. He writes, “The language used to describe substance use disorders affects implicit and explicit biases, shaping public perceptions and the quality of care” (Ashford et al., 2018, p. 135).
The Disease Model vs. The Choice Model: Shifting Our Perspectives and Responses
In many circles, the choice model of addiction is still dominant. This model implies that individuals with SUD lack willpower or moral conviction, reducing their struggle to poor choices. Viewing addiction as a choice rather than a disease separates those suffering and those who are healthy; this isolation is much like a modern-day leprosy epidemic. When we attribute addiction to “bad decisions,” we risk stripping individuals of their dignity, making it easy to ignore their pain and deny their need for support.
By contrast, the disease model allows us to see addiction as an involuntary struggle—a condition beyond simple willpower. This shift in perspective leads to greater compassion and motivates us to extend accommodations as we do for other chronic conditions. In Matthew 9:12, Jesus says, “It is not the healthy who need a doctor, but the sick.” With these words, Jesus reminds us that those who are suffering—whether physically or spiritually—need compassion and care, not condemnation.
Theological Implications
A biblically informed faith calls us to extend compassion, particularly to those in need. As Christians, we strive to follow the example of Jesus, who welcomed and healed those whom society often disregarded. In the story of the Good Samaritan (Luke 10:25-37), Jesus illustrates that our compassion should transcend biases and stereotypes, reaching out to those in distress. When we accept the disease model of SUD, we align ourselves with this compassion, recognizing that individuals with SUD are, first and foremost, people in need of understanding and support.
Further, if we recognize SUD as a disease, our language and actions naturally begin to align with how we treat those with other chronic illnesses or disabilities. In a church setting, this perspective can shift everything—from how we pray for individuals with SUD to how we develop ministries to support them. Instead of seeing addiction as a moral failing to be “fixed,” we can extend grace, welcome, and practical assistance. Ashford’s study found that person-first language leads to more positive associations and reduced stigma (Ashford et al., 2018, p. 134). This evidence challenges us to rethink our approach, cultivating spaces where individuals feel safe to seek help and healing.
Implications of the Disease Model: A Call to Accommodate and Support
By embracing the disease model, we can view SUD with the same compassion and care as other illnesses, motivating us to provide appropriate accommodations. In our society, accommodations for disabilities are seen as necessary and just. We understand that certain conditions limit a person’s ability to function without support, so we make changes to enable them to live as fully as possible. Why, then, should it be different for someone with SUD? The Apostle Paul’s words in Galatians 6:2—“Bear one another’s burdens, and so fulfill the law of Christ”—compel us to support those around us, especially in their struggles. We are called to lift each other up, not judge, shame, or distance ourselves from those who carry heavier burdens.
In practical terms, this approach calls for us to be watchful with our language so that when we interact with people with SUD, they can find understanding, support, and resources for recovery. Ministries could focus on everything from providing access to resources like counseling and medical support to developing prayer groups that offer encouragement without judgment. By recognizing SUD as a disease, we align ourselves with concepts of imago dei.