Tag Archives: drugs

Drugs: What do you know about the rising sea in which we swim?

Are you among the many people who will use a drug this month? When you answer, you may first think about what prescriptions you are taking. But include “self-medicating” with alcohol and marijuana — and maybe some other stuff.

You may also be experimenting with “psychedelics.” I am acquainted with people who have had profound experiences with two of the increasingly popular array of mind-altering drugs being offered to people seeking mental health (whether health means eradication or remission to them). Ketamine, psilocybin, and MDMA are high on the list of researchers as they look for new solutions to age-old problems.

In the consumer-driven U.S., buying whatever products are offered almost seems like an obligation, whether we need them or not. We have a lot of what we need, here, and a lot we probably don’t. Drugs are a well-advertised product, so you are more likely to be using them than not. I am with you. I will keep using the prescription drug I have been taking every day until the treatment is over. On our walk yesterday, I thanked God for a pain-killer that was so helpful to my wife, not long ago. According to SAMHSA, about half the people in the United States used a prescription drug in the last month. 24% used two or more. 13% used five or more (13% of the U.S. is 43 million people).

According to the CDC, when people went to see their doctor in 2018, 860+ million of them were given or prescribed drugs. 68.7% of visits included drug therapy. The drugs frequently prescribed were analgesics (pain), antihyperlipidemics (blood), and antidepressants (mental health).

In the same year, people who went to the emergency room were given or prescribed drugs 336 million times. 79.5% of the visits involved drug therapy. The drugs most frequently prescribed were analgesics, minerals and electrolytes (hydration), and antiemetics (nausea) or antivertigo agents (dizziness, nausea).

drugs: top ten drug companies 2022
The FDA approved 50 new drugs in 2021

Last year, the pharmaceutical giant, Pfizer (42nd St. NYC), netted $21.98 billion. Johnson and Johnson (New Brunswick, NJ) netted $20.88 billion. Two Swiss companies, Novartis and Roche were #1 and #4 in the top five profit-makers. Local favorite, Merck (Kenilworth, NJ), netted $12.35 billion to be #5. If you watch commercial TV for five minutes, you are likely to hear from one of these worldwide mega-corporations selling their latest wonder.

The medical/pharmaceutical industry is designed to sell products for consumers, like everything else in consumer economies. It is no wonder, with huge corporations needing to sell so shareholders profit and a huge distribution system dispensing drugs as a primary means of healing, there is a lot of encouragement, even pressure, to use drugs of all kinds, legal and illegal.

Suspicious drugs

Like so many products people want, certain drugs that used to be illegal are creeping into mainstream acceptance. People will kill the planet to inject fossil fuels into their environment, so we have companies too big to die who extract and refine those products for them to buy. It is not the same, but similar, with drugs. People do not think they should suffer and die (ever) and will buy whatever promises to stop that.

Drugs that were formerly illegal (or still are) are creeping into mainstream use. People appear to be more desperate for them every year. Legal opioids famously addict and kill thousands of people every year. Prescription opioids (natural and semi-synthetic opioids and methadone), along with heroin and synthetic opioids other than methadone (primarily fentanyl) caused 21,000 overdoses in 2010. People were aghast when that number rose to 69,000 in 2020. In 2021 the number shot up to 107,622.  2022 is expected to see further increase.

The sea of drugs we live in is full of wonders, but there are a lot of predators in it, too. So the experts are doing studies and the news people are reporting on what they are finding. I am writing because I think the researchers and reporters could be a bit more suspicious.

drugs: psilocybin capsule
A psilocybin capsule Credit…John Karsten Moran/NYU Langone Health, via Associated Press

For instance, the NYTimes published a story last week about how psilocybin (‘shrooms) curbed excessive drinking. The researchers suggested it might be a new treatment in the making. AA suspects it is more likely a new way to lose one’s sobriety. MDMA (ecstasy) is being tested as a treatment for PTSD.

In general, psychedelics are moving into mainstream mental health treatment. Forbes recently published a helpful article about the trend, focusing on treating autism. In it, the author noted the increasing use of ketamine for mental health purposes:

While the drug’s usage carries serious risks if used recreationally, there is a reliable protocol for doctor-controlled use that has a steadily increasing track record of success for treatment-resistant depression. There’s even an FDA-approved spray called Spravato that is helping to make ketamine more and more mainstream, and improve more lives each day.

I think it is easy to notice that most drugs which provide out-of-control experiences are rarely effectively controlled. The Spravato website is worth a look to see, again, how salesmanship leads the way when it comes to introducing treatments.

Generosity about drug use needs limits

With the legalization of marijuana and mainstreaming of hallucinogens, it is no surprise that the use of those substances among young adults rose to an all time high in 2021, according to the NIH.

When the NIH, CDC, DHHS, etc. talk about drugs, they are even-handed. They try to stick to the facts — even though they track illegal uses and deaths, which implies disapproval. I think I might have a similar generosity. I have clients who use cannabis for more than recreation. Other clients have had life-altering experiences with ketamine and mushrooms. In their cases, the impact was not long-lasting. But I don’t know about everyone else. I generally reserve judgment.

Even though our minds are open, our discernment needs to be sharp when we introduce drug technology into our bodies. About seven years ago, the church in which I served offered a time for our theologians to think about drugs together. I wrote about our findings and I think they still provide helpful discernment. What do God and the Church think about drugs? What are some practical ways to approach life in the midst of constant wooing into and opportunity for drug use?

Colombian drugs smugglers shipwrecked
Shipwrecked cocaine smugglers on rising seas in 2019

I’m still pondering and applying what I learned then and have learned over the past few years. Each year, as overdose deaths rise (significantly in my own hometown!), the need to think and act becomes more urgent. I can’t help but notice that as the oceans have risen due to climate change, the sea of drugs has been rising with them. Do the powers-that-be extravagantly use them to pacify the most vulnerable? Regardless, like the Covid-19 vaccines did not solve all the problems of the pandemic, most drugs over-promise and under-perform until the general population feels it is normal to have 100-year floods and 100+ thousand opioid deaths in a year.

I repeatedly encouraged drug use for my clients and loved ones last year. Some wonders were worked. But I suspect I am being too generous about the new normal, in which we use drugs as the first act of healing. I think of giant drug companies as part of the powerful forces who brought the world to the present disasters we face. Now they want us to rely on them to solve the problems with their latest products.

While I don’t think the blanket mistrust rampant these days is the answer, Psalm 146 comes to mind. Discernment begins with trusting God, not just assessing the data and making endless, experimental choices.

Do not put your trust in princes,
in mortals, in whom there is no help.
When their breath departs, they return to the earth;
on that very day their plans perish. (Whole psalm)

Practical thinking about drugs

The wisdom or rightness of whatever we are doing depends primarily upon our motivation or purpose for doing it. “Why?” and “what for?” make a difference. Jesus followers know why they are alive and what to live for.

The Apostle Paul masterfully helps us with our decision making about activities that could “go either way” in several of his letters — “Is this action wise or right?” For instance, in his day there was a debate about what to do with food that comes from the temple “store” after having been sacrificed to idols. He writes:

The one who eats everything must not treat with contempt the one who does not, and the one who does not eat everything must not judge the one who does, for God has accepted them. Who are you to judge someone else’s servant? To their own master, servants stand or fall. And they will stand, for the Lord is able to make them stand.

One person considers one day more sacred than another; another considers every day alike. Each of them should be fully convinced in their own mind. Whoever regards one day as special does so to the Lord. Whoever eats meat does so to the Lord, for they give thanks to God; and whoever abstains does so to the Lord and gives thanks to God. For none of us lives for ourselves alone, and none of us dies for ourselves alone. If we live, we live for the Lord; and if we die, we die for the Lord. So, whether we live or die, we belong to the Lord. For this very reason, Christ died and returned to life so that he might be the Lord of both the dead and the living. (Romans 14:3-9)

We may not have a similar circumstance in our own time (although some people think eating genetically modified foods might be something sacrificed to a corporation). But lately we have had the debate about ingesting drugs of various kinds; there is a parallel. This is the second half [previous post] of some thoughts we explored in our last “Doing Theology” time; Paul is a good guide to questions we have to keep asking.

This might be a question more suitable to what we are discerning:

Is it right or wrong to drink and glass of wine or smoke a joint?

The Bible seems to teach it depends — who is doing it, where and when? For myself, I rarely drink any alcohol in public and usually don’t serve it  because I am aware that some people should never drink any alcohol and I am in solidarity with them. In his argument about eating temple meat, Paul, likewise, says that even though he feels free to eat whatever he chooses, he abstains when he is around people who are against eating such things because he doesn’t need to do anything — especially if it causes someone to stumble over a debatable matter. He has enough confidence in his freedom not to need to exercise it just to prove he has it. His argument (above) easily applies to most ampliative drugs, since they are unnecessary.

More important to most of us is this question:

Are you using drugs to enjoy the gifts of God to the glory of God and to edify the body? Or are you trying to escape or numb pain? Is your drug use about God and others or just about you?

An ampliative or therapeutic drug is just a substance. It can (at least many drugs can) be used for good or it can be used sinfully or ignorantly. Instead of its potential good impact, it could have unintended or sin-ridden consequences. Like anything, it can take on meanings beyond what it is and have undue influence. Whether you use a drug or not, if Jesus is Lord and extending his kingdom motivates you, then you will be able to work things out – God has accepted you even if you have an alternative approach to someone else’s, or you interpret your needs differently, or even if you are just plain wrong at this moment.

You could use a drug and think “nothing can touch me. I am free and strong!” Or you could use a drug in fear, to escape what you should be facing. You could use a drug and feel holier than everyone else. Or you could not use a drug you need and be a big detriment to everyone who has to make up for how badly you behave. You could use a drug ignorantly or rebelliously and become addicted.

We’ll have to work it out.

How does one decide about using therapeutic drugs or attempting to use ampliative drugs therapeutically?

Here are some important questions to ask on the way to answering that question:

  1. Are you avoiding the hard questions that the drugs might help you avoid?
  2. Will the drug/medication aid your maturity or will it numb the process or even blind you to it?
  3. Are you praying things through or is the drug your refuge?
  4. Do you have friends and therapists to talk to or does the drug help you avoid scary relationships?
  5. Is taking the drug/medication an expression of faith and service or is it running and numbing? Conversely is refusing to take it relying on yourself instead of humbly admitting your need?
  6. Will not using the drug/medication build up or tear down the body?

Questions that help do theology from where you are starting:

How are you presently using drugs of all kinds?

Have you or your loved ones (friends or family) ever been prescribed or used drugs to their detriment? What happened?

What are the most important parts of this dialogue so far for your future health and the future health of Circle of Hope?

What is God telling you about using ampliative or therapeutic drugs?

Here are some “one-liners” we collected at the end of our Doing Theology time. These are not ‘last words,” just the wisdom some people were willing to offer:

  • Talking about drug use more lets everything that might be suppressed get out into the light. Not talking can leave us lost in feeling defective.
  • As a church, it is better to be known as a fertile ground for recovery than as a place where one is free to party.
  • Peer pressure is a big thing in a community. It runs things. We need to remember that what we do influences others.
  • Drinking wine could be joyful if Jesus is behind it. He obviously thought so.
  • We should handle substances relationally, not legally. Our sin addiction keeps us isolated and prone to cutting people off.
  • Avoidance is part of humanity. The Zoloft user could easily tell the alcoholic to get the speck of sawdust out of his eye while she has a plank of dependency in her own.
  • Jesus can transcend the space of our deepest suffering, dependent on a drug or not. We yearn for transformation.
  • Suspicion of one’s personal capacity is warranted. None of us is all that self aware. None of us is capable of competing with the billions  of dollars spent to get us to use unnecessary drugs.
  • The body  of Christ is useful in all healing processes. Just learning how to be the body is healing. The therapeutic dyad central to psychotherapy amplifies this truth.
  • Where does my necessary suffering end and unnecessary begin? I cause a lot of my own suffering. We all need the mirror.
  • Getting connected to something beautiful usually starts before sobriety.
  • How do we get to the place where we can ask the question: “Show me how I work so I can be healed?”
  • Rationalization and spiritualization are enemies of transformation.

What about drugs? Some background for doing theology.

When we are doing theology we are mentalizing with God and his people. We are not working on the social construction of reality; we are listening for the reality behind what we think we know — the voice of God. In that process we honor the Bible as the trusted basis for hearing from God and we respect people who have done the work to understand the Bible. But we are not just parsing words, making laws, or arguing over theories. We are trying to figure out who to be and what to do. Doing theology is thinking and feeling along with God and conforming one’s thinking and feeling to his or her truest self.

About a month ago we decided to do some theology about drugs. The situation in the United States is so drug-induced that it caused a government report: Epidemic: Responding to America’s Prescription Drug Abuse.  The solutions in the report did not do theology, of course, and they came up with the typical solutions of the the day: education, tracking and monitoring, proper medical disposal, and enforcement. All these solutions will be hard to implement, since drugs, legal and illegal, are a huge business in the United States.

Philadelphia is deeply connected to the drug industry, even historically.  When George Washington lived at 5th and Market he wrote to his gardener at Mt. Vernon, “Make the most of the Indian hemp seed, and sow it everywhere.” He and Thomas Jefferson traded herbal blends for their pipes. A recent Philadelphia Magazine highlighted how pot is coming. Recently the city recently decriminalized pot. There is now a $25 fine for possession of under an ounce and a $100 fine for smoking in public. And police are instructed not to arrest anyone with under an ounce.  People are lined up to help us become Colorado — let marijuana be legal and cash in.

There is a theological framework for why this subject is important.

What are drugs?

Drugs are not a malevolent force against which we should war. They are not the disease of the users who should be scapegoated. They are chemical substances that, when taken into the human body through ingestion, injection or some other means, modify one or more of the capacities of the body for either ampliative or therapeutic purposes and not for feeding or nourishing the body.

The history of drug use in the modern western world tracks the development that has ended up in our consumer economies. Just before the twentieth century, regulation of drugs by taxation changed to prohibition and criminalization of their use and distribution. Some of the factors leading to this were 1) industrial workers needed more presence of mind than agricultural, 2) governments thought drugs would sap the country’s fitness for war, 3) most drugs came from the southern hemisphere so there were racists fears about foreigners corrupting the young, 4) science discovered more about how bad various drugs could be, 5) Christians and socialist thought they were morally corrosive and made people poor. People are still having these debates.

What is thinking about drugs that might be contrary to revelation?

  • Drugs are a form of technology

They can make body an object of manipulation. The body can be seen as separate from a whole person, just a machine to manipulate.

  • Drugs are used to “progress” out of what is viewed as the tyrannous imposition of creation.

These days people tend to think technology will make everything better. We don’t like physical or psychological pain, so we employ new drug technology to get rid of it. The drugs circumvent what is built into our bodies to order our lives in relation to the world around us and to time. For instance, if I am tired and have a headache I probably need rest, not coffee or an aspirin. Rather than smoking weed to go to sleep, I might need to start exercising and stop watching the blue screen late at night.

  • Power: Drugs are a means by which one manipulates the body according to their will.

As a result of the philosophy of power, there is a big concern over the addict who is out of control and dependent. If one does not have power over oneself it undermines the whole philosophy on which western society is running. Marx highlighted this call for power when he called religion the opiate of the people. It is ironic, of course, that society as a whole is increasingly dependent on drugs.

  • Freedom: Drugs are a consumable that satisfies one’s needs and desires and frees one from suffering.

Ampliative drugs, in particular, are seen as freedom, even rebellion. It is ironic that they are in total conformity to the heart of present western culture. People have become engineers of experiences (maybe with their own meth lab). They don’t waste time waiting to bump into something good in creation, they make it at home. One author calls weekend party animals “bureaucrats of fun,“ administering their enjoyment like a nurse setting a med schedule.  The society thinks taking drugs is a moral imperative: they are a valuable technology through which we can manage and manufacture a better, more fulfilling life.  It must be added that they are also the ultimate consumer product: geared for maximum impact and instantly obsolete, used up – and they are easy: no need for training, travel or time. A good rebellion against “the man” would more likely be never using ampliative drugs, in particular.

I will follow this up soon with some practical advice for thinking about how to use drugs along with some of the thinking of the group we gathered for doing theology.