Introduction

Drug addiction and alcoholism is a threatful illness which has crippled the lives of many
individuals, families and society. And once trap in this web of addiction it becomes difficult to
come out of it so helping them release from the addiction problem of drugs and alcohol and to
cope up with life is one of the major concern of pastoral care and counselling. Thus this paper
will bring in light the issues related with drug addiction and alcoholism and ways in which a
pastoral counsellor can interfere in helping the addicts.

1. Drug Addiction

A drug is any substance, other than food, that produces changes in the physical or mental
functioning of an individual. Drug abuse refers to taking a drug for other than medical reasons in
amount, strength, frequency or manner that damages the physical and mental functions.
Addiction is a state of physical or psychological dependence or both in a person, who has taken
drug periodically or continually.1

2. Use and Abuse of Drugs

There are five major categories of Drugs:

2.1. Depressants: depressants are used to make people relaxed and tranquil hence, they are
sometimes called tranquillisers or sedatives. They calm down mentally or physically disturbed
persons and are therefore also called downers. Depressants have the potential for abuse
associated with both psychological and physiological dependence. They are prescribed by
physicians as well as psychiatrists for relief from anxiety, tension, irritability and for treatment of
insomnia. In excessive amount, they produce a state of intoxication that is remarkably similar to
that of alcohol. These drugs are mainly consumed by people working in call centres, film
industry to help them cope with problems, tensions and worries. Barbiturates are a type of
depressant tablet which are often contained in sleeping bills. Barbiturate abusers and addicts are
generally emotionally maladjusted persons. A heavy dose causes sluggishness and depression. It
leads to defective speech, poor comprehension, impaired memory, confusion in problem solving

1
Zubeno Kithan, Pastoral Care and Counselling (Kolkata: ESPACE, 2015), 268. (Hereafter referred to as Kithan,
Pastoral Care and Counseling)

1
and decision making. They can cause severe poisoning, deep coma and respiratory and kidney
failure and death.2

2.2. Hallucinogens: Hallucinogens are drugs which produce psychotic reactions as depression,
mania or schizophrenia in normal person. They induce a state of excitation of the central nervous
system manifested by alterations of mood, usually euphoric (overjoyed), but sometimes severely
depressive, which gives rise to the possibility of suicide. Under its influence the sense of
direction, distance and time become disoriented. The commonly abused drugs are mescaline,
psilocybin, psilocin, lysergic acid diethylamide (LSD) and phencyclidine (PCP). LSD drugs
often leads a person to violent and dangerous behaviour because the user sometimes imagines he
is being persecuted by people. Inorder to defend himself/herself he/she will not hesitate to attack
anyone he/she comes across. The prolonged use of LSD may damage the brain, cause deformity
or mental retardation in the user’s offspring. It also causes psychotic behaviour, suicidal
tendencies and mental abnormality. It last longer than four or five hours after which the tripper
passes into sleep.3

2.3. Narcotics: the word, narcotics, comes from a Greek word, neckosis, which means numbing.
This type of drug usually refers to any drug that dulls a person’s senses and when taken in small
doses produce a sense of well being. Narcotics refer to opium which is derived from the poppy
plant. Its user are characterised by attitudes of pessimism and futility which lead to aggressive or
violent behaviour. The intake leads to drowsiness yielding to sleep and coma which ends in death
due to the failure of respiration. The heart’s action may be feeble, the pulse irregular and slow. 4
Morphine, heroin, codeine, hydromorphone comes under narcotic drugs.

2.4. Cannabis: Cannabis has been used to treat female weaknesses, rheumatism, malaria,
constipation and absent-mindedness. It is claimed to give relaxation and peace, an enhanced
appreciation of music and colour, heightened awareness of self and reality. It also causes fear
and panic, poor memory, mental disturbance like unstable personality, lethargy, triggers sexual
debauchery and crime, magical thinking, lots of ideas and do nothing about it. It causes liver

2
H.G. Mithra, Youth and Drugs: Missional Concern Towards Therapeutic Care and Counselling (New Delhi:
Christian World Imprints, 2016), 9-10. (Hereafter referred to as Mithra, Youth and Drugs)
3
Mithra, Youth and Drugs…, 12-14.
4
Mithra, Youth and Drugs…, 16-18.

2
damage, chromosome damage or genetic defects. Marijuana, hashish and tetrahydrocannabinol
are some of the examples of cannabis.5

2.5. Stimulants: It increases central nervous system activity. More harmful and more addictive
form of stimulants are nicotine which can impact smokers but also non-smokers too, cocaine
which can lead to powerful states of euphoria (ecstasy) and increased alertness and
amphetamines (increase in people’s energy, makes them excited) which are most prescribe by
physicians for weight loss, sleep disorder and other physical disorder. Methamphetamine is
synthetic stimulant gives a feeling of euphoria, invincibility and energy that can keep users going
for days without food or rest, but in addition, the end result of repeated use can be serious
cardiovascular and other physical problems.6

3. Alcoholism

A progressive compulsive-addictive illness, the primary characteristics of which is the

continuing excessive use of alcoholic beverages in ways that damage one or more areas of a
person’s life- mental and physical health, family life and social relationships, job and economic
viability, creativity, and spiritual wholeness. To say that an alcoholic’s drinking is compulsive
means that psychologically the desire is driven to some degree from an unconscious level and to
that degree is beyond volitional control. Addictive refers to a physiological adaptation of the
organism to the presence of alcohol so that acute distress and craving are experienced when the
person stop drinking. The term progressive refers to the fact that the illness usually develops
through predictable stages and if not treated eventually will result in irreversible dysfunction and
death.7

5
Mithra, Youth and Drugs..., 31-32.
6
Gary R. Collins, Christian Counselling, 3rd edition (Nashville: Thomas Nelson, 2007), 685-686. (Hereafter referred
to as Collins, Christian Counselling)
7
Howard Clinebell, “Alcohol Abuse, Addiction and Therapy”, Dictionary of Pastoral Care and Counselling, edited
by Rodney J. Hunter (Bangalore: Theological Publications in India, 2007), 18. (Hereafter referred to as Clinebell,
Alcohol Abuse)

3
4. Phase of an Alcoholic Person

According to Jellinek cited by H.S. Wilson, alcoholic person goes through four distinct phases of
development, which are as follows: 8

Phase I- This phase is called as pre-alcoholic phase which last from 6 months to 10 years or
more. It has two main features: firstly, the person attempts to alleviate everyday tensions of life
by drinking and secondly, he/she begins drinking progressively large amounts of alcohol to gain
the same effects that less alcohol use to give and he/she begins drinking on more frequent
occasions.

Phase II- This phase is also called as the early phase where the person establishes himself/herself
firmly as an early alcoholic. He/she becomes psychologically dependent on alcohol. He/she
exhibits atleast several if not all of the five following characteristics:

Blackouts: Brief episodes of amnesia which occurs during or immediately following a drinking
episode, although the drinker may appear to be moderately alert and behaving normally while
drinking upon sobering up he/she will not remember the events which took place during the
drinking episode. Gradually the blackouts become frequent.

He/she begins to sneak drinks.

He/she develops a preoccupation with alcohol.

He/she become plague by feeling of guilt and as defence get angry when approach on the
subject.

He/she consequently avoids reference to alcohol in conversation particularly when sober. He/she
tries desperately to deny that he/she has a problem with alcohol.

Phase III: This phase is also called the crucial phase/ addiction to alcohol. The prominent
characteristics of this phase is the loss of control over the use of alcohol. At this phase he/she
exhibits marked aggressive behaviour; he/she exhibits grandiose behaviour; he/she may have
periods of total abstinence to prove to himself/herself that he/she can take it or leave it; he/she

8
H.S. Wilson, Theological Education and Addiction Concerns in India (Madras: GDN Prints Associates, 1989), 26-
28.

4
may stop drinking suddenly and go through a withdrawal syndrome consisting of shakes,
delirium tremens or alcoholic hallucinations.

Phase IV: This stage is the chronic phase, where there is marked deterioration in health, mild
chronic brain syndromes and he/she begins to drink any type of alcohol.

5. Categories of Drug Addiction and Alcoholism

Substance- related disorder can be divided into several broad categories:9

5.1. Intoxication: it refers to maladaptive behavioural changes which include aggressive

behaviour, mood changes, impaired judgement, impaired occupational functioning that may be
accompanied by slurred speech, unsteady walk.

5.2. Dependence: Dependence on alcohol or other substance is what normally is called

alcoholism or addiction. Common symptoms include a strong need or compulsion to drink, an
inability to limit one’s drinking on any given occasion, and withdrawal symptoms including
nausea, sweating, shakiness and anxiety. Alcoholics have been described as people in the grip of
powerful craving or uncomfortable need for alcohol that overrides their ability to stop drinking.
This need can be as strong as the need for food or water. Most often people who are dependent
on the substance are the ones who have withdrawal symptoms when they stop using the alcohol
or other drugs.

5.3. Abuse: Abuse does not include a craving for alcohol, loss of control over the drinking, or
physical dependence on the substance. Instead, abuse involves the development of problems that
comes from frequent drinking. These problems might include failure to fulfil major work or
home responsibilities, problems with relationships or having recurring legal problems such as
driving under influence of alcohol or arrest for disorderly conduct, including fighting.

5.4. Substance-induced disorders: It includes a wide variety of mental conditions that are
brought on by the use of alcohol or other harmful drugs. These are organic conditions, wherein
the brain or some other part of the body is not functioning normally because of the excessive and
continued use of a substance such as alcohol e.g. liver disorder, substance- induced anxiety, and
substance induced dementia.
9
Collins, Christian Counselling…, 658.

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6. Symptoms to Recognise Drug User and Alcoholism

The common signs are as follows:10

6.1. Change in behaviour and life style: Unexpected change in mood and attitude, secrecy
about activities and whereabouts being deceptive or lying, change of friends, loss of interest in
studies, with a fall in grades, selling of personal and household goods, and change in food habits
depending on the kind of drug used. Sleeplessness or oversleeping, loss of interest in cleanliness,
indifference towards family activities, use of sun-glasses (even in the night), and such radical
change of behaviour.

6.2. Changes in physical Conditions: Slurred speech or overemphasis on words, tremor, red
eyes or watering eyes, out of focus or glassy, complaining of regular illness to hide the effects of
drugs, constipation from reduction of appetite etc. Loss of short-term memories, craving for
sweets, occasional vomits late night, waking up at night to have a smoke (or may leave home
early with a sense of urgency if the home atmosphere is not conducive).

7. Causes of Drug Addiction and Alcoholism

These are causes of drug addiction and alcoholism:

7.1. Social influence: Peer pressure plays a major role in the abuse of drugs and alcohol. The
way drugs and alcohol are depicted in the movies also plays an influential factor. Too often
drugs and alcohol are linked to success in the media. Alcohol is always associated with good
times, memorable occasions causing the teenage in abusing drugs and alcohol. 11 Especially with
the youths, the addiction usually starts from experiments and later get hooked physically12.

7.2. Psychological factors: Alcoholism is a complex illness. It is difficult to understand why

some social drinker becomes addicted and other with similar drinking patterns over any years do
not. It would be accurate to say that people become alcoholics who tend to form compulsive-
addictive behaviour patterns relatively easily. The main cause which makes people addictive is
10
Kithan, Pastoral Care and Counselling…, 270-271.
11
John Bartimole, Teenage Alcoholism and Drug Abuse: Causes, Cures and Consequences (Florida: Frederick Fell
Publishers, NY), 65-66.
12
Collins, Christian Counselling…, 687.

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usually because of psychological problem. It is particularly attractive because it can deaden
awareness of painful anxiety, guilt, inner conflict, loneliness and low self-esteem. 13 Many
substance users have inner tensions and frustration. Some looks for experiences, including drug
experiences, that will bring excitement, stimulation, intoxication and feeling of freedom from the
worries and problems of life.14

7.3. Unstable Home Environment

The most likely cause of problem drinking is the effects of instability that is the growing child
experiencing conflict between or with parents, parental absences or early parental loss following
marital breakup and addicted parents.15

7.4. Gateway theories

It suggests that use of one drug opens the gate to use substances that are more harmful and
addictive. A young people may start with cigarettes, beer and then move to more addictive
substances.16

The team of experts from the South Asia Association for Regional Cooperation (SAARC)
identified some of the causes of drug addiction as: gradual slackening of parental control, erosion
of moral values, frustrations arising out of socio-economic problems, large scale westernisation,
affects of films and pornography, lack of recreation, chronic pain.17

8. Effects of Drug Addiction and Alcoholism

Following are the effects of drug addiction and alcoholism:

8.1. Physical Health Problems: Drinking on average more than three units of alcohol per day
for men and two units for women increases the likelihood of health problems. Alcohol is
absorbed from the stomach and the small intestine, and gets distributed to every organ, tissue and
cell in the body through blood circulation. The liver at a rapid pace absorbs most of the alcohol
circulating in the blood. The continuous alcohol use adversely affects multiple organs of the

13
Clinebell, Alcohol Abuse…, 19.
14
Collins, Christian Counselling…, 687.
15
Richard Velleman, Counselling for Alcohol Problems, 2nd edition (New Delhi: SAGE, 2008), 13.
16
Collins, Christian Counselling…, 687.
17
Kithan, Pastoral Care and Counselling…, 270.

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body. Physical health complications due to alcohol use can range from acute damage to the
stomach, to severe chronic liver damage, sterility and loss of intellectual functions. some
complication are liver damage like fatty liver, brain damage, stomach pains, blood pressure,
cancer, disorder of immune system. There is also change in the physical appearance such as
change in skin colour (dark and dry) and scratches on face etc.18

8.2. Psychological Effects: Drug addiction and alcoholism have the following psychological
effects in a person: a high level of anxiety in interpersonal relationships; emotional immaturity;
ambivalence toward authority; low frustration tolerance; grandiosity; low self-esteem; feeling of
isolation; guilt; compulsiveness. Another common psychological trait is the grandiosity which is
defence against his/her own real feeling of low self-esteem. Because of his/her low self-esteem
the addicts is hypersentive to criticism and will often misinterpret the behaviour as rejection.19

8.3. Sociological Effects: People with addiction problem becomes timid and less open with
people around, with less percent of involving themselves with the other societal activities thus
affecting the social relations.20

9. Implication for Pastoral Care and counselling

Therapy with drug addiction and alcoholics has four goals: motivating them to accept their need
for help; detoxification and medical treatment of problems resulting from withdrawal e.g.
delirium tremens- shaking, confusion and hallucination and prolonged malnutrition; enabling
them to interrupt the addictive cycle by learning to avoid taking the first drink/drug; helping
them rebuild their lives and relationship without drugs/alcohol; learning to satisfy in
interpersonal and spiritual ways the needs that they had attempted to satisfy by means of
alcohol/drugs.21

The following are the steps which can be used by the pastoral counsellor to help in counselling
the substance abusers: 22

18
C.P. Singh, Alcoholism, Family and Social Work Practice (New Delhi: Rawat Publication, 2015), 111-112.
19
Howard J. Clinebell, Understanding and Counselling the Alcoholics (Nashville: Abingdon Press, NY), 49-51.
20
Shiela Daniel, “Impact of Alcoholism on Wives and Children”, The Christian Response to Alcohol and Drug
Problem, edited by J.Kenneth Lawton et.al., (Bangalore: Ecumenical Christian Center, 1983), 59.
21
Clinebell, Alcohol Abuse…, 19.
22
Collins, Christian Counselling…, 693.

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9.1. Motivation: It involves helping people stay with their rehabilitation, even when they feel
like giving up or when there are relapses. Motivation is strengthened when the abuser in
treatment gets feedback from others about what they see happening. There can be great value in
knowing that other are praying and are concerned. Motivation also can be made stronger when
family members or friends honestly share how they are impacted by the substance abusers
actions. This is not meant to instill guilt; it is a process of showing love and consistent
encouragement.

9.2. Acceptance: It can be expressed in several ways, including the sustained presence of people
who care. Abandoning an addiction involves determination and courage. This rarely happens
apart from sustained and supportive relationships from others.

9.3. Commitment Building: It may involve helping the person admit that he/she cannot control
the substance abuse and cannot get free of addictive behaviour without help from others, self-
examination, and dependence on God. Often the abuser’s family can benefit from the
encouragement that comes from others who walk with the family while the treatment continues.

9.4. Support: It does not end when the treatment is over. Eventually, professional treatment will
come to an end. Sometimes, because of costs or other influences the treatment ends before it
should. It is here that the sustained and consistent support from others in the Christian
community, can help people through difficult times. Often, the temptations to go back to the old
substances will seem overwhelming and irresistible, apart from the presence of people who can
be there to give encouragement and support.

Conclusion

Addiction can be a highly destructive force, but for some it is the gateway to ecstacy and
euphoria or escape from the pressures of lives. Helping them cope with addictive behaviour is
one of the major and most important challenges facing Christian counsellor and the church which
should be undertaken with acceptance and love.

Bibliography

Bartimole, John. Teenage Alcoholism and Drug Abuse: Causes, Cures and Consequences.
Florida: Frederick Fell Publishers, n.d.

9
Clinebell, Howard J. Understanding and Counselling the Alcoholics. Nashville: Abingdon Press,
n.d.
Clinebell, Howard. “Alcohol Abuse, Addiction and Therapy”. Dictionary of Pastoral Care and
Counselling. Edited by Rodney J. Hunter. Bangalore: Theological Publications in India,
2007.18.

Collins, Gary R. Christian Counselling. 3rd edition. Nashville: Thomas Nelson, 2007

Daniel, Shiela. “Impact of Alcoholism on Wives and Children”. The Christian Response to
Alcohol and Drug Problem. Edited by J.Kenneth Lawton et.al. Bangalore: Ecumenical
Christian Center, 1983.

Kithan, Zubeno. Pastoral Care and Counselling. Kolkata: ESPACE, 2015.

Mithra, H.G. Youth and Drugs: Missional Concern Towards Therapeutic Care and Counselling.
New Delhi: Christian World Imprints, 2016.

Singh, C.P. Alcoholism, Family and Social Work Practice. New Delhi: Rawat Publication, 2015.

Wilson, H.S. Theological Education and Addiction Concerns in India. Madras: GDN Prints
Associates, 1989.

Velleman, Richard. Counselling for Alcohol Problems. 2nd edition. New Delhi: SAGE, 2008.

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