Jay Adams is probably the most pre-eminent Christian counselor who is still living. His nouthetic style of counseling, as explored in books such as Competent to Counsel, The Christian Counselor's Handbook and others makes him very well known and respected in the Christian Counseling community.

In his book Solving Marriage Problems, he makes an interesting claim:

Calling drunkenness a "disease" or a "sickness" rather than a "sin" may seem to thema gracious act, but it is just the opposite. You cannot be more gracious than God. To call drunkenness a "sickness" is to take away hope; there is no pull that will cure such a "disease". But if, as the Bible says, drunkenness is a sin, then there is real hope, because Christ Jesus came not only to free us from the penalty but also from the power of sin. (Solving Marriage Problems, p14)

This strikes me as contrary to worldly ways of thinking to say the least - namely there seems to be an implicit assumption of mine that is challenged here.

I've long held alcoholism - or at least the genetic predisposition towards it - to be a disease. As a disease of the body, I see this as somehow "less than sin" because, in fact, it is a biological process put in place by God. In the same way that just about every Christian more mature than Fred Phelps doesn't view "blackness" as a sin, I've always assumed that any biological function is simply a fact, and not a "sin."

Interestingly, Adams seems to then fight his own hypothesis, though, saying:

When, however, there may be an organic reason for any problem, the counselor should always advise the counselee to have a thorough medical evaluation. ... Because organic problems, which result from Adam's sin and the subsequent curse, are not themselves sin, Christian counselors must become thoroughly acquainted with their symptoms and advise counselees accordingly.

But therein lies the rub - Adams has made and I have made an assumption that a thing cannot be both a disease and a sin. It is definitely my gut feeling, but I don't know how I could biblically prove that point.

So, here's the question - What biblical texts or traditions would bear on the proposition that "Diseases and sins are separate things." In other words, how could I make either the claim that "If something is a disease, it is not at the same moral level as sin" or "Just because something is a disease, doesn't mean it's a sin."

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    A subtle word shift might explain some of the confusion here. Adams writes 'Calling drunkenness a "disease" or a "sickness" rather than a "sin" ...' and he is right. Alcoholism is a disease (in my opinion) but alcoholism and drunkenness are very different. One may be drunk without being an alcoholic, and one may (with much willpower and support) be an alcoholic without being drunk. Dec 4, 2012 at 21:06
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    And in line with what DJClayworth said, there's a difference between "the genetic predisposition to alcoholism" and "the sin of drunkenness". I've most likely got the genetic predisposition to alcoholism. But that doesn't force me to choose to start drinking in the first place. That part of it is my own choice, and I choose not to, because it would be a sin.
    – Mason Wheeler
    Dec 5, 2012 at 3:02
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    To be perfectly honest, I've never heard of Jay Adams before. But, I'll address what I perceive to be the core question anyway, if you don't mind me challenging the premise that a thing cannot be both a disease and a sin -- at least as you've presented it.
    – svidgen
    Dec 5, 2012 at 4:27
  • I guess I might also challenge the premise that diseases are hopeless conditions. I think most, if not all, NT mentions of disease actually presented it in quite the opposite manner.
    – svidgen
    Dec 5, 2012 at 4:34
  • If a genetic happening creates a disease that gives one a proclivity toward sin, this does not preclude that any actions coming from the genetic happening are not sin (alcoholism, homosexuality [according to some], etc.). We look at God and say "I do what I do because all humans have fallen into a metaphorical pit and cannot escape it. I am not without excuse because of my genetics that are affected by the fall." And then God answers: "I told you to keep away from the pit in the first place." The gospel though is that God can count people in metaphorical pits as righteous when they are not. Dec 5, 2012 at 15:58

5 Answers 5


I took some time to think hard on this one before answering, and also to double-check some Scripture.

When it comes to things like addiction - alcoholism, drug addiction, sexual addiction, and the like, the Bible never refers to them as "sickness". It refers to certain acts as sinful, or foolish. Drunkenness, for example, is never called a sin outright, but it is called "foolishness". Sexual sin is, of course, called sin (when it comes to a sexual addiction).

Modern psychology does recognized these types of things as illnesses. Scripture wasn't written with the concepts of modern psychology in mind. I'm not saying that these things aren't sicknesses or diseases of a sort, but nowhere in Scripture will you find such a claim.

With that in mind, from a purely Scriptural perspective, with no room for interpretation, Scriptures don't ever state directly that these things are illnesses.

But there are a lot of things that Scripture doesn't say that are still true. Silence or lack of Scriptural statement doesn't necessarily mean something can't be true. Perhaps a silly example: Scripture doesn't say that we will one day use computers to communicate - but clearly we do.

It also doesn't say that sickness (the more general form) is caused by bacterial or viral infection, improper nutrition, or the like. It does give practical advice in how to combat sickness.

Likewise, it doesn't say that addiction is a sin, but it does say how to combat it - don't do it. Avoid drunkenness, flee sexual immorality, and it does address drug use - the original word is Pharmakeia, which is unfortunately translated as sorcery these days, but it's the same word from which "Pharmacy" comes. Again, the Biblical advice - don't do it. It's sin and avoid it.

But as to whether addiction is a disease... Scripture doesn't say anytyhing, but since a lack of a statement indicating something is true doesn't necessarily mean it's false, all we can say with certainty is "Scripture doesn't say."

Therefore, this is one of those questions that can't be answered from a purely Scriptural perspective, as asked. (That's my answer)

And it's likely to be continued to be debated until we meet God and can ask Him ourselves.

Going beyond my answer, and just offering some thoughts, that are worth considering, in support for Jay Adam's statement...

I read an article several months back (and can't for the life of me find it to link to it) that talks about "the illusion of free will". Most of the article is not on-topic for this question, but there was an interesting statement.

(Paraphrasing from memory) While modern science indicates that free will is an illusion, the illusion of free will has an evolutionary advantage in that acting as if we have free will helps us to survive.

The article goes on to give some examples. Crossing the street was one of them. Someone who believes in ultimate predestination, with the attitude "What's going to happen is what's meant to happen" may just step out into the street without looking, and therefore get hit by a car. Someone who believes their actions are their choice and that they can control the future( to some point) by predicting likely outcomes and acting accordingly will know that looking both ways first is an opportunity to affect future events by deciding whether or not to step out into traffic.

Applied to the question, the thought process used by Jay Adams is somewhat similar. And I've seen it many times myself. Telling someone that addiction is a disease, and not their problem often reinforces the idea that it's not their fault, and that it's out of their control. So rather than working toward a solution, they fall into the trap of self-imposed helplessness. They see it as something external to themselves, and since it's a disease, not something they've chosen to do, they can justify that next drink, or that next hit.

Of course, that's not universal. Plenty of people with a disease fight like crazy to beat it. And I'm not saying that these things aren't diseases of the sort. But I've seen personally people that have been addicts for years, that believed it was a disease that were transformed both by the saving power of Christ and by changing their mindset (the definition of repentance) and viewing their addiction as sin. This was the first step in deciding to beat it. This is the basis of the Reformer's Unanimous program, which is a very successful addiction recovery program based on such principles.

Again, it's not always that way, and I'm sure there are plenty of people that are more effectively helped with the "Addiction as a disease" modern psychology approach. I am absolutely not stating that it's not a disease, or that it's 100% counter-productive to label it as such.

I'm also not saying that those who treat it as a disease aren't doing the best they can, that they don't mean well, that they're not often effective. I'm not saying any of that. I'm just expanding on the reasoning and personal examples of support for Jay's statement.


The full context of Adam's claims are obviously hidden from us here. However, addressing the visible claims from a lay Catholic perspective, I'd say he's simply off the mark with a few premises.

The First Faulty Premise

To call drunkenness a "sickness" is to take away hope; there is no pull that will cure such a "disease".

If secular medicine and psychology aren't enough to convince us that disease is not a hopeless state, we can open any one of the gospels and take a peek at almost any page to find healing upon healing upon healing. And these healings always denote the forgiveness of sin and the purifying power to go forward and "sin no more."

See Matthew 4:24, which gives us a short list of diseases Jesus cures. This items on this list are very important and relevant, mind you -- they're all conditions that directly inhibit our ability to perform God's will.

His fame spread to all of Syria, and they brought to him all who were sick with various diseases and racked with pain, those who were possessed, lunatics, and paralytics, and he cured them.

Or refer to Matthew 8:1-17, in which healing the diseased is portrayed again as routine operation for Christ. Even more astounding, note how final verse in the list of healings ends.

When it was evening, they brought him many who were possessed by demons, and he drove out the spirits by a word and cured all the sick, to fulfill what had been said by Isaiah the prophet: He took away our infirmities and bore our diseases.

One of Christ's missions and trademarks, as explicitly stated in scripture, is to cure the sick, take away our infirmities, and bear our diseases. Thus, I'd submit that hopelessness in the shadow of disease is sin; it rejects Christ's power and mission to heal.

The Second Faulty Premise

Adams has made and I have made an assumption that a thing cannot be both a disease and a sin.

I'm not sure this statement of yours matches Adam's exactly:

Because organic problems, which result from Adam's sin and the subsequent curse, are not themselves sin

From what I can see in your citations, Adam's seems to leave room for the interpretation that the organic roots of sinful behavior are not sinful, but that the resulting actions may still be sinful.

But, giving you the benefit of the doubt, since I'm not familiar with Adam's or his book(s), one passage in particular comes to mind. See Mark 9:42-48.

42 “Whoever causes one of these little ones who believe [in me] to sin, it would be better for him if a great millstone were put around his neck and he were thrown into the sea. 43 If your hand causes you to sin, cut it off. It is better for you to enter into life maimed than with two hands to go into Gehenna, into the unquenchable fire. 44 45 And if your foot causes you to sin, cut it off. It is better for you to enter into life crippled than with two feet to be thrown into Gehenna. 47 And if your eye causes you to sin, pluck it out. Better for you to enter into the kingdom of God with one eye than with two eyes to be thrown into Gehenna, 48 where ‘their worm does not die, and the fire is not quenched.’

In this segment, Christ is not necessarily addressing diseases, but He is very clearly addressing biological causes for sin. And in doing so, He makes it very clear that the sins resulting from these biological causes do condemn us. And while we tend to believe He's speaking in hyperbole here, the importance of earnestly trying to cut oneself off from any and all sources of sin, even those ingrained in our own body, is very important to our salvation.

In Summary

We can certainly distinguish between disease (or any biological cause) and the resulting actions, be they sinful or not. However, a biological cause is neither a hopeless condition nor a judgement free condition. For, if the biological causes for sin left us guiltless, Christ would neither warn us against them, nor spend His time healing us and "bearing our diseases." Bearing our diseases is a large part to Christ's mission. So, we're definitely not left hopeless.

Catholic doctrine teaches that our guilt is diminished to the extent our actions are beyond our direct control. However, sinful actions are still sinful even when we are guiltless in performing them. Thus, if we are complacent in our diseases or sins, I would argue I think with the support of Catholic doctrine, that we regain the guilt of those sins!

(And by "guilt" I mean some measure by which we may be condemned.)

  • I suppose it's notable to mention that we don't need to look to scripture to distinguish between disease and sin, the same as we don't need to find the distinction between a toothbrush and walrus in scripture. They're simply different things. However, scripture, as I've shown, links these two different things together pretty strongly, contrary to what your question seems to be hunting for.
    – svidgen
    Dec 5, 2012 at 5:40

This is not a full answer, but one place to look is John 9:1-3.

Jesus seems to say that the man he went on to heal of blindness was not blind as a result of either his own sin or his parents'.

I would personally interpret this to mean the disease was not the result of any specific sin at all. What is the cause or purpose of suffering, of course, is "the" big question, so I won't try to answer that one!

With regard to your example of alcoholism, I think that your quoted author has (perhaps intentionally) misrepresented the position of secular medics. The purpose of a doctor diagnosing alcoholism as an illness is to give it a label, in order to simplify the process of giving help. "If patient X is diagnosed with disease Y, then the textbook says give treatment Z."

While many people in society will see a technical name or a medical diagnosis as a way of saying "it's not your fault, it's your disease", a doctor's professional role is not to assign blame, and not to absolve it either. We should all see the label in that way, and then act according our love for our neighbour.

  • In medicine there is a danger of treating symptoms or secondary causes rather than primary causes (or alternatively of not properly handling symptoms, e.g., pain management, and intermediate causes). In spiritual life similar dangers may exist; excessive focus on the root (rebellion against/disharmony with God) or intermediate (specific sins) causes or even symptoms ('overflow of heart') can hinder sanctification.
    – user3331
    Dec 5, 2012 at 0:46

Is the problem in the deffinition of Sin? As an evangelical, I'm going to give what I think is an evangelical view point.

Sin is not the act itself, it's the breaking of relationship with God - or to put it another way it is us telling God that we know better than Him and will do it our own way. We live in a sinful world - it is broken and not perfect and a consequence of that our bodies are not perfect (not because of any particular sin, but because of the sinful world).

This however doesn't excuse us from our sin. We are accountable for our words and actions (E.g. Matthew 12:36-37, Romans 14:12). Although there might be a biological reason that we might be pre-disposed to being an alchoholic, doesn't mean that we have to drink. In a similar way, our biology/environment/upbringing/education/experiances might mean that we have a violent nature - this doesn't excuse us from acting on that nature and hurting or killing another human.

Again, there is an argument particularly in the western world today that being gay is not a choice - you are born that way. From a hard line conservative evangelical point of view, even if it is true that you were born that way, it doesn't excuse you from dissobaying God and being in a homosexual relationship.

Basically you are born sinful, even before you take your first breath, you are sinful. BUT this does not excuse you from your sin, you are accountable for all of your sin.

  • Hi, The last sentance of the second paragraph is the exact opposite of what I said! In John 9:1-3 Jesus says that the imperfection of the man's body is NOT the result his or his parents' sin. I take this to mean that it is not the result of any sin. While the majority of human suffering is clearly the result of sin, I am not convinced that all suffering is (neither am I certain that the opposite is true).
    – TomCV
    Dec 7, 2012 at 21:22
  • @TomCV. Sorry, I must have missunderstood your argument. I thought you were saying that it wasn't a direct result of a sin committed by the man or his parents, but a result of the world that we live in. This was the argument that I was trying to draw on. I will edit my answer.
    – Greg
    Dec 9, 2012 at 4:50
  • Sorry again, maybe my 2nd paragraph was not explained well enough. I hope this makes more sense
    – Greg
    Dec 9, 2012 at 4:52

Disease and sins are not separated.
The man having infirmity 38 years heard from God:

sin no more, lest a worse thing come unto thee. (John 5:14)

Disease comes always as consequences of sins, because:

God saw every thing that he had made, and, behold, it was very good (Genesis 1:31)
by one man sin entered into the world, and death by sin (Romans 5:12)

Sometimes, the connection between sins and disease are not obvious because the sins are inherited from ancestors:

your children shall wander in the wilderness forty years, and bear your whoredoms (Numbers 14:33) For all have sinned, and come short of the glory of God (Romans 3:23)

because the human nature can carry across generations, from one person to another, not only the sins (from Adam), also the virtutes, also the knowledges, also the blessings and cure(from Lord Jesus Christ).

our old man is crucified with him, that the body of sin might be destroyed, that henceforth we should not serve sin. For he that is dead is freed from sin. (Romans 6:6-7)

The root of sins are localizable in the human souls, and the diseases in the human bodies.
This is why, medical science cannot address sins, because the soul is not subject of science, or it uses a wrong definition of the soul (in psychology or psychiatry). At most it can record patological manifestations of the sin at the body level, and make statistics, but cannot administer real cures.

Only a true christian can have a complete view of human anatomy, and can address the true cause of the diseases: the sin.

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    "Disease comes always as consequences of sins" is directly contradicted by John 9, and the whole book of Job. Dec 5, 2012 at 16:17
  • @DJClayworth: The "blindness from birth" of Bartimaeus is not a disease, is just a lack. Disease is when "life" is replaced with "death". God doesn't do this replacement. About Job, don't be so sure. In Orthodox tradition is known (an archangel says): he entered into a debate with the Creator (tzarlazar.tripod.com/lazar05.htm)
    – Iulian
    Dec 5, 2012 at 17:25
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    Job's 'comforters' insisted that Job must have committed a sin to be visited with the diseases and other misfortunes, and God rebukes them for saying that. Dec 5, 2012 at 17:33
  • @DJClayworth: because they guessing; even if guessing is according with reality or not, the conforters cannot say the truth; sins of Job is not their job; same archangel says: "in the holy heavens no human deeds are evaluated in and of themselves, but only in the light of the sort of motives and quality of the will with which these deeds are performed" (tzarlazar.tripod.com/lazar08.htm)
    – Iulian
    Dec 5, 2012 at 17:45
  • You're saying that Job's comforters spoke the truth, but were nonethless rebuked for it because they couldn't be sure it was the truth? Dec 5, 2012 at 17:49

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