Since the 1990’s, natural and synthetic opioids have fueled a public health crisis in the United States. Dubbed a national emergency by the U.S. Department of Health and Human Services in 2017, the wave of destruction wrought by opioid addiction and overdose raises significant questions regarding theological views of addiction and the positions that churches and Christians should take towards those struggling with substance abuse. Although models of addiction vary in pinpointing the etiology of addiction, the crux of much of the debate centers around culpability for the addictive behaviors, rather than their precise origin. As Christian theology describes sin as behaviors and attitudes that stray from God’s law—a law founded on a love for God and a love for one’s neighbor—a Christian theology of addiction understands it as an extreme manifestation of a misorientation from God and, therefore, a sin. However, this theological understanding does not neglect other dimensions of human experience. Although addiction is a sin with the addict being morally culpable, Christians can understand addiction as being multifactorial in nature, with an addict’s agency being physiologically affected by the addiction. Considering the tension of addiction as both misoriented idolatry and affected agency, the church has a major role in providing a community of spiritual healing to persons with addictions.