Healing in the Ditch: Julian of Norwich, the Limits of Medicalization, and Redemption in the Opioid Crisis
Brett McCarty, ThD, MDiv, Duke University
Drawing from the speaker’s qualitative research in southern Appalachia, this presentation begins with a case study of someone whose struggles with substance use issues have been marked by medical treatment, legal proceedings, and the accompaniment of a church community. By attending to this person’s story and agency, the paper seeks to offer a prophetic account of how medicalization is at work in the opioid crisis while also arguing for the possibilities of redemption within these complex contexts.
Following decades of substance use issues being criminalized, often along racialized lines, the opioid crisis has been shaped by the increasing medicalization of addiction. This presentation takes medicalization to name interpreting aspects of our embodied existence primarily as medical problems requiring medical solutions. Advocates seeking to destigmatize addiction have promoted its understanding as a chronic-relapsing brain disease, often treated indefinitely with medications like buprenorphine (Suboxone). The shift in terminology from “medication-assisted treatment” (MAT) to “medications for opioid use disorder” (MOUD) reflects this deepening medicalization. Drawing from the work of psychiatrist and anthropologist Helena Hansen’s Addicted to Christ: Remaking Men in Puerto Rican Pentecostal Drug Ministries (University of California Press, 2018), the presentation argues that the medicalization of addiction can enervate the agency of people struggling with substance use issues.
While medical treatment can be life-saving, this presentation critically examines how the broader cultural logic of medicalization can undermine the agency of individuals and communities. The medicalization of substance use issues risks reducing persons to patients forced to rush from one appointment to another, and it can shift away from the pursuit of healing in favor of a more reductionistic, lifelong pharmacological management. Perhaps most importantly, medicalization can fracture the communal discernment necessary for pursuing a shared life of flourishing.
In response, the second half of the presentation turns to Christian theology, particularly the work of Julian of Norwich in her Revelations of Divine Love, to imagine alternative visions of redemption. Drawing from her own near-death experience, Julian portrays Christ as the healer who suffers with humanity, transforming wounds into sites of divine grace. Her parable of the lord and the servant offers a vision of redemption rooted in tender care and communal healing, where Christ’s redemptive work is likened to a gardener cultivating life from the soil of affliction. Drawing from Amy Laura Hall’s Laughing at the Devil: Seeing the World with Julian of Norwich (Duke University Press, 2018) and Deny Turner’s Julian of Norwich, Theologian (Yale University Press, 2011), the presentation argues for the pressing contemporary relevance of Julian’s vision of redemption.
Julian’s theological imagination challenges the assumptions of medicalization by reframing healing not as a technical intervention but as a slow, relational process of transformation. Her vision invites us to consider how communities might embody forms of care that restore agency and nurture flourishing beyond the confines of medical or criminal paradigms. Similar to how Victoria Sweet’s God’s Hotel: A Doctor, a Hospital, and a Pilgrimage into the Heart of Medicine (Riverhead Books, 2012) drew from the work of medieval mystic and theologian Hildegard of Bingen, this presentation draws from Julian to argue for the contemporary importance of the communal work of healing, extended over time. The importance contributions of modern medicine are not discarded but rather nested within a wider, more holistic vision.
The presentation concludes by returning to the Appalachian case study, exploring the prophetic implications of how Julian’s vision of redemption illuminates this person’s path toward healing and redemption in the midst of the opioid crisis.
Following decades of substance use issues being criminalized, often along racialized lines, the opioid crisis has been shaped by the increasing medicalization of addiction. This presentation takes medicalization to name interpreting aspects of our embodied existence primarily as medical problems requiring medical solutions. Advocates seeking to destigmatize addiction have promoted its understanding as a chronic-relapsing brain disease, often treated indefinitely with medications like buprenorphine (Suboxone). The shift in terminology from “medication-assisted treatment” (MAT) to “medications for opioid use disorder” (MOUD) reflects this deepening medicalization. Drawing from the work of psychiatrist and anthropologist Helena Hansen’s Addicted to Christ: Remaking Men in Puerto Rican Pentecostal Drug Ministries (University of California Press, 2018), the presentation argues that the medicalization of addiction can enervate the agency of people struggling with substance use issues.
While medical treatment can be life-saving, this presentation critically examines how the broader cultural logic of medicalization can undermine the agency of individuals and communities. The medicalization of substance use issues risks reducing persons to patients forced to rush from one appointment to another, and it can shift away from the pursuit of healing in favor of a more reductionistic, lifelong pharmacological management. Perhaps most importantly, medicalization can fracture the communal discernment necessary for pursuing a shared life of flourishing.
In response, the second half of the presentation turns to Christian theology, particularly the work of Julian of Norwich in her Revelations of Divine Love, to imagine alternative visions of redemption. Drawing from her own near-death experience, Julian portrays Christ as the healer who suffers with humanity, transforming wounds into sites of divine grace. Her parable of the lord and the servant offers a vision of redemption rooted in tender care and communal healing, where Christ’s redemptive work is likened to a gardener cultivating life from the soil of affliction. Drawing from Amy Laura Hall’s Laughing at the Devil: Seeing the World with Julian of Norwich (Duke University Press, 2018) and Deny Turner’s Julian of Norwich, Theologian (Yale University Press, 2011), the presentation argues for the pressing contemporary relevance of Julian’s vision of redemption.
Julian’s theological imagination challenges the assumptions of medicalization by reframing healing not as a technical intervention but as a slow, relational process of transformation. Her vision invites us to consider how communities might embody forms of care that restore agency and nurture flourishing beyond the confines of medical or criminal paradigms. Similar to how Victoria Sweet’s God’s Hotel: A Doctor, a Hospital, and a Pilgrimage into the Heart of Medicine (Riverhead Books, 2012) drew from the work of medieval mystic and theologian Hildegard of Bingen, this presentation draws from Julian to argue for the contemporary importance of the communal work of healing, extended over time. The importance contributions of modern medicine are not discarded but rather nested within a wider, more holistic vision.
The presentation concludes by returning to the Appalachian case study, exploring the prophetic implications of how Julian’s vision of redemption illuminates this person’s path toward healing and redemption in the midst of the opioid crisis.