One thing I've been learning a lot about lately on my family medicine clerkship is the narcotics contract. I hadn't really heard of it before this block, but basically, it is an agreement that a physician makes with his or her patient when he is prescribing potentially addictive medicine (pain-killers mainly). It can include all sorts of things like:
-Promising not to call in for refills early because the medication is lost or stolen
-Promising not to go to another source for the medication
-Promising to be honest about medication usage
-Promising not to use illegal drugs while on the medication
-Promising to comply with drug checks
-Promising to be honest about one's condition and pain level
As well as a whole host of other things. For those of you that are curious and want to know more, click here.
I couldn't help mulling over in my substance abuse lecture yesterday how similar this contract is to our covenant with the Lord.
Therefore hear the word of the LORD, you scornful men, who rule this people who are in Jerusalem, because you have said, “We have made a covenant with death, and with Sheol we are in agreement. When the overflowing scourge passes through, it will not come to us, for we have made lies our refuge, and under falsehood we have hidden ourselves.”
Therefore thus says the Lord GOD: “Behold, I lay in Zion a stone for a foundation, a tried stone, a precious cornerstone, a sure foundation; whoever believes will not act hastily. Also I will make justice the measuring line, and righteousness the plummet; the hail will sweep away the refuge of lies, and the waters will overflow the hiding place. Your covenant with death will be annulled, and your agreement with Sheol will not stand; when the overflowing scourge passes through, then you will be trampled down by it. ~Isaiah 28:14-18
I think in a lot of ways, sin can be something that is addicting to us. It offers us all sorts of perceived "benefits," and it's hard to give it up even when it doesn't deliver. God's covenant with the Israelites that they would be His people and be obedient to Him is a lot like a "sin contract." The Israelites were promising that they would not go to other God's for their satisfaction, that they would come to the Lord with their struggles with sin, and that they wouldn't turn to other sinful actions for their satisfaction. God certainly tested them at varying time to make sure that they were complying with their side of the bargain. You can see in this first half of Isaiah 28, that the Israelites traded this covenant with the Lord for a covenant with death, choosing instead to rely on lies and falsehoods for satisfaction.
One of the things we talked about yesterday is how doctors should deal with patients that blow their narcotics contract. Do you give them a second chance? Do you kick them out of your practice? I love the second part of Isaiah 28 because it reminds me that even though we've blown our "sin contract" with the Lord, he deals with it by sending his son to accept the consequences of our disobedience. God breaks our contract with death, making a new contract with us that totally blows away all of the lies and falsehoods that we've been taking refuge in. Certainly not a pretty or clean process, but getting over an addiction never is.
My "challenge" us for today is to spend some time talking with the Lord about how sin is something that we can become addicted to, how we've blown our sin contract with the Lord, and how God in his amazing grace has renewed that contract.
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