Organized religion has played a key role in shaping national and international policy for millennia. This paper discusses the parts some Christian churches have played in creating and supporting drug control policies stipulated in un multilateral treaties. Mainstream churches have largely ignored the harms these policies inflict on vulnerable populations, including both people who use drugs, and those who are terminally ill and cannot access controlled medicines for pain relief. Mainstream – especially theologically “conservative” – churches reject people who use drugs, an approach that damages individuals, families, and communities both inside and outside the church, along multiple dimensions. This damage has, dialectically, produced a counter-theology and praxis that prioritizes compassionate ministry and insists on metanoia, a scriptural ethic of hospitality and evidence based care. Churches must play a prophetic role according to scripture, contemporary theologians, and Christians engaged in social justice praxis, in ministering to individuals who are marginalized and criminalized for using prohibited substances.