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What happens when addiction is defined as a sin instead of a sickness? In Guatemala, it means snatching addicts off the streets and holding them against their will in “compulsory” Christian rehabilitation centres.

In the hardscrabble reality of one of Central America’s poorest and most populous nations, the response to an epidemic of crack cocaine use has seen more than 200 such centres set up in Guatemala City alone, many run by Pentecostal churches operating with little oversight or regulation.

In the eyes of their captors, the estimated 6,000 internees in those rehab centres are sinners, not addicts, their problem a matter for religion, not science or medicine.

It's precisely this entanglement that intrigues University of Toronto ethnographer Kevin Lewis O'Neill.

“Democracy, security and drugs define Latin America today, and for me religion is a window into how people navigate these processes,” said O’Neill, an associate professor at the University of Toronto’s department for the study of religion.

The author of several books on Christianity's influence in the region, O’Neill is working on a new book, For Christ’s Sake, which looks at the concomitant rise of crack cocaine and Christian drug rehabilitation centers in Guatemala City. His work is funded by the Social Sciences and Humanities Research Council.

“If you ask why Guatemala is one of the most violent non-combat zones in the world, many Christians in Guatemala will say that this is a moral issue, people aren’t being good enough Christians,” said O’Neill, “In Guatemala, if you want to raise the issue of how does one deal with crack cocaine you don’t turn to, for example, public health or a doctor, you turn towards the church, because the church is the dominant language of change. The church is the answer.”

Scholars such as O’Neill can point to an unbroken string of misery – from natural disasters and civil war to murderous gangs locked in turf wars and the consequences of U.S. anti-drug trade policies – for laying the groundwork for that unblinking world view.

Once overwhelmingly Roman Catholic, Guatemala is now 60 per cent Pentecostal and charismatic Christians, explained O’Neill. The new form of Christianity dominates a civil society where almost 60 per cent live in poverty and government resources are scarce.

With virtually no medical alternatives, desperate families pay the pastors and churches who run the Christian rehab centres anywhere from $13 to $20 a month on average to keep their loved ones inside and away from drugs. 

Officially, the government claims it has no evidence of people being abused, but 48 of the 50 centres that are part of O’Neill’s research have bars on the windows and locked steel doors.

The average stay is three months but O’Neill knows people who have been locked inside for more than a year. The only way out is to convince the pastor they’re ready through “an extended demonstration of piety” and if the family is paying well, there is very little incentive for the centre to release them.

O’Neill, who has been doing research in Guatemala for 15 years, admits there is a certain tortured logic behind the centres. 

“It is effective in the sense that it keeps the user alive. It also relieves the family of tremendous stress,” he said. "The most difficult part for me is, in some ways, the lock itself. I would feel much more comfortable with these scenarios if they’d just take the locks off the doors.”