For many historic and modern churches that deal with snake handling, the practice all comes down to a set of Bible verses that command the faithful to take up serpents (via ABC News). At least, those lines do when read under a fairly literal interpretation of the holy book in question.

First, there’s Mark 16:17-18: “They shall take up serpents; and if they drink any deadly thing, it shall not hurt them; they shall lay hands on the sick, and they shall recover.” Meanwhile, another gospel also seemingly encourages snake handling, as Luke 10:19 tells the faithful that “Behold, I give unto you power to tread on serpents and scorpions” without being harmed. Some churches may also reference Acts 28:1-6, where the apostle Paul wrangles a venomous snake that, though it bites him, causes the faithful man no harm.

However, there is still plenty of debate amongst churches as to how, exactly, the passages should be taken. Some argue that a literal definition of the verses is too simplistic and that references to “serpents” can reasonably be taken as larger references to misdeeds or general evil in the world. Others might question the utility of testing God, who famously doesn’t cotton to that sort of thing, given that Matthew 4:7 contains the well-known line: “Thou shalt not tempt the Lord thy God.” For the skeptical, picking up a rattlesnake during a church service is doing just that.

Though it’s been linked to other cultures and religions, snake handling is now almost universally thought of as a product of the oftentimes remote communities of Appalachia. According to NCPedia, this practice is especially prominent in southern Appalachia. It may have arisen there due to a confluence of pre-existing religious belief, relatively isolated churches, and a certain amount of happenstance. George Went Hensley, who’s often credited with introducing snake handling to protestant churches there and who clearly had a hand in popularizing it, first started it in Tennessee. Perhaps if Hensley had lived somewhere different, we’d link snake handling to intensely devoted religious communities in, say, rural Maine or the Pacific Coast.

NCPedia also notes that some midwestern churches also were known to host snake handling, in part because congregants had brought the practice with them as they moved from Appalachia. However, it’s not clear if snake handling still goes on in other regions, as most of the press coverage largely focuses on Appalachia.

In 2013, NPR reported that there were an estimated 125 churches that still practiced snake handling, mostly located in a swath covering the southern portion of the Appalachian Mountains, as well as parts of Alabama, Georgia, and the Carolinas. Yet, a great majority of states outlaw the practice for what many consider to be obvious safety reasons.

Despite a person’s faith or submission to God, the bare truth is that snake handling can be deadly. Take Kentucky pastor Jamie Coots, who had previously appeared in a number of televised reports and features on snake handling, including the National Geographic special, “Snake Salvation.” According to ABC News, Coots was bitten by a rattlesnake during a 2014 service. He reportedly refused medical treatment and, when an ambulance crew found him unconscious at home, his wife signed a form also declining treatment for her husband. He died later that night from the effects of snake venom.

While some took it as an affirmation of Coots’ faith and submission to God’s will, others were more reluctant to accept his death. Andrew Hamblin, another pastor who had been outspoken about practicing snake handling in his own church, told National Geographic that he hadn’t offered it in the wake of Coots’ death. “Since Jamie died, I’ve offered a rattler to no one. I am the shepherd, and I am responsible for what happens in this building,” he said. 

Hamblin, along with a growing number of other snake handling preachers, actually encourages getting medical attention as soon as someone is bitten. After all, there is no Bible verse that says you can’t call 911 after a rattlesnake strikes. Even “Little Cody” Coots, the son of Jamie Coots, requested emergency medical attention after his own encounter with a rattlesnake. Unlike his father, Little Cody survived.

Though it’s technically possible for people to handle snakes without being bitten, it’s still a practice that many outside of these church services strongly discourage. That’s because, seemingly regardless of someone’s faith or the weakness of an individual snake, it’s still possible to be bitten by an agitated and very venomous snake. Kentucky pastor Jamie Coots certainly said that it happened on multiple occasions in his church, according to NPR. Yet, he and other pastors have claimed that many people have walked away from the strikes, oftentimes declining emergency medical attention and antivenin. What’s more, they say, many have survived (it’s worth noting again that Coots himself died of a rattlesnake bite delivered during a 2014 church service, per ABC News).

But, for those lucky parishioners who are bitten but don’t die, what’s going on? For believers, of course, it’s all to do with their own strength of faith and God’s protection. Yet, others require a more concrete scientific explanation, which may lie in the state of the snakes themselves. Herpetologists speaking to NPR note that malnourished, poorly cared-for snakes may not be able to deliver much venom in a single bite. The Mountaineer also suggests that snakes may have released most of their venom in an earlier strike, meaning that they are effectively firing blanks when someone is bitten later.

Snake handlers may have a rich history and some deeply held personal and social reasons for picking up a bunch of rattlers and other venomous snakes. But, for legislators and law enforcement, there’s still a pretty clear line that people shouldn’t cross: don’t touch those snakes.

According to The First Amendment Encyclopedia, snake handling has been subject to various legal challenges and laws throughout the years. While most laws and lawmakers acknowledge that freedom of speech and religious belief are indeed protected under the U.S. Constitution, they also argue that regulating a person’s actions in the interests of public health and safety are a different matter.

That doesn’t mean that legal challenges don’t arise, of course. According to ABC News, pastor Andrew Hamblin was charged with illegally possessing dangerous animals in November 2013, after state wildlife officials seized an estimated 50 venomous snakes from the preacher. Hamblin pleaded not guilty and argued that the state was violating his First Amendment right. However, as the case was eventually dismissed, the legal challenge remained unsolved. The debate over the legality of snake handling is, for some, still very much ongoing.