The vast majority of addictions are the result of people making poor choices. Now all of a sudden we have made them a medical problem, a disease!
Addiction as a disease is not supported by any evidence and is more like a political policy statement than a reasoned intellectual argument. There has been a steady erosion of individual responsibility and the loss of personal blame for bad choices. Calls to destigmatize addiction remove any sense of personal responsibility.
Addiction does not meet the criteria specified for a core disease entity, period. In other words, the presence of a primary measurable deviation from physiologic or anatomical norm. Addiction is self-acquired, not transmissible, contagious, autoimmune, hereditary, degenerative or traumatic. Treatment consists of little more than stopping a given behaviour.
True diseases worsen if left untreated. Take a diabetic, a heroin addict, an alcoholic and lock them up for three months without their drug of choice. The heroin addict is cured until they choose to take another “hit,” the alcoholic is cured until they choose to have another drink. What happens to the diabetic? Well, he dies, no insulin.
Criminal courts do not hand down verdicts of “not guilty by virtue of mental illness” to drunk drivers who kill pedestrians. At best, addiction is a maladaptive response to an underlying condition, such as depression or a nonspecific inability to cope with the world. Medicalizing addiction has not led to any advances at the individual level.
The need for helping people with addiction is not in doubt, but social problems require social intervention. So, should we keep funding programs for addictions from our health-care budget? I think not!