In September, we recognize Addiction awareness month. Similar to being blind or deaf, addiction is often thought of as a disability. The question of if addiction should be considered a disease is still controversial even decades later when it was designated as such. Some experts argue that addiction should instead be classified as a dysfunction or a disorder. A new approach is needed to better understand addiction, with many believing that addiction should be considered a disability that can be provided reasonable accommodations in society.
If we consider a well-established disability such as blindness, it is known that being blind is atypical, relative to a person who is not blind. Society has been structured for those who are typical but recognizes the disadvantages that come with blindness. Accommodations are created to help alleviate these disadvantages, such as including braille on signs.
People who suffer from addiction can be viewed as atypical when compared to those who are not prone to addiction or are addicted to a substance. Research is beginning to show us how the psychology and neuroscience of those with addiction differ from others considered to be typical. Addicts are simply different.
The primary difference between a blind person and a person suffering from addiction is that people with addiction are discriminated against, often in ways that are not apparently obvious. These forms of discrimination range from state support of lottery tickets to the sentencing guidelines for possession of a controlled substance. A society that is self-aware recognizes these disadvantages and makes accommodations. In some communities, for example, self-injection sites are available for individuals who use intravenously injected drugs.
If a society uses a disability model of addiction, it recognizes addiction as a disability and focuses on addiction policies that provided people suffering from addiction with reasonable accommodations. Disability models are already in use in the United States. Drug and alcohol addiction are currently recognized as disabilities under the Americans with Disabilities Act. However, although some forms of addiction are included in the law, no disability model exists.
The prior disease model of addiction is still the dominant view in the United States. The disability model accepts this but under the disease model, addiction is only treated as a medical problem. A person with addiction is first treated as a patient, which has profoundly affected how society treats an addicted person. This encourages only viewing addiction on a clinical and public health level – as something that needs to be treated and cured. By following this model, reasonable accommodations are ignored. People with recognized disabilities understand that only viewing the disability from a clinical perspective leaves out the lived experience of a person with a disability.
While addiction is a condition that does benefit from medical treatment, it is not simply a medical issue. Instead, it is a disability that has been shown to benefit from accommodations and interventions including medication-assisted treatment, safe injection sites, and the rehabilitation system. These are all reasonable accommodations rather than medical treatments of the disease itself.
Moving from the disease model to a disability model helps society move past seeing addicted persons as morally defective or as criminals. It helps society view addicted persons as citizens who need certain accommodations to live out their lives and achieve their goals.
Maier, J. (2021). Addiction Is a Disability, and It Matters. Neuroethics.