Persistence Of The Moral Perspective

Despite the preponderance of medical opinion that some drug and alcohol users have a disorder— a diminished capacity to choose freely whether or not to use a particular substance—the moral models retain some vitality. In 1882, when the disease concept was first gaining momentum, the Reverend J. E. Todd wrote an essay entitled ''Drunkenness a Vice, Not a Disease.'' In the late 1980s, the disease concept critics Fingarette and Peele put forth almost precisely the same thesis. Peele has argued that the disease concept exculpates the individual from responsibility, runs counter to scientific facts, and is perpetuated for the benefit of the treatment industry. However, his thesis has been criticized for using the classic disease model as a ''straw man'' because it does not take into account the more recent adoption of the biopsychosocial model.

Some sociologists in the United States have noted that the term alcoholic is still commonly used as a synonym for drunkard rather than as a designation for someone with an illness or disorder. The word addict is similarly used in a pejorative way, even when it is used more loosely to refer to a wide range of relatively benign behaviors, such as running or watching television. In the minds of most people, the concept of alcoholism or drug addiction as a disorder or disease can coexist quite comfortably with the concept of drunkenness or drug use as a vice. Since the nature of drug dependence is so closely linked to questions about the nature of free will and human volition—issues that have fascinated philosophers and scientists through the ages—it is likely that the disease concept of addic-

tion will continue to be debated for a long time to come.

(SEE ALSO: Addiction: Concepts and Definitions; Alcoholism; Causes of Substance Abuse; Tolerance and Physical Dependence; Treatment, History of, in the United States)


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