Slate has an article criticizing recent congressional attempts to change the language regarding addiction in order to destigmatize it with the hopes that it will encourage more users to seek the help they need. The author's rebuke this attempt on a few basic grounds http://www.slate.com/id/2171131/pagenum/2/.

~That considering drug addiction along the same lines as a chronic brain disease diminishes the sense of autonomy in the user that is necessary for him/her to take the steps needed to quit their use because it implies that it is out of their control.

~ That if addiction were equivalent to other brain diseases like schizophrenia, the addict would not be able to make other choices in between their times of use.

<blockquote>  Yet addicts rarely spend all of their time in the throes of an intense neurochemical siege. In the days between binges, cocaine addicts make many decisions that have nothing to do with drug-seeking. Should they try to find a different job? Kick that freeloading cousin off their couch for good? Register for food stamps? Most of the patients one of us treats hold jobs while pursuing their heroin habits.<blockquote>. 

~The authors argue that it diminishes the role a person's choices play in their affliction. <blockquote>it threatens to obscure the vast role personal agency plays in perpetuating the cycle of use and relapse to drugs and alcohol. <blockquote>

~And finally, it questions whether stigmas are necessarily bad because the social stigma can help motivate people to stop their destructive behavior. 

I have a few problems with this.

To begin with, while addiction may not be exactly the same as other chronic diseases like schizophrenia, that doesn't mean it's completely different either. While the details may not match up exactly, drug addictions are physiologically based. There is even a significant amount of evidence suggesting that those who become addicts may be genetically predisposed to their addictions.

And while therapy and behavior modifications may help those with addictions recover, they are normally matched with some type of medical help initially. I'm very skeptical of over prescribing medication for a ton of reasons I don't have time to get into, but even I acknowledge that in some cases medication may be necessary, if only as a temporary crutch. Therapy and behavior modifications, mixed with practical advice like people and places to avoid so you won't relapse, are wonderful techniques but in the first few weeks of withdrawal, if the person is climbing the walls because of their body's physiological reaction to the absence of the chemicals it became dependent on via narcotics, attempting to avoid certain triggers is not enough.

That is why things like the patch or nicotine gum have become more widely used in helping people quit smoking. Sure, a few people can quit cold turkey, but realistically most people are going to need a crutch initially in order to successfully quit for good. If we can accept this for nicotine, there shouldn't be any reason not to accept it for other addictions as well.

This also raises a general question about free will because there is a growing body of literature that suggests it is just an illusion.

 I believe part of the author's fear stems from the fact that the idea that we aren't really in control of our actions can lead to a defeatist view in life and this I can sympathize with. However, as is the case with most issues, few things are simply black and white and there's still many, many, many more questions than answers regarding these problems.

In the meantime, we need to make the best decisions with the knowledge we already have. In terms of brain diseases and addictions, we know that there is a huge role our brains and bodies play (of which we are just finally being able to grasp) but we also know that behavior modification, therapy and lifestyle changes can have enourmous postive effects as well. So why should we keep pretending it's a one or the other situation? Why can't we accept both pieces of the puzzle and find the best way to piece them together?

As for what how we should refer to addiction, I think at present Senator Joe Biden has the right idea because stigmas ARE bad. While social pressures may influence our decisions to a point, they are not the end all and once a person has developed an addiction, they've moved beyond the point where that really matters.

They may try to distance themselves from people and places who may increase their chances of relapse, but the biggest step for them to take is to look for the help they need to begin with and more people will be willing to do this if they feel as though the rest of society isn't going to ostracize them for their inherent weakness or hold it against them for the rest of their lives. It can also increase public approval for programs that will assist those with addictions who need help and make it easier for them to reintegrate in society after they've been treated for their disease.

 I used to feel a little bit uncomfortable at the increasing normalcy of discussions regarding medications for children. It seemed children were being medically treated for any slight  change in behavior they had when in some cases it seemed they'd be able to improve without the medical help. However, the fact that developmental and mental issues have become destigmatized has led to a much better, and more understanding, public perception of the issues that plague so many families.

While it may be possible that we do at times over-rely on medications when other methods may be just as, if not more, successful, the benefit is that more people are being educated and the issues and more time and money will then be spent on research to develop a more comprehensive understanding of what the underlying causes are and how to best treat the disease in question.

So, overall, while imperfect, I think it's a huge step forward and we shouldn't step back now just because we're not yet completely comfortable with the implications. Just because we don't like how something sounds does not mean it's untrue. And intervention methods in the mean time, need not and should not, be exclusive. We simply don't know enough to begin completely ruling things out, especially when the evidence so far supports it.