Theodore Dalrymple:

There are cheap lies and expensive lies, and the lie that addiction is a disease just like any other will prove to be costly. It is the lie upon which Washington has based its proposed directive that insurance policies should cover addiction and mental disorders in the same way as they cover physical disease. The government might as well decriminalize fraud while it is at it.

The evidence that addiction is not a disease like any other is compelling, overwhelming, and obvious. It has also been available for a long time. The National Institute on Drug Abuse’s definition of addiction as a “chronic, relapsing brain disease” is about as scientific as the advertising claims for Coca-Cola. In fact, it had its origin as a funding appeal to Congress.

To take only one point among many: most addicts who give up do so without any medical assistance—and most addicts do give up. Moreover, they do so at an early age. The proximate cause of their abstinence is their decision to be abstinent. No one can decide not to have rheumatoid arthritis, say, or colon cancer. Sufferers from those diseases can decide to cooperate or not with treatment, but that is another matter entirely. Therefore, there is a category difference between addiction and real disease.

The pretense that a non-disease is a disease may actually hinder people from deciding to behave better: they will instead wait for their medical savior, as Estragon waits for Godot. Whether this hope is justified or not, the pretense will certainly involve much public expense, just as would fitting out an expedition to discover unicorns somewhere in the world.

To treat addicts as people to whom something has happened rather than as people who have decided to do something is to infantilize them. It is another small step in the transformation of the population into wards of government. Far from being generous and understanding, the government’s directive is a thinly disguised grab for power…