I have not officially come out on this blog to offer up my opinion on the debate over whether addiction is a disease or not. I will eventually publish my views on addiction, it is a topic that I have spent a lot of time reading about and musing over. For the record let me just say that I do NOT think addiction to opiates (or any other addictions) is a disease, although it does have some qualities that are disease-like. This post is not about adding to the debate of disease or not. The notion that addiction is a disease that primarily has to do with drugs, the NIDA paradigm of drug addiction, has many problems. For a critique of the NIDA paradigm, see the article Rise and Fall of the Official View of Addiction by Bruce K. Alexander (Professor Emeritus, Simon Fraser University).
The following is a discussion of the concept of neurodiversity. Neurodiversity is the belief that differences in brain function are not due to a disorder or disease but the result of human diversity akin to diversity in sexual orientation or ethnicity. There are many activities that humans engage in which have been called mental illnesses. The most glaring example of medicalizing normal human diversity in recent times is homosexuality. For some heterosexuals, the thought that someone may be sexually attracted to someone of their own sex was unthinkable. Homosexuality was so obviously "wrong" that no rational person would ever engage in a homosexual act, ergo they must be insane. Psychiatry in particular has a long and sordid history of labeling all sorts of deviant behavior as mental illness, followed by novel, often brutal "treatments" for these "diseases."
Dirk Hanson, the author of the blog Addiction Inbox, has coined the term Metabolic Chauvinism. Maia Szalavitz, in this Time article, defines metabolic chauvinism, "... is the idea that one’s own experience — of a drug, a condition, a cure or sensation — is the same as that of everyone else. It’s similar to the way male chauvinists assume that the male perspective is the only one that matters."
When it comes to the use of opiates, outside of physical pain most people cannot understand why people choose to use these substances. If some people who find some relief from emotional pain by using opiates they are derided as "fleeing reality" and need to be "cured" of their desire to consume opiates. The notion that the opiate user may be using the drug to make their life better is referred to as "self-medication." Rather than viewing self-medication as the fundamental human right to be sovereign over their own bodies and medical decisions, it is viewed as a symptom of the disease of narcotic addiction. It is only considered legitimate medical use when an individual cedes the sovereignty over their own body and mind to the authority of a medical professional. Self-medication is perversely redefined as "drug abuse." This language reinforces the notion that opiate users are sick and their drug use is self-abuse.
Diversity in America has come to mean people of different ethnicity's, religions or cultures that may look or speak differently but think all alike. I advocate that the concept of diversity be expanded to include neurodiversity to the growing list of diversities in America. Maia Szalavitz, in her article "Should There Be Such a Thing as Addict Pride?", expands on this theme:

Rather than aiming to “cure” addictive behavior or punish people in order to try to end drug problems, we can seek to understand them and provide what addicts need to function comfortably in a world that isn’t built for brains like theirs. And just as autistic behavior should not be seen as problematic when it is helping people function and not hurting others, the same should be true with addictive actions...we can begin to stop throwing away addicted people who are already here in counterproductive attempts to "save them from themselves" without understanding their perspective.

Stand up for your right to use opiates as you see fit. Stand up against the pathologizing of opiate use. Stand up against the prohibitionists and their barbaric tactics of social exclusion and harm maximalization.

Junkie Pride!!! Junkie Power!!!