[WordWhiz]

This far, and no mention of Thomas Szasz? It's extremely difficult to define addictions as diseases without conjuring up moral judgments. Analogize it to homosexuality. Used to be a disease; now it isn't. What's the difference? Society stopped condemning it, so it was removed from the DSM. Both alcoholics and homosexuals engage in lifestyles that others condemn. Presumably they do so because such a lifestyle is still superior to the alternatives. The homosexual lives openly and has homosexual relationships--even if this distresses his religiously conservative family, and perhaps even causes him to get shunned--because the alternatives (celibacy; faked heterosexuality, etc.) are even worse. The alcoholic drinks away his paycheck, even if it distresses his family, causes him to lose his family, lose his job, become homeless, get cirrhosis, etc. because the alternative (sobering up) is even worse.

Without invoking the judgmental term "addiction," it's literally impossible to distinguish the choice to consume large quantities of alcohol with the choice to have intercourse with members of the same sex, to have no sex at all, to live as a hippie in a commune, to work 80 hours a week, to own 100 cats, to trek across Antarctica, or a million other lifestyle choices that we consider unusual, but not insane.

Before anyone invokes brain chemistry, there is also evidence that certain groups--such as homosexuals, or risk takers--have different brain chemistry than "normal" people. Are they diseased? Why or why not? What we end up with is finding that alcoholism or any other "addiction" is a disease largely because people morally condemn the choices such individuals make, not because there is any sort of scientific shibboleth which separates such behavior from other unpopular behavior.