Addiction as Disability

I don’t think I’ve ever heard anyone in an AA meeting or other recovery group refer to themselves as a disabled person on the basis of being an addict (or whatever their preferred term for their problematic behavior). I wonder why not. I also wonder if there could be something to gain from referring to addiction as a disability.

The Diagnostic and Statistical Manual of Mental Disorders, fifth edition, classifies Substance Use Disorders as a mental disorder, meaning that according to the American Psychiatric Association, substance addiction is truly, officially, an illness. Of course, the book Alcoholics Anonymous made that claim in print 80 years ago, but to call it specifically a psychiatric or mental illness has important implications.

For myself, I believe the best way to understand disability is through what is called the “social model.” Under this model, what makes someone disabled is that they are excluded from certain social arrangements–the standardized ways of access to spaces, to work, to education, and even to love and support. The exclusion is because those standardized arrangements do not provide for disabled people to gain access. In other words, disability is not the attribute of a person, but the name of an exclusion of that person by social convention.

People with mental illness and some other conditions are frequently excluded, and battle the invisibility of their exclusion as well as the disabling effects themselves. Someone who has depression or anxiety may not be able to work, learn, or live in the ways prescribed by the predominant social arrangements, and is for that reason disabled. I would argue that most or all mental illnesses lead to similar exclusions/disabilities.

Why not addiction? After all, addicts are frequently subjected to exclusions and other oppressions. There is a tremendous stigma, even now–as there is for mental illness generally. There certainly are exclusions that addicts are subjected to systemically.

Here’s one way that thinking of addiction as a disability might influence social change. In social events, the presumption of the norm of alcohol consumption is a subtle form of oppression of alcoholics. How often do alcoholics need to be sure of making their own careful preparations for social events, because of the standardized expectation that alcohol will be present? How often do alcoholics have to answer awkward questions about what they are drinking, or why they are not drinking? I’ve also heard many share in meetings that because they are alcoholics, family or friends rely on them as designated drivers, so that they become de facto chauffeurs. If we understood this kind of arrangement as disabling exclusion, as oppression, perhaps we might reconsider how we put interact, how we plan those kinds of events, and more broadly, how we include people with different ways of life.

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