In contrast, today, descriptions of “brain disease” imply that people have no capacity for choice or self-control. This strategy is meant to evoke compassion, but it can backfire. Studies have found that biological explanations for mental disorders increase aversion and pessimism toward people with psychological problems, including addiction. What’s needed now more than ever, with overdose deaths on the rise, is not fatalism or dehumanization, but hope.

I am not saying that addiction is not a real problem, and as a person in addiction recovery, I would never deny that it is a problem of profound challenges with self-control. I know that for some of my peers in recovery and their families, the disease analogy helps them make sense of those struggles and the terrifying breakdown of reason that comes when people cannot seem to change despite their best efforts.

There are innumerable ways to make sense of addiction and many paths to recovery. But the view of addiction as disease fails to capture much of the experience of addiction, and disease language is not necessary to make the point for humane treatment.