Is Addiction Really a Disease? A Challenge to Twelve-Step Programs

For most of America, having a disease means having a foreign body assume residence in the biological tissue, multiplying itself and attacking the surrounding healthy tissue. This idea is a direct result of the discovery of microscopy and the bacterial origin of many afflictions. The metaphor here is war, and all good doctors are on the front lines, battling leukemia, eradicating AIDS and other serious illnesses. Sometimes we cause the war ourselves and sometimes we are simply invaded. But where is the infection in addiction? To what can we actually point?