What do you believe carries more stigma: the
concept that somebody who misuses/abuses
substances does so by choice, or the concept they
repeatedly do so because they have a disease?
In rethinking the issue of which carries more stigma, the courts have historically viewed addiction as a choice, not a sickness. Thus, people with addictions have gotten jail time instead of the professional help they need.
Attempts to destigmatize addiction by advocating it is NOT a "sickness", "condition", "ailment" or treatable "disease" hold individuals with addictions
accountable for their behavior. The cost,
unfortunately, is the loss of compassion and
understanding for this population and their families
who are grappling with habitual behavior and its
consequences.
When we fight for the human rights of those affected by Substance Use Disorders (SUD's), we need to improve the public's understanding that this is a bio- psycho-social condition. Otherwise, advocates who assert that repeated addictive behavior is a choice face harsh stigma and judgments from the public at large rather than empathy and appropriate treatment
options.
The conundrum: whether you buy into the disease concept or not, it may hold less stigma than the claim that SUD's and other addictive behaviors (such as compulsive gambling, debiting, gaming, sex, etc.) are by choice.