one of the main failings of the disease model of addiction is that it doesn't actually say that drug use or alcohol use is morally neutral. it says that people who do them cannot help themselves; it's not "their fault".
which still maintains the belief that drug/alcohol use are, fundamentally, Bad, just some people have Diseases which Force Them To Do Bad Things. it actually fits very neatly within reactionary + puritanical beliefs about drug/alcohol use + the benefits it has for reducing stigma/violence against ppl who use drugs (which it has evidently done, to some extent!) are limited by this
expanding on what i said in replies- the disease model was once a very important step in prying our culture away from the idea that drug/alcohol use == purposeful deviancy. it helped others understand the complex biological mechanisms of addiction to certain substances (such as opioids). it released drug/alcohol users from some of the intense shame + opened the doors for treatment to be offered in a less judgmental (+ insurance funded!!!) context.
all of this being said, based on my experience in the field + with the research, the disease model is not on a trajectory to undo itself in the interest of more liberatory + less individualist models. very few people are approaching it as a "stepping stone".
the trajectory it is on is one that leans towards bioessentialism (ppl who "abuse" drugs/alcohol as biologically flawed in some way, fundamentally different from others), demonizing substances based on cherrypicked research (drugs like opioids or crack cocaine as so inherently dangerous that a single dose can "corrupt" ppl + "turn them" into addicts- do you see the religious rhetoric in here, recast?), + coercive/paternalistic approaches (addicts are biologically incapable of making the "right decisions"/addicts have the "brains of juveniles"/use of medical approaches such as methadone to force ppl into more socially acceptable forms of substance dependence, ones which can exert significant power over individuals.
this trajectory minimizes or abandons approaches that emphasize harm reduction, autonomy, decriminalization, structural/social response, + removing the moral taboo on drug/alcohol use. i have faith that we can empathically acknowledge that the suffering that can come from drug/alcohol use is almost always outside of the sufferers' control, mired in biological realities, + not a moral failure, all without forcing ourselves into the dead end project of the disease model.
