This post from Points does a good job framing why, I think, so many people resist the concept of addiction:
Although addiction may be defined and operationalized in a number of different ways, the heart and core of the concept lies in its implication of the loss of the ability to choose – that is, the loss of free will. Hence, and logically, the concept of addiction also implies the actual existence of free will. And there lies the rub.
The addiction concept repackages one of the Big Questions – free will and determinism – into a new and seemingly more manageable form. But should we be entirely comfortable with the tacit implication that ordinary, non-addictive conduct is freely willed?
Of course, this assumption underlies much of our day-to-day lives. We show up at work late and we are responsible for the choices we made that caused our lateness. Our legal system relies on the same assumption as well. It assumes people freely do what they do and must take responsibility for their actions.
It seems to me that most of the brain disease resistance I encounter can be boiled down to protecting the universal existence of free will. People feel compelled to protect this for good reason, our social interactions and institutions depend on it.
Progress on acceptance of addicts and addiction as an illness depends on us continuing to find ways to respond to these concerns and make the case. We’re getting better, but we still have a long way to go.