A thought hit me in the half-awake time this morning: What addiction is -- whether it's a disease or a moral defect -- depends on where you are in the power structure. Walker talks a lot about power structures, where those at the top have the epistemic authority -- high-fallutin' talk for the ability to define themselves and those below them. One way this is done is by defining its own ways of being as the norm, so that anything deviating from that standard is thus seen as inferior. For example, she argues that a definition of rationalism has been used to shut out women and ethnic minorities whose legitimate concerns are dismissed as signs of "moodiness" or "hot-headedness."
The nature of addiction became a source of tension between an ex-girlfriend and me. Her mom was a 12-stepper; I happened to bring up, just for consideration (and not necessarily in agreement), the arguments made in the episode of Penn & Teller: Bullshit! that took a skeptical view of 12-step programs and the notion that addiction is an illness. (Their take was that the way to stop drinking was to stop drinking; but again, I'm not endorsing that, as I have many problems with the way the libertarian Penn Jillette sees the world.)
Walker explains that power structures are preserved by what she calls necessary identities (necessary not for those upon whom they are grafted but for the interests of those defining the marginalized) and that those necessary identities are preserved in a number of ways -- what she calls epistemic firewalls -- that move the power dynamic out of sight or otherwise keep people from talking about it. Stereotypes are one useful tool for changing the subject or showing why it's only normal that "those people" would be at a lower level in the social structure.
Wealthy white conservative radio talk show host Rush Limbaugh is found to have a bunch of oxycodone and hydrocodone obtained illegally. Though he shows no mercy toward ethnic minorities and the poor if they drink to excess, use illegal drugs or abuse legal ones, he's allowed to go into a recovery program. He spends about an hour in jail before bail is posted; he keeps his radio show, eventually becoming for some time the de facto head of the Republican Party.
Wealth of course plays a part in Rush Limbaugh's not picking up an alias of Prisoner #12483649468345 or a new understanding of same-sex relationships during a stay in a correctional facility. But race is surely a part of it as well. Ask African-American actor Sam Jones III -- who played Pete Ross on Smallville and a recurring role on late-days ER -- once he gets out of the federal prison where he's spending a year for a small part in an oxycodone trafficking ring (and could have served up to 20 years).
Intent to distribute plays a role there, sure. But apples to apples, our society tends to look at a privileged person's illegal drug use or excessive drinking as signs of a disease called addiction and at a less privileged person's parallel activities as proof that "those people" make poor decisions, lack moral fiber, are naturally inclined toward bad behavior.
Remember what Walker said about declaring a narrowly defined elite group's behavior as the rational norm. If addiction is a disease, then it can be treated through a process and does not reflect poorly on the moral character of the addict; it was the disease that missed the children's sporting events and sold the items bequeathed to the spouse by a deceased grandparent, not the addict himself of herself. But when the poorer addict missed those sporting events and pawned off items that the spouse had worked hard to buy, it's all on the addict.
These dynamics underlie much of our drug policy. Powder cocaine is imagined to be a drug of wealthy white persons, crack cocaine as the drug of poor blacks, and so there are vast differences in legal severity for possession of one versus the other. I imagine a look at the court system, specifically at who is allowed a pre-trial diversion to drug treatment, would suggest racial disparities as well. And while one need only look at death row to see how the color of skin affects sentencing for identical crimes, the readings in my spring course Mental Illness and Oppression in the United States also showed how a white person and a black person engaging in the same behaviors will be diagnosed differently by the mental health care system -- with the black patient always at a greater risk of being labeled violent, which again (Walker would say) illustrates a perceived and/or projected deficit of rationality.
Twelve-step programs do help some people. Some people are able to just quit on their own if they like. Dogmatically clinging to 12-stepping or dogmatically opposing it is naivete, either way. Until we solve the problems of inequality and human suffering that lead some people to a point where the only way they can see fit to survive is by numbing themselves, we're going to have the problem.