There is also a concern - valid in my opinion- that the pharmaceutical lobby has a vested interest in the redefinition of "eccentric" behaviour as a "disorder", whereby existing drugs which suppress such behaviour can be prescribed to "treat" it.
The list of persons contributing to the DSM who have (or have at some later time acquired) financial connections to drug companies is longer than makes some interested laymen comfortable.
Now while I agree the marketing of the drug industry does have an impact on the culture in a society, I question what the impact is on the DSM, many if not most of the diagnostic categories have remained stable DSM II through DSM IV, it is not as though they just come up with new ones all the time.
And in fact the tentative categories seem to be shrinking, in the Axis II area the potential PDs have decreased.
Now as for the rest, it all comes down to functioning, if you function in your enviroments of choice then fine.
Now in strict terms there is a spectrum, there are disorders that are strictly behavioral (most paraphilias), some that have mixed causes but behavioral pattersn (addictions) and those that have a larger biological component and a smaller behavioral component.
But the fact that lay people do not understand something does not mean it invalidates a concept.
The cure for addiction is not is labelling it as a 'disease' or 'illness' something not usually done by professionals, the change that is needed is making choices to avoid use, stop use and get help.
The biological vulnerability is a causative explanation not an excuse.
the helplessness of the addict is that :
If they choose to use they will keep using, that is what they are helpless in, stopping. They must admit they can not control their use.
They are not helpless to not use, they are helpless if they do use (or at least drowning in the shallow water).
The 'cure' avoid use, identify when you are going to use and avoid it, plan to avoid it, plan to stop if you do use, get help.
