I don’t feel it is conflated with taking responsibility for the disease at all. Over and over I’ve heard people in recovery say that step 4 is a moral inventory, not an immoral inventory. Alcoholics are distinct in 2 respects. 1 is we avoid taking responsibility while in active addiction. 2nd, there is a correlation between alcohol or drug addiction and harmful behaviour that doesn’t exist with other medical conditions. To use your example, I’ve never heard of anyone linking bad behaviour with their Crohn’s disease.

I don’t know which recovery groups are giving you the impression that there is a conflation between taking responsibility for bad behaviour and taking responsibility for alcoholism, but I suspect they are doing it wrong. In my experience the phrase, “we are not bad people trying to become good, we are sick people trying to become well.” Taking responsibility for one’s recovery is not the same thing as taking responsibility for one’s disease.

I have heard people refer to the “shame method of abstinence” but I honestly don’t know where that comes from. Certainly not the big book of AA.