I disagree with a few points. First the substance abuse of course induces brain changes, which create problems. However never underestimate human willpower. I am a bit perplexed that the greatest obstacle is that the addict identifies as an addict and has to drop this self-image. The very essence of addiction is the denial. In my experience the addict believes to the end that he has control. There lurks also a dangerous concept around by not calling the addict an addict, like in India apparently, they can come back to social drinking. This, as of the brain changes by the substance, is no longer possible. The very idea of continuing the use of a substance, which nearly ruined one’ life, is already an oxymoron. To blame the life circumstances is considered one of the classical games by the anonymous alcoholics. Principally in it’s severe and self destructive form, addiction has always a basis in a severe early disturbance. So the concept of “poisonous milk” and relationship to the dead object etc.. This certainly needs to be dealt with after the addiction is discarded. I am a bit wondering what happens after the therapeutic community in the real world.