It comes down to will power because without will power, you can have all the other ingredients of therapy, and the abuser will still fail. This makes willpower the intregral ingredient, the one ingredient that sobriety cannot succeed without. What you describe is compulsive behaviour. A person who has lost control of themselves, have lost their instinct for survival over their dependence on one thing or another, in this case a substance. The one thing that is missing is willpower to stop. They need to get it back in order to regain control. This is both simple in theory and the hardest thing in the world to accomplish.
What you say is true, many abusers, will die if they go cold turkey. Nothing new here. That is why there are withdrawal unit drug protocols, whole cocktails of drugs given to the patient in order to get them through the initial stages of abstenance. Sadly, alcohol being a legal drug and easily obtainable, many alcoholics wait too long before seeking help and die during this phase. Their organs are shot from years of abuse and they can’t handle it. Rehabs lose more alcoholics than any other type of abuser this way. So, what’s your point, Glopro? The same result would occur soon in the alley.
After the initial stages of withdrawal, comes the communicative stage, where the abuser is sober and can begin dealing with the problem. Very few of these people simply got caught up in a cycle of partying and one day found themselves dependent. There is always a backstory to self medication. And this has to be dealt with, confronted, and it takes courage to do this and willpower to not go running off and self-medicating, thereby avoiding the process, ending back at square one, and back into that cycle of destroying themselves and all the people around them. Courage. Will Power. The cycle of compulsive behaviour cannot be broken without it.
I think you mentioned once that you’ve worked the ER. I have respect for that, as so have I. Then you know that when someone comes in, say, a guy who fell face first into a powered-up outboard motor prop while he was flushing out the saltwater, you don’t get all freaked out at the fact that there is nothing left of his face but burger and gristle, because you’re too busy setting the IV access for the MSO4 and at the same time looking for a significant bleed coming form the damaged areas. The MSO4 is as much for the patient as it is for the medical team, because as important as it is to relieve any suffering the patient may be experiencing, it is also necessary that the patient is not thrashing about, resisting the medical team while they are attempting to address the most immediate problems. The MSO4 not only helps to reduce the pain levels, but by doing so, we get a more cooperative patient to work on. We need a modicum of cooperation in order to get this person through.
It’s much the same with treating abusers. You don’t get emotionally hung up in all the bullshit, the sad and horrible things they often do to themselves and their loved ones, you treat the problem. And in order to do this, you require their assistance. They have to have the will to get better, through that will they must find the courage to confront and make sense of all that bullshit describe above, or you are just wasting your time.
I’m sorry, but you sound like someone who is still in shock after their first visit to critical care psych unit.