Addiction medicine is a field unlike any other....patients know that there is something wrong, that they want to change, but often do not know what to do next. They will come to either a primary care provider or an addictionist to seek help. Often they will not welcome the news that they will hear; that they need to discontinue the medications (opioids, sedatives or stimulants) that they believe are helping them; that they may need to go to treatment, sometimes for weeks to months, and that they need to continue supervision for an extended time. The suggestion that they go to twelve step meetings or take medication is often rejected immediately. It is also no surprise that there is also an urge to "shoot the messenger". You will see all of this in the reviews on me or any addiction specialist! My philosophy is that I am here to offer help; it is OK to decline, and the "door is open" for the future.