What pressures does the addict feel?
The addict doesn't necessarily share the same beliefs about their substance abuse that non-addicts might. For instance, he/she may have semi serious health problems, lack of friends and job or income but feel like they are "doing OK". Many addicts have actually overdosed on drugs coming very close to death and are right back using drugs the very next day.
This may appear crazy but in fact is only part of the pain for the addict. With this in mind, the addict from time to time will encounter added pressure, which forces them to make an actual decision about whether to seek help or continue to use. Pending legal charges that could easily lead to jail time, threat of losing spouse, pending loss of job, all are possible situations where a person has enough pressure to fight their compulsions and seek help.