Practice Area – Services


It's Never Too Late

The Impact of Addiction
Many families have been affected in some way by addiction to alcohol, gambling, nicotine, illicit substances and eating disorders. It could be someone you know, heard about or someone in your own family. Dependency to alcohol and other drugs is an illness that has been surrounded by moral judgments and misunderstanding. Most people continue to think of addiction -- particularly to illicit drugs -- as a moral deficiency or character problem, something caused by immoral behavior or a lack of willpower.

Blaming someone for the illness of addiction does not help them recover and is often counter productive. It is understandable that people impacted by that addiction are frustrated and often unsure of what to do. Substance addiction not only destroys the person, but everyone around them. A chemically dependent person is unable to stop drinking or taking a particular mood-altering chemical despite serious health, economic, vocational, legal, spiritual, and social consequences. It is a disease that does not discriminate by age, sex, race, religion, or economic status. It is progressive and chronic and if left untreated can be fatal.

A person can also be addicted to prescription medication which they receive from a physician. This leads to the denial that since it is prescribed by a physician then it is legal. I am not an addict. The truth is that anyone can become dependent on prescribed medication. Have you ever asked yourself whether I need that extra pill? Am I in enough pain that I should take another pill? Am I so anxious that I need another pill to relax? Will that drink make the situation better or help me to cope? Has a family member ever asked you to slow down or stop your use? Do you avoid family or social invitations because of the annoying questions about your use? Are you isolating yourself from friends or family? Do you ever feel bad or guilty about your use of the substance? If you have asked yourself any of those questions there is a chance that you may need to speak with someone about it. Are you fearful of trying to stop or think that you can’t do it? You can do it and always remember that “It’s Never Too Late”.

The definition below from Webster’s New World Medical Dictionary may help to develop an understanding of the complex issue

Addiction: A chronic relapsing condition characterized by compulsive drug-seeking and abuse and by long-lasting chemical changes in the brain. Addiction is the same irrespective of whether the drug is alcohol, amphetamines, cocaine, heroin, marijuana, or nicotine. Every addictive substance induces pleasant states or relieves distress. Continued use of the addictive substance induces adaptive changes in the brain that lead to tolerance, physical dependence, uncontrollable craving and, all too often, relapse. Dependence is at such a point that stopping is very difficult and causes severe physical and mental reactions from withdrawal. The risk of addiction is in part inherited. Genetic factors, for example, account for about 40% of the risk of alcoholism. The genetic factors predisposing to addiction are not yet fully understood.
Webster’s New World Medical Dictionary Last Editorial Review: 10/3/2003

The disease model doesn't mean that the person addicted cannot stop using that substance- only that doing so is difficult and often requires treatment and major lifestyle changes. In 1956 the American Medical Association identified Addiction as a disease that causes changes in the brain, which then drive certain behavior -- taking that substance compulsively – but anyone addicted to whatever the substance can learn to change the behavior. Treatment and recovery from addiction are possible. It is time to start living your life as you wanted to but was changed due to addiction. A chemically dependent person does not use their substance to feel good or to feel bad but simply not to feel. Achieving sobriety is not about a bad person becoming good but instead a sick person getting well. There are also clients with diagnoses of abuse and co-occurring disorders.

Co-Occurring Disorders

Clients diagnosed with co-occurring disorders have one or more disorders relating to the use of alcohol and/or other drugs of abuse as well as one or more mental disorders. A diagnosis of co-occurring disorders (COD) occurs when at least one disorder of each type can be established independent of the other and is not simply a cluster of symptoms resulting from the one disorder. Many may think of the typical person with COD as having a severe mental disorder combined with mild- to moderate-severity mental disorders; an example would be a person with alcohol dependence combined with a depressive disorder or an anxiety disorder.

Substance Abuse Treatment for Persons with Co-Occurring Disorders.
TIP 42 U.S. Department of Health and Human Services.
Center for Substance Abuse Treatment.

Also known as Dual Diagnosis – substance abuse problem & psychiatric problem. Dual diagnosis – chemical dependency treatment community. MICA (mentally ill chemical abuser) in the mental health treatment community.


  • Geriatric Addiction
  • Co-Occurring Disorders
  • Drug/Alcohol Evaluation
  • Group Therapy

  • Gambling Addiction
  • Nicotine Dependent
  • DWI Evaluations
  • Individual Therapy

“Mr. Koffler’s program is one of the few programs of its kind in New York City”

- NYU School of Broadcasting & Journalism documentary January 2005