Thanks for the reply
I've always suspected that there is a psyc component that makes it additionally difficult for him to regulate his behavior. Specifically, I think he is Bipolar. He has a family history of the condition and has acted in very erratic ways since we were really young kids.
I made the decision to help him this time because he reached out to me for help. His comment is that his decision making process doesn't work and that he desperatly wants to change and doesn't know how to begin to do that. What has been tried hasn't worked, so I'm looking into alternatives.
I realize I can't do anything for him, but I can help him frame the decision. Please feel free to tell me I'm doing the wrong thing if you disagree, I'm just doing the best I can and would love knowlegable opinions from anywhere I can get them.