I tend to agree that addicts need to hit some kind of bottom where negative consequences outweigh the benefits addiction provides. For some people there may be none. The progressive illness has gone so far that they have reached a point of no return. Is it not our goal to prevent our addict to avoid reaching that point of no return? This I think can be done by a combination of a carrot and stick policy (provided the addict remains reachable). I don't think "all or nothing" thinking is what is needed here.