Always great to get your input on this subject, Jeff! Total respect for your continuing to try to help people caught up in this, I don't know how you keep doing it for so long, it must be the successes that keep you going!
I realized that as I was reading your post that what you do isn't too far off from coaching High School athletes. Most aren't going to achieve the levels that they hope for, but some will, and often it's the amount of effort and focus they're willing to put in to succeed along with (in track) a fair amount of genetics that help give them the edge to succeed. I imagine that genetics can play a role in treatment, as well, with some more predisposed to be addicted to something than others.
It seems you have a similar passion for this as I do for coaching Track.