The use of drugs by patients with addiction is most appropriately seen from the perspective of "solitary self-treatment of an individual who cannot be cured by other people and faces difficulty in daily living". The patients tend to have a low overall self-esteem, to possess a sense of self-denial and shame, and to have a strong sense of anxiety about being abandoned and cannot open their minds to anyone. In recovering from addiction, it is essential to change oneself first in order to enable curing by others by building a trusting relationship with them. Accordingly, " a safe place where the individual can tell the truth(speak one's mind)and where confidentiality is protected" is required. In particular, because the use of stimulants itself is a crime, patients cannot see a doctor out of fear of being reported(notified to the police)despite the need to do so because of their own inability to stop using stimulants. The importance of confidentiality protection was reported in the case studies of "Welcome to outpatient clinic", "LIFE program", "Self-help group(Narcotics anonymous(NA)", and "Drug addiction rehabilitation center(DARC)". Harm reduction provides support for the difficulties faced by a patient, irrespective of whether the patient is using drugs or whether such use is illegal. The underlying basis of addiction therapy is not to "aid patients to stop using drugs" but to "help with difficulties in daily living"that are external to the abuse. The use of drugs by patients with an addiction should be considered keeping the "the symptoms" in mind, which must not be punished as "evil", but used to set patients on the path to recovery. Protection of confidentiality is called for as a minimum requirement in the attitude of therapy providers and forms the basic lifeline of therapy. A trusting relationship cannot be built, and recovery cannot be achieved, in a place where confidentiality cannot be protected. "People who can be trusted", and "a place where one feels safe and secure" are necessary for recovery.
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