Why do addicts refuse help?

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There are a number of reasons an addict refuses to get help, or accept help from others. Unfortunately, the most prevalent reason help is not sought out or accepted is due to the fact the addict is being enabled in their addiction.  This means they are not shouldering the burden of their addiction alone, but distributing it amongst many friends and family. As long as their "problem" isn't entirely their "problem" they have a successful enabling system to help their life work addicted. This is why it is so important that interventions take place. Family and friends often need additional support and tools to learn how to stop the enabling process and give the addict the choice to quit with a list of consequences if they don't. It's finding a way to hand the problem back to the addict. It may involve extreme changes in everyone's thinking, and lifestyle but the sooner an addict realizes his safety net is gone, the chances of him getting the help he needs increases.
Additional reasons may be the addict is self medicating with the use of drugs and alcohol to mask an underlying problem. These problems can be deep seated emotional issues, current physical problems and in some cases mental illness can be the cause. Addicts become addicts because they are very good at being in denial. When the human mind is caught in emotionally traumatic situations, it will try to find defense mechanisms to cope with the trauma. It is different with everyone, but for addicts the coping mechanism initially is denial. Once that mechanism is in place, there is usually a mental breakdown, as the mind can only remain in states of denial for so long before it needs help from an outside source. In walks alcohol, and drugs. Now add to this  guilt, and pain, and you have a perfect recipe for addiction. Most alcoholics and addicts were exposed in their lifetime to alcoholism and addiction, and in some cases they suffered abuse by family members under the influence. This is why the condition breeds out of control. Addiction casts a long shadow over many lives. Lastly, fear could be a major factor in why an addict will not seek or accept help. Remember an addict has forsaken the ability to think and feel rationally and fear of quiting something that has been used to modify feelings, emotions and personal responsibility is a scary thing. Its like giving up a medicine that you are sure is helping you...an addict will think there is much that is sacrificed to "feel" better, but they are certain it is worth it. Many also believe they can quit if they "need" to. Unfortunately they don't have the rationale to realize that "need". There are, with all addicts,  many layers that must be dealt with to really understand and get them on the road to recovery. Friends and family will have to assume the role of doing the thinking for the addict, get them into treatment asap, with or without their cooperation. It may mean getting them arrested, refusing to assist with any more financial support or anything else that has been done to assist them in their life. One thing is for certain, addicts can not stay addicted with out help. They also wont live long with out help. Its what kind of "help" you are going to give them that will make the difference.