Addiction to Laxatives

- I am not sure to treat as an addiction, for constipation, for emotional anxiety issues.

Based on your short desc above, it may be nessesary to treat for all 3. IMHO clearly addiction is an "emotional problem", so that brings it down to 2. After years of laxitive abuse, it is likely they will have a problem with constipation. Whether it is a "weight loss issue" or not, also IMHO, is moot. Based on my exprience in treating a few individuals with TCM and eatting disorders, you cannot council someone out of it. I doubt this would be any different. Its not your job. They MUST find someone (ie professional councellor) else to help with that. Or you can refer them to someone.

I am guessing after years of laxitives, she/he has a condition of vacuity constipation, so treating the root of that problem with Blood, Spleen, Yin tonics, etc as nesseary will help ease the physical need for the laxitives without nessesarily promoting more "laxitive like actions". Ie, not using more purgatives type herbs (unless they are very specifically called for). Its not your job to assist them in purging, but to get regular bowel function back.

Inform them that your herbal treatment is unlikely to work if they continue to abuse other herbs/ drugs. You cannot help someone who does not want to help themselves. Not as a TCM doctor at least.

Obvioulsy your tx should take into account there emotional state/ tcm pattern as a whole. Bob Flaws has a good psych book (which you could probably even borrow from someone else, but thats really just a starting place. The formulas need to be carefully modified to the patients condition, esp regarding the nature of the herbs in purging stools and lubricating the bowels, etc.

Acupuncture could also be helpfull. At least with the acupuncture, your tx would not be as effected directly by the patients intake of herbs/drugs (in the digestive sense), but again, as long as they continue there behavour, it will be difficult to tx. Acupuncture needs to be very frequent. Not this once or twice a week idea.

Most importantly you can continue to suggest councelling. The idea of purging stress, anxiety or emotions with drugs/laxitives/herbs is a psychological problem that needs to be addressed directly by a professional in that field.

It is a really difficult position to see someone who you know hurt themselves, but ultimatly, they need to want to get better before its going to happen. Just being there to listen (but not council or enable them), can be helpfull. Just remember to keep your own boundries and not take there problem onto yourself.

I could go on and on, but really that is gist of it.

Can you elaborate on there S/s ?

How 'bout treating the patient's presenting pattern(s)?