Toronto Mayor Rob Ford\u2019s been the pie-faced punch line since his blustery denials of drug use were disputed by video of him smoking crack. TV\u2019s Late Night with Jimmy Fallon, on the eve of the Thanksgiving Macy\u2019s Parade, even joked that the portly Ford does helium benders. After weeks of substance abuse reports that Ford furiously discounted, YouTube captured him partying on what he later conceded was cocaine. But the mayor of Canada\u2019s largest city denied he\u2019s addicted, downplayed its hold on him and disputed that his cursing boasts of bravado and manhood might be reasons for him to quit. \u201cAt this point, Ford doesn\u2019t believe he has a problem,\u201d observed Dr. David Sack, a nationally recognized addiction expert and CEO of Promises Behavioral Health. \u201dHe is in the pre-contemplative stage, meaning he likely hasn\u2019t given any thought to treatment and believes other people\u2019s concerns are overblown. A typical pattern with addiction, especially among public figures, is to deny, lie and then seek treatment \u2013 often only because treatment seems to be the lesser harm.\u201d Still Viable for Public Service? Amid a spectacle of international reporters and fascinated locals attending a recent Toronto City Council meeting, Ford\u2019s colleagues, except his brother Doug, voted to usurp him of most budget and staff authority, though he insisted he was still viable for public service. Ford last week told Fox News that he was "seeking professional help," but that he is neither a drug addict nor alcoholic. During his Ford Nation TV talk show with his councilman brother last week, Rob Ford made what might be the closest nod at contrition. \u201cI understand people were embarrassed by actions I made in the past,\u201d Ford said on the show, which premiered Nov. 22; it drew the station\u2019s largest audience but was cancelled for costing too much staff and an entire day to produce the one-hour program, according to the New York Daily News and other media. They quoted Ford saying: \u201cAll I can do is assure you, assure you, that I am changing my behavior.\u201d We asked some of our addiction specialists: What would you tell Ford if he walked in your treatment center door? Said Dr. Sack: \u201cIn treatment, we\u2019d start off with a comprehensive assessment to determine the extent of his drug and alcohol problem, if any, and whether any co-occurring addictions and\/or mental health issues are present. If any of these issues goes unaddressed, the risk of relapse increases significantly. Dr. Sack said that part of treatment involves understanding what motivates a person to seek help, why he or she thinks others are upset with them, and setting realistic goals. \u201cThe good news is that even if treatment is precipitated by a public fiasco or is initiated to repair an image or appease someone else, it can still be effective,\u201d Dr. Sack said. \u201cWhat matters is that once he gets into treatment, he\u2019s open to considering how it can help him.\u201d Public figures disgraced by their addiction-driven or compulsion-driven behavior are, by now, notorious: New York Atty. Gen. Eliot Spitzer\u2019s prostitution patronage; New York mayoral candidate and former legislator Anthony Weiner\u2019s sexting photos, and an early mayoral crack abuser, and the frequently cited case of Washington D.C.\u2019s crack-using Marion Barry. Getting Past the Guilt \u201cWhen high-profile individuals come to treatment, particularly in the wake of a widely publicized scandal,\u201d said Sack, \u201cone of our goals is reducing the guilt, shame and remorse they often experience. Left to fester, uncomfortable emotions like shame can lead to more self-medicating with drugs and alcohol, thereby perpetuating the addictive cycle.\u201d Dr. Jason Powers, regional chief medical officer for the Right Step treatment center in Houston and Promises recovery center in Austin, part of Promises Behavioral Health, said hope is an important factor in recovery. \u201cThe first step in change begins in our minds,\u201d Powers said. \u201cWe must first believe that we can change before anything else happens. And, hope is key because it is a powerful motivating force and is common to all therapeutic modalities.\u201d Powers said that he would remind Ford that just coming to treatment or participating in this type of self-improvement means that he has at least enough hope to motivate and energize him. Whether Ford will acknowledge a need to seek professional help is unknown. According to a New York Times piece, Ford \u201crode to power in 2010 on a populist wave of suburban rage after 10 years as a city councilor,\u201d and \u201chas a long and well-known history of profane, intemperate outbursts. But his recent behavior, which has mortified many of his constituents, has also enhanced his appeal with many of his core voters \u2014 working-class residents of the unified suburbs, the people he calls the Ford Nation. \u201cBut in the six months since The Toronto Star and the website Gawker first reported viewing a video of the mayor smoking crack,\u201d the Times continued, the anti-tax politician\u2019s \u201csupport has plummeted among the wealthy conservative voters in the city\u2019s core.\u201d The ridicule of Ford in popular media has caused his name to trend on Twitter repeatedly, and spoofs of the hefty mayor are all over the Internet, from late-night comedy sketches on mock news like \u201cThe Daily Show\u201d and \u201cThe Steven Colbert Report\u201d to \u201cSaturday Night Live.\u201d He\u2019s become an instant caricature of excess reminiscent of the obese late comic actor Chris Farley, who died of an overdose in 1997. Dr. Sack views this as a window of opportunity for Ford: \u201cIf Ford indeed has a drug problem, this could be a powerful time to get help. To help break through denial, we often recommend that loved ones stage an intervention after a serious negative consequence occurs, such as a DUI charge or arrest. This helps the individual recognize the consequences of their drinking or drug use at a time when it\u2019s difficult to minimize or rationalize the problem. Although the spectacles that have unfolded in recent weeks are unfortunate, they may be the types of consequences that will help Ford move past denial and agree to treatment.\u201d Finally, we\u2019d encourage him to give treatment a chance. We recognize that addicts don\u2019t necessarily want to be in treatment. They may feel conflicted about giving up drugs and alcohol, and their commitment to recovery may waver throughout their stay. All of this is normal. We do not ask anyone to pretend to feel otherwise.