In America, largely due to the isolation of our parishes from one another and influence of Protestantism, our communities tend to be 'parish-centric.' Our view of the Church really involves our view of the parish, and the rest of the Church is seen as a distant, but perhaps influential, extension of the parish. Priests are expected to 'run' their parishes and provide for all of the needs of the community, supported at a distance by the bishop and occasional extras from the diocese/eparchy/jurisdiction.
Priests are expected to effectively carry out teaching, preaching, spiritual counseling, elementary marital and pre-marital counseling, youth counseling & 'youth ministry' along with handling the occasional parishioner with an addictions issue. I say 'occasional' because most addicts will hide their addictions from their priest at all cost or will leave the community when it becomes obvious. Most of our communities do not do well with encouraging repentance, mostly because of the shame-based cultures of origin. As a single influence on the group, the priest is not only over-stretched as far as talents necessary, but also numerically outnumbered when it comes to changing the shame-paradigm to an ascetical one that encourages repentance rather than shame and indelible stigma.
Being outnumbered, the priest is simply not going to do all of his jobs effectively. That's why the traditional model of the Church as always been the eparchy (we here, for some reason, continue to call these larger units 'dioceses' though this is not what they are). Within our dioceses/eparchies, the bishop presides over a number of parishes from which members can easily pass without having priests complain that Father X is 'sheep stealing' and parish councils are wondering if Mr. Y is going ot fill out his pledge card here or somewhere else.
Such a system also allows for the creation of larger ministries. Addictions counseling by a dedicated, or at least talented, person can be provided for all of the parishes. Father X does not have to struggle with all these various forms of counseling, and he can refer people to specialists within the eparchy/diocese for help when he discerns the problem is beyond his abilities to handle on his own.
This is how the Romanian Orthodox Church is handling addictions: all the priests are starting to receive education in addictions, but treatment is being handled by the eparchies and metropolitanates. In rural communities, the priests are being encouraged to start AA and Al-Anon groups, but only 'get the ball rolling' and then let the recovering addicts self-manage their meetings and provide their own sponsorship. Of course, the Church is providing the materials, guidance, and encouragement.
What the Romanian Orthodox Church has discovered is that the Orthodox Faith is a powerful medicine for healing addicts, but they must begin with educating their communities and removing the stigma from addiction so that addicts stay in the Church and get help. They are making good progress.
We here in America have the advantage of being surrounded by 12 Step groups, who often help our parishioners even before the priest even knows about the problem. But, what this has done is allowed our parishes to become isolated from the problem of addiction, expecting someone else to handle it. This is a false idea: addiction is a spiritual disease, so where better than in the Church? Why are we not seeking to help addicts, given the gift of the Tradition we have received?
Again, this has a great deal to do with the expectations of our communities that our parishes are 'ours.' We do not see beyond our few families. In order for us to better treat addicts, and offer addicts the Gospel and the healing of our Lord Jesus Christ, our bishops really need to step in and start educating and providing local treatment options for both Orthodox and non-Orthodox. We must evangelize and re-evangelize.
Such a massive change in expectations must come down from the hierarchy. Priests and parishes cannot do this on their own. While a few isolated parishes might 'get it' and offer help to addicts, a vast majority don't know how. They might even not know that it is possible.
Until this happens, it is important for Orthodox Christians to prepare for this change:
1) Learn about addictions by reading about the 12 Steps (Fr. Meletios' book is a good starter: http://www.amazon.com/Steps-Transformation-Orthodox-Priest-Explores/dp/1888212632/ref=sr_1_1?ie=UTF8&qid=1324571300&sr=8-1 )
2) Talk to your priest and community about what your parish can do to open itself to helping addicts. You may find that by opening the topic you have more than a couple of addicts in your parish that have been afraid of being 'found out' and shamed.
3) Open your parish to hosting a 12 Step recovery group such as AA, OA, or NA.
4) Ask your bishop to consider guiding all of his parishes towards a new understanding of addiction as a spiritual disease and bringing in recovering addicts as a type of evangelization.