As an elementary teacher, one important concept that I teach my students is the "pivotal moment", where I have each kid write a journal about the day/event that the “conductor snapped out of his daze long enough to switch tracks and take the train in a better direction.” (yes, we had just learned about analogies). We all have epiphanies (big, small, important, unimportant, acted on, and not etc.) Our Pivotal Moment is when the stimulus, or cause is SO strong that we realize at a deep internal level that, though difficult and sometimes painful, we MUST make changes, often radical changes immediately, or watch our lives self-destruct.
With me the stimuli (pivotal moment) was the often expressed concern by both of my parents, and family regarding my drinking habits, and the havoc it caused in relationships. Then I had a friend come stay at my condo “until he got a job” (never did), and we would play crazy hard-core drinking games until 4am, regularly throughout the week. This had a severe draining effect on my adhd, my health, and my bank account, as I bought all the booze (over $$2300) while he just drank it, and slept on my couch. At this point I admitted inwardly that I had very little ability to say 'no', not just to booze/weed, but to manipulative pseudo-friends who prey on people like us. Being open and approachable, spontaneous, with the "naive little kid inside", makes us extremely prone to manipulative, self-serving people; and trust me, they can spot us a mile away, and when they work their way into our idealistic minds, it's an easy kill for them (but they play with their catch for a while just for sport, and once it’s in pieces they move on to the next one). 
Ever heard the saying that lessons are repeated until learned? This is SO true with all aspects of add, especially relationships and social skills.
I am learning that effective coping with adhd is comprised of the accumulation of many little steps forward, many backwards, some slips, taking the initiative to snap one's self out of periods of inertia, being mindful of the power, and the potential impacts of every single decision; from the smallest to the biggest decisions. Mustering up the decisiveness to do this is VERY foreign, scary, and extremely difficult for an adhder to do (that's why so many adhder's end up in relationships with the Mother/Protector types. The protector takes them on as a quest, or charity case, and tries to change them into the kind of person they themselves are having difficulty being. Problem is, any decision made without ownership (i.e. due to training wheels) is not authentically yours, so when the day comes that there is no one to rescue you and you have to do it yourself, you become paralyzed by indecision, and the fear of failing and having no one to pick you up.

Some only need a little hurt here and there before they grab the reigns and take control of their minds/lives to lead them in the right direction. Others (myself included) need years of frustration; numerous heartbreaks (loss of friendships, consistently failing relationships that most often can't even make it past 4 months); years of self-destructive coping strategies (booze, drugs, affairs , gambling etc), that can easily take over your life, increase the frequency and intensity of arguments, and the predictable repeating pattern failed of relationships, job problems, money problems, and perhaps most importantly, the disintegration of their already low self-esteem.

 For me it took several lost loves (and when I fall for someone, I fall HARD), including two canceled engagements; MAJOR job problems, never-ending financial problems (much of which could be attributed to drinking excessively on a regular basis) etc. Eventually it seemed like everything was slipping through my fingers, and I had nothing good to hold onto; no hope. That's when the pilot light ignited the desire to change my life, and the only way to do that is take a long, deep, hard and honest look into yourself and the repercussions of years of bad choices. The impact my escapist/coping behaviours had on friends and family, my health, finances; everything and everyone in my life in some capacity was affected negatively by the things I did and shouldn't have, as well as the things I didn't, but should have. Even after having found effective meds, I still continued to resort to the booze comfort; it was WAY out of hand, like 8-10 beers a night minimum (whether alone or with someone), about 5 or 6 days of the week. I researched Revia (naltrexone), a drug used to combat heroin addiction, and found studies of its potent effect on alc. craving/consumption. I printed the journals out and gave them to my Doctor. I would not take no for an answer. He said he hadn't heard of it, and will discuss it with colleagues. I told him ok, while you do that, I’ll be drinking a 40oz a day until I hear back from you. Ok, so a 40 a day was an exaggerated bluff and I felt bad for dropping a guilt trip...but he gave me the prescription. Revia was the first major disruptor of my regular pattern of alc. abuse. I visited my folks in Mexico, and they both told me they were worried about my drinking, that they thought it would eventually kill me. That was one of the rare times I have seen my Mother cry. That has a tremendous impact on most "mama's boys" (which I am proud to say I am), and of course it was amplified by the emotional nature of adhd. I felt SO bad, and it became clear that day, that the tears she was shedding were out of love, fear, and the desperate futility of trying to help me change my self-destructive ways. She looked so sad and helpless, and when I hugged her, I could feel the pain in her heart that I had caused her. My eyes are all welling up just typing this, because the shame I felt (still a vivid memory) for hurting the one person in the world who loves me more than anything, unconditionally, and whom I love more than life itself. That was the final lesson/cue, whatever. Now I rarely drink, and when I do it's only one or two. It was easy to quit once I reached that pivotal point; as was quitting smoking and stopping weed. Learning to acknowledge when I have wronged someone, AND apologize for it is a bit more difficult (esp. Being a Leo), but it’s a continuous learning process and I have committed to it.

Sorry if that got repetetive!