How do you ask your doctor for help with an addiction that does not require hosptilization and trust it remains confidential even with privacy laws?

A doctor is bound by doctor patient confidentiality. They cannot discuss your diagnosis or treatment with anyone else without your permission. In the US, that confidentiality is covered by HIPAA.

In my experiences. Your Dr. can not supply anyone with information, no matter what it is, with anyone. Not even the law. You should definitely tell him about the addiction, and ask him for help. It could get much worse. And the longer you wait, the harder it will be. There are a lot of medications out there that can help. Just be careful, because being an addict myself, I will tell you that it is so easy to switch your addiction from one to the other, without even knowing it. It's a lifetime struggle, but well worth it. I am not a Dr. But in my opinion, it is a big step in the right direction posting this question for advice. Good luck to you, and God bless.

Keep it from who ? Your insurance company ? Pay cash

But also it is your opinion you don't need in patient, many times it does.