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I disagree that willpower plays any part, certainly if a patient is up to a bottle of spirits a day - any more than willpower has anything to do with healing a broken leg.
The treatments carried out by the Sinclair Clinic in Espoo showed 70% of alcoholics who were approved for naltrexone (the toxic one) had got their drinking down to manageable levels within 6 months. As long as they took the blocker before drinking, they continued to recover. And many of these patients were bottle a day types.
The main problem is that for these people, drinking dominated their lives, and when that behaviour starts to be erased, there is a behavioural void for which counselling is needed.
But theoretically, opioid blockers work in such a way that IF every alcoholic drink contained a small does of nalmefene, nobody would become an alcoholic. You can't be me, I'm taken
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