You Should Know

Yes, Disulifram is the oldest of these, been around many years, and some chronic alcoholics just drink over it and power through the hangover

Naltrexone is the one I have heard most positive things about, never even heard of Acamprosate before.

Unfortunately when I was in a relationship with an alcoholic some years back Disulifiram was the only thing doctors here were even aware of.

Baclofen has also shown promise as adjuvant to naltrexone, I believe.

Hows he doing currently?

I went cold turkey and the first week felt like a nightmare. I know everyone is different so a multitude of options is very good. Props to you for being a supportive wife. My wife helped me through my addiction immensely and I'll never be able to repay her for the amount of support she gave me. I'm 2.5 years sober now and feeling great.

I try to find ways to sho my thanks to her everyday and our marriage is significantly better because of me overcoming my urge to drink.

(Used to be 8-12 beers on work nights, drink until blackout on weekends)

Naltrexone cuts of the euphoria by blocking opioid receptors. Opioid receptors also mediate liking so you stop liking the experience because you're blocked at the time. Eventually, you stop neurochemically associating alc with pleasure and benefit. You just get the shitty impairment effects, no joy

Yes, referring someone to AA if they know it will not work for them is just stupid. AA may work for some people but it cannot and should not be the only referral or treatment option - medication is going to be a better option for many. Unfortunately its much the same here

I read that AA has an 8% success rate. It didn’t work for me.

Wellbutrin/Zyban/bupropion is FDA approved for smoking cessation. I was prescribed it for depression and found it helpful for that. At the same time, I was smoking and didn't know that it worked for smoking cessation. Shortly after starting it, I noticed that cigarettes no longer gave that calm feeling and tasted extra disgusting. I eventually stopped smoking because it wasn't enjoyable anymore and seemed pointless.

Bonus: it can make orgasms insanely intense

There are drugs that cure nicotine addiction in a majority of the patients that are not composed of "more nicotine".

If the experience of several of my relatives that smoked is a rule, way too many doctors actively refuse to acknowledge and prescribe them, and believe only "willpower" based abstinence (known to fail in the vast majority of cases) is a reasonable treatment.

I have no idea why doctors do that. The reasons from the article don't really explain what I see (the article imply doctors are universally corrupt). But be aware that this problem exists, and it's possible that you have options you don't know about.

Apparently they regulate brain chemistry - from the article;

Long-term alcohol abuse causes dysregulation in brain chemistry and neural function that can last for months or even years after the initial period of detoxification. Perfectly sober patients, who are well past the detox phase, often experience crushing levels of anxiety, insomnia, irritability, depression, loss of appetite, and anhedonia (the inability to take pleasure in any aspect of life). Addiction experts now believe these post-withdrawal symptoms are a driving force behind chronic relapsing.

I'm not sure how applicable these would be for nicotine addiction however, the article mainly discusses alcohol and drug addictions

I mean, I hate to go all Reddit on you, but read the article. It explains the whole thing.