For those that have tried several routes including Acamprosate, Naltrexone etc and more extreme measures and haven't found a solution (or haven't even gone as far as those options): find a doctor who will prescribe you Baclofen (Lioresel):
https://en.wikipedia.org/wiki/Baclofen off-label. If your doctor says they won't prescribe it to you, then call them a retard and find another and tell them to read the wikipedia page and do some research because its a fairly obscure/novel treatment that can have promising results for some people.
I used to be a prolific drinker and struggled with it a lot, I tried many things and was also on antidepressants (which I found to amplify the amount of alcohol I could drink and greatly increased my desire to drink). I only started drinking heavily after a traumatic event happened and found a sort of "superpower" when I did because it made my anxiety go away, I have a very high anxiety level naturally (and especially when going to social gatherings etc), I used alcohol to overcome that, but eventually it gets out of hand rather quickly and depressive drinking starts happening.
Baclofen is a muscle relaxant for people with spinal injury or multiple sclerosis. It's non addictive and not habit-forming (although with regular use can supposedly be a bit hard to come off of I have heard, but I don't know how true that is). It works on the same part of the brain that alcohol does (GABA). You can use it in place of drinking when going out and it makes socializing a hell of a lot easier and can reduce anxiety as well. Because it is not addictive/habit forming you can basically take it forever.
For hardcore drinkers you would probably need to taper off first or try to figure out how to take it without combining it with alcohol (ask a doctor)
The French have been using it for quite a while and it has had a fair few success stories. It's a very interesting medication and some guy wrote a book about how it cured his alcoholism, there have been a few studies that haven't been able to replicate its success so it doesn't work for everyone.
In the book the guy wrote (who basically found out about this treatment) I believe he took hardcore doses, but at least for me that wasn't necessary. It has dramatically reduced my interest in alcohol significantly, and especially in the early days I could actually go out to social gatherings and have zero interest in drinking. Because I take it daily though that effect isn't as great anymore but I have heard some people say that if you take it only 3-4 times per week you can keep that kind of effect. (If I want to have a drink, I just don't take the medication or wait 4 hours until it has left my body)
Some people get side effects, but I don't get any really (besides a small impact on my memory). It makes your sex last longer (for both sexes) and helps with anxiety for me (a lot more than any other medication did) and it can also cause euphoria (I'm not sure why they list that as a side effect). So your mileage may definitely vary.
The Guardian article I linked below explains a bit more, but the best part is that it doesn't require total abstinence (which many people argue is retarded to begin with anyway)
A lot of the studies and literature have crazy high doses, but I am on 75mg per day and have been for months and it works perfect.
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https://www.theguardian.com/society/2016/sep/16/baclofen-controversial-pill-cure-alcoholism
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https://en.wikipedia.org/wiki/Baclofen
There's a lot more literature available about it online, but its inexpensive and definitely worth a try.
