While it's optimistic as hell to think Ralph would actually follow through I think he genuinely wants to get better*. He sounded on the verge of tears through the 2nd half of that speech to the point of if it was anyone other than Ralph I would actually feel bad for them.
Unfortunately for Ralph, it's clear to anyone paying attention he's only wants to get better as a "See I can do better!" move to try and get Faith/Amanda/Any of his other burnt bridges to come back. So even if he does get better, once he realizes they're still not coming back he'll most likely fall back into his old ways.
*Until he actually has to put in effort and realizes it'll be easier to just give up and relapse.
(warning: lengthy post about addiction/rehab/detox/psychology stuff)
Can't state this enough but if someone is trying to get sober to "own the haters" or purely to try and rekindle relationships that they've fucked up previously then they probably have deep issues that it won't resolve (I know that this probably goes without saying the case of Ralph even though I'm not super familiar with him). Going into it with the wrong mindset is generally a bad idea and IMHO if you're going to get sober and are serious about it the prime motivation should be for self improvement combined with taking better ownership of your own personal health + wellbeing.
If someone is serious about becoming sober then IMHO they should shut up about it as much as possible and nurture it like its a very private little baby that they have that is hidden from the world and that almost no one else knows about except their most trusted friends, family and doctors - combining the journey of becoming sober with internet updoots (and downdoots) by putting it out in the open is a tremendously bad idea (although given his situation I'm not sure how possible it is for him to keep a separation going).
The reason for this in case it isn't obvious is that once someone goes off alcohol + pills they're going to experience emotional ups and downs. Alcohol + Xanax + Ambien are all depressants. That doesn't mean they make a person depressed but they basically "depress/mute a person's emotions" and do a number of things such as numbing and changing the way the brain deals with the emotional rollercoaster of life. Once someone stops using depressants after a prolonged period of using and abusing them a whole bunch of emotions that were hidden away and muted will start to come out and want to play again. It can be pretty confronting for someone if they've never been through the journey before (I don't know if Ralph has tried being sober before).
How long is takes for someone's brain and body to adjust "back to normal" after abusing or heavily using 3 separate depressants is unclear to me but it will probably take several months at minimum even just with alcohol just to have the body physically adjust (withdrawals etc). It's also possible he suffers from actual legitimate depression or any number of other conditions on top of that (such as anxiety) that aren't really possible to deal with because abusing that kind of shit (or even using it habitually) makes it difficult to identify them... this is kind of why therapy with even a trained, extremely high-level psychotherapist or psychiatrist is challenging because without the person being somewhat sober everything they do is going to be modified by depressants.
This is why I mentioned earlier there's a very big distinction between "detox" and "rehab". He claims he's going to rehab but rehab is the therapy part of all of this. Detox is just medical management of a person who is discontinuing abuse of whatever substances (and that alone can take several weeks or even months) - the rehab part, such as even going to AA meetings and/or therapy should ideally come after that (although it would probably help significantly to also have access to that shit while he is detoxing).
So even being seriously online and exposing the giant fucking rollercoaster that will come after detox to the general public and internet fans (and in Ralph's case probably a huge number of haters) is a really, tremendously bad idea because it opens the door to the challenges that come being impacted (both negatively and positively) by what "you" (Ralph) say and how people react to that - it can and likely will become a vicious circle and feedback loop where the person's behavior is changed by this interaction (this is why some prominent internet thinkers/writers have gone to the extent of saying that internet use can cause people to become BPD - borderline personality disorder not bipolar disorder. In fact there is even research that shows this to be the case:
https://www.psypost.org/screen-time...ersonality-traits-and-psychological-distress/)
It's one thing if someone is a "closet alcoholic/pillhead" and after some bizarre behavior and missteps comes out and says to their fandom/hatedom "hey I have come to realize that I have a significant personal problem that is caused by (substances) and I'm going to spend some time to work on it. I'm sorry if I hurt anyone with my behavior." but if they've had that problem very publicly for ages its going to be difficult to keep things separated.
I'm not sure how serious he is about it all (most of the people in this thread seem extremely cynical about his likelihood of success and also his motivations) but it seems evident that he is reliant on efame to make an income which puts him in a pretty precarious situation. If he were able to disconnect for a few weeks or months or only stream once a week or something it'd probably help a lot to stabilize things but I doubt that is going to happen. In an ideal world he'd have some other career he could do in the meantime so he could purely focus on detoxing and rehab and all that shit)