Spite. I believe that his spite is strong enough. Ralph knows with 100% certainty that when he dies especially if he dies as a result of his habits that there will be 500 streams laughing at him and having roasted pigs in hell as the thumbnail. He knows that the dead retard streams will make tens of thousands of dollars for the people he hates the most and they will jokingly pour corn liquor out for him and eat pork sandwiches.
He has said before that the only thing keeping him from killing himself is spite, he lives for spite, and he will get clean for spite. I believe! All the nurses have to do is give him a print out sheet of his thread or Twitter every day of people saying he has no chance and he will do it!
Every single person on this website thinks he can't do it. I think he can! I CHOOSE to be a positive polly!