Last time I talked about a group of people for whom the Sinclair Method (or any other alcoholism therapy) is not appropriate -- the young, who can learn better life habits via conventional means.
That raises some questions. One is simply this: Who is a good candidate for pharmacological extinction of the desire to drink?
If you want to get totally blasted, you're probably not a good candidate. If you don't want to get totally blasted but it seems to just keep happening anyway, maybe so.
If you make a conscious choice to start drinking, that's one thing. If you feel compelled against your will, almost as if your body were moving by itself in spite of your mind's wishes, that's another thing entirely.
If you quit or cut down when external pressures (family, job) require you to do so, and you can maintain that for more than a few weeks, your conscious mind is likely still the main showrunner. If you drink even in the face of dire consequences and are baffled by your own behavior, you may well be conditioned.
That's the common thread among all of those dichotomies -- conditioning. We humans have more freedom of choice than other animals in many respects, but we're still subject to conditioning. Those of us who merit the label of "alcoholic" have spent years conditioning ourselves to seek alcohol, and now we're finding that it's not as easy to back out as it was to walk in.
The Sinclair Method provides an intervention which lets us unlearn this conditioning. The behavior (drinking alcohol) has been producing rewards (endorphins -> opioids) which we've conditioned ourselves to seek. By blocking the rewards, we interrupt that system and gradually unlearn the behavior.
That's the whole point of this method -- unlearning the conditioned behavior. It's not well suited to someone who is still in the driver's seat of drinking but is choosing to drink. It's perfectly suited to people who want very much to stop but feel like they simply can't, feel trapped, feel as if they can't control their own actions.