Hey NYC1,
Welcome. I know this is hard but you are in the right place. That is the best part of this - no need to tell anyone (other than the doctor) unless you want to. You are not alone and once you a bit of distance from your own suffering, you will see it even more clearly. Since I started TSM and started going to work events/conferences and out socially I see how many people definitely have challenges with alcohol and are just working hard everyday to contain the damage. AA didn't work for me however that was one of the best things about it for me when I went, realizing how you really are not alone in your experience and there are a million others like you, who have a good life and should not be addicts, but who are. Genetics are a real kick in the ass.

The side effects will fade. It usually takes a good week or two. My first time around I was really nauseous for several weeks but I think it was because I jumped right in at 50. What I did find this time around was that even if you can have 1 AF day each week, and you can not take the Nal on that date, it seems to undermine the nausea for me. I'm not sure why, but it seems to work that way. Because this really is a long term plan, easing in may be your best option. Even if you take 12.5 just before bed for a couple weeks and then 25 for a couple weeks and then start using it 1 hour before drinking, if it works, it will be worth delaying the endorphin block for the month. Something you may want to consider is Baclofen if you are having anxiety attacks. There seems to be some indication that high dose Baclofen can also be a treatment for Alcoholism. I know that there are some people on here are taking a combination of Nal and Baclofen but there does seem to be a lot more problems with side effects for those who have tried the Baclofen.
The way I see it is that you are already drinking and know you can't stop on your own so my advice is to do whatever you can to make this work for you, even if that is easing in slowly. If you give up there is no hope you will get better so whatever it takes to get to the place where you can take the full dose in a way that is tolerable for you, is the right plan of action.
Honestly, this part does suck. We all struggle with being patient and are all so sick and tired of being sick. It is a bit like a marathon that we all agree to because we know that the other option is worse than this one. Just be gentle with yourself and keep remembering that this is about the long term goal and as long as you are moving towards your goal, you are two steps ahead of where you were before.
Jephiner