isn't the only real benefit of any nasal spray over a pill the fact that it enters your bloodstream faster? with a NAL spray, maybe that means you would just have to spray 5 minutes before drinking, instead of an hour.

The spray is Naloxone, not Naltrexone. It does a similar thing but has a much shorter half-life, making it suitable for food, but perhaps not for drinking alcohol. It might be okay though if you were only having one drink (i.e a short drinking session where the alcohol would be out of your bloodstream quickly). Interesting stuff though.

I thought we are trying to block the "first drink effect", which would make a fast acting short-lived version interesting. Additionally, there is a study using actual Naltrexone in a nasal form going on, but I am not sure of the results or details yet. I wrote the doctor conducting the trials but have not heard back.

We're trying to block all the endorphins released by drinking, not just the initial ones from the first drink. The first drink effect is one of the things we enjoy about drinking, but blocking it doesn't make you stop craving. You need to unwire the neural pathways formed over years of drinking, and that requires blocking all endorphins, not just the initial ones. And if we blocked the "first drink effect", we'd probably then have to coin a "second or third drink effect" and worry about that. 25mg NAL would block the first drink effect, but as we've seen with a few people on the board, 25 mg isn't always enough.