I'm in full agreement with not skipping those meds and appointments... I believe they are vital to your well being and sobriety. I also agree that your self loathing is off the charts. You say because your gf left you, you are worthless. Well, it's asinine to put our value in the hands of another I now know an enormous part of my problem was seeking validation outside of myself. Yes, it is nice to be accepted and liked by peers but it hardly happens when we don't care about ourselves. Your ultimate responsibility here is accepting and liking yourself. What do you do that is so horrible? You have been afflicted with the dis-ease of low self worth/value that often manifests in addiction. You have no self love (acceptance of you). But why not? You are not your drunken behaviour.
You really, really, really need to work on your self acceptance. What measuring stick are you holding yourself up to? If you were to sit down and write out a list as to why you are unloveable? What would you come up with? Very little I'm sure. You are an important part of this community and people care about you....because you're a good guy. What is better than being a good guy???
Looking after you is JOB 1. There is just no other person or thing with higher priority. YOU are the most important person in your world and you need to knock yourself out looking after your best interests..always.