There is no way to make him realize it, if you stay. He looks at it as " If I was hurting you as bad as you say, you wouldn't be here." kind of thing. Also he's a sick person and until he gets help for himself, there is NOTHING you can do. It's all about him taking responsibility for his life, his choices, and their outcomes.
And let me tell you, this past week has been one of the worst of my life.