You can do get the temperance achievement as well if you save after defeating Adam
1. Complete all of Panam Palmer's side-quests and unlock the Life of the Road Trophy.
2. During Nocturne Op55N1, head out onto the balcony with Mysty and talk to Johnny Silverhand.
3. Select: "[Call] Panam."
Select: "Just need a minute."
Select: "Somethin'... I gotta do today."
Select: "Gonna ask Panam for help."
Select: "Take Omega Blockers."
4. Complete We Gotta Live Together.
5. Complete Forward to Death.
6. During Belly of the Beast, defeat Adam Smasher and interact with the Alt AI.
Select: "Wanna live out whatever life I got left."
Enter the Well.