I've been afflicted with diagnosed treatment resistant major depression, crippling anxiety, and ptsd for most of my (32m) life. As well as dangerous and reckless substance use even when faced with terrible consequences as a form of escape and self medication. I've been in endless, traumatic treatments, meds, and confinement for 17 years and nothing has stuck. I truly desire to be better and get better, but I can't shake this compulsion any more than a drowning man eventually breathes water. It's going to kill me, it's just a matter of when. I'm still alive by some medical fluke that doesn't make sense. I don't want to die, but I'm not afraid to given the amount of suffering I always live with. But I can't knowingly make my amazing parents bury their son that they have fought so hard for. I'm recovering from my most recent brush with death, hospital stay, etc. And my mental health team is at a loss as to what to do. Personally, I see the only realistic option is harm reduction, using dispensed and controlled meds not typically used the traditional way as a method of harm reduction to satisfy that uncontrollable urge to be "functionally" altered. I'm not a doctor, so I don't know what drugs specifically. And presumably a rotation of drugs to avoid tolerance as much as possible. I'm doing spravato twice weekly which only works that day. This is the only realistic and safest option I can see. We've tried everything else and I'm unfortunately pretty clever and determined when I'm desperate. Some will say that I'm not unique and sobriety long term is possible if I really try, but I know that it's just a matter of time until I do something crazy and end up dead finally. How do I approach this?