Thank you for your brutal honesty. It is really healthy that you are able see your faults so clearly. I guess now the challenge is to fix those problems, one at a time. Your meds will never have the opportunity to work if you use drugs or excessive alcohol, but also they probably need some tweeking if you have struggled so much over the last 10 years. I would suggest talking with your pdoc to get a med change to try and get a better handle on things. Talking with a therapist might also be helpful to understand why you feel the way you do about the people close to you, and to help you stay off drugs.
good luck with your journey.