I thought, as I read (and I printed it out so it would be easier to read as a unified piece), that you showed such story-telling skill, the way you described the family scene, pregnant with history. And of course, the addiction, the weakness, the struggle, the couple separate and coming together. The exact nature of their self-mutilation--of course it's shocking, but not gratuitously so. It's a horror story in the best tradition of horror stories. I have no patience for pointless violence--Quentin Tarrantino movies are unwatchable, for example (to me). No depth. A cartoon that uses blood and gore to distract. Not what you do here.
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I think that fiction is a powerful tool for understanding reality. Thanks again.