You say you're pretty fluent for the most part. Be proud of that. You've probably spoken most of your words today perfectly fluently, but now you're having a bad patch. So what? As you say, it comes in waves. Take some time out to reflect on how well you're actually coping, and understand those fluent waves will come around again. We all have ups and downs in life in many areas other than stuttering. During those downtimes, we need to build our confidence that we have the skills, experience to ride out the downtimes and learn from the experience. Relax. You're doing far better than you might imagine. And you already know the drugs and booze aren't helping. They're probably making things worse. You're using them to avoid dealing with the issues of whatever you're feeling. Those things are just delaying your own acceptance of your situation and degrading your self-confidence. You don't need a lecture from me on that stuff. Use this down energy to galvanize yourself to making small steps to change your life by addressing the root cause of your issues.