I believe that the song is about being deceived by the one you love into doing their "dirty work" from the "blood on my hands" lines, referring to having done something to harm someone and regretting it. Unfortunately I cannot confirm who is being "used" in the song. However I can speculate that this person is in fact regretful of their decisions, but has committed similar crimes before, as implied in the lines, "I'm only evil when I need to be, but you did this so easily". We can also back this up with the beginning lines "Wake up in the middle of insanity the other night, with some tears on my pillow and some blood on my knife!" meaning that this poor soul is waking up in a hot sweat after having a nightmare, caused by his actions and his conscience haunting him for it. Also the song explains that the person wants to die for his actions and not wanting to be entangled in his love's web of lies, while also having been tormented by her as well, as explained in the lines, "I have nothing to give, so I gave you my life. Didn't want to see me live, so you gave me your knife. Didn't hear you as you tip-toed coming from behind, you took away my kids, so I guess you killed me twice.There's blood all over your knife you know you've burned yourself, and its a matter of time before you burn in hell!"