Glad to see so many different opinions and how each one's vision of the world makes it perfect to so many viewpoints.
I don't see the sex there, but after reading a bit of the comments, I do agree that it's Sia's inner-self speaking up, she's trapped by the thing that helped her grew up. Yes, the alcohol and self destruction is evident, but it's not only that.
We usually try to run through a lot of stages in our lives doing what looks good and don't care about the after effects, we are so blinded by the possible outcome that we ignore the bad effects it can have to ourselves and to our surroundings.
Our reality changes, our mentality and actions towards everything change and it's like seeing someone grow: if you see them everyday you'll need a picture of the past to see how much it has changed, else you won't even notice a real change had occur, either being it good or bad.
I do not know her, so I cannot speak for her, but I can say this: even thou a lot of people have it really hard in life, I'm sorry you too had to go through that, and this goes a for almost everyone. Starting with the scars from our childhood to what made us what we are today, we all had a lot of tough choices to do and most of us have been led to ways or things we didn't want in our lives.
All in all, we lived it, some of us still do and even tho this for me is a real call for help, it's also sharing what her ways led her to as a first person experience so we are warned and think a little bit better if we really wanna be led like that.
It's a warning for each and every one of us to open our eyes and take hands in our own lives, because we are all messed up.
Peace.