how true this is, but I've heard that sometimes having a family history of substance use/abuse is a sign of people who lacked access to proper medications trying to get some relief through "self-help" (and almost always with disastrous consequences).

Medications help when the brain chemistry is off. Having a careful doctor prescribe and monitor proper dosages to help the brain function properly--to me, it feels like it's in the same category of having a doctor prescribe the correct amount of insulin for a patient whose pancreas isn't producing correct amounts on its own.