Lyric discussion by Brendonsoh 

Cover art for In Vein lyrics by Alkaline Trio

Now that I see the lyrics I dont think it is this but I used to think it was about a heroin addict Because when their shooting up (Its not In VAIN its In VEIN) they usually have the front of their hands facing themselves, they wouldnt recognize the back of their hand cuz their always shooting up, but the rest of the song makes no sense in that meaning