Yes they mean what they say, the reason they say the most hurtful and outrageous things is to get a reaction.
Addicts have no sense of themselves and they only get validation and worth when they get attention, so when you react to their nonsense, they feel validation.
This is why what they do and say is extreme because any "normal" person would not react to their BS.
I think back to people who've said the craziest sh&t to me and it all came from the mouths of addicts.
Whether they mean it or not, it's still damaging and crazy and no tolerance is all that is needed. I put up with it for far too long.