This article provides a mixed-methods analysis of mental health and substance use outcomes among participants in the Ontario Basic Income Pilot’s (OBIP) Hamilton region, alongside a critique of the pilot’s research design. While previous research has established a relationship between basic income and improved mental health, the mechanisms through which this occurs, particularly the role of chronic stress, remain underexplored. This article addresses this gap by examining how financial security can interrupt the feedback loop between poverty, stress, and diminished well-being. In doing so, it challenges neoliberal frameworks that present addiction as an individual deficit and obscure the social structures that encourage it as a coping mechanism. Quantitative results (N = 217) indicate that higher benefit levels and longer participation were strongly associated with improvements in depression, anxiety, stress, and confidence. Long-form qualitative interviews with 48 former participants affirmed that income stability helped alleviate poverty-related stressors, contributing to improved overall well-being. Reduced reliance on alcohol and tobacco emerged as a downstream effect of reduced stress and enhanced emotional well-being. Although basic income’s unconditional nature could benefit Indigenous and other racialized communities, these benefits were not fully realized in OBIP due to its failure to include these communities in meaningful numbers or to account for structural inequality in its research design. Employing a Marxist framework, we critique OBIP’s individualist methodological approach, which, by relying on randomized control trials, overlooks the structural nature of poverty and the ways these conditions shape agency.