No, you prefer to describe him as coked up. Big difference. </sarcasm>
As was said, he earned a reputation as a butcher by sending men into the meatgrinders that Lee and others had put in place.
Thanks to the southron myth machine. As McPherson pointed out in his book, both Grant and Lee commanded army-sized units for about the same length of time - Grant from February 1862 and Lee from June 1862. But Lee's casualties for the entire war were higher than Grant's. Grant accepted casualties when he had to, maneuvered when he could, and did not lightly accept the lives lost under his command. Had Lee been placed in exactly the same circumstances with exactly the same resources I honestly don't think that his tactics would have been much different. Grant was out to end the war. In order to do that he had to destroy the main confederate army at the time. In order to accomplish that he found the army and fought it to the end. What other way was there?
With the blockades in place, and the foreign temper toward the Confederacy, there likely was a containment option. That, however, would have been disasterous for the South, much more so, I believe, than the pursuance of Lee.
Grant's willingness to sacrifice probably saved more Southerners than any other alternative.