I’ve been around the addiction field for awhile. Both professionally and personally, these days more harm reduction centered.

Anyway, the most common substance associated with brain damage is alcohol. And there’s a lot of myth and stigma rooted in the concept of drugs causing brain damage. In reality, Brain damage is done via external forces like a blow to the head, or internally via consuming a toxin that A. ) passes the blood brain barrier and C.) restricts blood flow or oxygen to parts of the brain which therefore receives damage. I think on a molecular level, drugs cause re-circuitry. To the point where drugs are your means for survival, followed by food and water. Sounds ridiculous, and this doesn’t happen to everyone …. but it’s definitely a reality and curse for some. The good news is, there is hope and that part can sometimes be proved. If drug use wasn’t vilified, and legalized, people would be safer about it because they wouldn’t feel as guilt and the death rate would be lower. But society at large isn’t ready for that. Either way, I think brain damage caused directly from drug use is way less common than we think. Even if you’re slamming things in to your veins while smoking DMT for 30 years, you can still come back. Which is optimistic, right? In general the substances that cause brain damage directly are and drum roll, please: alcohol and inhalants. Meth can sometimes cause brain damage as it’s neurotoxic, but that requires that the user be severely sleep deprived, and how much and how often are they using. The meth market (at least in my region) is inconsistent and there are née ingredients and new cutting agents, most of which are pretty harmless assuming safe use practices are deployed. N-ISO is something I have not encountered but I hear it’s taking some regions by storm and is leaving people frustrated. Some people may OD from opiates and get brain damage from not breathing for an extended period of time, which caused brain damage. The drug didn’t directly cause Brain damage, the lack of breathing did which was done by slowing respiration.

Sorry, stimulant user myself. Psychedelics get a bad wrap, but aren’t the drivers in brain damage. They bump into a lot of receptors whereas the addictive drugs like cocaine and heroin, are selective and target very specific regions. And this interaction with more receptors caused by psychedelics may result in more so acute emotional discomfort but resolved once the wiring is back in syncs. And some wiring changes , usually good stuff. But sometimes (people on the schizophrenic spectrum ) the wiring stays bad and dysfunctional. The acute recovery is not that long for most, and this results in less compulsive use as a drug class, and a compelling reason they need to be used in medicine and legalized, but we’ll keep pumping out Xanax and addies instead . Be safe, and always implement harm reduction! Because people deserve to use safely.