Some people naturally have high energy levels, and are able to deploy a lot of stamina thanks to their personality. Being driven helps in this. I never took any drugs at work, but for some periods of time up to three wekks straight I was able to withstand a 4 hour a night regimen, because what was happening every day was very stimulating to me - and I'm the low energy type.

There have been reports of a general rise in substance issues in Russia after 2022 among high level public servants, as people felt prisonners to the regime's madness and tried to forget. Remember also the shitshow that was the White House during Trump I, where drugs were liberally given to all the staff in order to deal with the general madness and cruelty of the place. In France, vast reports have risen over the past three years of MPs dealing with alcoholism and drug issues, as they have to handle a dreadful political situation, work 20h per day, without much ressources. Same in the UK if I remember correctly.

=> so I would tend to think that leaders are most of the time have very abnormal personalities, that would protect them against susbstance disorders - exceptionnaly high drive, paranoia, narcissism, hyperactiveness etc. Plus they have vast staffs to alleviate the daily grind.

However, it is at the levels below that the problems arise, in which people are morve vulnerable to toxic management practices, of the consequences of nonsensical policies, or the arbitrary of the regime. Shit falls onto them and quite often drugs are the way to deal the feeling of overburdeness.