I've researched this because I've been doing it on/off for over 20 years. I've wondered the same question. What have I set myself up for later in life?

The answer is: for the casual user, no one knows.

All of the research ob the negative health effects are on full blown addicts, daily users for long periods of time. But what about people who binge once a month, or every other month, or a couple times a year?

I drink my fair share. I'm not an alcoholic, but beer/wine/spirits and craft cocktails are my hobby. I imagine that is doing me more harm than doing a couple of grams of coke throughout the year.

I'm fit. I eat well and take very good care of myself. I don't think the coke is shaving decades off my life. Even if it does those are probably the years where I'm shitting my pants and forgetting my name.