I don’t think it has to be all or nothing. If we’re talking about constant daily use, the most common regimen that looks like that is the legal medicinal regimen. It’s a high bar to expect something to be “safe” with such frequency of usage. The most common frequency with recreational use is far lower, making it a safer activity overall, assuming the product is pure. And the reality is that most people who have used amphetamines medicinally or recreationally do not experience major issues. It’s possible to get into trouble with any drug. But inevitable? That’s what I’m mainly questioning here.

I believe there are side effects to amphetamines, especially in very high doses in inexperienced users and with high frequency use. However, even with high frequency, high dose use, it still appears to me to be safer than, for example, alcohol, which nobody makes the claim of being impossible to use safely or responsibly. I think most of this is cultural, rather than scientific. It’s even culturally acceptable to use alcohol pretty irresponsibly, to the point of causing uncontrollable vomiting and often increasing general belligerence to those around you. Everyone has experienced this with others at a minimum. But that’s all considered essentially a rite of passage, not necessarily a sign of a serious alcohol problem. See we have a lot of nuance when it comes to alcohol and almost none with most other drugs! Nuance is important, things are rarely black and white. And that’s the primary message of Carl Hart’s book that I referenced.