"Brain damage" isn't a binary yes-or-no thing that happens to you.
It's not even clear that regular as-prescribed usage of amphetamine is without some harm potential. With regular doses and route of administration it's obviously limited or negligible, but someone insufflating (snorting) it routinely is exposing their brains to much higher concentrations and much faster onset.
Note that dopamine itself is toxic when metabolized normally, but your body is equipped to mostly handle that. Using drugs that disrupt dopamine flows in high doses can overwhelm the systems designed to keep dopamine metabolism from doing damage.
> Typical cocaine use also does not result in meaningful harm.
The works "typical" and "meaningful" are doing a lot of work here. One of my friend groups has a lot of ER nurses. They see a non-trivial number of people coming to the hospital from casual cocaine use. These cases are generally waved away as other conditions by drug users (e.g. heart attacks, etc) and therefore they don't "count" in some people's minds. Yet it's a common finding for them on blood workups for people, including young people, arriving with cardiovascular problems.
> The vast majority of people I know, whether they’re 25 or 65, will not say no when offered.
Significant drug users often don't realize how much of a bubble they're in. Also, the goalposts for having a drug problem tend to be moved around a lot when everyone you know is using drugs regularly. Typically, being unable to say no when offered a drug is a sign of having a problem.
Similarly, I don’t think you could reasonably suggest that someone who has a couple of glasses of wine during such events has a drinking problem.
> Significant drug users often don't realize how much of a bubble they're in. Also, the goalposts for having a drug problem tend to be moved around a lot when everyone you know is using drugs regularly. Typically, being unable to say no when offered a drug is a sign of having a problem
Personally, I’d consider someone who uses cocaine on a daily basis to have a problem. I’d also like to suggest that it’s pretty hard to have a cocaine problem and not use cocaine on a daily basis.
OTOH, someone who infrequently shoots up cocaine probably isn’t addicted but would be engaging in some seriously risky behaviour unless they’re able to very precisely measure their dosage. I’ve never heard of anyone doing that though, it’s certainly not a common activity among the upper socioeconomic classes.
> The works "typical" and "meaningful" are doing a lot of work here. One of my friend groups has a lot of ER nurses. They see a non-trivial number of people coming to the hospital from casual cocaine use. These cases are generally waved away as other conditions by drug users (e.g. heart attacks, etc) and therefore they don't "count" in some people's minds. Yet it's a common finding for them on blood workups for people, including young people, arriving with cardiovascular problems
To my knowledge there exists no evidence that anything less than massive cocaine use could result in new cardiovascular issues. Of course it may trigger an existing condition, but someone who has a heart attack during normal casual use of cocaine would probably be prone to have one during exercise also. The stress on the heart from cocaine usage is not particularly different from fairly normal day-to-day activities of people who do not use cocaine.