Dangerous drug myths and what evidence actually shows
Korea’s drug landscape has changed dramatically over the last 10 years, driven largely by rapid advances in digital technology. The use of smartphones and online platforms has made illicit drugs far more accessible, and public perceptions are being shaped more by fear, stereotypes and media sensationalism than by scientific evidence.
Social media often portrays drugs as tools for productivity, relaxation or creativity. Some risks are exaggerated and others are dangerously underestimated. Effective prevention depends not only on government policies and law enforcement, but also on an informed public. This column examines common myths about illicit drugs in light of the scientific evidence, beginning with a common misunderstanding about controlled drugs.
Although controlled drugs are often assumed to be universally illegal, many have well-established clinical uses. Morphine relieves severe postsurgical pain, and pharmaceutical fentanyl is essential in anesthesia and pain management. Methylphenidate has become a mainstay of ADHD treatment, and benzodiazepines are commonly prescribed for anxiety. Controlled drugs are strictly regulated because of their potential for misuse and dependence. Unauthorized possession or use — including sharing with others — is illegal.
Another misunderstanding is that prescription drugs are always safe because they come from medical professionals. Drugs such as opioids, sedatives and stimulants offer substantial clinical benefits when used appropriately, but they also carry significant risks, particularly when misused, overprescribed or diverted. The opioid crisis in the United States illustrates this danger. Widespread exposure to prescription opioids and the underestimation of their addictive potential contributed to dependence, fatal overdoses and, in some individuals, subsequent use of illicit opioids. Ultimately, therapeutic benefit and misuse potential can coexist in the same drug. Whether a drug heals or harms depends largely on how and under what conditions it is administered. The critical takeaway is that “prescription” does not mean “risk-free.”
Many people, particularly young adults, perceive so-called “party drugs” as relatively harmless. Ecstasy and ketamine are often associated with clubs and festivals rather than addiction, obscuring their potential danger. Furthermore, growing clinical research into ketamine and certain psychedelics as treatments for depression and PTSD may lead some to assume that occasional use is safe. However, these substances can still trigger adverse psychological effects, such as hallucinations and paranoia, and result in addiction, particularly when used outside medical supervision. Preliminary findings from clinical research should not be conflated with unsupervised recreational consumption.
It is misleading to judge a drug’s danger solely by its potential for physical dependence. Ketamine, for example, produces less pronounced physical withdrawal than opioids or methamphetamine, which may create the false impression that it is low-risk. However, repeated ketamine use can severely impair cognitive function while increasing the risk of psychiatric complications. Even more alarming is direct toxicity to the urinary system. Long-term misuse can cause chronic bladder inflammation that may progress to irreversible kidney damage. A drug does not need to cause severe physical withdrawal to inflict devastating harm.
Addiction is often associated with character flaws. The initial decision to experiment with drugs remains a matter of personal choice, but with continued use, the underlying neurobiology becomes more complex. Brain circuits that govern reward, motivation, learning, stress and self-control are altered. Environmental cues, such as familiar places, friends, sensory experiences, or emotions can trigger intense cravings long after a person has stopped using. At the same time, impulse control and long-term planning become impaired, making it harder to resist these cravings. Neurobiology helps explain why recovery is rarely achieved through willpower alone. Successful treatment typically requires a combination of medication, cognitive-behavioral therapy, strong support networks and sustained lifestyle changes.
Popular portrayals of addiction commonly depict either the most severe cases or dramatic recoveries. In reality, addiction exists on a spectrum and prevention, treatment and recovery must be individualized. Whether addiction develops depends on a complex interplay of biological, psychological and social factors. For example, inhalation and intranasal administration deliver drugs to the brain more rapidly, producing sharp dopamine surges that elevate addiction risk. In addition, women tend to progress from initial use to addiction faster than men, particularly with stimulants such as cocaine and methamphetamine. One-time use may prove fatal for one person, whereas another may develop addiction only after repeated use.
Just as there is no single path to addiction, there is no simple or quick way out. In the case of severe drug addiction, detoxification is only the first step. Although it removes the substance from the body, it does not instantly restore normal brain function. Cravings, sleep disturbances, emotional instability, impaired concentration and heightened stress responses may persist for weeks, months or longer. Some individuals may experience vivid drug-related dreams or intrusive memories well into recovery, making them feel as though they are using again. Old habits and environmental cues can still trigger a return to use, even after extended abstinence. For many, recovery becomes a lifelong process.
Effective prevention begins with evidence-based education. People need to understand why drugs are dangerous, how addiction develops and how seemingly casual choices can lead to life-altering consequences. Lasting prevention depends on replacing myths with accurate information and fear with understanding, enabling individuals to make informed decisions, recognize risks early and seek help when needed.
Ma Kyung-hee is an editor and researcher specializing in psychological well-being and community care. Kim Ji-woon (jiwoonkim@khu.ac.kr) is an associate professor at the College of Pharmacy, Kyung Hee University. His research focuses on the neuropharmacology of brain disorders, with particular interests in psychedelics and ketamine.