Which Drug Messes Up Your Voice the Most?

This story is from the spring 2025 edition of VICE magazine: THE ROCK BOTTOM ISSUE. To subscribe to receive 4 print issues of our newly relaunched magazine each year, click here.

It’s a simple question. To get answers, I spoke to Dr. Abie Mendelsohn, a fellowship-trained laryngologist based in LA, who told me which drug might give you frostbite in the throat and which is like putting a biochemical weapon in your mouth each time you smoke it.

Ecstasy

Dr. Abie Mendelsohn: Essentially harmless. Even chronic use won’t have any measurable effects on the vocal cords. I’d put ecstasy much lower on the damage scale than cigarettes.

VICE: I guess you could smoke a shit load of cigarettes on ecstasy, though?
Yeah, fair point. Ecstasy is going to dramatically shift your decision making.

Heroin

Dr. Abie Mendelsohn: Injecting heroin is going to be a problem. In habitual heroin users, the opioids change the way the body processes the gastrointestinal tract—so you will certainly get effects on the vocal cords, though it’s unlikely to be the most noticeable change in someone’s health.

Cocaine

Dr. Abie Mendelsohn: Cocaine is generally provided in an acidic form, so you’re basically snorting acid directly into your nasal tract. This helps the absorption, and subsequent high, but ultimately will burn into the nasal tract, causing considerable nasal mucus.

Let’s say a buddy’s got a real punchy cocaine habit, could their voice change?
Oh, yeah. They would be risking their singing voice, no question. Singers who have to breathe through their mouths are drying out their vocal cords. This leads to mucus and other nasal discharge raining down upon the vocal cords, which makes the voice raspy and gravelly.

That doesn’t sound very sexy. Could they undo all that damage by abstaining?
Absolutely. And some people want to do both, right? Have a great voice, and use cocaine a lot. If they can maintain their nose with nose sprays, washes, then maybe doing both is possible.

Weed

Dr. Abie Mendelsohn: Some say it’s worse than smoking cigarettes. I’d say it’s probably on par, though a bong is different because it has some kind of filtration system through the water.

Meth

Dr. Abie Mendelsohn: First of all, there’s no telling what’s actually in meth. One of the ways it’s made, though, is with the tops of matches, and so that red phosphorus will turn into phosphine gas. So it’s kind of like you’re smoking a literal biochemical agent.

Is this good for the vocal cords?
It is not.

Crack

Dr. Abie Mendelsohn: Smoking crack is the same [as meth]. Burning cocaine is going to result in some very gnarly, noxious chemicals directly hitting the vocal cords. You get immediate inflammation, which can result in scarring that is very difficult to fix.

I see.
Now, I’m sure people are going, ‘Well, I’ve done crack, and my voice is totally fine!’ But it’s like Russian Roulette.

Can a crack user recover from that damage?
It’s unlikely that damage will be reversible.

Ketamine

Dr. Abie Mendelsohn: Nasal ketamine, nasal cocaine, heroin, and smoking weed are probably on a par with cigarettes, meaning damage to the vocal cords that is done on a timescale of weeks or months.

Nitrous Oxide

Dr. Abie Mendelsohn: Whippits are probably going to have minimal-to-no effect on the vocal cords themselves. The only potential issue is just how cold [the gas] is when it comes out. I guess if you were aggressively hitting ice-cold whippits and breathing it in really quick, you could technically get frostbitten vocal cords. But I’d say that would be pretty difficult to do.

This story is from the spring 2025 edition of VICE magazine: THE ROCK BOTTOM ISSUE. To subscribe to receive 4 print issues of our newly relaunched magazine each year, click here.