{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,15]],"date-time":"2026-09-15T13:09:04Z","timestamp":1789477744973,"version":"build-2803163510"},"reference-count":30,"publisher":"SAGE Publications","license":[{"start":{"date-parts":[[2025,6,1]],"date-time":"2025-06-01T00:00:00Z","timestamp":1748736000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2025,6,1]],"date-time":"2025-06-01T00:00:00Z","timestamp":1748736000000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"funder":[{"DOI":"10.13039\/100007865","name":"University of Texas Medical Branch","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100007865","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Substance Use: Research and Treatment"],"published-print":{"date-parts":[[2025,6]]},"abstract":"<jats:p>In today\u2019s rapidly evolving substance use landscape, the traditional image of drug consumption is being replaced by a subtler, more socially accepted aesthetic. High Risk, Low Key: The New Face of Drug Use explores how modern intoxicants, from THC-infused beverages to microdosed psilocybin and nitrous oxide canisters, are increasingly marketed as wellness products rather than recreational drugs. This shift, driven by cultural, technological, and mental health trends, has led to the normalization and concealment of daily drug use, especially among youth. Cannabis, once emblematic of rebellion, is now branded as organic and therapeutic, despite rising potency and associated risks. Meanwhile, legal gray-area substances like kratom and nitrous oxide offer easily accessible highs with potentially serious health consequences. The rise of self-medication, fueled by online platforms and a mental health crisis, further blurs the line between therapy and abuse. Digital platforms now serve as decentralized drug markets, contributing to the fentanyl crisis through counterfeit pills. This article calls for a new framework to address these trends, one that includes updated education, regulation, and clinical tools responsive to a generation navigating a silent, rebranded drug crisis.<\/jats:p>","DOI":"10.1177\/29768357251389682","type":"journal-article","created":{"date-parts":[[2025,10,26]],"date-time":"2025-10-26T17:05:08Z","timestamp":1761498308000},"update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":1,"title":["High Risk, Low Key: The New Face of Drug Use"],"prefix":"10.1177","volume":"19","author":[{"ORCID":"https:\/\/orcid.org\/0009-0003-9682-365X","authenticated-orcid":false,"given":"James R.","family":"Burmeister","sequence":"first","affiliation":[{"name":"Department of Foundational Medical Studies, Oakland University William Beaumont School of Medicine, Rochester, MI, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"John K.","family":"Jung","sequence":"additional","affiliation":[{"name":"John Sealy School of Medicine, University of Texas Medical Branch, Galveston, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2025,10,26]]},"reference":[{"key":"e_1_3_3_2_2","unstructured":"Engle T. 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