Drug abuse is not a big issue in SV in general. There are a few general themes:

1) Some startups have a heavy-drinking bro-y environment.

2) Weed is common outside of work (in all of SF)

3) As part of the burning man culture a lot of people will occasionally let loose all weekend with molly, LSD, shrooms, and anything else you’d expect at BM

4) Some people will use adderall/modanfil to stay productive during work.

5) People in SV are willing to try new, untested drugs more than in any other culture I’ve seen, besides MIT.

In summary, I never expect to see someone jonesing in SV. It’s overall a responsible drug culture, not like what I’ve seen with my medical/finance friends. In NY it’s not uncommon to hear ‘I need some coke’ but I never got that sense in SV.