I always got the drug reference, but I figured it was a surface analogy to something deeper. My early, pre-commonplace-internet assumption was that it was about the cruising lifestyle, and the strain of deciding whether to come out or not. You know, like he was ready to lose his mind.
Or issues/people in their lives. I have a brother who I've always had strong proof has been struggling with the cognitive dissonance of being conservative Republican and a closeted homosexual, if not at least bisexual. I've been waiting for that blister to pop for years, and certainly hope it won't involve guns.