She doesn’t do drugs, but she does smoke cigarettes as it helps her deal with her poor ability to cope with stress. It also, ironically, keeps her in shape - a common, albeit shortsighted trait on dancers. She does give smoking up after becoming pregnant, but periodically relapses back into it throughout her life.
I tried Pearl’s pudge and weight again, and can see plenty of problems still, but I feel like I’m improving all the same. I imagined Pearl taking a cigarette break mid-practice, and all the dance students that do smoke just wander out in leotards without giving a fuck before getting back to work.