They’d just about have to be, that or they’re completely unaware of the effects. I just can’t envision a sane person wanting to experience this.
Last summer in a town near me a guy killed his elderly neighbor and took her head home with him. Police found him wearing her dress.
He had a long history of drug abuse issues and an even longer history of mental health issues. His own family had been trying to get him locked up for years but the courts wouldn’t touch it because he’s a PhD. so he clearly couldn’t be nuts. Now his family has joined the victim’s family in a big lawsuit against the state.