I suspect that this may be partially a result of a recent post of mine that some may considered to be in bad taste. So this response is likely to be a bit biased.

For what it is worth, I considered tagging mine as NSFW but ultimately decided it was not necessary. I thought the image was very clearly a staged representation of drug use. Similar to how the Eric Andre meme is clearly a staged representation of murder. Further, there was no blood nor any indication of physical injury and I liked it to an image of somebody smoking pot or drinking to excess.

Do I think drug use alone require a NSFW tag? No.

Should drug coupled with blood, gore, physical injury, exploitation, etc? Possibly.

It’s a screen shot from this “flour in hairdryer” prank. Skip to about the 1:30 mark to see where the prank goes wrong.