People in this topic are perhaps being a little bombastic with their language.
I think it would be nice if the game recognized various things in some way, but I don't necessarily expect a reward as such for deciding to not huff tadpoles. Letting the addicts off with a clean detox and no long term issues is both a little predictable and a little disappointing, as it goes against that whole "choice and consequence" thing without really subjecting them to all that much consequence. But Larian is trying to "promote evil" a little bit and they're also trying to push this game into mainstream, so tough consequences were probably never really going to happen. The average player would have fits if their 80 hour playthrough ends in tentacles because they failed to resist the peer pressure and did a worm or two 60 hours ago.
My current character is not a tadpole-huffer for power. She's a chaotic good drow rogue / ranger who got away from Lolth and who has had quite enough of brainwashing and magical mucking about with her mind, so she's not that into stuffing bugs into her brain. And that's really all there is to it. My next character probably will be on the 'poles. I'm building a fiend warlock and what's one more gambit for power to such a person? What is there to lose?
But it is disappointing if Larian messed up the dialogue so players get railroaded into particular paths. Disappointing but not entirely unexpected, given how many branches of dialogue they're working with. Even so, one would have expected them to pay particular attention to the whole "just say no" thing. It is a fairly serious matter and it is something that translates very directly into real world themes.
