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..
I think this is my issue with it. There is SO much emphasis placed on resisting the tadpole influence, like you're going to lose an important part of you, and the guardian keeps saying obvious hints about "hey, you should totally use this *wink* *wink*" so much so that you're thinking "Oh ho ho, I see what you're trying to do game, no way, I'm not biting" and then...nope, turns out there is zero narrative repercussions, only what you make up in your own head canon.
I get WHY they let addicts have an easy way out, I guess it's just frustrating that they have more severe consequences for some quests (fail to save a specific npc at a certain fight in Act 2), or choose the wrong dialogue that is impossible to guess without either just blind luck or save scumming a specific companion that drastically changes their story in Act 2 as well, but then for a main story point, just have a "eh, don't worry about it, use it for a while, see how it fits, we'll warn you if you get too far" line.
idk, maybe I got into the hype too much. I guess I just feel stupid for NOT doing specific things (saving SH in the very beginning) just because I thought there would be narrative consequences. Now that the curtain is pulled back, I'm disappointed. It feels very much like I'm playing a video game now.