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Moon sugar, a skooma pipe and skooma

Skooma is a hallucinatory narcotic refined from moon sugar.[1] Extremely addictive, its victims are left in constant, alternating states of delusional euphoria and lethargy.[2] Sustained use of the drug seemingly results in permanent confusion and mental deterioration.[3]

The drug can be smoked through a water pipe or consumed in liquid form, some of the apparatus used can be quite elaborate.[2][4] When poor quality ingredients—like rotted moon sugar—are used in its production, the resulting "tainted" skooma has more extreme side effects including death. As spoiled moon sugar is cheaper to obtain, this practice is regrettably common.[5] Regardless of the quality of the Skooma consumed, withdrawal from the drug can have mental effects with violent consequences.[6]

Sheogorath, Daedric Prince of Madness, is thus known as the Skooma Cat among the Khajiit, "for what is crazier than a cat on skooma?"[7] Some stories about the Mad God claim that skooma is the medium which the Prince speaks through the protection of the Lunar Lattice.[8] Because of the prevalence of moon sugar in Khajiiti culture, skooma addiction has proven to be a particular menace for Khajiit with a "sweet tooth".[9] However, the "sacred sugar" as it is also referred to, does have use in certain Khajiit ceremonies, where it is strictly controlled by the Moon Bishops.[1] The visions seen during these rituals are seen as messages from the Twin Moons, but the user runs the risk of attracting Sheggorath's attention.[10][11]

In the Fourth Era it is said that the drug was originally developed by the Dunmer.[12] The drug has been banned throughout history by both the Aldmeri Dominion and the Third Empire, skooma is typically smuggled along with moon sugar.[13] However, a seemingly skooma-specific smuggling route existed between Daggerfall and Vivec in the Third Era.[14] The traffic of skooma has led to violent criminal conflicts both individual and organized.[15][16] In the third century of the Fourth Era, a far more potent form of skooma was refined using the water from the Bloodspring of Lengeir's Feast in Skyrim, known as Redwater Skooma and used by vampires to exploit skooma addicts for blood.[17]

The liquids used to refine skooma from moon sugar are highly flammable.[18] [verification needed — needs more information on the process of creation]

Although addiction to skooma is commonly thought to be incurable,[2] cures have been achieved through both alchemy and the elimination of the addict's own self-hatred.[19][20] Some medical practices, such as the application of numbing agents are said to relieve the symptoms of withdrawal.[21]