Lyric discussion by AnguishOfAnger 

Cover art for Dope Hat lyrics by Marilyn Manson

My opinion in this song is strangely controversial to the ones posted here. Instead of drugs this could be the hardships of someone who's gained fame in what they do and when something happens that's so bad to that same person they become sad and lonely and destructive but to be able to go on in life materially they continue to do their entertainment job, which causes a sort of insanity within that one, since he is doing something completely against his will. He's turning his "tragedy" into "magic", for the viewers, and he's not doing it because he wants to, it's for his own personal material needs. The hat is wearing him.

@AnguishOfAnger Same thoughts. Strangely I never thought about drugs. Even with the "needle" mentioned in the song I only thought that he solutes to drugs to ease his pain caused by other factors.