The gun, drugs, ashtray and the bottle are all made out of Lego.
The gun is modeled after a Glock 17 and is loosely based on the design of MyDifferentUserName, although the interior is radically different and much more solid, at a cost of a minor bit of realism.
All "ash" in the ashtray are attached, so you can't spill any ash. I actually think it looks very good. I had various people do a double-take when seeing it for the first time.
The pills are just Lego 1x1 cylinders in a small baggy.
The "cocaine" is just a makeup mirror and some white Lego bricks.
Of course it is image manipulated, but not actually that much. Here's the unedited version: