According to the ethnohistorical record, the yaupon leaves and branches used for the black drink were traditionally picked as close to the time of its planned consumption as possible. After picking, historically they were lightly parched in a ceramic container over fire. The roasting increases the solubility in water of the caffeine, which is the same reason coffee beans are roasted.[6] After browning, they were boiled in large containers of water until the liquid reached a dark brown or black color, giving it its name. The liquid was then strained into containers to cool, until it was cool enough to not scald the skin, and drunk while still hot. Because caffeine is 30 times more soluble in boiling water than room temperature water, this heightened its effect. It was then consumed in a ritual manner. Its physiological effects are believed to be mainly those of massive doses of caffeine. Three to six cups of strong coffee is equal to 0.5 to 1.0 grams of caffeine; the black drink could have delivered at least this much and possibly up to 3.0 to 6.0 grams of caffeine.[7] Owen gives the caffeine content of coffee as between 1.01 and 1.42 percent [8] In comparison, Ilex vomitoria leaves contain 0.0038 to 0.2288 percent caffeine by weight according to experiments performed by Adam Edwards in 2002.[9] Similar methods of production were adopted by European colonists for the production of a drink that often shared the same names with Native names for the black drink but was used for different, secular purposes.

The general method of production is known, but not all details of the preparation and ceremonial usage of the black drink are. The source of the emetic effect of black drink is not known and has been speculated upon by historians, archaeologists, and botanists. Some professionals believe it to be caused by the addition of poisonous button snakeroot.[10]

Contemporary preparation and usage of the black drink by Native Americans is less well documented. Online recipes for the black drink have been criticized by some Native Americans as potentially dangerous and potentially poisonous due to those recipes leaving out key steps. The berries of the yaupon holly are poisonous.[11] Kidney failure is one possible outcome of consuming beverages containing holly leaves. Adam Edwards and Bradley Bennett tested stems, roots, and leaves of the yaupon. They found that the only possible toxic substance was theobromine, an alkaloid, but the amounts of the chemical were so low that a single gram of cocoa contained over 2,255 times more theobromine than yaupon.[12]