I didnt have time to read everyone's response throughly but Neptune is a big focalizer in my chart (I attached it). Neptune conjunct asc (within 10 degrees) in Scorpio first house, Moon in 1st house conjunct Neptune, Sun sextile Neptune and also Neptune sextile pluto (generational I believe) and trine Chrion. My only major negative aspect is Venus square Neptune - and Venus/Neptune aspects are a story all on their own! Eek!
So, Neptune is very prominent in me. I notice I see many times that it is said that Neptune conjunct Asc people "can not see themselves clearly" - I do not find this to be true for me. I am very sure of the kind of person I am - my beliefs, ideas, what I stand for (this might be because I older so I have gone through changes after changes and transformation after transformation - this is the bane of a Scorpio Rising). I have a few ideas that maybe I am indecisive about but I know I have other placements and aspects in my chart that are responsible for this and I don't think it is my Neptune. What I find is that OTHERS do not see me clearly and I have to fight tooth and nail to get them to see who I truly am and not the person they imagine me to be as it is said that Neptune in the 1st house causes others to see you as a fantasy - in other words, THEIR fantasy - they want you to be what THEY want you to be and have a difficult time seeing the true person. This causes lots of problems for me - people make assumptions about me all the time (in fact, this happened yesterday and I had to set the person straight). I know that many people do this with others - but I swear, it happens to me more than most. And I think it is Neptunes fault.
This said, I dont consider my Neptune aspects bad (except the Square to Venus - that's a pain in the butt). All I have read are positive on them and I consider them unique qualities. My Neptune conjunct Moon (in Sag) and Sun sextile Neptuen loves music, fine arts, films etc and yes I use them as a form of escapism and I don't think there is anything wrong with that. I never saw it as a negative. These also make me a compassionate person. The Neptune in the 1st gives me lots of intuition. I feel I am also slightly psychic but I am not sure exactly how to use it all the time. My sixth sense is very right on.
Because I have Neptune in the 1st house - I have never used drugs or anything like that for my escapism. In fact, I don't see the point of wasting money on this stuff and I never have. Why do Neptunians like me need to escape? Because we are like energy sponges who absorb lots from our surroundings and it is honestly exhausting and we need time to "get away and escape" to give ourselves a break. For me, esp. the "people misunderstaning me" is the most exhausting. I have learned to deal with the "sponge" stuff ( I honestly thought everyone felt that way - until I realized it is just us very Neptuney people) and have excepted that I need time to recharge but the outside influence of others from my Neptune is the difficult part. I can change and control my own Neptune but I can't seem to change how it makes others see me - even those people that get to know the real me, they still want to hold on to that fantasy version they had of me in the beginning - even if I shatter it.
I do tend to sometimes like the escapism too much and I get too comfortable in it esp. if reality is causing me pain and problems. Sleeping and dreaming esp - oh, I could sleep forever - probably because it too is a form of escapism.
Lots of actors and actresses and models have Neptune conjunct asc because it makes it easy to become a "fantasy" to someone else - that is why they have so many stalkers.
I guess because I don't fall into any of the self-destructive Neptune escapes (drug, alcohol etc) that this is why I don't see it as a big negative. Sure it can cause problems for me - if I let it. Being aware of it is important because than I can catch myself in it if I can get too comfortable with it and use to "hide" away too much. But in todays world, who doesn't want to "hide away" sometimes? Good thing I am very practiced at it because when those times come I can easily slip right into "escape mode".