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The 5 Most Addictive Drugs

7 minute read

In the last couple of decades, several studies have explored why some drugs are more addictive than others. Researchers typically base their evaluations on factors like:

  • Prevalence of use.
  • Harm to the individual.
  • Harm and cost to society.
  • Number of people who’ve sought treatment for the drug.
  • Potential for physical and psychological dependence.
  • How quickly physical dependence develops.

While there are some variances, the majority of research concludes that these five substances are the most addictive drugs.

1. Heroin and Other Opioids

Considered by some to be the most addictive drug in the world, opioids account for around 70% of overdoses a year. Opioids like heroin, fentanyl, and prescription drugs have a high potential for abuse and addiction because of the way they work on the brain’s reward system. These types of drugs release excessive amounts of dopamine in the brain. High dopamine levels are what provide the rush and feeling of euphoria that people who abuse opioids are trying to achieve.

Heroin addiction develops quickly because of:

  1. The intense high it provides, which you want to achieve again (also known as “chasing the dragon”).
  2. The quick way physical dependence can develop because of rapid depletion of the brain’s natural supply of dopamine. You begin needing the drug to prevent opioid withdrawal symptoms. Without the drug, the central nervous system goes into shock, trying to rebalance itself without the drug. This causes flu-like symptoms and extreme discomfort.

Opioid addiction treatment often involves medication-assisted treatment (MAT). These are prescription drugs that bind to opioid receptors and ease cravings and withdrawal symptoms. Without discomfort and a strong urge to use, you’re better able to focus on getting the behavioral health treatment and relapse prevention skills you need to stay sober.

2. Cocaine

Heroin makes the headlines these days, but cocaine abuse is still alive and well in America. A national survey reports about 1.5 million people over age 12 used cocaine within the past month. In 2020, cocaine overdose deaths increased by 26.5% according to the CDC.

Researchers continue to study the specific processes that make cocaine so addictive. A highly addictive stimulant drug, cocaine produces feel-good chemicals in the brain that may make you feel energetic, giddy, and confident. Over time, cocaine abuse drains your dopamine supply. This can lead to mental health symptoms like depression as well as feelings of agitation without cocaine. You may start a cycle of self-medicating these symptoms by taking more crack cocaine. The problem is that in the long run, this only worsens them. 

Cocaine addiction treatment may begin with medical detox depending on how long you’ve been abusing it and your individual make-up. Medications are usually prescribed to ease withdrawal symptoms like anxiety and insomnia. Antidepressants may also be used for a length of time as the brain rebalances its neurotransmitters. Drug rehab centers may include contingency management and cognitive-behavioral therapy in your treatment plan, which have been proven to be effective cocaine addiction treatments.

3. Alcohol

Over 14 million U.S. adults met the criteria for an alcohol use disorder in 2019. Alcohol abuse changes the brain in some of the same ways as other addictive substances. It boosts your serotonin and dopamine levels, providing the relaxed, happy feeling you may seek in drinking. Regular alcohol abuse creates strong associations in your brain with people, places, and feelings tied to alcohol. Just seeing or feeling these things can be like having a drink in front of you and cause an unbearable urge to drink.

Because alcohol is socially acceptable and readily available, there are endless opportunities to feed an alcohol addiction. You’re at higher risk for alcohol addiction if:

When you’re addicted to alcohol, you have withdrawal symptoms when you stop drinking. These can be painful and disturbing, which may lead you to reach for a drink to ease these symptoms. This perpetuates the addiction cycle.

Alcohol addiction treatment begins with alcohol detox. It can be dangerous and deadly to quit alcohol cold-turkey on your own. At a treatment center, medical professionals oversee the detox process and ease withdrawal symptoms with medications. After detox, specialized treatment that involves behavioral therapy, family therapy, medications as clinically appropriate, and relapse prevention training supports long-term recovery.

4. Methamphetamine

Some meth abusers say crystal meth produces a high like none other. The drug works by flooding the brain with extremely high amounts of dopamine. The high is quick and strong. Very high levels of dopamine can make you feel euphoric and invincible. As you continue to abuse meth, the intensity of that high grows weaker. Many meth abusers say they keep trying to chase the intense meth high they got the first time they used meth. They know they’ll never obtain it, but that doesn’t stop them from trying. This cycle is how you can quickly develop an addiction to meth and tolerance to its pleasurable effects.

After a meth binge, you’ll inevitably crash. Each time you binge and crash, your “normal state” gets worse. Taking crystal meth over and over can cause the brain to rewire itself. It stops being able to produce regular amounts of dopamine on its own. It also thinks it needs excessive amounts of dopamine to function.

When you get used to having meth in your system, you no longer feel as “high” on your usual amount of methamphetamine. In order to get the desired high, you keep increasing meth intake. In time, this cycle repeats itself. It’s the ongoing spiral of rising tolerance and increasing intake that leads to meth addiction.

Sometimes mental disorder symptoms are part of the psychosis that meth causes. Conditions like depression can come about because of changes in dopamine from meth effects. Other times, you may already have a mental health disorder prior to using it. Meth abuse may be your way of self-medicating mental disorder symptoms. Meth addiction treatment involves treating these symptoms and other underlying causes of substance abuse.

5. Nicotine

Smoking is the leading cause of preventable disease, death, and disability. Though health experts have warned the public that nicotine is as addictive as heroin and cocaine, every day around 1,600 youth start smoking. Around 40 million Americans smoke and 16 million of them have a serious illness because of it. Though nicotine doesn’t provide the high of harder drugs, it does produce a quick surge of dopamine that activates your reward system in similar ways. This continues to bring you back for more to get the same feeling. Over time, nicotine changes your brain like other drugs by altering neurotransmitters. This can cause dependency and withdrawal symptoms when you try to quit smoking.

Nicotine is extremely difficult to quit. The American Cancer Society reports around half of the smokers try to quit every year without success. Quitting smoking with the help of specialists trained in addiction and a number of evidence-based therapies for substance use can increase your chances of success. People use nicotine for some of the same reasons they abuse other drugs and alcohol. Many of the treatments for drug and alcohol abuse are also effective for nicotine addiction because they address similar underlying issues, which may include:

Co-occurring mental health disorders – Research shows that people with nicotine dependence are more likely to also struggle with mood disorders, anxiety, and psychosis.

TraumaStudies indicate a strong link between trauma and smoking. People that have PTSD are much more likely to smoke cigarettes.

Social pressures – Peer pressure and behavioral issues are key risk factors for smoking. Young people who lack protective factors like strong self-esteem and close, healthy relationships with caregivers are more susceptible to smoking.

Treatments that have proven effective in treating nicotine addiction include medications as well as cognitive behavioral therapy, biofeedback, acupuncture.

Get Help for Addiction

Overcoming addiction is possible. We see it every day at our treatment centers.

If you or a loved one is struggling with alcohol or drug abuse, our specialized addiction treatment programs can help. We offer a full continuum of care, including:

Our substance abuse treatment is evidence-based and effective. You’ll take part in traditional therapies like individual therapy, group therapy, and family therapy. We’ll also integrate alternative approaches into your treatment plans like art and music therapy, yoga, and psychodrama. We have three convenient treatment locations and experienced, compassionate addiction experts who are ready to help. Call us today for a free, confidential consultation.


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