What is the Most Addictive Drug?

Edited on October 7th, 2020

The addictive potential of a drug can be difficult to determine because it may vary greatly based on several factors, such as how easily a person will become addicted, the severity of its withdrawal symptoms, how much the drug activates the brain’s reward system, or how much physical and psychological harm the drug causes.

So, what is the most addictive drug? Depending on who you ask, the answer will be different. However, one group of researchers consulted addiction experts to pinpoint some of the most addictive drugs on earth and here is what they found.¹

What is the Most Addictive Drug?

Due to the many different factors involved, it’s difficult to narrow it down to just one single most dangerous drug. However, there are several notable drugs that addiction experts agree are some of the most addictive and harmful substances in the world. Here are some of the most addictive drugs, listed in no particular order.

1. Heroin

Heroin increases dopamine levels in the brain by up to 200 percent, making it one of the most addictive drugs in the world.² Users who inject or smoke heroin are more likely to become addicted very quickly because it reaches the brain faster. To add to its physical potency, this drug also carries the highly dangerous risk of overdose.

One large dose of heroin can cause an overdose that depresses heart rate and breathing to a life-threatening extent.³ Most people who overdose are already addicted to heroin, but some people overdose after their very first dose. Between 2010 and 2017, heroin-related overdose deaths increased 400 percent and in 2017 alone,15,482 people died from heroin overdoses.⁴

Aside from the risk of overdose, chronic heroin abuse causes many harmful side effects, such as:⁵

• Liver disease
• Skin abscesses around injection sites
• Infections of the valves and lining of the heart
• Kidney disease
• Stroke
• Heart attack
• HIV and Hepatitis B or C
• Seizures
• Collapsed, scarred veins
• Tolerance and physical dependence
• Irreversible brain changes and brain damage
• Painful and persistent withdrawal symptoms
• Addiction

Additionally, heroin abuse has severely damaging societal effects and cost America an estimated $51.2 billion in 2015 U.S. dollars. That’s $50,799 per heroin user.⁶ Heroin abuse and addiction also heavily contribute to widespread unemployment, homelessness, drug-related hospitalizations, premature death, lost productivity, criminal activity, incarceration, treatment for infectious diseases, and more.

2. Cocaine

Cocaine is another highly addictive drug that causes dopamine levels in the brain to rise more than three times the normal level.⁷ As a result, cocaine abuse is highly rewarding for the user despite its negative effects. Crack cocaine is also a significantly addictive form of cocaine and has been deemed even more addictive than the powder form of cocaine, as it produces a more powerful and potent high.

Cocaine can be abused in many different ways, such as snorting it, smoking it, or dissolving it and injecting it into a vein. Using this powerful psychostimulant regularly can cause:¹⁰

• Irritability
• Restlessness
• Panic attacks
• Auditory hallucinations
• Increased risk of HIV and hepatitis C
• Tears and ulcers in the gastrointestinal tract
• Weight loss and malnourishment
• Chest pain
• Tolerance
• Withdrawal symptoms
• Stroke
• Seizures
• Heart problems
• Bleeding in the brain
• Parkinson’s disease
• Cognitive impairment
• Strong cravings

According to the 2018 National Survey on Drug Use and Health, an estimated 5.5 million people ages 12 or older used cocaine in the past year, including about 757,000 crack users. About 977,000 Americans ages 12 and older were addicted to cocaine.⁸

According to the Centers for Disease Control and Prevention (CDC), cocaine was involved in one in five overdose deaths in 2017. The same year, cocaine-related overdose deaths increased by more than 34 percent, with nearly 14,000 Americans dying from overdoses involving cocaine.⁹

3. Alcohol

Alcohol is one of the most commonly abused drugs in the world, yet it is also one of the most harmful. According to the World Health Organization’s 2018 Global Status Report on Alcohol and Health, more than 3 million people die every year as a result of harmful alcohol use. This is equivalent to 1 in 20 deaths and makes up more than five percent of the global disease burden.¹¹

Worldwide, about 237 million men and 46 million women have alcohol use disorders, with America being one of the most highly affected regions.¹¹ Despite the many harmful effects of this drug, alcohol abuse across the world is expected to increase.

The global demand for alcohol remains high because of the pleasurable effects it provides when abused. Research studies show that alcohol increases dopamine levels in the brain’s reward system by as much as 40 to 360 percent.¹² The more a person drinks, the more dopamine levels will increase, which only encourages the person to drink more.

Although alcohol abuse rates are high, chronic and excessive use of alcohol continues to harm drinkers with side effects like:¹³

• Physical injuries
• Violence
• Risky sexual behaviors (sexually transmitted disease, unwanted pregnancies, etc.)
• Miscarriage and stillbirths
• High blood pressure
• Heart disease
• Stroke
• Liver disease
• Digestive problems
• Various types of cancer
• Learning and memory problems
• Lost productivity
• Damaged relationships
• Unemployment
• Alcohol dependence and addiction

4. Barbiturates

In the past, barbiturates were used to treat anxiety and insomnia, but today, they have largely been replaced by other prescription drugs. Back when they were frequently being prescribed, barbiturates were heavily abused and barbiturate addiction was common. Now that they are more difficult to get, barbiturate abuse is less common.

Regardless, barbiturates are highly addictive. Even low doses of these drugs produce strong feelings of euphoria, which makes them likely to be abused. In high doses, they are not only addictive but also very dangerous, as they can suppress breathing and cause death. According to the U.S. National Library of Medicine, one in ten people who overdose on barbiturates or a mixture of drugs including barbiturates will die.¹⁴

Chronic long-term abuse of barbiturates can cause:

• Breathing problems
• Pneumonia
• Sexual dysfunction
• Delayed relaxes
• Short attention span
• Memory loss
• Increased risk of fatal overdose
• Severe withdrawal symptoms (can sometimes be fatal)

5. Methamphetamine

Methamphetamine (or meth) has long been considered one of the most difficult drugs to quit, due to its addictive qualities and the powerful high it produces. Meth is an extremely powerful man-made stimulant drug that is produced in powder form or a crystal form called crystal meth.

One of the reasons meth is so addictive is that people who use it develop a tolerance to it very quickly. As a result, they take more and more of the drug to keep feeling its pleasurable effects. With larger more frequent doses, a person can very quickly become addicted to meth.

Unfortunately, chronic abuse of meth comes with many negative consequences. Many long-term meth abusers suffer from brain damage, cognitive problems, and difficulties regulating their emotions. Regular use of meth also depletes levels of dopamine in the brain, which often results in severe depression, suicidal ideation, and very strong cravings for meth.

All of these side effects can make it very difficult to stop using meth once you’re addicted and the latest nationwide statistics reflect this. In 2018, about 1.9 million Americans ages 12 and older used meth in the past year and an estimated 1.1 million were addicted to meth.⁸

How Drug Addiction Works

Research has shown that drug addiction is a chronic relapsing disease with genetic and environmental causes. Although choosing to use a drug is a choice, the disease of addiction is not. 

Once someone abuses a mind-altering drug like methamphetamine, heroin, or cocaine, it begins to change the structure and functions of the brain, keeping the user coming back for more, despite the drug’s negative side effects. As these brain changes occur, the person will begin to develop behaviors that signal something is wrong, such as:

• Being unable to control his or her drug use
• Trying to stop using but being unable to
• Experiencing withdrawal symptoms when unable to use
• Continuing to use drugs despite the negative consequences

Other behavioral signs that someone is suffering from drug addiction include:

• Severe mood swings
• Depression
• Anxiety 
• Problems concentrating
• Poor judgment and decision-making
• Memory loss
• Issues with cognition

Although some drugs are more addictive than others, as described in this article, addiction is a treatable disease that can be managed on a long-term basis. With the right treatment and support, a person can stay sober, heal the physical damage done to their brain and body by drug abuse, and make healthy lifestyle changes to establish a sober life for themselves.

Beating Addiction

The drugs listed above are all very powerful substances that can change the way a person’s brain functions with continued use over time. Often, this results in physical dependence and addiction. Although these drugs are powerful, overcoming addiction is possible and you don’t have to be controlled by your substance abuse any longer.

Drug detox is often the first step to achieving long-term sobriety. If you are severely addicted, medical detox can provide enhanced medical and clinical support that is individualized to meet your needs and ensure your safety during withdrawal. You’ll also meet with a licensed clinical counselor during detox to work through psychological symptoms of withdrawal, such as anxiety, depression, or PTSD.

Once you are sober and stable, your detox treatment team will provide you with individual recommendations and referrals to ongoing treatment. Most people continue their care with inpatient or outpatient drug rehab, where they gain life skills, strategies, and peer support to make lasting life changes and sustain their sobriety long-term.

References:

1. https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(07)60464-4/fulltext
2. https://onlinelibrary.wiley.com/doi/abs/10.1002/syn.890210207
3. https://www.americanscientist.org/article/the-toxicity-of-recreational-drugs
4. https://www.drugabuse.gov/publications/research-reports/heroin/what-are-long-term-effects-heroin-use
5. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5448739/
6. https://www.sciencedirect.com/science/article/abs/pii/000689939190690W
7. https://www.samhsa.gov/data/report/2018-nsduh-annual-national-report
8. https://www.drugabuse.gov/publications/research-reports/cocaine/what-are-long-term-effects-cocaine-use
9. https://www.who.int/substance_abuse/publications/global_alcohol_report/en/
10. http://jpet.aspetjournals.org/content/267/1/250.short
11. https://www.cdc.gov/alcohol/fact-sheets/alcohol-use.htm
12. https://medlineplus.gov/ency/article/000951.htm