The 12 Most Addictive Drugs in the World

Donald L Moore

Drug and alcohol counselor.

Latest posts by Donald L Moore (see all)

    Since the dawn of recorded history, human beings have sought and used substances that alter the subjective experience, performance, and other biological processes. Whether for spiritual reasons, for recreation, or as medicine, humankind has a long history of experience with drug use. As far back in time as the evidence goes, we also see evidence that humans have struggled with the perils of addiction.

    Whatever a person’s drug of choice, that substance interacts with our dopaminergic reward system. This is a subdivision and function of the brain that evolved in order to help us to be emotionally motivated to do things that are good for us. Food, sex, shelter, companionship and other healthy human motivations activate the dopaminergic reward system and rewards us with a dose of dopamine which makes us more likely to repeat the behavior.

    Unfortunately, many of the drugs humans have used throughout the millennia also have the ability to activate this reward system. The more powerful the release of dopamine, the more likely a person is to become addicted to a given drug. While it’s impossible to say whether a given person will become addicted to a given drug, we know that some of us are more prone to addiction than others. But we also know that some drugs are statistically more addictive than others.

    Here, we will cover 12 of the most addictive and dangerous drugs in common use today. Most of these drugs are illegal, but some are not. However, all of them can be extremely dangerous- especially to those of us who are prone to addictive behavior. While some of these drugs do certainly have rates of addiction and a risk of death and injury that are higher than others, it is impossible to tell who among us will be at most risk from addiction to a given drug.

    Factors for consideration are genetic predisposition, culture, personality, availability, education, income level, and more. It might be irresponsible to say that one drug on this list is less dangerous than another as this is the equivalent of saying it is “less dangerous.” For the record, there is no such thing as a “less dangerous” drug of abuse. For that reason, we have made no attempt to list the substances in order of addictiveness or danger, but rather in alphabetical order.

    The 12 Most Addictive and Dangerous Drugs in the World

    1. Alcohol

    Possibly the most popular drug in the world, this legal substance acts as a depressant to the central nervous system (CNS). Alcohol has a long history as a social drug that sometimes has horrific effects. Alcohol’s effects are a feeling of relaxation, a lowering of the inhibitions, and the suppression of anxiety. When consumed, alcohol releases both dopamine and endorphins.

    As with most drugs, the more a person consumes over time, the higher resistance becomes. This makes it necessary to consume greater and greater amounts to achieve the same effect. So, while the damage to the body remains the same, the intoxicating effect of alcohol decreases with use.

    Prolonged and repeated alcohol abuse leads to a condition known as alcohol dependence. When dependence is reached, the cells of the body have prioritized alcohol as a metabolic fuel. For this to happen, the biology of the cell has to change. This makes the user literally physically dependent on alcohol. Coming off alcohol in the extremes of dependency can be dangerous, and must be done under strict medical supervision.

    While this effect, sometimes referred to as the hedonic treadmill, is common for most substances of abuse- alcohol triggers addiction in a way that is well understood. An important difference early drinkers should watch for is the sensation of a surge of energy after imbibing a few drinks. For those who respond this way, it is believed that the risk of addiction is much greater.

    2. Amphetamines

    A CNS stimulant, amphetamines give the user a powerful burst of excitability, energy, and a sense of euphoria. Amphetamines trigger a potent release of dopamine, producing pleasure and enthusiasm that are very difficult to produce naturally. Amphetamines come in both legal and illegal forms. They are given as a prescription to those lacking in motivation or attention. In certain individuals, drugs of this kind can actually produce a sedative effect for reasons related to individual brain chemistry.

    Amphetamines are highly addictive and tolerance levels tend to increase rapidly with use. Increasing dosage levels can trigger psychotic episodes, making the drug especially dangerous when abused.

    3. Benzodiazepines

    Common versions of benzodiazepine, such as Xanax and Valium, are used to treat anxiety and insomnia. They are also used as an aid for those going through alcohol withdrawals. While these drugs can be very effective in their intended therapeutic uses, they can also lead to addiction when abused.

    According to the National Institute on Drug Abuse (NIDA), benzodiazepines have a relatively short half-life. This means that those who abuse these drugs can develop high tolerances very quickly. In as little as six weeks, NIDA claims, dangerously high tolerances can develop- placing abusers at high risk for an overdose. Once a person is addicted to benzodiazepines, the original symptoms of the disorder that the drug was given to treat can often resurface. The process of weaning the user off of these drugs can be very long, intensive, and difficult often calling for extended inpatient treatment programs at drug rehab centers.

    4. Cocaine

    A CNS stimulant, cocaine was originally used by doctors and surgeons as a topical anesthetic. After it was first used in medicine, the numbing effect when taken orally and the stimulant effect when inhaled nasally was soon discovered. When used as a substance of abuse, it produces feelings of euphoria, a sense of energy, and in many cases a sense of enthusiasm that tends to be socially oriented.

    Cocaine has a very short half-life and is highly addictive. While the user is under the effect of the drug, dopamine release is steady and strong- but dopamine production is halted. This leads to powerful withdrawal symptoms typified by an intense depression, lack of enthusiasm, and sometimes a powerful feeling of doom.

    Because of the social-euphoric nature of the high and the stimulating nature of cocaine, the drug triggers addiction not only to the drug itself but to the social circumstances surrounding the first few use cases. This is a kind of interpersonal addiction that creates bonds of addiction between users. This socio-chemical reinforcement can make cocaine addiction especially difficult to overcome. Many times the recovering addict cannot escape the drug unless he or she leaves the area and associations wherein the addiction was acquired.

    According to a study “Probability and predictors of transition from first use to dependence on nicotine, alcohol, cannabis, and cocaine: Results of the National Epidemiologic Survey on Alcohol and Related Conditions (NESARC)” the rate of addiction to cocaine was just over 1 in 5 people.

    5. Crack-Cocaine

    Crack cocaine is a powerful stimulant that is made from baking soda and cocaine in a process that pairs down the active chemical in cocaine until it is highly concentrated. Another effect of the distillation process is to reduce the half-life of the drug dramatically. Rather than a few minutes to a few hours- such as with cocaine- the high achieved from crack lasts fifteen minutes to half an hour. This makes crack much more addictive and dangerous.

    Another important difference between clack and powder cocaine is that crack is used by smoking it. While some cocaine users will occasionally smoke cocaine in small doses- crack is used primarily by smoking. This accelerates metabolization for a more intense and dangerous result.

    The exceedingly short half-life makes the user crave exorbitant amounts of the drug. The frequent result of a crack binge is a total mental and physical exhaustion, depression, and psychosis. The brief high and intense effects frequently lead users to spend every last dime they possess in the course of a few nights- or a few hours. Needless to say, crack addiction is devastating- often reducing a fully functional person to complete dependence and destitution in a matter of days or weeks.

    6. Crystal Meth

    A scourge to communities all across the United States since at least the 1980s, methamphetamines are a potent and lasting CNS stimulant. The drug activates the dopaminergic system but it also mimics norepinephrine. The result is that the receptors for these chemicals become very numerous very fast, causing the user to develop an intense craving and resistance to the drug.

    Like alcohol, crystal meth can result in hangover symptoms. But the hangover is so intense- both emotionally and physically- that the user feels a powerful motivation to use more.

    Crystal meth is unusual in that its effects can last many hours. This makes it a popular drug for those who work long hours in lines of work that are especially physically oriented like construction work, mining, and the like. It is impractical for those who perform mental labor as the drug hinders the function of the higher reasoning centers of the brain.

    Those who become addicted suffer fearful hallucinations, psychosis, memory loss, and depressions. Suicide rates are high for crystal meth addicts. Outward signs of abuse and addiction include large open sores on the face, head, and neck resulting from persistent itching sensations.

    7. GHB

    Gamma Hydroxybutyrate (GBH) is a central nervous system depressant. The Food and Drug Administration (FDA) approved the drug for use in treating narcolepsy in 2002. While the drug can initially cause pleasant sensations of euphoria and relaxation, abuse involving larger doses of the substance can cause loss of consciousness, coma, and death. Repeated use can lead to addiction. Withdrawal symptoms include insomnia, tremors, anxiety, and profuse sweating.

    Since GHB became a common drug of abuse, it has also seen a great deal of use as a “remedy” for the “come down” phase after using cocaine or meth. It is a drug that enables addicts and abusers to maintain the appearance of normal functioning over longer periods of time. This means that it can be more difficult to spot users who use both of these drugs in tandem. For that reason, and because of the compounding of symptoms, this drug and comparable “come down drugs” can be especially dangerous.

    8. Heroin

    The classic drug of abuse in fiction and rumor, heroin is certainly dangerous. But has been surpassed of late in both potency and toxicity by artificial opiates known as opioids. Because of high levels of dependence and abuse of opioids, many people with chronic pain turn to heroin when they can no longer afford their opioid prescriptions.

    Some studies suggest that one large initial dose of heroin can send a person down the spiral of addiction. Experts estimate that as many as 25% of every person who has tried heroin even once became addicted. The drug acts as a pain killer, causing feelings of euphoria and an intense “aura” of well being. The drug works by shutting down pain signals in a deep structure of the brain known as the nucleus accumbens.

    After repeated use, the neurons within the nucleus accumbens become exhausted and can no longer function normally. The result is an intense withdrawal experience where the body’s normal pain inhibition capabilities are shut down. This causes the user to experience a long-lasting withdrawal which has been described as intense full-body aching akin to arthritis- but with the throbbing persistence of a headache.

    Recent research shows that addiction rates are higher for those who smoke the drug, rather than injecting it. Known as “freebasing,” smoking heroin is extremely dangerous with high rates of deadly overdose associated with this method of use.

    Heroin, the largest segment of illegal opiates, has a market value of US$55 billion (as of 2009), so likly to be much higher today with the opioid epidemic. That increases to $65 billion when you count all opiates.

    9. MDMA

    Popularly known as “Molly,” MDMA is a synthetic drug that directly affects three neurotransmitter networks within the brain. While few studies focus on abuse and addiction to MDMA, the few on record make up a solid basis for the highly addictive nature of the drug.

    Lab experiments on rats have shown that the neurological damage done by the drug happens rapidly and is long lasting. Users develop a high tolerance very rapidly and withdrawal symptoms include fatigue, depression, the inability to concentrate, and loss of appetite.

    Heavily associated with youth party culture, MDMA is often one of the first drugs of abuse that people between the ages of 15 and 30 encounter. The physical brain damage that it has been shown to trigger destroys the ability of long term users to regulate behavior- often permanently, with tragic and debilitating effects.

    10. Methadone

    This potent synthetic opiate (opioid) was created and is commonly used, as a replacement therapy for those recovering from heroin and alcohol addiction. This controversial use of the drug has helped many people to overcome dependency to those and other drugs of abuse. But many others have become addicted to methadone in turn.

    The drug works by blocking the ability of heroin to alter the mind- depriving the user of the heroin high. It also eases the symptoms of heroin and alcohol withdrawal. But methadone comes with a high of its own and has become a common drug of abuse.

    When the methadone addict comes off the drug, similar withdrawals to those of heroin and alcohol ensue. With these symptoms also come a strong urge to use more despite the consequences. When addiction replacement therapy fails with methadone, often Suboxone is the next step.

    11. Nicotine

    Many years of heavily corroborated research shows that nicotine, when taken in the form of smoked tobacco, is a leading cause of cancer, disease, and disability in the United States. At any given time, an estimated 16 million Americans suffer from a disease caused by long term nicotine use. The most common of these diseases are lung cancer, throat cancer, and mouth cancer. Birth defects are also common among the children of smokers.

    Nicotine works by mimicking the function of an acetylcholine receptor in the brain. At first, a cigarette produces a potent high and feelings of well being and calm. In time, however, the perceptible effects pass away and the user simply continues to smoke just to avoid feeling jittery. The ease of use and the legal nature of nicotine makes it easy to start and easy to maintain. As a social drug, it can be especially hard to quit for those who friends and family also smoke.

    Nicotine is arguably the most addictive drug of abuse that we know of. It has the lowest rate of recovery (permanent cessation) and comes with some of the most dire consequences of any recreational drug. Like many other social drugs, such as alcohol and cocaine, nicotine is frequently used in tandem with other serious drugs of abuse.

    In addition to the severe increase of cancer risk, other symptoms of long term nicotine use are shortness of breath, heart disease, poor circulation, cardiovascular disease, and macular degeneration.

    12. OxyContin

    America is in the throes of an Oxycontin crisis. Like methadone, Oxycontin is an artificial opiate, or opioid. It is a powerful pain killer and is more potent, more addictive, and more deadly than unadulterated heroin. OxyContin is frequently prescribed for pain- both chronic and temporary (such as after surgery).

    The high that this drug produces is achieved by stimulating the reward center of the brain. In so doing, the drug delivers a powerful sense of well being, relaxation, and euphoria.

    Abusers of the drug discovered years ago that crushing and snorting it produces a high similar to that of heroin. Crushing Oxycontin pills also defeats the time release barrier they are frequently manufactured with, allowing for a rapid release of the drug into the system.

    Oxycontin is appealing to heroin addicts since a similar high can be achieved. However, because the drug is synthetic, it is much more damaging to the liver, kidneys and other filtering organs of the body. When taken in high doses, users can overwhelm the protective capacity of the filtering organs very quickly and suffer a deadly overdose.

    As mentioned earlier, Oxycontin is a gateway drug for heroin. Many people who would have never used street drugs before become hooked. If their pain condition is not remedied or is chronic, they can remain powerfully dependent for decades- or until death. Those who can no longer afford their Oxycontin prescription, will all too often turn to cheaper heroin.