There are several factors that determine how addictive a substance is. These factors include how much the drug affects your brain’s reward system, how fast-acting the substance is, how hard it is to get, how quickly you become dependent, and how hard it is to quit. Intense or protracted withdrawal symptoms are among the biggest barriers to quitting a drug. While we can assess these factors in a broad way, every person responds to drugs a little differently. We’ve identified dozens of different genes related to addiction. There are genes that make people have a much more pleasurable response to alcohol or cocaine and there are genes that make people more prone to getting sick when they drink or smoke cigarettes. With that caveat in mind, here the substances that are typically considered most addictive.
Opioids have gotten all the media attention recently, as 2017 set yet another record for opioid-related overdose deaths in the US, with about 48,000 deaths. Opioids are both highly addictive and dangerous. Just how addictive and dangerous they are depends on what you use and how you use it. Opioids taken orally, such as opioid painkillers like OxyContin or Vicodin, act slower and last longer. You can certainly become dependent and addicted to them, and many people do, but it takes a little longer. Smoking or snorting them makes them act much more quickly and the high is more intense. It also wears off more quickly, leading to a harder crash, leaving users craving more. Injection is the most addictive form of opioid use. Heroin is often injected, but prescription opioids like OxyContin can also be crushed, dissolved in water and injected. This results in the fastest, most intense high, and the hardest crash. It’s estimated that 23 percent of people who use heroin will become addicted.
As with opioids, how addictive cocaine is depends on the method of use. Smoking crack cocaine is the most addictive. Crack tends to be low purity and smoking it gets it into your system more quickly than snorting it. The high is very short, usually about 10 minutes, after which the user comes down quickly and may feel agitated and depressed. This immediately leads to more cravings, which can usually be satisfied because crack is cheap and easy to get. Regular cocaine is not as addictive as crack, but it’s still very addictive. When cocaine of reasonable purity is snorted, the high might last for several hours. Cocaine works by binding the transporter proteins in the brain that are supposed to clear dopamine from the synapses in the reward center of the brain. A huge amount of dopamine accumulates, causing feelings of confidence and enthusiasm. However, the brain quickly adapts to this excess dopamine and becomes less sensitive to it, so that when you stop using, you feel lethargic and unable to focus. Around 17 to 20 percent of cocaine users will develop a serious addiction.
While alcohol is not as addictive as opioids or cocaine, it is far easier to get. In fact, it’s often hard to avoid. Alcohol is cheap, abundant, and socially encouraged. On top of all that, alcohol is also physically addictive. Alcohol simultaneously enhances the effects of the inhibitory neurotransmitter GABA and inhibits the effects of the excitatory neurotransmitter glutamate. In effect, it turns down the activity of your brain cells, which produces a relaxing effect. For that reason, it often becomes a home remedy for people struggling with anxiety, depression, ADHD, or PTSD. As with other substances, your brains soon adapts to the change in neurotransmitters. If you quit drinking, your GABA levels will suddenly be too low and your glutamate levels will be too high. This can lead to anxiety, agitation, insomnia, sweating, and tremors. Severe withdrawal, or DTs, can cause seizures or death in a small percent of cases. About 15 percent of drinkers will develop an alcohol use disorder.
Tobacco is the most addictive substance on this list and the most deadly. About ten times as many people die from tobacco use as die from opioid overdose. The main difference is that younger people die from opioid use and older people die from tobacco use. Although cigarettes are increasingly taxed and restricted, they are still easy to get. They are short-acting, and perhaps most importantly, smoking is often reinforced by physical and social habits. People smoke at regular intervals and often with friends. People who quit often complain they have nothing to do with their hands. This makes it very easy to fall back into the habit. About 32 percent of tobacco users will develop an addiction.
Methamphetamine is a longer-lasting drug that causes an intense surge of adrenaline. You have a lot of energy and you may not sleep for several days. However, the crash is also intense. Like coming off cocaine, you may feel lethargic and depressed, which makes you crave more of the drug. Methamphetamine is also cheap and easy to get. However, the withdrawal symptoms are not quite as intense as other drugs like alcohol, opioids, or benzodiazepines, making it slightly less addictive.
Benzodiazepines are typically prescribed for anxiety disorders or insomnia and they are only intended for occasional use. Using them daily for as little as two weeks can lead to physical dependence and, ironically, make your anxiety worse. Benzodiazepines can be short-acting, like Valium or longer-acting, like Klonopin. The effects of benzodiazepines are often pleasant, but not particularly intense. What makes them so addictive is the short time it takes to develop dependence and the intensity of withdrawal symptoms. Regular benzodiazepine use causes your brain to produce less GABA. If you quit taking it abruptly, you may suffer hallucinations or seizures. Sometimes this can be fatal.
If you or someone you love is struggling with addiction or mental illness, we can help. Recovery Ways is a premier drug and alcohol addiction treatment facility located in Salt Lake City, Utah. We have the resources to effectively treat a dual diagnosis. Our mission is to provide the most cost-effective, accessible substance abuse treatment to as many people as possible. Request information online or call us today at 1-888-986-7848.