Heroin Addiction Score: 9
- Dependence: 10
In 2016 about 948,000 Americans reported using heroin in the past year. That same year the number of people meeting the criteria for heroin use disorder rose to 626,000. In other words, just over sixty-six percent of heroin users become addicted. Heroin have an outrageously high rate of dependency. Almost one quarter of the people who try heroin become addicted. Relapse among users is particularly concerning because so many people die from overdose after going back to the drug. Chasing the effects of a users first high, along with concern over withdrawal, contribute to users opposition to quitting, and heroin cravings are generally considered the worst of any drug.
- Withdrawal: 8
While heroin withdrawal generally doesnt have the potential to be fatal, like alcohol and benzodiazepines do, its an absolutely miserable experience and the cause of many a relapse. Addicts go through intense pain, terrible restlessness, a wide range of flu like symptoms, and the inability to control their bodily functions. Its rare for someone to make it through these symptoms without medical assistance. Without professional help the success rate for quitting is somewhere between five and ten percent, unfortunately the success rate for most programs isnt much higher. This is why its important to recognize relapse as part of the journey into recovery, as few people get it there first try.
- Tolerance: 10
- Reinforcement: 9
- Intoxication: 8
Comparison: David Nutts Research Vs Dutch Findings
There are several similarities and differences between the initial research conducted by David Nutt and that brought forth in the alleged Dutch study. Both agree on the most addictive drug, but other rankings differ slightly. The Dutch study seemed to get into more specifics, whereas the original focused more on general classifications.
Similarities: Both David Nutt and the Dutch study seem to agree that the most addictive drug of all is heroin. If we are generalizing, both do find various forms of cocaine to be the second most addicting, and nicotine to rank third on the addiction scale.
Differences: The studies differ in various drug rankings and ratings. The Dutch study seems to have standard forms of cocaine ranking lower on the scale than alcohol. Additionally in the Nutt study, specific formulations of drugs such as crystal meth or crack cocaine are not mentioned. One striking difference was the mention of GHB in the newer study as being ranked #10 and in the older Nutt study, being among the least addictive drugs. Since theres no formal citation for this newer research, I gave more weight to the published study by Nutt.
Henningfield Ratings
The 5 Most Addictive Drugs
Heroin. According to the National Institute on Drug Abuse , heroin is the fastest acting and most abused opioid. Opioids are drugs that relieve pain and provide a euphoric âhigh.â Opioids include prescription painkillers, like oxycodone and morphine, or illegal drugs like heroin and street fentanyl.
According to a 2020 review published by the National Institutes of Health, about 80 percent of heroin users began with abusing prescription opioids, and about 400,000 Americans aged 12 and older live with heroin addiction.
Cocaine/Crack. Cocaine is a highly addictive illegal powder. Itâs a stimulant, which means its users become more alert, active, and euphoric before crashing. According to the Drug Policy Alliance, crack is a type of smoked cocaine that is faster acting but almost chemically identical. According to the United States Department of Health and Human Services, five and a half million people used cocaine, including crack, in 2019, and about a million of those people were addicted.
Alcohol. Alcohol is a depressant, meaning it slows down the brainâs reactions and functioning. It also reduces anxiety in lighter doses. The availability of alcohol and its popularity can make it more addictive, Antonello Bonci, MD, founder of Global Institutes on Addictions in Miami, Florida, tells WebMD Connect to Care.
“In terms of the sheer number of people addicted, alcohol is the substance with the highest number of cases worldwide,â Bonci says.
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The Best Way To Use Nicotine Is
While e-cigarettes let vapers inhale nicotine without all the toxins typically present in tobacco smoke, e-liquids can still contain chemicals, such as acetals, aldehydes, and heavy metals, that are not safe when inhaled. Most also contain flavoring agents that are addictive. Furthermore, the health effects of inhalation are unknown over long periods of time, and since this form of nicotine delivery has only been around for a few years, we wont know these long-term effects for quite some time. Plus, theres the speed of it hitting your brain, which is at least as fast as cigarettes. Emerging evidence indicates that the lung has its own microbiome, and smoking disrupts it.
However, nicotine when consumed orally has the advantage of avoiding the interaction between any chemicals present in the product and the lungs. Ive tried every non-smoking nicotine delivery method out there, and have found oral nicotine to be the best way to consume nicotine to experience performance-enhancing effects, as long as I can avoid artificial sweeteners, which have no place in a product Im taking to promote brain function. They do the opposite!
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Acute Effects And Insight Into Reinforcing/addictive Properties Of Cannabis
All drugs of abuse increase DA release a key neurobiological process that generates their reinforcing effects . Here we evaluate the acute changes in DA circuitry associated with cannabis intake in preclinical and clinical studies that provide basis for the reinforcing effects of cannabis. While the two main constituents of cannabis are delta9-tetrahydracannabinol and cannabidiol , THC seems to be responsible for cannabis addictive potential due to its psychoactive properties and associated effects on brain dopaminergic function. Acute THC administration elicits striatal DA release in animals and humans . However, another study found no evidence for THC-induced DA release this may be because THC induces quantitatively less DA release than psychostimulants such as methylphenidate or amphetamine . Nonetheless, these findings suggest that THC increases DA release similar to other drugs of abuse.
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Causes Of Nicotine Addiction
Smoking cigarettes or using other tobacco products causes nicotine addiction. Nicotine is very addictive, so even infrequent use can lead to dependence.
Its possible for smoking cessation products, such as nicotine gum, lozenges, or patches, to cause nicotine addiction. However, the risk is low. This is because the amount of nicotine in these products is lower and delivered more slowly than the nicotine in tobacco.
Vaping Vs Regular Cigarettes
Weighing the pros and cons of vaping versus smoking is difficult to do. On the one hand, e-cigarettes likely do not produce 7,000 chemicalssome of which cause cancerwhen they are activated, like regular combustible cigarettes do. However, the aerosol from a vape device has not been proven safe. Studies have found that it contains lead and volatile organic compounds, some of which are linked to cancer. Researchers are still gathering data on the possible long-term health effects from vaping. Its notable that e-cigarettes have not been approved by the Food and Drug Administration as smoking cessation devices. However, e-cigarettes may be a better choice for adult smokers if they completely replace smoking, according to the Centers for Disease Control and Prevention .
But where nicotine levels are concerned, a newer and popular type of vape device, called a pod mod, outcompetes many other e-cigarette devices. The form of nicotine in these pods is estimated to be 2 to 10 times more concentrated than most free-base nicotine found in other vape liquids. A single pod from one vape manufacturer contains 0.7 mL of nicotine, which is about the same as 20 regular cigarettes.
Despite its extremely addictive nature, people can successfully quit using nicotine with personalized approaches, especially under the guidance of physicians who understand addiction.
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How Is Drug Addictiveness Measured
The addictiveness of drugs can be measured using a variety of factors. Nutt and colleagues analyzed each substance based on physical and psychological dependency, physical harm and societal harms. Dependence was based on pleasurable effects, tolerance, withdrawal symptoms and the drugs ability to influence repeated use.
In the 1990s, Dr. Jack E. Henningfield of the National Institute on Drug Abuse and Dr. Neal L. Benowitz of the University of California at San Francisco each ranked the six most addictive drugs.
- Rates of dependence and relapse
- Level of intoxication
Henningfield ranked nicotine as the most addictive substance, followed by heroin, cocaine, alcohol, caffeine and marijuana. He said that heroin caused the second most intense withdrawal symptoms, followed by nicotine, cocaine, caffeine and marijuana.
According to Henningfields rankings, alcohol caused the highest level of intoxication, and it had the most serious withdrawal symptoms. Alcoholism can lead to delirium tremens, a severe form of alcohol withdrawal characterized by sudden and severe changes to the nervous system.
Both addiction experts found that cocaine ranked highest for reinforcement, which is a measure of a substances ability to drive repeated use based on human and animal tests.
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How Addictive Is Alcohol Compared To Other Drugs
Alcohol is a substance that affects the brain and body the same way that drugs do. Its a socially accepted and encouraged drug, but a drug nonetheless. Millions of Americans abuse alcohol and drugs every year. With alcohol, it can be difficult to realize that you have a problem. Access to alcohol is easy to come by, and people dont see frequent drinking as a huge problem. But how addictive is alcohol compared to other drugs?
The answer: Alcohol is one of the most addictive drugs in existence. Researchers estimate that it is more addictive than any drugs except for cocaine and heroin. Nicotine is the next most addictive drug, followed by meth.
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What If A Person Wants To Quit
If someone you know is smoking or using tobacco in another way, encourage him or her to talk to a parent, school guidance counselor, or other trusted adult. A national toll-free number, 1-800-QUIT-NOW , can help people get the information they need to quit smoking. Callers to the number are routed to their state’s smoking cessation quitline or, in states that have not established quitlines, to one maintained by the National Cancer Institute. In addition, a Web site — www.smokefree.gov — from the U.S. Department of Health and Human Services offers online advice and downloadable information to make stopping easier.
Cocaine Addiction Score: 62
- Dependence: 5
This score might come as a surprise given that cocaine is typically seen as very addictive, its dependency level is lower than nicotine or heroin. Users do experience a rush of euphoria from the drug, however fewer users will actually develop addiction. In terms of relapse, rates are also considerably lower because of an easier withdrawal and less severe cravings. With that being said, rates are higher for crack cocaine.
- Withdrawal: 7
Withdrawal from cocaine is considerably less severe in comparison to other hard drugs. There dont appear to be any physical characteristics of withdrawal. Users tend to experience intense fatigue, general discomfort, depression, agitation, and restlessness. Cravings are still quite intense during the worst of the withdrawal.
- Tolerance: 5
Tolerance to cocaine seems to be lower than most other substances surprisingly. This is likely a contributing factor to why its dependence levels are lower than expected.
- Reinforcement: 9
While dependence and withdrawal are relatively low on addiction scales reinforcement rates for cocaine are considerably high. Cocaine intoxication makes you feel invincible, give you bountiful energy, and makes you far more sociable in public settings. Furthermore, when youre on cocaine all you can think about is doing more cocaine.
- Intoxication: 5
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The 5 Most Addictive Substances On Earth
Addiction of any kind is likely to wreak havoc on an individuals life, but there are various substances that have qualities that make them especially hard to beat.
4. Barbiturates
These substances are typically used to treat anxiety and induce sleep. Popular street names for Barbiturates include Blue Bullets, Gorillas, Nembies, Bars, and Pink Ladies. At low doses, these drugs can produce euphoria at higher doses an overdose due to suppressed breathing can result.
3. Cocaine
An estimated 14-20 million people worldwide use Cocaine, resulting in a billion-dollar industry. Cocaine reacts with the brains level of dopamine, preventing neurons from turning the feel good signal off. This results in abnormal activation of the brains reward pathways. An estimated 21% of people who try Cocaine will become addicted at some point in their lifetime.
2. Alcohol
Addiction to beer, wine, orliquor can have a very negative effect on the body and mind that is often irreversible. Studies have shown that alcohol increases the level of dopamine in the brains reward system by as much as 360%. This legalized substance has a death rate of over 3 million per year.
1. Heroin
Why Is Nicotine Dangerous
Nicotine can lead to addiction, which puts you at risk of becoming a lifelong smoker and exposing you to the many harmful chemicals in tobacco. These chemicals cause cancer and harm almost every organ in your body. Teens are especially sensitive to nicotines addictive effects because their brains are still developing and this makes it easier to get hooked. Using nicotine at your age can also rewire your brain to become more easily addicted to other drugs.
Nicotine can have other long-lasting effects on your brain development, making it harder for you to concentrate, learn, and control your impulses.
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Is Vaping As Addictive As Smoking
So the most extreme statements about nicotines addictiveness are actually misrepresentations of claims made about smoking, which fly in the face of the abundant evidence of significant differences between the addictiveness of smoking and that of nicotine, but what about vaping? Well, for all of the same reasons, vaping doesnt appear to be as addictive as smoking either.
One key point raised by Tom Pruen is the speed of nicotine delivery. In Dr. Farsalinos study comparing the nicotine delivery from cigarettes to that from first and later-generation e-cigarettes, it was shown that the speed of nicotine delivery from even higher-quality, later-generation e-cigarettes was much slower than from smoking. It took 35 minutes of vaping to obtain the same amount of blood nicotine found after just 5 minutes of smoking.
The speed of delivery of the drug is a crucial factor in determining how addictive it is, so this is pretty compelling evidence that e-cigarettes arent as addictive as tobacco cigarettes. The lack of the additional chemicals that enhance nicotines addictive effects are even more reason to assume this to be true. Acetaldehyde is present in e-cig vapor, admittedly, but in non-dry-puff conditions, the levels are about 275 times lower than in cigarette smoke, so even though this does seem to increase the addictive potential of nicotine, its effect will be much greater in smoke than in vapor.
Most Addictive Drugs: The Basis Of Our Ranking Most Addictive Drugs
Our list is based on information gleaned from two different studies. The first was published in The Lancet in 2007, from a team headed by British psychiatrist David Nutt. The idea was to create a system for assessing the addictive level of various types of drugs. Three different aspects were measured, including physical dependence, psychological dependence, and pleasure generated by the drug.
The findings of this study were somewhat controversial because it was found that alcohol and nicotine, two legal and commonly accepted substances, were more addictive than ecstasy. Various newspapers in his homeland and the public ridiculed the studies and called for Nutt to resign.
Though he didnt resign, the controversy led to him being fired and another study was allegedly undertaken to confirm the truth of his hypothesis. This study has been reported to agree with Nutts findings, though no online publication of the study has been found.
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Causes & Risk Factors
Anyone who smokes or uses other forms of tobacco is at risk of developing nicotine dependence. Various factors influence who is more likely to use tobacco and to develop nicotine dependence:
- Genetics: Heredity may determine how receptors in the brain respond to high doses of nicotine delivered by tobacco products.
- Family and friends: Children with parents who smoke are more likely to eventually take up smoking themselves. Children with friends who smoke are also more likely to try cigarettes.
- Age: The younger a person is when they start using tobacco, the greater the chance that they will continue to smoke and develop nicotine dependence as adults.
- Co-existing mental health problems: People with mental health problems, such as depression, anxiety and schizophrenia, have much higher rates of tobacco use.
- Other substance use: People who use alcohol, cannabis and illegal drugs have much higher rates of tobacco use.
What Happens When Someone Uses Tobacco For Long Periods Of Time
Long-term use of nicotine frequently leads to addiction. Research is just beginning to document all of the changes in the brain that accompany nicotine addiction. The behavioral consequences of these changes are well documented, however.
The way that nicotine is absorbed and metabolized by the body enhances its addictive potential. Each inhalation brings a rapid distribution of nicotine to the brain — peaking within 10 seconds and then disappearing quickly, along with the associated pleasurable feelings. Over the course of the day, tolerance develops — meaning that higher doses are required to produce the same initial effects. Some of this tolerance is lost overnight, and people who smoke often report that the first cigarette of the day is the strongest or the “best.”
When a person quits smoking, they usually experience withdrawal symptoms, which often drive them back to tobacco use. Nicotine withdrawal symptoms include irritability, cognitive and attentional deficits, sleep disturbances, increased appetite, and craving. Craving — an intense urge for nicotine that can persist for 6 months or longer — is an important but poorly understood component of the nicotine withdrawal syndrome. Some people describe it as a major stumbling block to quitting.
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