There are an estimated 230 million, or roughly 1 in 20, people on the planet that use illicit drugs to some degree. Despite most countries' best efforts to curtail the proliferation of narcotics and substance abuse within their borders, notwithstanding the debate many nations have over what exactly constitutes an illegal narcotic in 2014 (re: marijuana), drug abuse is a prevalent issue in society. Compounding that issue is the fact that some legal drugs are also routinely abused, leading to either addiction, treatment, and recovery, or addiction, desperation and sometimes even death. While there are many more than ten drugs that are highly addictive and routinely lead to abuse and complications for the user, the ten drugs on this list, based on a study by Dutch scientists that devised a scale of 0-3 in determining a drug's addictive potential, are considered the ten most addictive drugs in the world.
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Gamma Hydroxybutyrate, better known as GHB, is a central nervous system depressant. Most commonly known as the ‘date rape’ drug and also used amongst many club goers, particularly of the "all night" variety, as CNS, the drug can cause feelings of peacefulness and euphoria, aid in easing anxiety and if too much is taken, or if used in combination with alcohol, can cause the user to pass out. Because of its short half-life and similar properties to other CNS depressants, the withdrawal from GHB can cause extreme anxiety, panic, dizziness and insomnia. According to the Dutch study, GHB’s dependency rating is 1.71.
One of the most commonly prescribed families of drugs by physicians worldwide, benzodiazepines can be torture to get off of. Used to treat anxiety, panic, obsessive compulsive disorder, and anything else a doctor may see fit, benzodiazepines work to reduce many of the overreacting neurons in the user's brain, and they work; for a short time. With a dependency rating of 1.89, the problem with benzodiazepines is that they have a short half-life, and are also drugs which the patient builds tolerance to, sometimes in as little as 6 weeks. Once tolerance is built to benzodiazepine, the drug actually causes rebound symptoms of the disorder it was used to treat originally, only much worse, leaving patients little choice but to up their dosage. It can take years and a process of slow weaning to get off benzodiazepines.
Like most drugs, amphetamines are a perfect dichotomy. Unlike the previous drugs on this list that help abate anxiety, but turn around and cause more during withdrawal, amphetamines are a central nervous system stimulant. So, when one takes amphetamines it can treat depression, make one more aware and also excitable, and when one is withdrawing from an amphetamines they can suffer from severe depression and fatigue, thus making the user need the drug more; a vicious cycle. With a dependency rating of 1.95, amphetamines like Adderall, so widely mentioned in the news lately, build tolerance very quickly, making increased usage at a higher dose common.
Another stimulant, at one point in time there wasn’t anyone who didn’t know someone who had used cocaine at least once; it was the designer drug of the later 1970s and the 1980s. Though cocaine is still very prevalent today, it may perhaps be less romanticized, though that doesn’t make it any less addictive. With a dependency rating of 2.13, cocaine is so addictive because of its extremely short half-life and method of action. Cocaine keeps a steady stream of dopamine in the brain while the user is high, thus stopping the brain from producing more and shutting down dopamine receptors, but as soon as withdrawal sets in, the brain begins to crave the lost dopamine the drug provided, hence the need for more.
The second legal drug on this list, alcohol actually acts in a very similar fashion to benzodiazepines. As a CNS depressant, alcohol relaxes, reduces anxiety and un-inhibits users. All good things in moderation, but the problem with alcohol is that it is so adept at what it does to the brain, that users who are addicted cannot drink in moderation, or casually. It becomes a measure of excess, or habituation, which, with a dependency rating of 2.13, is no surprise. Indeed, withdrawal from alcohol for alcoholics is not only physical and psychological torture, it can also be deadly, and many heavy alcoholics require acute hospitalization to stop drinking.
Meth is similar to cocaine in the way the drug capitalizes on dopamine in the brain, but meth just takes it to an entirely different level. Meth doesn’t keep naturally produced dopamine around in the brain longer, it actually mimics dopamine and norepinephrine, causing the brain to release more of its own. When cessation of the drug begins, the brain intensely craves the loss in both dopamine and norepinephrine, prompting the user to get high again. With withdrawal symptoms ranging from severe depression to psychosis, hallucinations, and even suicide, it’s no wonder meth’s dependency rating is 2.24.
Ironic isn’t it, that a drug used to treat heroin addiction is so high on this list. In reality, the use of methadone in a controlled medical setting is a good way of helping heroin addicts recover, as methadone is an effective way of treating heroin withdrawal symptoms. The bad news? Methadone is extremely effective at treating withdrawal symptoms from heroin, and because of this many heroin addicts simply take methadone until they become tolerant to the drug, and then continue using it as a barrier to suffering the severe withdrawal process that comes with heroin use. With a dependency rating of 2.68, methadone addiction is a rising problem, particularly amongst the homeless.
One of the hardest things in the world to do is to quit smoking, or, at the very least to remain a non-smoker. There’s no debating that as nicotine’s allure just keeps drawing so many successful quitters back for more. It’s no wonder, as nicotine acts in the same way as the two most addictive drugs in the world do; by mimicking an acetylcholine receptor in the brain, while simultaneously reducing the number of these receptors that the brain actually produces. So in theory if you had 100 of these receptors before you started smoking, you may have 50 naturally produced ones now. Nicotine makes up the other 50, meaning your brain needs nicotine just to maintain a ‘normal’ level. As one of the leading causes of death around the world, and the deadliest drug on the planet by mortality rate, nicotine’s dependency rating of 2.82 is thoroughly alarming.
Oft thought of as a poor man’s cocaine due to its widespread introduction to North America via impoverished inner city neighbourhoods, crack is essentially the same drug at a lower purity level and mixed most often with baking soda in order to allow the user to smoke the drug. And that’s precisely where crack has earned its dependency rating of 2.82. The method of ingestion causes the high from crack cocaine to be much faster and more intense than from cocaine, but it is also extremely short, maybe ten minutes, causing the user to crave more less than twenty minutes after first getting high. Withdrawal symptoms can cause immense depression, agitation and insomnia as well, furthering an addict’s need for the drug.
The most mythologized, romanticized and demonized drug on earth, the king of the opiates, heroin, and the addiction and withdrawals that accompany it, has become legend. Rock stars, authors and poets have all written about their exploits with heroin and captured the public’s imagination, from every euphoric high down to every degrading low. The fact is, heroin is a drug many like to ruminate about, but luckily, many never try. Heroin’s dependency rating is a staggering 2.89 and it is estimated that nearly 25% of all people who have tried heroin once became addicted. That’s the dichotomy of heroin society is so fascinated with; there must be something about the drug that is just irresistible for it to be so addictive. Heroin causes euphoria, eases pain and numbs the brain and body, acting on the pleasure receptors in the brain. Heroin withdrawal causes fevers, severe depression, pain, nausea, vomiting, insomnia, and intense cravings for the drug. The worst illness you have ever experienced in your life for a week or more. It really is no wonder that methadone was the only thing powerful enough to combat heroin addiction; heroin truly is the most addictive drug in the world.
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