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The Most Addictive Drugs

Parents want to know: Which drugs should I be most concerned about my child using? This is a difficult question to answer because addiction is based on a complex blend of biological, social, and psychological factors, and different people are drawn to different drugs for a whole host of reasons. One person may get hooked on marijuana the first few times he uses it because it helps him relax and unwind, while another person may have no interest in the high marijuana produces, choosing to turn instead to methamphetamine or speed.

Despite the difficulty in determining which drugs are the most addictive, Dr. Jack E. Henningfield of the National Institute on Drug Abuse and Dr. Neal L. Benowitz of the University of California at San Francisco attempted to define the most addictive drugs by ranking six psychoactive substances on the five criteria they found most applicable to addiction:

  1. Withdrawal - The severity of withdrawal symptoms produced by stopping the use of the drug.
  2. Reinforcement - The drug's tendency to induce users to take it over and over again.
  3. Tolerance - The user's need to have ever-increasing doses of the drug to get the same effect.
  4. Dependence - The difficulty in quitting, or staying off the drug, usually measured by the number of users who eventually become dependent.
  5. Intoxication - The degree of intoxication produced by the drug in typical use.
Based on the level of dependence, the most common measure for determining the addictiveness of a drug, the substances ranked as follows, from most to least addictive:
  1. Nicotine
  2. Heroin
  3. Cocaine
  4. Alcohol
  5. Caffeine
  6. Marijuana
Both alcohol and tobacco ranked near the top of the scale in many areas, with nicotine placing highest in dependence and alcohol placing highest in intoxication. Other notable results included the fact that both researchers ranked caffeine higher than marijuana on a number of criteria, and both researchers identified alcohol as having the most severe withdrawal symptoms, above even heroin and cocaine. In addition, both researchers identified cocaine as having the highest reinforcement value, meaning users got hooked on the feelings the drug evoked. On the third criterion, tolerance, Henningfield rated heroin first and Benowitz rated cocaine first, suggesting users need more and more of these drugs to get the high they are seeking.

In a separate analysis, In Health magazine asked a panel of experts to rank commonly used drugs by their potential for addiction, based on how easily people become addicted and how difficult it is to quit. Of course, the findings represent addictive potential only, as each individual has unique preferences, backgrounds, and risk factors.

Again, the drug that topped the most addictive list was nicotine. Found in cigarettes, cigars, pipes, and chewing tobacco, nicotine produces pleasurable, mood-altering effects that make the body and mind crave more. Smoking is the leading preventable cause of death in the United States and can take 10 to 15 years off users' lives. With withdrawal symptoms ranging from headaches and irritability to restlessness and anxiety, nicotine has been described as the single most difficult drug to quit.

Number two on the In Health list is crystal meth (smoked meth took the number two slot, while injected meth ranked a few places lower at number four), which creates an instant sense of euphoria in the user and threatens such long-term effects as brain damage, memory impairment, suicidal thoughts, and extreme mood swings. Addiction experts have described meth's withdrawal symptoms as "physical agony" and have estimated a 92 percent rate of relapse in those seeking treatment. Even small amounts of meth can cause hyperthermia and convulsions, and even death.

Falling in at number three on the In Health list of most addictive substances is crack cocaine (smoked crack ranked number three while cocaine was listed at number 11). The rock crystal form of cocaine, crack was described by psychopharmacologist Arnold Washton in Newsweek as "the most addictive drug known to man." Despite a high that lasts only a few minutes, many users get hooked on their very first use of the drug and suffer from long-term effects that may include anxiety, delusions, paranoia, lung cancer, panic attacks, heart disease, and bronchitis.

The In Health assigned gave the number-five slot to the prescription sedative hypnotic drug Valium (diazepam). Known for particularly severe withdrawal symptoms, such as anxiety, nervousness, loss of appetite, nausea, vomiting, increased heart rate, and stomach cramps, these "downers" and other prescription drugs are becoming increasingly popular with teenagers and young adults.

In descending order, the following drugs rounded out In Health's top 15 most addictive drugs: Quaalude, Seconal, alcohol, heroin, crank (amphetamine taken orally), cocaine, caffeine, PCP (phencyclidine), marijuana, and Ecstacy.

Although many people assume drugs like marijuana are only "gateway" drugs and aren't actually addictive, some addiction experts estimate that 10 to 14 percent of regular users become dependent. Given certain predisposing risk factors, marijuana can be detrimental to chronic users. Similarly, more "accepted" and widely used drugs like caffeine, alcohol, and nicotine have proven to be some of the most addictive drugs in existence today.

If you or a loved one has a problem with these or other illicit or prescription drugs, don't delay getting help. Many drugs are highly addictive, sometimes destroying lives after just one use. Speak with a therapist or addiction specialist, or look online to find a residential treatment center or drug addiction treatment program near you.

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How does this happen? Let's follow Joan J. through several aspects of her treatment experience.

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