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Healing, Strengthening, and Advancing the Lives of LGBTQ People Seeking Recovery

A Surprising Look at the Most Addictive Drugs in the World

A Surprising Look at the Most Addictive Drugs in the World

Drug NamesGenerally, most people assume that hard drugs like cocaine and heroin are the most addictive of their kind when in fact, they aren’t. While the addictive properties in these drugs are intense, potency isn’t the only factor that plays into addiction; availability and frequency of use are important too. It might surprise you to know that all of these drugs aren’t illegal.


First formally acknowledged in 1571, this highly addictive substance is said to have originated nearly 20 years prior to that, when it was introduced in its plant-like state.[1] The drug forms in the roots of the tobacco plant, later spreading throughout the leaves. The average tobacco leaf contains between 0.05 and 7.5 percent nicotine.[2] While chewing tobacco is the original and oldest way of consuming nicotine, most nicotine is now ingested from smoking cigarettes. As the primary cause of preventable disability, disease and death in America, smoking continues to claim the lives of 480,000 US citizens annually.[3] Currently, an estimated 42 million adult Americans are cigarette smokers.[4] Recent research points to 13.4 million people smoking tobacco via cigars, 2.5 million via pipes, and another nine million chew their tobacco.[5] Smoke is inhaled when smoking cigarettes whereas it isn’t when smoking a pipe or cigar. Due to this, many hold the opinion that cigars and pipes are a safer method for tobacco use, but this isn’t true at all. Cigars and pipe tobacco both have a higher nicotine content than cigarettes do. This means smoking one cigar is the equivalent to smoking several cigarettes, even without inhaling.[6] Chewing tobacco — sometimes referred to as snuff or dip and available dry or moist — is placed behind the lip where it rests between it and the gums and teeth or inside the cheek; nicotine is absorbed through the skin and ingested via swallowing of saliva that becomes infused with it. Use of any nicotine increases your risk of cancer, lung and heart disease, and oral disease.[7]All of these products are sold over the counter in convenience stores, supermarkets, and gas stations everywhere. In most other parts of the world, you would never find tobacco for sale at a pharmacy, but in America, it’s been a commonplace part of our commercial culture until recently. Pharmacies like CVS have committed to ceasing the sales of tobacco products in their retail stores.[8] In light of medical knowledge on the health effects of ingesting nicotine, the number of people smoking tobacco has declined from 42 percent of the American population back in 1965 to only 18 percent as of 2012.[9] “Genetic factors may influence how receptors on the surface of your brain’s nerve cells respond to high doses of nicotine delivered by cigarettes,” per the Mayo Clinic.[10] Likewise, the younger one begins smoking, the more likely they are to keep smoking and do so heavily during adulthood.[11] A Georgetown University Medical Center study produced results that depict a direct correlation between parental smoking and the development of like behaviors in their children; the longer a child was exposed to a parent’s smoking, the more likely they were to eventually engage in the same behavior themselves.[12] Those who are abusing other drugs or alcohol and those with depression or mental illness are also at increased risk.[13] Nicotine use isn’t restricted to the US; it is an epidemic that is responsible for one out of every 10 adult deaths worldwide every year.[14] It takes a mere 10 to 20 seconds for nicotine to enter the brain after inhaling it.[15] This potent drug activates the pleasure centers of the mind and increases production of dopamine — a happy, feel-good chemical.[16] Nicotine addiction develops over time after habitual use. Some people report being addicted not only to the drug, but also to the act of smoking. From nicotine patches and prescription oral drugs like Chantix to cessation programs and quitting cold turkey, most individuals struggle with quitting. Every year, fewer than seven percent of the 35 million people who attempt to quit smoking are successful for at least one year’s time.[17]


Caffeine comes from over 60 known plants and is now also available in manmade form.[18] It is ingested primarily though foods and beverages by 90 percent of the global population.[19] While caffeine is used and abused worldwide, it is a growing and serious problem in America specifically. Americans consume a staggering 170 liters of soda annually, a number that is 16 percent ahead of Mexico, the second leading country in soda consumption.[20] With variants of 16 to 55 mg of caffeine in a given 12-ounce soda, that can mean a lot of caffeine.[21]Of course, soda isn’t the only culprit; Americans down about three cups of coffee every day per person on average.[22] One 8-ounce cup of brewed coffee contains anywhere from 95 to 200 mg of caffeine.[23] Caffeine concentrations in supersized energy drinks are far higher. Popular fat burners and over-the-counter pills like No-Doz promise to deliver a quick boost of energy and mental clarity while contributing to caffeine addiction behind the scenes for many. Is it mere coincidence that Americans lead the world in coffee consumption too, or is something bigger at play, like caffeine addiction?[24] More than half of the participants in some studies have claimed they had difficulty quitting or even lessening their caffeine consumption.[25] Certain people are more at risk for becoming dependent on caffeine:

  • Those diagnosed with mood disorders[26]
  • Those with certain genetic predispositions to dependence[27]
  • Persons who, in the past or currently, have other substance abuse problems[28]
  • College students[29]

When caffeine enters the brain, it affects nerve centers that are responsible for neurological reward systems. In essence, caffeine makes you feel good and the releasing of dopamine in the prefrontal cortex of your mind reinforces the behavior, consequently making you want to do it again and again.[30] Despite what we do know about caffeine and how we should limit our intake of it, consumption of coffee is on the rise with 83 percent of US adults gulping down the brewed bean concoction in 2013, a five-percent increase from the year before.[31] Regular consumption of caffeine has been associated with cancer, osteoporosis, and cardiovascular disease.[32] In 2010, a 23-year-old man died after ingesting approximately 5 mg of caffeine between powder and energy drink consumption.[33] Completely legal and found in everything from chocolate to your favorite morning beverage, extreme caffeine consumption is not without risks. Dating as far back as 3400 BC, heroin was discovered to be a derivative of opium poppy plant pods[34] that are now grown mostly in southern Asia and Latin America.[35] Today, the drug is most commonly used via intravenous injection, but the trends of snorting, sniffing and smoking the drug are growing in popularity due to the risks involved in sharing needles and keeping them clean.[36]Heroin turns into morphine when it enters your brain, and from there, it acts on opioid receptors involved with pain and reward mechanisms.[37] The effects are felt pretty quickly — including the rush that heroin abusers seek — a pleasant and euphoric sensation when the skin flushes with warmth.[38] The risk of addiction correlates highly with the drug’s potency, but you’re also at increased risk if you have other psychiatric problems or if you begin using heroin at a younger age.[39] It is thought that around 23 percent of heroin users become addicted to the drug.[40] An estimated 9.2 million people worldwide are using heroin.[41] Heroin is most popular in countries like Pakistan and Afghanistan, but US use is steadily on the rise. In 2007, 373,000 people in America were using heroin; just five years later in 2012, that number has nearly doubled at 669,000.[42] Likewise, overdose is increasing too, jumping 45 percent between 2006 and 2010.


Cocaine is a derivative of the coca leaf.[43] In use since at least 1860, the coca plant is primarily cultivated today in Latin America — particularly in Columbia, Bolivia and Peru.[44] Today, cocaine use is particularly rampant in Scotland.[45] In the United States, cocaine use has actually been on the decline, dropping almost 50 percent between 2006 and 2010.[46] In terms of addictive properties, it is second in line only to methamPowdered cocaine can be snorted and thereby ingested via the lining of the nostrils.[48] The powder can also be mixed into a water solution and then injected into the body; another form of cocaine, the rock form known as “crack,” is generally heated and then smoked.[49] Perhaps one of the biggest risk factors for cocaine use and dependence is among those who are already using other drugs. A 2010 study showed that children ages 12 to 17 who use gateway drugs like cannabis, alcohol and tobacco are up to 266 times more likely to use cocaine than children of the same age who do not use any gateway drugs.[50] Per the study, children who used marijuana were 85 times more likely to use cocaine; those who drank were 50 times more likely to use the drug.[51] Upon reaching the brain, cocaine causes a surging high feeling that is immediately followed by a plummeting low.[52] This high is achieved because cocaine inhibits the brain from reabsorbing released dopamine.[53] Tolerance builds quickly with cocaine use, requiring more frequent stronger doses of the drug to achieve the same high — something that often leads to serious health consequences or death.


Alcohol is a byproduct of fermented grains, fruits and vegetables.[54] It is unclear how long alcohol has been around, but it dates back to at least 10,000 BC.[55] Although efforts have been made over the years to dampen alcohol usage, even banning it in the United States in the 1920s and 1930s, it continues to increase in popularity. With 67 percent[56] of adult Americans currently being alcohol drinkers, a number that hasn’t been seen since 1985, it’s no wonder it is the leading risk factor for disease in the Americas.[57] Eastern European countries like Russia, Moldova and the Ukraine lead the world in alcohol consumption.[58] When alcohol enters your bloodstream, it progresses to your brain where it ramps up norepinephrine, a feel-good chemical that heightens your state of arousal.[59] Delaying effects on the cerebellum account for an alcohol-impaired person’s slowed reaction time.[60] About 18 million Americans have an alcohol use disorder.[61] This legal substance creeps into the lives of many, often in adolescence and during the college years, aiding in an increased risk for the development of alcohol dependency.[62] Having a parent who is addicted to alcohol also predisposes you to a fourfold increased risk of the same fate.[63]

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