The 6 Most Addictive Drugs: Types & Treatment Resources

Drug addiction, like other mental health disorders, is non-discriminatory. It can happen to anyone, of any gender, age, race, or ethnicity.

There are some people who are more susceptible to showing signs of a substance use disorder, and there are some substances that are considered more addictive.

Knowing this can help people identify if they are experiencing addiction and seek the treatment they need to get their health, and their lives, back.

What Makes A Drug Addictive?

A drug’s addictiveness can be determined based on many different factors. Two important ones to consider are its potential for abuse and its effects on the brain.

Factors like the amount of harm caused by the drug are also important to consider.

For example, marijuana is a Schedule I drug, but it doesn’t create as many problems for people as some Schedule II drugs, such as cocaine and prescription opioids.

Drug Schedules

In 1971, Congress passed the Controlled Substances Act as a way to regulate the manufacture, importation, use, and distribution of certain substances.

These substances are divided into five categories, or schedules, with Schedule I drugs having a high potential for abuse and no medical purpose.

Each following schedule number represents drugs with either decreasing addictiveness, more medical uses, or a combination of both.

So a Schedule III drug would typically have less potential for abuse and more medical uses than a Schedule II drug.

Effects On The Brain

A drug’s impact on the brain most notably has to do with the communication between neurons through neurotransmitters.

In some cases, drugs cause the release of more neurotransmitters or prevent their recycling. In other cases, they mimic natural neurotransmitters and activate neurons.

In either case, drugs disrupt normal communication between the neurons. This happens in multiple areas of the brain.

Drugs And The Brain’s Reward Center

Drugs can over-activate the basal ganglia, the “reward circuit” of the brain, which rewards us with pleasurable feelings for engaging in healthy behaviors, like eating and sex.

When over-activated by a drug, this part of the brain produces the feelings of euphoria that are associated with the drug’s high.

Over time, the reward circuit becomes tolerant of the drug, requiring higher doses to achieve the same effects and diminishing the ability to feel pleasure from anything other than the use of the drug.

Drugs And The Stress Centers Of The Brain

The withdrawal symptoms of some drugs, including feelings of anxiety and irritability, can also contribute to addiction.

This happens in the extended amygdala, or the part of the brain that assigns emotions to sensory stimuli.

Often, people will keep using a substance to avoid these and other uncomfortable effects during the body’s detoxification process.

List Of The 6 Most Addictive Drugs

The drugs that made our list are schedule I or II drugs that are fast-acting and difficult to quit, despite the negative consequences.

Their use has also resulted in a large number of deaths in recent years, including overdoses as well as associated chronic conditions and diseases like heart disease or cancer.

1. Heroin

Heroin is an illicit opiate drug. Opiates are natural opioid drugs, and heroin comes from the seed pod of the opium poppy plant.

It is also a Schedule I drug, the class of drugs with the most potential for abuse and no current medical uses.

As a fast-acting drug with several pleasurable effects, heroin is highly addictive. People may use it often to maintain the high and require higher doses to achieve the same effects.

Prescription opioid abuse is considered a risk factor for heroin abuse. Of the people who began using heroin in the 2000s, three-quarters reported misusing a prescription opioid first.

2. Cocaine And Crack Cocaine

Cocaine is a Schedule II stimulant drug, and crack cocaine is generally considered the more addictive type of cocaine.

While Schedule II drugs aren’t considered as addictive as Schedule I drugs, they still have a high potential for abuse. They have some medical uses with severe restrictions.

The use of cocaine results in a flood of the “feel-good” hormone, dopamine, in the brain. This neurotransmitter is released in higher concentrations and blocked from recycling, reinforcing drug use behavior.

Like heroin, cocaine’s effects come on quickly and don’t last long, which can lead people to want to use the drug more frequently to achieve or maintain a high.

Crack cocaine is faster-acting than cocaine, with more intense and short-lived effects due to the delivery system. This is why many people consider it to be more addictive than powdered cocaine.

3. Prescription Opioids

Another category of Schedule II drug, prescription opioids were thought not to be addictive when doctors began prescribing them for pain more often in the 1990s.

However, the surge in overdose deaths since that time has proved otherwise. From 1999 to 2020, fatal overdoses involving prescription opioids saw nearly a five-time increase.

In 2020, almost 75% of all overdose deaths involved an opioid, according to the Centers for Disease Control and Prevention (CDC), with the majority of those involving fentanyl or similar synthetic opioids.

Like heroin, prescription opioid use can cause a rush of euphoria, while also decreasing or eliminating pain.

People may require higher or more frequent doses to achieve the same effects. This is partly why the powerful, synthetic opioid fentanyl has seen such widespread use in recent years.

4. Methamphetamine

Fatal overdoses from the use of psychostimulants like methamphetamine have also increased in recent years, according to the CDC, with meth accounting for 15% of fatal overdoses in 2017.

According to the National Institute on Drug Abuse (NIDA), deaths from psychostimulant abuse, mainly meth, have risen significantly every year since 2015.

Meth, like the other drugs on this list, creates a high that comes on quickly and doesn’t last long. This can lead to repetitive, “binge and crash” use of the drug.

Stopping the use of this Schedule II drug can result in withdrawal symptoms such as severe depression, anxiety, psychosis, and intense drug cravings.

5. Nicotine

Nicotine is not a controlled substance but is highly addictive. NIDA reports that, in a given year, only 6% of people who smoke are able to quit, despite negative consequences.

Although a person can’t overdose on nicotine, use of the drug does contribute to the top three killers in the United States: heart disease, cancer, and COVID-19.

A recent study showed that a whopping 67.5% of people who try smoking will go on to develop a chemical dependency on nicotine.

Although the drug doesn’t have the same effects on everyone, nicotine can produce a quick high, due to increased dopamine in the brain, peaking within 10 seconds of use.

This also affects the brain’s reward circuit, reinforcing drug-using behavior.

Withdrawal symptoms, including anxiety, increased appetite, and sleeping disturbances, can also make it difficult to quit nicotine.

6. Alcohol

Like nicotine, alcohol isn’t a controlled substance, but it makes our most addictive drugs list in part because so many people in the U.S. experience alcohol abuse.

The same study that revealed nicotine’s addictiveness showed that 22.7% of first-time users of alcohol will go on to develop a chemical dependency on alcohol.

Alcohol is the most abused substance in the U.S., and the CDC reports that more than 140,000 people die in the U.S. every year from excessive alcohol use.

The CDC defines excessive alcohol use as:

• binge drinking (four or more drinks on a single occasion for women, and five for men)
• heavy drinking (eight or more drinks per week for women, and 15 for men)
• any drinking by people under the age of 21
• any drinking by pregnant women

Many people who abuse alcohol also misuse other substances while drinking in what is called polysubstance abuse, which comes with added health risks.

Treatment For Substance Abuse Involving Highly Addictive Drugs

Personalized treatment can help ensure that anyone living with a substance use disorder receives the best, most appropriate care to get them onto the path to recovery.

For all substances, healing involves adopting new behaviors in order to stop drug use, improve brain health, and plant the seeds for long-term recovery.

For some substances, medications can help the brain adapt to the absence of the drug, easing many of the person’s withdrawal symptoms and reducing drug cravings.

Cognitive Behavioral Therapy (CBT)

One of the most effective tools that addiction therapists and other mental health professionals have to help someone change unwanted behavior is CBT.

This form of therapy involves addressing thoughts, even subconscious ones, that are influencing beliefs and behaviors.

Once the root of the behavior is addressed, it’s easier for the person to change that behavior.

Studies have shown CBT to be effective in treating addictions to all of the substances on this list as well as other substance use disorders.

When opioid use disorders are related to pain, CBT can even help people manage their pain in healthy ways.

Motivational Interviewing

Motivational interviewing (MI) is another type of therapy used to treat substance use disorders.

It involves helping people find their own motivation for healing, which can be difficult when drug-seeking behavior has become ingrained through changes in neurotransmitter activity in the brain.

This type of therapy helps people find their own inner confidence and self-worth.

The four principles of MI are:

• having and showing empathy for the person with the addiction
• providing support for the person’s own self-determination
• highlighting discrepancies between where the person is in their life and where they’d like to be
• helping the person work through any resistance

MI is often combined with stress-reduction techniques and other therapies, including CBT, for the best results.

Medical Detox And Medication-Assisted Treatment (MAT)

Before even starting therapy, some people with substance use disorders may have to go through a detoxification process, where the body rids the system of the drug.

This can lead to severe withdrawal symptoms, especially for people with long-term or severe alcohol addiction or benzodiazepine abuse.

Having a team of medical professionals available 24/7 can help ensure a safe and successful detox process for anyone battling addiction.

For some people with alcohol addiction or opioid use disorders, detoxing can be helped with the use of MAT.

These medicines trick the brain into thinking the substance is still being taken, without producing a high, which can help reduce cravings and eliminate withdrawal symptoms.

Find Treatment For Substance Abuse

If you or a loved one is in need of help for a substance use disorder, call AddictionResource.net to learn about your treatment options.

Published on February 15, 2023

Written by the Addiction Resource Editorial Staff