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What are the Most Addictive Substances?

Medically Verified: 2/1/24

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All of the information on this page has been reviewed and verified by a certified addiction professional.

Addiction is hard on a person’s body and mind. The more experts understand addiction and recovery, the better they can treat people’s unique needs and help them meet their goals. Understanding which substances are highly addictive may help people make informed decisions about their substance use and treatment options.

So, what are the most addictive drugs? We’ve gathered information about which substances carry the highest risk for dependence and addiction.

How Do People Determine Which Are the Most Addictive Drugs?

Many factors contribute to a drug’s potential for addiction. Things like a substance’s availability and popularity, how people use it, its effect on a person’s body and brain, and its chemical makeup can raise or lower the risk of dependence and addiction.

A panel of drug and alcohol addiction experts used specific criteria to categorize substances by their potential for addiction. These criteria included:

  1. How much the substance activates the brain’s dopamine (a neurotransmitter involved with pleasure and reward) system
  2. How pleasurable the drug is to use (reported by people who use it)
  3. The potential for users to experience withdrawal when they stop using the substance
  4. The drug’s street value
  5. How much physical and cognitive damage the drug can do
  6. How quickly users may develop dependence

Using these criteria, the team of addiction experts developed a list of highly addictive substances and ranked them.

Why Do We Need to Recognize the Most Addictive Substances?

Understanding which substances are objectively the most addictive drugs may help shape treatment options and provide better care for those living with addiction. This guidance can help addiction counselors, medical professionals, and addiction specialists who treat people with substance abuse as they develop treatment plans and provide aftercare services.

Knowing which are the most addictive substances can also help those living with addiction to understand what may come next at each stage of recovery. This knowledge may help people know which drugs to avoid to limit their risk of addiction. It may also help people spend more time engaging in effective treatment that allows them to identify triggers and make good relapse prevention plans.

The Five Most Addictive Substances

Many health and addiction experts agree that some substances have a higher potential for dependence and addiction than others. According to a panel of experts, here are the five most addictive substances.

1. Heroin

Heroin is a highly-addictive opiate drug that can be snorted, smoked, or injected. Heroin users face a very high risk of addiction and may experience life-threatening complications, including overdose. Heroin addiction is very hard to overcome, but it is possible with the right treatment and support.

The National Institute on Drug Abuse (NIDA) reports that an estimated 0.2% (or about 691,000 people ages 12 and older) had a heroin use disorder in 2020.[1]

2. Alcohol

Alcohol abuse is common in US culture. Some people can maintain a healthy relationship with alcohol, but others develop tolerance and addiction to it. Alcohol abuse is linked to an increased risk of certain chronic health conditions like stroke, cancer, and heart disease. People who abuse alcohol are more likely to be injured, cause accidents, or be involved in a physical assault than those who do not.

According to NIDA, More people over age 12 in the United States have used alcohol in the past year than any other drug or tobacco product, and alcohol use disorder is the most common type of substance use disorder in the United States.[2]

3. Cocaine

Cocaine is a potent stimulant drug that gives people a burst of energy and euphoria. People who abuse cocaine may become dependent on it because it is a relatively short-acting drug. Cocaine users are at increased risk of grave health conditions, including stroke, heart attack, and respiratory failure.

Among people aged 12 or older in 2020, 0.5% (or about 1.3 million people) had a cocaine use disorder.[3]

4. Barbiturates

Barbiturates are sedatives or tranquilizers that depress the central nervous system’s activity and are typically prescribed to help people manage the symptoms of anxiety or insomnia. When people abuse barbiturates, they risk developing an addiction to the drugs. Taking too high a dose of barbiturates can lead to respiratory depression, hallucinations, confusion, and coma.

In 2020, an estimated 0.4% (or about 1.2 million people ages 12 and older) had a prescription tranquilizer or sedative use disorder.[4]

5. Nicotine

Nicotine is a highly addictive substance found in tobacco products, including cigarettes, cigars, and e-cigarette liquids. Users experience a temporary feeling of calm and well-being because nicotine increases the amount of dopamine in a person’s brain. Nicotine withdrawal is very uncomfortable and causes intense cravings, making it very hard for people to stop using it on their own.

NIDA reports that 8.5% (or about 23.6 million people aged 12 and older) had nicotine dependence in 2020.[5]

Recognizing the Signs of Addiction

Anyone can become addicted to drugs and alcohol, even if they don’t have other risk factors for addiction. Although people are more likely to be addicted to one of the most addictive drugs, they can develop a dependence on many substances–even those not considered highly addictive.

Recognizing the signs of addiction is an essential first step toward getting the treatment you need to overcome it. Addiction has many physical, emotional, and behavioral symptoms. These include:

  • Using more of the substance than you intended to
  • Needing to use more to get the desired effects
  • Having withdrawal symptoms if you stop using the substance
  • Neglecting your responsibilities at work, school, or home
  • Thinking about using the substance a lot
  • Isolating from friends and family or letting go of hobbies and other interests
  • Experiencing changes in your mood, sleep, appetite, or appearance
  • Facing legal or financial trouble associated with your substance use
  • Feeling like you’re unable to stop using when you want to

It’s essential to be aware of the risk of addiction, whether people use the most addictive drugs or any other substance. If you or someone you love shows signs of addiction, seek immediate treatment.

Get Help Now

If you or someone you love need help overcoming addiction, reach out to the Carolina Center for Recovery specialists today. Our admissions counselors can help determine which program will best support your recovery goals and will work to make the admission process as quick and easy as possible.