The 10 Most Addictive Drugs in the World
Most addictive substances affect the brain’s reward system. They trigger the brain to release dopamine, often in excessive amounts.
These increased dopamine levels cause euphoria, reinforcing the desire to repeat pleasurable but unhealthy behaviors like taking addictive drugs.
10 Most Addictive Drugs in the World
Many forms of central nervous system stimulants (CNS) and depressants can be highly addictive.
These ten most addictive drugs worldwide are accompanied by intense withdrawal symptoms, further complicating recovery.
1. Prescription Opioids
Prescription opioids belong to the class of drugs derived from poppy plants or produced synthetically in a laboratory. Regardless of how they are made, all opioids have structural and functional similarities.
Examples of distinct chemical structures and potency include:
Opioids bind with receptors in the brain to block nerve signals between the brain and the body. It allows them to effectively alleviate discomfort, which is why they’re often used to manage chronic pain.
In the United States, 96.6% of people who misuse opioids use opioid prescription painkillers.1 Globally, opioid use disorder (OUD) affects about 16 million people.2
Some of the most addictive opioids are:
- Oxycodone (Tylox®, Percodan®, and OxyContin®)
- Meperidine (Demerol®)
Heroin’s an illicit opioid made from morphine. Heroin also appears as a white or brown powder or a black sticky substance known as black tar heroin.
Those with heroin addiction inject, sniff, snort, or smoke this habit-forming substance. Its common street names include:
- Hell Dust
Activating opioid receptors in the brain, heroin can bring comfort and joy and soothe discomfort or pain. The National Survey on Drug Use and Health (NSDUH) recorded 745,000 heroin users in 2019.1
Cocaine is a stimulant drug from the coca plant native to South America. It looks like a fine white powder or a crystallized rock.
Although health professionals use it for legitimate medical treatments like anesthesia, most cocaine trafficked on the streets has been altered with other substances like amphetamines to magnify profits.
Cocaine’s common street names include:
- White Powder
Both forms of cocaine are highly addictive. But according to the literature, crack addicts outnumber pure cocaine addicts.3
4. Crack Cocaine or “Crack”
Unlike cocaine hydrochloride, crack is a form of cocaine processed with baking soda and water. It produces instant but short-lived effects, so users tend to binge on them since their effects don’t last long.
Typically smoked to reach an intense high quickly, crack cocaine sends large quantities of the drug into the lungs. This creates overwhelming sensations of pleasure that are incredibly hard to resist or recover from without proper treatment.
Alcohol alters the brain’s chemical balance, leading to mood, behavior, and cognition changes. Its main active component is ethyl alcohol or ethanol, found in all alcoholic drinks (including wine, beer, and liquor).
Due to its easy accessibility, alcohol addiction is common and globally prevalent. About 14.1 million American adults struggle with alcohol addiction.1
Nicotine is a powerful stimulant that speeds up the transmission of nerve impulses between the brain and body. It’s the primary psychoactive ingredient in tobacco products such as:
- Pipe tobacco
- Chewing tobacco
Nicotine is a habit-forming substance; like alcohol, it’s an easily accessible legal substance. Over 14 in every 100 American adults in the United States smoke cigarettes or have a nicotine addiction, making nicotine the most abused drug in the country.4
Amphetamine is a commonly prescribed medication to help manage and treat attention-deficit/hyperactivity disorder (ADHD) and narcolepsy. This CNS stimulant is also an FDA-approved medication for treating binge-eating disorders through its long-acting form ‘Lisdexamfetamine.’
Some varieties also manage Parkinson's disease. Speed and other high-potency forms, such as crystal methamphetamine (ice), can be found on the black market and dangerously abused by athletes looking for an edge in competition.
8. Barbiturates or Benzodiazepines (Downers)
Barbiturates or benzodiazepines are commonly prescribed to decrease activity in the CNS. These “downers” are generally used to treat severe cases of insomnia, but they can also control seizures or be used as an adjunct to anesthesia.
People misuse barbiturates to help with sleep, reduce anxiety and inhibitions, and treat the unwanted effects of illicit drugs. As many as 405,000 Americans aged 12 and above use barbiturates.6
The most addictive Barbiturates include:
- Alprazolam (Xanax®)
- Valium (Diazepam®)
- Klonopin (Clonazepam®)
- Ativan (Lorazepam®)
- Librium (Chlordiazepoxide®)
- Sleeping Pills
Methadone is an FDA-approved medication that effectively provides pain relief to those suffering from opioid use disorder or chronic pain. It works by activating the same pathways as other opioids but lasts much longer.
Methadone treats more severe conditions that don't respond well to non-opioid treatments. This makes it a viable option for people with cancer or others facing terminal illness while providing suitable comfort from persistent ache syndromes.
10. Meth and Crystal Meth
Meth or methamphetamine is a stimulant that speeds up the body's systems. It is medically prescribed as Desoxyn® for the treatment of obesity and ADHD.
Meth is used as a recreational drug and is smoked, snorted, or injected. It is one of the most highly addictive substances and looks rock-like.
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Symptoms of Substance Use Disorder (SUD)
Symptoms of substance use disorder (SUD) include one or more of the following within 12 months, resulting from alcohol, certain drugs, prescription drugs, and other substances:
- Recurring substance use
- Reduced capacity to fulfill obligations at work, school, or home
- Continued use in places or situations that are inappropriate or physically dangerous (e.g., driving, at work or school, while using heavy machinery)
- Legal and financial problems due to substance use
- Social or interpersonal problems
The most addictive drugs—which include crack cocaine, crystal meth, and prescription opioids—are also accompanied by intense withdrawal symptoms that make it difficult to quit.
If you or a loved one is addicted to one or several of these substances, seek medical help immediately. Starting addiction treatment early helps ensure a safe and long-lasting recovery.
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Addiction Treatment Options
Drug addiction treatment options include inpatient, outpatient, partial hospitalization, and detox programs. Drug abuse therapies can include medications, behavioral therapies, or their combination.
The proper treatment program depends on the person’s needs and the types of drugs they use, including alcohol and other drugs. Effective addiction treatment options include medical support to manage withdrawal symptoms, ensuring a safer and more comfortable recovery process.
Why Do People Get Addicted to Drugs?
People with mental health problems, such as depression or anxiety, may use dangerous substances to self-medicate. They do so to get temporary relief from stressful situations or trauma, leading to drug abuse, alcohol abuse, and addiction.
Taking illegal drugs triggers the release of large amounts of dopamine, which causes pleasure. Dopamine in the brain is a vital chemical neurotransmitter responsible for:
- Reward processing
As addiction progresses, a person’s brain becomes more sensitive to dopamine. Eventually, the brain also becomes less responsive to dopamine’s effects. This results in decreased pleasure, reduced ability to control behavior and increased need for medication.
Dopamine receptors in a user’s brain can also become desensitized after extended exposure to dopamine. This desensitization causes a need to increase the dose to achieve the same pleasurable effects. Users may also experience withdrawal symptoms if they attempt to stop their drug use and abuse.
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- “2019 National Survey on Drug Use and Health.” Substance Abuse and Mental Health Services Administration, 2019.
- “Opioid Addiction.” National Center for Biotechnology Information, 2023.
- Hatsukami, D. K, et al. “Crack cocaine and cocaine hydrochloride. Are the differences myth or reality?.” Journal of the American Medical Association, n.d.
- “Tobacco Product Use Among Adults – United States, 2019.” Centers for Disease Control and Prevention, 2020.
- Palmer, R. S, et al. “College Student Drug Use: Patterns, Concerns, Consequences, and Interest in Intervention.” Journal of College Student Development, 2013.
- “2018 National Survey on Drug Use and Health.” Substance Abuse and Mental Health Services Administration, 2018.