Dr. Leonard is a Doctor of Medical Science and a clinical anatomist. He achieved his bachelor’s degree in human biology from the University of Miami. He received his Master of Science in anatomy from Barry University’s School of Podiatric Medicine, he then achieved his Master of Medical Science from Nova Southeastern University, and lastly, he achieved his doctor of medical science from Lincoln Memorial University’s DeBusk College of Osteopathic Medicine. He has practiced in both internal and emergency medicine at the University of Florida medical system. He has published several, peer-reviewed scientific articles, as well as a medical book chapter.
The Five Most Addictive Drugs
While all drug addictions can be extremely detrimental both psychologically and physically, some drugs due to their potency and chemical makeup, can lead to addiction sooner than other drugs.
When a person takes a potentially addictive drug, there are multiple factors that determine if/ how soon they will become addicted to the drug. These factors include the intensity of pleasure that the drug induces, and the level of psychological and physical dependence that occurs. The pleasure that a drug brings can be affected by how quickly the drug enters the system, its effect on the pleasure centers of the brain and the amount of dopamine released. Psychological dependence can happen as a result of this pleasure. A craving for the drug develops that can lead to repeated use.
Physical dependence occurs when a person builds up a tolerance (needing a higher dose to receive the same effect) to the drug that they are taking. A tolerance can lead to dependence, which means without the drug the person will go through withdrawal symptoms. These physical symptoms that are often extremely uncomfortable and can become dangerous if not monitored by a medical professional.
Different drugs have different half-lives (the amount of time that it takes for them to clear your system), and this can greatly affect the time it takes to become dependent on them, and subsequently addicted.
The following is a list of the most addictive drugs as they relate to these factors.
According to the criteria listed above for addiction potential, Nutt et al. found that heroin was the highest rated across the three criteria. Heroin is an opioid and when taken it creates a massive influx of dopamine in the brain. It binds itself to the opioid receptors in the pleasure centers of the brain. These areas house our bodies reward systems. When heroin binds to the opioid receptors it creates a feeling of euphoria.
When a person stops taking an opioid like heroin, their mind and body will go through powerful withdrawal symptoms. While this particular study tested heroin, there are many other extremely strong opioids such as morphine, oxycontin, codeine, and fentanyl. In fact fentanyl is 30 to 50 times stronger than heroin. This means that it would most likely be even more addictive than heroin. Opioids are so addictive that a person can become addicted even if they are taking the drug as a prescribed medication.
In the same study, which rated the most addictive drugs, cocaine scored particularly high for feelings of pleasure and psychological dependence. Cocaine primarily acts on the neurotransmitter dopamine. When a person takes cocaine, the cocaine interferes with the process that allows the body to reabsorb dopamine, consequently flooding the brain with extra dopamine. This is what makes the person who is using cocaine feel euphoric.
Additionally, the way cocaine acts on the limbic system in the brain changes the structure of the brain and contributes to the persistent cravings for the drug. These cravings and intense pleasure lead to a strong psychological dependence on the drug, but since there are few physical withdrawal symptoms, the risk for physical dependence is much lower for cocaine.
Tobacco (nicotine) scored high across the board for causing feelings of pleasure, and creating psychological and physical dependence. When smoked, nicotine gets absorbed into the body extremely quickly, and binds to nicotinic cholinergic receptors; this releases dopamine into the pleasure centers of the brain.
After smoking consistently, tolerance to nicotine develops quickly, leading the person to smoke more and eventually become physically dependent on the drug. Tobacco (nicotine) is so addictive that while 80% of users attempt to quit each year, only 3% successfully quit the drug. Due to its harmful effects, many people desperate to quit seek out professional help.
Barbiturates have a long history of abuse despite primarily being prescribed as a medication for anxiety disorders. Barbiturates are a powerful central nervous system depressant that binds on the GABA receptor. Barbiturates scored highly for pleasurable affect and psychological dependence.
When taken, barbiturates produce a calming sensation leading the user to feel euphoric and relaxed. Tolerance and dependence can develop quickly due to the fact that they are likely to be taken repeatedly. Many people may become addicted to barbiturates after using them as medication, or self-medicating for anxiety. More recently many physicians have chosen benzodiazepines over barbiturates due to the fact that they may be safer.
According to Substance Abuse and Health Services Association, in 2017 1 in 19 had alcohol use disorder. While it is safe to consume alcohol is moderate amounts, many factors can lead a person to develop an addiction to the powerful substance. It can be easy to drink too much, too regularly and develop a tolerance and dependence on alcohol, especially if you have a genetic predisposition for alcohol addiction.
Alcohol is ranked fairly high across the board for pleasurable feelings, and physical dependence. It ranked even higher for psychological dependence due to the fact that the cravings for alcohol that an addict experiences are intense. Like many other strongly addictive substances, alcohol consumption has been linked to the release of dopamine in the brain, leading to the activation of the reward systems and the feeling of euphoria.
Going Cold Turkey Vs. Finding a Drug and Alcohol Treatment Program in Arizona
As might be expected, a lot of people would rather attempt to quit using drugs or alcohol on their own before going to rehab. This is extremely common, but it can also put people in a lot of danger as well. There are some drugs that are not safe to quit using abruptly, and doing so can result in overwhelming withdrawal symptoms.
Even so, there are still some people who want to attempt to quit on their own first. In these cases, it is important for them to know what to expect when they do.
Quitting Heroin Cold Turkey
Because heroin is an opioid drug, a person who quits using it cold turkey is going to experience withdrawal when they stop using. The most common opioid withdrawal symptoms include:
- Problems with sleeping.
- Excessive sweating.
- Tearing of the eyes.
- A runny nose.
- Extreme agitation and anger.
- Muscle aches and pains.
- Feeling anxious.
- Stomach cramps.
- Nausea and vomiting.
- Dilated pupils.
The National Institute on Drug Abuse states that quitting any opioid drug cold turkey is not the best way to get off it. While it can be done, and people do recover this way, this type of withdrawal can become incredibly painful, both mentally and physically.
Business Insider did an article on quitting heroin cold turkey from the perspective of someone who actually did it. It is definitely worth checking out, but a quote from the article speaks volumes:
“Listing the symptoms or even describing them cannot even begin to convey the pain and fear one experiences while going through this. The poison seems to make a horrid effect to convince you that you will in fact die if you do not get one more fix.”
The writer goes on to say that withdrawal lasted about two weeks. He was not prepared for the mental aspect of quitting at all. 95% of heroin addicts never get clean; they simply continue on in a dangerous cycle of addiction that unfortunately, never ends.
Quitting Cocaine Cold Turkey
Cocaine is a drug that can lead to a quick addiction once a person starts using it regularly. As one of the most addictive drugs on the planet, it makes sense that the withdrawal symptoms would be quite severe when stopping it.
Some of the typical cocaine withdrawal symptoms include:
- Having a depressed mood.
- Excessive fatigue.
- Feeling uncomfortable in one’s own skin.
- Having an increased appetite.
- Having vivid and unpleasant dreams.
- Getting agitated easily.
- Feeling restless and unable to sit still.
- Slowing of activity.
Quitting cocaine cold turkey is likely to result in a crash that can make it really difficult to cope with the aftermath. People who have been using cocaine for a long period of time could struggle with thoughts of suicide or experience paranoia or hallucinations.
Fortunately, cocaine withdrawal is typically not lethal, even when people attempt to quit using cold turkey. But that does not mean that they should try it because it will be incredibly difficult. More often than not, this type of quit results in people going back to using over and over again.
Stopping Smoking Cigarettes Cold Turkey
Just about the only drug that many experts recommend quitting cold turkey is nicotine. They claim that any other method of quitting (and there are many) is likely only to result in a relapse. Relapsing on nicotine can make it even harder to quit in the future.
Of course, quitting cigarettes cold turkey does result in withdrawal symptoms, which can be hard to deal with. Some of the more common nicotine withdrawal symptoms include:
- An increase in appetite, which can result in weight gain.
- A down or depressed feeling.
- Problems with sleeping at night.
- A jittery, shaky feeling.
- Intense cravings for cigarettes.
- Irritable, angry feelings.
- Problems with concentration.
- Coughing and an accompanying sore throat.
- Changes in bowel habits.
- The onset of nausea.
- Feelings of restlessness.
Health.com offers some helpful tips that can assist people in quitting their use of cigarettes, even if they choose to stop smoking cold turkey. They recommend:
- Having a plan. Planning ahead is key because it can help to mentally prepare the person for what they are about to change in their life. Also, it is important to plan for other things too, such as the removal of ashtrays and lighters from the home.
- Changing the routine. Most cigarette smokers do not realize how triggered they are to smoke by the things they do every day. Getting through withdrawal is a lot easier when eliminating those triggers. Even if it means avoiding certain people or places until after the withdrawal phase has passed.
- Chewing gum or sucking on hard candies. For many smokers, not having something to do with their mouths can be a real problem for them when they are trying to quit. Anything they can do – even if it means holding toothpicks in their mouths – can help them avoid giving in to smoking.
- Drinking water rather than eating. It is common for people to gain weight when they stop smoking because they tend to eat more instead of smoke. But this can be avoided, at least in part, by increasing one’s water intake. Drinking more water gives the mouth something to do and it can also increase alertness throughout the day. Not to mention, water has lots of health benefits of its own.
- Stay away from alcohol and coffee. Both of these drinks are often associated with smoking, so it is best to avoid them if at all possible. Breaking that connection could help because it eliminates these triggers.
- Staying as active as possible. One of the great things about stopping the use of cigarettes is the fact that people start to breathe better soon afterwards. This is a great time to take advantage of clearer lungs and get more exercise. The smoker will be motivated to stay healthy and it can also help them to avoid gaining weight.
It is so easy to get discouraged when it comes to quitting cigarettes cold turkey. Relapses are common, but it is important to keep trying. It can help to make a list of all the reasons for quitting and keep that list on hand.
Stopping the Use of Barbiturates Cold Turkey
Barbiturates were once extremely popular, and while people do not use them as much today, there are people who continue to take them. Most of them have been taking them for years for various reasons.
Stopping the use of barbiturates abruptly should never be considered. Doing so can lead to a long list of withdrawal symptoms, such as:
- Feeling nauseous with or without vomiting.
- A high fever.
- Symptoms of anxiety.
- Feeling restless.
- Having problems sleeping.
- Feeling fatigued and exhausted most of the time.
- Feeling aggressive and angry.
There can be a lot of complications people experience when quitting barbiturates cold turkey. Some of the risks include:
- Having hallucinations.
- Having tremors.
- The onset of seizures.
- Circulatory failure.
- Delirium tremens (DTs).
It is also possible for people to die as a result of barbiturate withdrawal. Knowing the risks is important, and anyone who takes these drugs should be aware of what can happen if they choose to stop cold turkey. It is a much better idea to quit by going through professional treatment.
Is it Safe to Stop Drinking Cold Turkey?
It is extremely common for people to believe that when they want to stop drinking, they can just stop. The problem is that they do not realize how at-risk they are for complications as a result of alcohol withdrawal. But people assume that because alcohol is so readily available, they should be able to stop without a problem. Unfortunately that is not the case.
Delirium tremens is a condition that can occur within 48-96 hours after the last drink has been consumed. But that is not a hard, fast rule. It is possible for people to experience it even 10 days following the last drink. This is a potentially fatal condition if it is left untreated.
Some of the symptoms of DTs include:
- Having bodily tremors.
- Feeling agitated and irritable.
- Feeling excited or fearful.
- Experiencing frequent and quick mood swings.
- Feeling sensitive to light, touch and sound.
- Feeling sleepy and fatigued.
- Falling into a deep sleep that can last for a day or longer.
- Hallucinations and/or delusions.
- Having quick bursts of energy.
- Experiencing changes in mental function.
- Feeling restless.
Seizures can occur as a part of DTs as well, and they are most common within the first 12-48 hours following the last drink. It is more common with people who have had complications from alcohol withdrawal in the past.
Even if a person does not experience the DTs, they will at least go through alcohol withdrawal if they are addicted. Some of the most common alcohol withdrawal symptoms include:
- Nausea and/or vomiting.
- Excessive sweating, especially on the palms of the hands or face.
- Feeling fatigued.
- Having painful headaches.
- Trouble falling asleep and/or staying asleep.
- Loss of appetite.
- Feeling nervous.
- Having heart palpitations.
- Pale skin.
- Quick emotional changes and mood swings.
Getting professional treatment is extremely important for anyone who is an alcoholic in recovery. No one should ever stop drinking cold turkey.
Arizona Alcohol and Drug Treatment Programs: What to Expect During Rehab
People who are addicted to most of the drugs mentioned above (except cigarettes) should seriously consider getting professional treatment when they are ready to quit. But this can make some people nervous; especially if they have never been through any type of rehab before. It can help to know what to expect before making the commitment.
Drug and Alcohol Detox
Alcohol and drug detox is often a very important part of the recovery process for people with addictions. Heroin, alcohol, barbiturates and cocaine should all be treated with detox prior to starting any other type of treatment.
The detoxification process is important because it can help to ease the severity of withdrawal symptoms. The goal is to make it easier on the body and mind as the drug is processed out of the body. There are typically two different types of treatment that are offered to people as they go through detox.
Medical detox refers to the use of medications to help with withdrawal symptoms. Anyone who is addicted to an opioid drug like heroin is usually recommended for a medication like Suboxone, Methadone or Vivitrol, which is non-addictive. These drugs help by keeping withdrawal symptoms at bay and keeping the person comfortable. Of course, not all drugs have medications that can be used to treat their withdrawal specifically. That means doctors will pick and choose certain ones that have been proven to treat various symptoms.
Holistic treatments are also important, such as dietary changes and physical exercise. These and other treatments, such as Yoga and meditation, can contribute to a person’s overall health and wellbeing. This makes recovery easier and it can also help the body process toxins faster.
The Rehabilitation Process
Drug and alcohol rehab is another important part of addiction recovery that should never be overlooked. It is not enough for people to get help with only the physical aspect of their substance abuse problems. They also need treatment for the mental part as well. That is why rehab is so critical.
Addicts need to understand the reasons behind their addictions, and this information is usually discovered during therapy. A lot of people start using substances because they suffer from mental health conditions like anxiety or depression. When these conditions are present alongside addictions, experts call this having a co-occurring disorder.
Co-occurring disorders happen for about 50% of people who suffer from addictions. Dual diagnosis treatment is necessary to help people recover when they have one of these conditions.
The Most Addictive Drugs Are Not Untreatable
While abusing the drugs listed above may lead to addictions, this does not mean that there is not treatment available. Whether the addiction is primarily physical, or psychological, there is hope for recovery. Entering an addiction treatment program that values a holistic approach to treatment, and understands that addiction is multifaceted, can allow patients to not only understand the root causes of their addiction, but also find a way to live a life of sobriety. Even the most addictive drugs can be conquered. If you are ready to get help, or would like more information, contact a caring professional today at SpringBoard Recovery.
Frequently Asked Questions
What Does it Mean to Have an Addiction?
The American Society of Addiction Medicine defines addiction as, “A treatable, chronic medical disease involving complex interactions among brain circuits, genetics, the environment, and an individual’s life experiences. People with addiction use substances or engage in behaviors that become compulsive and often continue despite harmful consequences.”
The National Institute on Drug Abuse state that addiction is also a relapsing disorder that is characterized by compulsive drug-seeking behaviors. People who are addicted to drugs or alcohol will continue to use even though they may be experiencing harmful consequences as a result. They tend to experience long-lasting changes in their brains because of their behaviors.
How do People Get Addicted to Drugs?
According to NIDA, when a person uses drugs, they have an impact on their brain’s reward system. The substances cause a euphoric feeling, which means that the brain is being flooded with a chemical messenger called dopamine. Proper dopamine levels serve to reinforce and motivate people to repeat certain behaviors that are needed in order for them to thrive. But with the surges that occur with drug use, the wrong behaviors are rewarded. This causes the person to continue to use drugs again and again to get those same feelings.
As the drug use continues, the user’s brain adapts by reducing the ability of the cells to respond to it. As a result, the individual does not feel as high with the same dosage level, which means they have formed a tolerance to the drug. The user will typically compensate for this by taking even more in an attempt to reach the high they want.
What are Some Common Signs of Addiction?
There are many signs and symptoms of addiction. If any of the following is present in your life, you may be addicted to drugs or alcohol:
- You are unable to stop using. It is possible that you have tried, but you always return to your substance abuse eventually.
- You continue to use even though you are having health problems. This is often seen in people who smoke cigarettes or drink alcohol. They may not be aware of the potential health effects, or they may be aware, but continue to use because they feel they cannot stop.
- You turn to the drug when you have problems. For many addicts, using drugs or alcohol becomes a way to cope with the stress they experience in their everyday lives.
- You become obsessed with using your drug of choice. For example, you may be careful to ensure that you always have a plentiful supply on hand. You also could be spending a lot of time looking for ways to get more of it.
- You take risks that you would not normally take in order to get more of the drug or to use it. For instance, it is not uncommon for some drug users to resort to stealing or prostitution in order to obtain their drugs of choice.
- You may take a large dose initially to feel the effects sooner. This is very common for alcoholics. They will often drink a considerable amount of alcohol when they start drinking for the day.
- You make sacrifices because using drugs is more important than anything else. Addicts will frequently give up activities and hobbies that they once enjoyed in favor of being able to use more often.
- You keep your drug use a secret from other people. You only use when you are alone or you use in secret as a way to protect your addiction.
- You deny that you have a problem. Most addicts claim that they can stop using any time they want to. This way of thinking allows them to believe that they have control over their substance abuse behaviors, but in actuality, they do not.
What Factors Affect How Addictive a Drug is?
There are several factors that can be used to indicate how addictive a drug truly is. Those factors are the pleasurable effects that the drug produces, how quickly a person can form a tolerance, the drug’s ability to influence continued use and the withdrawal symptoms that occur when it is stopped.
How Long Does it Take to Get Addicted to a Drug?
The length of time that it may take to get addicted to drugs really depends on the type of drug the person is taking. But there are other factors that can have an influence on it as well. A person who has a history of addiction to other substances or even behaviors is likely to get addicted much faster than someone who has never used a drug before.
Some drugs can cause quicker addictions than others. For example, there are experts who believe that a person can get addicted to crack cocaine after just one or two uses of the drug. Conversely, there are those who may take a highly addictive drug for a long period of time and never get addicted at all.
Addiction is very personal and everyone responds differently to substance abuse. The best plan is to not put yourself in a position where you could form a dependence on anything.
Is There a Cure for Addiction?
Most people are upset when they learn that there is no known cure for addiction. This is because it is a chronic disease that requires extensive treatment once it has taken hold in a person’s life.
But the good news is that even though addiction cannot be cured, it can be treated. When people get the right kind of help for their substance abuse problems, they can leave that part of their lives behind for good. It is challenging, but it is possible.
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