THE 18 MOST ADDICTIVE SUBSTANCES AND THEIR EFFECTS - ARTE

The most addictive and consumed substances are characterized by their great capacity to produce neurophysiological changes in the brain and by their power to generate psychological dependence. Among them are heroin, cocaine or crack.

We all know that most drugs can be addictive when used. However, it is often difficult to know which ones are addictive and which are not, and what addiction potential each one has.

Is alcohol addictive? Is marijuana or caffeine addictive? What does it depend on whether a drug is more or less addictive? Well, the answer to these questions is not as simple as it may seem, since measuring the degree of addiction that a given substance can produce is a remarkably complex process.

According to different experts, the potential of a drug to be addictive can be judged based on the damage it causes or the extent to which it activates the brain's dopamine system.

Likewise, the indications of the people who consume it about how pleasant it is, the withdrawal symptoms it can cause or the ease with which people "get hooked" are other important aspects when evaluating the degree of addiction to a drug.

In order to resolve doubts and offer a broad and clear vision of the addictive potential of each substance, below we will review the studies that have been carried out and comment on the substances that have been shown to be the most addictive.

The most addictive and consumed substances

Heroin

Most studies agree that the most addictive drug we can find on earth is heroin. In fact, a study carried out by the Imperial College of London showed how this substance obtained a dependency ratio of 2.89 points, showing clearly superior to other drugs.

Likewise, an investigation carried out by the National Institute of Drug Addiction revealed that 23% of people who had ever tried heroin, ended up developing a clear dependence on this substance.

Heroin is a semi-synthetic drug derived from morphine that emerged in the early 20th century, initially as a therapeutic substance. However, its recreational use quickly spread and it ended up becoming one of the most consumed substances and with the highest rates of addiction.

Cocaine

The next most addictive drug that closely follows heroin is cocaine, which, according to the study discussed above, obtained a dependency ratio of 2.82 points.

Cocaine is a tropane alkaloid that is obtained directly from the leaves of the coca plant. At the brain level, it acts as a very powerful stimulant, and activates the reward system at extremely high levels.

For this reason, the action of cocaine is highly addictive, since it acts directly in the brain regions that carry out this type of process.

Today, cocaine has superseded heroin and appears as the second most widely used illegal drug, only behind marijuana.

Crack

Crack is a drug derived from cocaine, which owes its name to the sound it makes when heated. Specifically, crack is the compound that results from the mixture of cocina free base with a variable part of sodium bicarbonate.

Its effects are very similar to those of cocaine and despite the fact that like this, it does not produce physical dependence, it causes a high psychological dependence that makes it one of the most addictive drugs.

Nicotine

Nicotine is undoubtedly the legal drug that causes the most addiction among its users. Its effects on the brain are very similar to those of cocaine. However, the stimulation performed on the reward system is much less and does not cause the typical feelings of euphoria and "rush" of coca.

As the stimulation it performs is much less, nicotine by itself does not modify brain function in global terms or damage brain structures. However, this is not to say that it is not addicting, as nicotine directly affects the reward regions of the brain.

In fact, it is estimated that 30% of people who use nicotine over a period of time develop addiction to the substance, and it shows the same dependency ratio as cocaine.

Likewise, nicotine is the drug that causes a greater number of addictions, affecting, as demonstrated by Professor David Nutt in his research, 50 million people in the United States.

Methadone

Chemical structure of methadone. Source: Leyo

Methadone is a synthetic opioid that is used as a detoxification and maintenance treatment for addiction to opiates, especially heroin.

However, the fact that its use is mainly therapeutic and that it is an essential substance to treat heroin dependence does not mean that it is not addictive.

In fact, it is postulated that the addictive potential of methadone is very high, which is why its therapeutic use should be closely controlled by medical professionals.

Research carried out by David Nutt showed that methadone has a dependency ratio of 2.68, values very similar to those of nicotine and cocaine.

Methamphetamine

Source: Radspunk

Methamphetamine is a powerful psychostimulant that acts as an adrenergic agonist. It is a synthetic drug with a chemical structure similar to that of natural amphetamines, however, its effects on the central nervous system are more pronounced.

In fact, the synthesis of this drug is aimed at increasing the rewarding effects and therefore increasing its addictive potential.

At present, methamphetamine is a substance classified by the International Convention on Psychotropics as highly addictive.

Morphine

Source: Vaprotan

Morphine is a powerful opiate drug that is frequently used in medicine as a pain reliever.

It is used abundantly in the treatment of pain such as acute myocardial infarction, post-surgical pain, pain associated with blows, bone pain or pain caused by cancer.

However, as with the rest of opiates, the addiction of this substance is very high and it can generate physical dependence with some ease.

Thus, despite the fact that morphine remains the most effective classic analgesic for relieving acute pain, its use is decreasing as new synthetic drugs appear that cause less addiction.

Methaculone

Molecular structure of methaculone in 3D. Source: Vaccinationist

Methaculone is a sedative-hypnotic medication that produces effects similar to those of barbiturates. At the brain level, it is responsible for reducing the level of activity of the central nervous system.

During the 60s and 70s it was used as a hypnotic for the treatment of problems such as insomnia or chronic pain, as well as a sedative and muscle relaxant.

It is not currently used as a therapeutic substance due to its high addictive potential, but its recreational use has become widespread, especially in South Africa.

Barbiturates

Source: Choij

Barbiturates are a family of drugs derived from barbituric acid that act as sedatives of the central nervous system and produce a wide range of effects, from mild sedation to total anesthesia.

They are mainly used as anxiolytics, as well as hypnotics and anticonvulsants. These substances have a very high addiction potential and can cause both physical and psychological dependence.

For this reason and because of the danger posed by the massive intake of these drugs, currently they are practically not used for therapeutic purposes.

Alcohol

Alcohol is the second most addictive legal drug, behind tobacco. Its use is highly widespread and most consumers do not develop addiction to the substance.

However, this does not mean that alcohol is not addictive, as it is very much. In fact, alcohol addiction, despite appearing more slowly and requiring prolonged consumption over time, is one of the most difficult to overcome.

According to the study carried out by the Imperial College of London, alcohol has a dependency ratio of 2.13 points, a value slightly lower than that of methamphetamines, for example.

Likewise, an investigation carried out in 2010 revealed how 7% of the US population had alcohol addiction, and alcoholism is considered one of the great public health problems in the world.

Benzodiazepines

Source: Gotgot44

Benzodiazepines are psychotropic drugs that act on the central nervous system with sedative, hypnotic, anxiolytic, anticonvulsant, amnesic, and muscle relaxant effects.

Currently they are the most widely used antidepressants and have shown greater effectiveness in the treatment of different anxiety disorders. However, prolonged use of this substance can lead to addiction with relative ease.

In fact, it is estimated that the addictive capacity of this substance is slightly lower than that of alcohol (1.89 points).

Amphetamines

Source: Christian «VisualBeo» Horvat

Amphetamines are synthetic adrenergic agents that stimulate the central nervous system. They are used for therapeutic purposes to improve wakefulness, increase alertness levels, increase the ability to concentrate, promote basic cognitive functions such as attention and memory, and reduce levels of impulsivity.

However, although its addictive potential is less than that of its synthetic derivative for recreational use (methamphetamine), it also acts on the brain's reward system and can cause addiction with its use.

Buprenorphine

Source: Tmeers91

Buprenorphine is a drug from the group of opiates that is useful for the treatment of addiction to other opioids such as morphine or heroin. It has a function similar to that of methadone, and presents an analgesic activity superior to that of morphine.

Buprenorphine has shown a dependency ratio of 1.64 points, which is why it is also a highly addictive substance.

GHB

Source: DMTrott

GHB is a central nervous system depressant that, although popularly known as "liquid ecstasy," has little to do with this drug. Initially it was used as an anesthetic, however it was withdrawn from the market due to its low analgesic effect and its high epileptogenic capacity.

Its effects are similar to those of alcohol or anxiolytics: disinhibition, increased sociability, relaxation and decreased sexual function, and its addictive capacity is also similar (1.71 points).

Ketamine

Ketamine 3D molecular structure. Source: Benjah-bmm27

Ketamine, also known as "Special K" or "Kit Kat" is a dissociative drug with a high hallucinogenic potential. It is a derivative of phencyclidine and was initially used for therapeutic purposes due to its sedative, analgesic and anesthetic properties.

However, due to its adverse effects and, above all, its addictive potential, it was withdrawn from the market and is currently used only for recreational purposes.

MDMA

Source: DMTrott

MDMA, better known as ecstasy or crystal, is an empathic drug belonging to the family of substituted amphetamines. Its consumption usually produces euphoria, a feeling of intimacy with others, decreased anxiety, hyperactivity, increased muscle tension and partial loss of the feeling of physical pain.

Although its addictive potential is notably less than that of methamphetamine and even amphetamines, it acts directly on the brain's reward mechanisms and its use can lead to addiction.

Caffeine

Caffeine is an alkaloid of the xanthine group that acts as a psychoactive, slightly dissociative and stimulant drug. Its consumption is widespread worldwide and has rarely been associated with adverse or harmful effects on health.

However, consuming caffeine causes an increase in the level of stress hormones in the body and increases the levels of dopamine in the brain. Although it is not usually the usual, caffeine can cause addiction, especially in those people who consume it compulsively.

Marijuana

The addictive potential of marijuana is one of the most controversial in recent years. Marijuana is a psychotropic obtained from the hemp plant and is the most widely used illegal substance in the world.

There is a certain consensus in stating that the addictive potential of this substance is not very high, however, its consumption can generate psychological dependence, which is why it is concluded that cannabis is also an addictive drug.

References

Andres JA, Diaz J, Castello J, Fabregat A, Lopez P. Drugs of abuse: evaluation of addictive behavior units in a health area. Rev Diagn Biol 2002; 51 (2): 63-68.
Report of the Working Group of the American Psychiatric Association. Benzodiazepines: Dependence, Toxicity and Abuse. EDIDE. Barcelona. 1994.
Glatt, SJ, Lasky-Su, JA, Zhu, SC, Zhang, R., Li, J., Yuan, X., et al. (2008). Drug Alcohol Depend, 98, 30-34.
Jimenez L, Correas J. The drug dependent patient. In: Manual of Psychiatric Emergencies. Edit. Chinchilla A. Ed. Masson. Barcelona, 2003

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