The 5 Most Addictive Drugs In The United States

Medically reviewed by

Debra Wallace, MA.Ed, LPCC-S, LICDC-CS

February 26, 2019

The following drugs are highly addictive and dangerous when used alone: heroin, fentanyl, cocaine, alcohol, and benzodiazepines. These drugs are often used together in patterns of polydrug or polysubstance abuse (using two drugs together or even taking two within close periods of time). Polydrug abuse increases the risk of addiction, overdose, death, and drug-related health problems.

1. Heroin

Heroin is an immensely addictive derivative of morphine, which comes from the opioid poppy. Heroin can cause a physical dependency shortly after abuse begins. Drug abusers quite often progress quickly to higher doses to overcome tolerance, a pattern of use which increases both the odds of addiction and overdose.

Heroin causes dopamine to work in a dysfunctional way. This causes surges of the neurotransmitter to flood the brain. As heroin impacts our nervous systems it changes the way our body is able to control pain, movement, and emotion; it also elicits an overwhelming sense of reward and pleasure. These sensations enforce drug seeking and use by propelling individuals to increase dosages of this drug.

The rush or euphoric state from heroin is experienced almost immediately when injected intravenously (into the vein). Snorting, smoking, or injecting the drug in a different manner has a more gradual onset, but this does not mean that a person faces a decreased risk for addiction. No matter how you administer the drug, when using heroin the risk of dependence and addiction is high.

2. Fentanyl

Fentanyl, a synthetic opioid, and fentanyl analogues (or drugs containing these substances) forge some of the most serious addictions our nation faces today. As opioids, these drugs work in a similar manner to heroin, only in a much more potent way. Tolerance and dependence form quickly when these drugs are abused. Drugs containing fentanyl have such a high rate of overdose that many individuals lose their life before they even experience addiction.

Fentanyl, both prescription and that which is produced illicitly, is 50 to 100 times stronger than morphine, making it responsible for drug-induced fatalities across our nation. Fentanyl analogues, which are essentially chemical cousins of fentanyl, are even more potent and deadly. Examples of these illicitly produced “designer drugs” include carfentanil, U-47700 (“Pink”), and grey death, a lethal concoction which may contain any of these drugs, heroin, cocaine, and more.

Not only are these fentanyl-containing drugs some of the most addictive, they are many of the most dangerous. The threat of overdose and sudden death are very real possibilities when using these drugs. Many times these drugs are laced into other substances like heroin or cocaine, so an individual isn’t even aware they are using such an addictive and life-threatening substance.

3. Cocaine

Cocaine comes in two forms, both of which are highly addictive stimulants. As a stimulant, cocaine alters the production of dopamine in your brain, causing a surplus of this neurotransmitter. These heightened levels, and the quick speed at which cocaine hits your system, are the main contributing factors to cocaine’s potential for addiction.

The powdered versions, simply referred to as cocaine, appear as a fine white powder. Cocaine is typically snorted, however some users liquefy and inject it. Either method can quickly produce extreme addictions.

Crack cocaine, a rock-like, crystallized version of cocaine (also known as freebase cocaine), is even more addictive. Smoking the drug is preferred by many, though individuals inject it as well. The Center for Substance Abuse Research notes that “After the initial ‘rush’ subsides, the user experiences an intense desire for more of the drug—this is how users can become addicted after just their first hit.”

4. Alcohol

Many people dangerously overlook alcohol’s addictive nature due to its legal standing. Despite the accessibility and social acceptance of alcohol, it is a very addictive drug.

Like other highly addictive drugs, alcohol vastly disrupts dopamine production. As an individual comes to rely on the feel-good effects produced by this excess, they often find they cannot experience a significant sense of pleasure or reward without alcohol. This tolerance drives individuals to drink more, thus upping the possibility of addiction and dependence.

Alcohol can generate severe physical dependencies, so much so that withdrawal from it can be deadly. Accompanying this is what can be a deeply embedded psychological addiction, as many individuals turn to alcohol as a tool for self-medication.

5. Benzodiazepines

Benzodiazepines (benzos), a class of drugs frequently prescribed to treat anxiety and sleep troubles, can quickly create physical dependency and addiction when misused or consumed recreationally. Examples of frequently abused benzos include alprazolam (Xanax), diazepam (Valium), and lorazepam (Ativan).

Short-acting, high potency benzos (like Ativan and Xanax) are often preferred by drug abusers because they hit the system faster and more intensely. This leads a person to use a second dose sooner, which in turn can cause both tolerance and dependence to develop quicker, factors which make addiction more imminent. Benzodiazepines form powerful dependencies. Like alcohol, these states may precipitate what can progress into fatal withdrawal.

Benzodiazepines are used recreationally for pleasure, often with other drugs. Many also stumble into addiction after using these drugs for the purpose of self-medicating mental health disorders or sleep dysfunction.

Abusing Any Drug Is Dangerous

Any form of drug abuse is dangerous, regardless if it’s one of the most addictive drugs or one less so. Abusing a drug in any way alters a person’s life and the manner in which their body and brain functions.

Over time, and as a person begins to consume more of the drug on a regular basis, physical and mental health problems, deteriorating relationships, damage to careers or vocations, and other detriment begins to occur. It’s when an individual continues using despite these things that addiction has taken hold.

If you’re concerned that your drug use is spiraling out of control, or that you’re already suffering from an addiction, it’s important to seek professional help and treatment right away.