Addiction is an impulsive & irrational attachment to a product, which makes you so addicted that you can no longer do without it. Some highly addictive substances are illegal drugs, but not all.
What are the most addictive drugs?
Depending on the researcher being questioned, the addictive potential of a drug will be judged according to different criteria:
- its health hazards,
- its price,
- its ability to activate the « reward circuit » in the brain, the pleasure that people who consume it find there,
- the strength of withdrawal symptoms in the detoxification phase,
- and the ease with which a first-time user becomes « hooked ».
There are also other criteria for measuring the addictive potential of a drug, and some researchers even claim that no drug is addictive in itself. Because of these divergent views, it seemed appropriate to ask expert panels to classify drugs according to their more or less addictive nature.
In 2007, David Nutt and his colleagues interviewed addiction experts and made some interesting discoveries.
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1. The heroin
Nutt’s study shows that heroin is the most addictive drug of all, with a maximum score of 3/3. It is an opiate that causes a 200% increase in dopamine levels in the brain’s reward system, as demonstrated by experiments on laboratory animals.
In addition to this highly addictive factor, the danger of heroin also comes from the fact that the lethal dose is only 5 times higher than the dose necessary to obtain a « high » effect.
Heroin is ranked 2nd in terms of harmfulness because of the damage it can cause both to users of the drug and to society. The market for illegal opiates – including heroin – was estimated at $68 billion in 2009.
It was synthesized from morphine by Heinrich Dreser in 1898 for Bayer laboratories. Bayer laboratories used it as a tuberculosis drug and then as a treatment for morphine dependence (because it was believed that heroin did not induce dependence).
At the beginning of the century, it was sold over the counter in pharmacies, as a substitute for morphine, for pain relief. As soon as the First World War ended and following numerous addiction problems, its therapeutic use was challenged.
The side effects
In addition to the undesired effects of nausea, vomiting, tickling and scratching, heroin use can disrupt sleep cycles, modify the feeling of hunger, relax muscles, modify sexual desire either by decreasing or increasing it. It narrows the pupils (« pinhead »), work as antitussive, i. e. calms cough, slows down the production of secretions for a few hours (« no tears », constipation. In men, it can delay or prevent ejaculation and in women it can disrupt or stop menstrual cycles ( but not fertility!!!!!) and cause vaginal dryness.
2. The cocaine
Cocaine directly interferes with the way the brain uses dopamine to carry messages from one neuron to another. In summary, cocaine prevents neurons from turning off the dopamine signal. This results in an abnormal increase in the activity of the brain’s reward circuits.
In animal experiments, cocaine increased dopamine levels more than three times the normal level. It is estimated that 14 to 20 million people use cocaine worldwide and that the cocaine market is worth about $15 billion.
According to experts, cocaine consumed in the form of crack cocaine is the 3rd most dangerous drug. While cocaine in the form of powder, which causes a less pronounced « high », is ranked 5th.
About 21% of those who try cocaine become addicted to it at some point in their lives. Cocaine resembles other addictive stimulants, such as methamphetamine – which is becoming more and more problematic because it is more and more available.
Cocaine brief story
Coca leaves have been used by South American Indians for more than 3000 years. The use of coca is historically associated with religious ceremonies and is reserved for nobles. Currently, the leaves are chewed in Peru and Bolivia for their therapeutic properties. Chewing coca leaves gives a slight euphoria, increases physical stamina and reduces the effects of mountain sickness and oxygen deprivation.
A medical précis on cocaine was published in 1569. In 1860, Albert Neiman isolated cocaine from the leaf and described the anesthetic action of the drug when it is placed on the tongue.
It was first used in ophthalmology. In addition to its anesthetic action on the eye, cocaine reduces eye reflexes and causes vasoconstriction of the arterioles, which reduces bleeding in this highly vascularized region.
During the 19th century, cocaine was used against respiratory diseases such as tuberculosis, asthma and respiratory failure. It has also been used, particularly by Sigmud Freud, as an aphrodisiac and in the treatment of alcoholics and morphine addicts with the results that we can guess.
By the 1890s, cocaine had become the main component of many elixirs and other tonics. It was incorporated in cigars, cigarettes, chewing gum and also in Coca-Cola. Cocaine was not removed from Coca-Cola until 1906. The doses used at that time were not insignificant and in 1891, 200 people died from overdoses.
In 1914, 46 American states, in an effort to reduce crime, brought the use and distribution of cocaine under control. In the same year, the use of cocaine, other than for medical purposes, was prohibited. In the 1950s, cocaine was no longer considered a public health problem.
Cocaine reappeared as a drug in the 1960s. Since then, its consumption has been steadily increasing and is no longer limited to certain wealthy groups in which it seemed to be confined.
What cocaine actually causes
- a contraction of most blood vessels. The tissues, insufficiently irrigated, become poorer and, consequently, die. This is often the case with the nasal septum, which can even be perforated in users who regularly inhale or sniff cocaine.
- heart rhythm disorders and high blood pressure. They can cause cardiovascular accidents, especially among vulnerable people or those who consume large quantities of tobacco or cannabis.
- in more sensitive people, or when taking large doses, cocaine can cause psychological disorders, high mood instability, paranoid delusions, hallucinations (especially auditory) or panic attacks. In addition, cocaine sometimes causes toxic psychosis, which is characterized by a loss of contact with reality. The intoxicated individual’s behaviour then becomes unpredictable and potentially dangerous.
- an increase in psychological activity and, consequently, insomnia, phases of excitement and memory disorders.
- Another characteristic of cocaine is to remove inhibitions, which can lead to violence, sexual assault, compulsive spending, etc. The feeling of omnipotence caused by cocaine makes it a product that makes it easier to act on various undesirable or even criminal behaviours.
Nicotine is the main addictive ingredient in tobacco. When someone smokes a cigarette, nicotine is quickly absorbed by the lungs and carried to the brain. The researchers classified nicotine as the third most addictive substance.
More than two-thirds of Americans who tried smoking reported that they had become addicted to cigarettes at some point in their lives. In 2002, the World Health Organization (WHO) estimated that there were more than a billion smokers. Moreover, it is predicted that tobacco will kill 8 million people each year by 2030.
Laboratory animals are smart enough not to smoke. However, rats in laboratory experiments press a button to receive a dose of nicotine directly into the blood – and this causes a 25 to 40% increase in levels.
History of tobacco
It is in America that tobacco originated more than 3000 years ago, as evidenced by ancient pipes discovered in South America.
In 1492 Christopher Columbus arrived in Cuba then very popular among the Incas and Aztecs to communicate with spirits, to get drunk, to soothe pain and fatigue.
The petun (indigenous name for tobacco) was smoked, especially during religious festivals and ceremonies. Christopher Columbus discovered it as soon as he arrived in Cuba, smoked in the form of a long tube called « tobago » or chewed, and brought back leaves and seeds to Europe. The success was immediate.
Europeans attributed many therapeutic virtues to it, such as healing asthma, coughing… In 1556, Father André Thévet, returning from an expedition to Brazil, acclimatized the first Jean Nicot plants in his garden in Angoulême.
And Jean Nicot, Ambassador of France in Lisbon, is the first to promote the use of the petun in the french elites. He sent some to Queen Catherine de Medicis to calm her son’s migraines. Very quickly we only talked about the abassador’s grass, giving it the names of Nicotiana, Nicot’s grass, Reyne’s grass….
For a long time used only for medicinal purposes, tobacco was over the centuries more and more consumed for pleasure. The pipe, once used during the shamanic rites of the ancient tribes or in the administration of tobacco as a remedy, became the companion of great discussions.
Tobacco was also taken or cigars smoked. Taking advantage of this very lucrative trade, Cardinal de Richelieu introduced the first tobacco tax and Colbert made it a state monopoly.
Gradually, its therapeutic virtues were questioned and many influential people such as King James I of England opposed its use. Even Pope Urban VIII in 1642 banned its consumption or risk excommunicating its users. However, despite its detractors, tobacco found a new lease of life with the industrialization and creation of cigarettes in 1843. This new form of consumption marked the beginning of the global expansion of tobacco.
4. Barbiturates (old sleeping pills)
Barbiturates are a class of drugs initially used to treat anxiety and promote sleep, such as Gardenal. They interfere with the brain’s chemical signals, with the effect of « turning off » different areas of the brain. At low doses, barbiturates cause some euphoria, but at higher doses they can be fatal because they inhibit breathing reflexes.
Dependence on barbiturates was more frequent when these drugs were commonly prescribed. Fortunately, it decreased dramatically when they were replaced by other drugs, mainly benzodiazepines (Lexomil, Xanax, Valium…). This highlights the role of context in addiction: if an addictive drug is no longer available, it can no longer harm. The researchers in Nutt’s study ranked barbiturates as the 4th most addictive substance.
Alcohol consumption – legal in most countries – was rated 1.9 out of a maximum of 3 by the Nutt team. Its main effect is to increase dopamine levels in the brain’s reward system by 40-30% – in animal experiments. The more they drink, the higher their dopamine level increases.
Some 22% of those who have « had a drink » develop alcohol dependence at some point in their lives. WHO has estimated that 2 billion people consumed alcohol in 2002 and that more than 3 million people died from excessive consumption in 2012. Alcohol has also been classified as the most dangerous substance in the world by other experts.
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