Addiction to alcohol or drugs affects millions of lives in the United States alone. It is a chronic, escalating and relapsing disease that is characterized by drug-seeking behavior and substance use, despite the adverse consequences that accompany it. Along with addiction comes a stigma, despite the broadening consensus that it is a disease like any other, and is better treated using this approach. But what exactly does make a person become addicted to a substance? It is a lack of morals? Mental illness? Past trauma? There are many factors that contribute to the development of a substance use disorder, and sometimes it’s as much about the individual’s biology and life experiences as it is about the substance itself. That said, let’s examine the most addictive drugs in the world – substances that hijack the pleasure center of the brain and offer false promises of happiness and well-being.
Alcohol is both a legal central nervous system depressant that induces relaxation, lessens anxiety, and weakens social inhibitions. When alcohol is consumed, endorphin concentrations at opioid receptors become elevated and dopamine accumulates in the brain’s reward center. As tolerance increases, a drinker requires more and more alcohol to achieve the same feelings of pleasure and satisfaction. The quest to maintain the desired effects of alcohol can lead to physical dependence, and the physical and psychological withdrawal symptoms of alcohol can be dangerous.
Amphetamines are central nervous system (CNS) stimulants, giving users a burst of “energy,” excitability, and euphoria. These drugs instigate the release of “feel good” chemicals in the brain, particularly dopamine. The effects are powerful and producing pleasure sensations in the brain’s reward center and thus are responsible for the addictive character of amphetamines. Amphetamines can cause “crashes” in which the user becomes tired, depressed, anxious or irritable and wants to continue using in a binge-like fashion to perpetuate the high and avoid cravings and withdrawal symptoms.
Benzodiazepines (e.g., Valium and Xanax) (benzos) are commonly prescribed to treat anxiety, insomnia, alcohol withdrawal and other conditions. Although they work well for their indicated uses, benzos are extremely addictive and can be incredibly challenging to defeat. According to the National Institute on Drug Abuse (NIDA), benzos have a short half-life, which causes users to develop a tolerance quickly in just a few weeks. A benzo detox is often an elaborate process that requires careful weaning/tapering on a long-term schedule to avoid dangerous withdrawal symptoms.
Cocaine and Crack Cocaine
Cocaine is a stimulant narcotic that rapidly floods the brain with dopamine. Because its effects are short-lived, cocaine can be extremely addictive. Cocaine actively disrupts the brain’s ability to produce its own dopamine or control dopamine receptors, making cocaine withdrawal a possibility after just a single use, which motivates addictive behaviors. Crack is a less pure form of cocaine created from a mixture of baking soda and powder cocaine. Crack is generally smoked in crystal rock form, producing a more intense and rapid high than powder cocaine, which is typically snorted. The high from crack is remarkably short, lasting only about 15 minutes, and provokes violent cravings. Crack withdrawals can result in agitation, depression, and insomnia, motivating repeated drug use to alleviate the symptoms.
Crystal meth, like cocaine, floods the brain with dopamine but also mimics norepinephrine, another neurotransmitter. This results in the affected neurons being altered and to require more to function properly. A crystal meth withdrawal is grueling and can last many days with the sufferer on the verge of mental and physical collapse. Addicts often experience memory loss, hallucinations, psychosis, and profound depression, all of which dramatically increase the risk of suicide as an escape.
Heroin is infamous for being the most addictive drug. Countless studies indicate that a single dose of heroin is so intense that a subsequent addiction is tough to avoid. Indeed, an estimated 25% of individuals who try heroin will become addicts. Heroin induces extreme euphoria, numbs the brain and body, and washes all stress and concerns away. The heroin-induced oversaturation of the nerve cells with dopamine causes them to become exhausted and dysfunctional. Because a heroin user can no longer feel normal on their own without the drug, the chemical’s absence compels repeated abuse. Moreover, the addictiveness of heroin varies depending on its route of administration. Studies suggest that those who inject heroin intravenously have much higher rates of physical dependence than those who smoked it.
MDMA, also referred to as ecstasy or Molly, is a synthetic, hallucinogenic drug that affects three neurotransmitter systems in the brain – serotonin, dopamine, and norepinephrine. While there haven’t been many studies that examined MDMA dependency, those that have been conducted have shown that the drug is indeed addictive by nature. Moreover, tests on lab rats have revealed that MDMA damages neurons that contain serotonin, and the damage can be long-lasting. People who regularly use MDMA experience a rapidly increasing tolerance and withdrawal symptoms upon cessation such as fatigue, loss of appetite, depression and impaired concentration.
Research has shown that tobacco use is the #1 preventable cause of disease, disability, and death the U.S. Unbelievably, an estimated 16 million suffering from a major illness caused by smoking. Nicotine, the active and addictive component of cigarette smoke has a profound impact on the brain. Activation of its receptors by nicotine has adverse consequences for activity in the brain and contributes to the addictive property of the drug. Nicotinic acetylcholine receptors (nAChR, also known as “ionotropic” acetylcholine receptors) are especially responsive to nicotine.
For many chronic smokers, the long-term brain changes caused by repeated nicotine exposure results in addiction.
OxyContin, or the brand name for oxycodone, is a powerful synthetic opioid. Similar in some effects to heroin, OxyContin induces a euphoric high that is instigated by activation of the brain’s reward center. OxyContin use increases levels of dopamine, a brain chemical responsible for feelings of well-being. People who abuse OxyContin have learned that crushing tablets allows them to snort or inject the drug, producing an intense high not unlike that of heroin. Crushing the drug also eliminates the time-release property of the tablets, significantly increasing the risk of addiction. In fact, recent research found that OxyContin is a gateway drug for heroin, which addicts may prefer as a less-expensive alternative to OxyContin when they can no longer afford or obtain their drug of choice.
Treatment for Drug Addiction
Regardless of which substance a person abuses, treatment is available and recovery is possible. After detox, a process that helps the patient rid his or her body of drugs or alcohol, patients are urged to participate in long-term rehab treatment in either inpatient or intensive outpatient format – or preferably, both. Comprehensive, evidence-based treatment such as that provided by our center has been shown to increase positive outcomes. All programs are customized to the individual and include behavioral therapy, counseling, group support, aftercare planning services, and more. Recovery from addiction is a lifelong process, but you don’t have to do it alone, and you don’t have to suffer from it for the rest of your life.