Some of the Most Addictive Substances

Though effects can vary from one substance to the next, an important shared feature amongst many addictive substances is their ability to elicit a pleasurable surge of dopamine in areas of the brain instrumental in reward, as well as the eventual reinforcement of the behaviors in question that lead to such neurochemical changes.1 Substance use disorders (SUDs) can quickly develop as the use of addictive drugs or alcohol continues and, often, escalates in an effort to repeatedly achieve a rewarding, euphoric rush. As SUDs develop and compulsive substance use continues, individuals are likely to experience several negative effects throughout all areas of their lives.

This article will go into more detail about some of the most addictive substances, what addiction is, and how to find help if you or your loved one is experiencing a substance use disorder.

Some of the Most Addictive Drugs

A collection of substances including drugs and alcohol

Addiction is characterized as a chronic, relapsing disorder that includes compulsive drug-seeking behavior despite the negative consequences of substance use.2 No one strives to become addicted to drugs or alcohol. However, as substances can ultimately change our normal brain reward hierarchy—placing the artificially reinforcing effects of drugs and alcohol above otherwise pleasurable activities such as food, sex, and socializing—it can become increasingly difficult to not think about using, and exceedingly tough to quit.1

While the initial decision to drink alcohol or use drugs may be a voluntary one, repeated use of drugs and alcohol are associated with changes in the brain that make addiction more likely to take hold.2 These changes can impact memory and learning, decision-making and judgement, and behavior control to drive the compulsive drug seeking and use characteristic to addiction.2


Like other addictive substances, alcohol can produce reinforcing pleasurable feelings.3 As with other types of addictive drug use, chronic alcohol consumption is associated with gradual changes in the structure and function of the brain, which can last long after one quits drinking.3 Alcohol can impact a person physically and psychologically. Some of the desirable or rewarding psychological effects of alcohol, such as a reduction in anxiety and stress, serve to reinforce consumption and contribute to alcohol’s addictive properties.3

However, alcohol’s initially pleasant effects of euphoria and anxiety reduction may be eventually outweighed by cumulatively negative consequences on the mind and body.

Negative consequences of alcohol use include:3

  • Alcohol poisoning or overdose toxicity.
  • Progressive liver disease.
  • Cardiovascular disease.
  • Increased risks of certain types of cancer.
  • Impaired judgment that can result in car accidents and other catastrophes.
  • Strained interpersonal relationships.

Increased risk of violence, homicide, and suicide.

Heroin and Other Opioids

Opioids include illicit drugs such as heroin, as well as several legally prescribed pain medications.4 Prescription opioids can be taken safely if under the directive of a medical professional.4 However, opioid misuse can lead to adverse outcomes. Addiction and overdose are serious risks associated with opioid misuse.4

In a dose dependent manner, heroin, fentanyl, and other prescription opioids bind to and activate opioid receptors in the brain to alter pain sensation, but they may also adversely impact physiological processes such as breathing.4,5

Heroin can be smoked, snorted, or injected, and short-term heroin effects can include:5

  • A euphoric rush.
  • Decreased levels of consciousness.
  • Feeling heaviness in legs and arms.
  • Warm, flushed skin.
  • Skin itching.
  • Dry mouth.
  • Nausea and vomiting.

Potential long-term consequences of heroin use include:5

  • Insomnia.
  • Worsened mental health issues, such as depression.
  • Severe, chronic constipation.
  • Increased risk of pneumonia.
  • Kidney and liver disease.

Additional risks of injecting heroin:5

  • Localized tissue inflammation and/or infection (e.g., abscesses).
  • Collapsed veins.
  • Endocarditis, or infection of the heart lining.
  • Increased risk of communicable disease transmission (i.e., HIV, hepatitis C, etc.).


Cocaine is a highly addictive stimulant drug. Though pharmaceutical cocaine continues to be used for very limited medical use, recreational use of cocaine is illegal in the United States.6 Like heroin, cocaine can be ingested in a few ways. In powder form, cocaine is most commonly snorted or dissolved into liquid solution for injection use, though it may also be processed into a freebase, crystalline form that can be smoked.6 Cocaine increases activity of several monoamine neurotransmitters, including dopamine. More specifically, cocaine stops dopamine from being recycled back into the brain cells that previously released it as a chemical signaling molecule, which leads to a build-up of dopamine in the brain’s reward circuitry.6 This strongly reinforces continued use of the drug, making cocaine powerfully addictive.

For many people, cocaine has desirable short-term effects such as increased happiness and a temporary boost of energy and mental alertness. However cocaine use can have additional adverse short-term effects such as:6

  • Anxiety.
  • Irritability.
  • Agitation.
  • Restlessness.
  • Hypersensitivity to touch, sound, and sight.
  • Paranoia.
  • Increase in body temperature.
  • Irregular heartbeat.
  • Constricted blood vessels.

Additionally, method-of-use dependent long-term effects of cocaine include the following:6

  • Snorting – nosebleeds, difficulty swallowing, loss of smell
  • Smoking – cough, respiratory distress, and asthma
  • Injecting – risk for contracting blood borne diseases, skin infections
  • Oral consumption – ischemic bowel injury from blood vessel constriction and reduced blood flow

Other Addictive Drugs

Other substances, such as marijuana, MDMA, and benzodiazepines like Xanax can be misused and lead to substance use disorders (SUDs) and addiction, too. Let’s take a closer look at each substance.


  • Results in a euphoric buzz, altered sensory perception, and relaxation.
  • Can lead to slowed reaction time, impaired balance and coordination, and problems with learning and memory.
  • Can increase anxiety, as well as increase heart rate and blood pressure.
  • Chronic use may be associated with long-term lung issues such as chronic cough and respiratory infections.

MDMA is also known as ecstasy or molly and:7

  • Is associated with both stimulant and hallucinogenic properties, leading to both enhanced sensory perception and increases in blood pressure and heart rate.
  • It can increase muscle tension and dangerous elevations in body temperature, which may be associated with kidney injury in certain situations.
  • May be associated with confusion, problems with attention and memory, anxiety, and depression with regular use.
  • May not follow the same patterns of compulsive use and/or addictiveness as many other more common substances of misuse.

Xanax is a prescription benzodiazepine, which are sedative medications widely prescribed for conditions such as anxiety and panic disorder. Benzodiazepines:7

  • Are central nervous system (CNS) depressants.
  • Slow or inhibit certain types of brain activity.
  • Can cause slurred speech, poor concentration, slowed breathing, decreased blood pressure, drowsiness, and dizziness.

Risk Factors for Drug Addiction

young woman with depression feeling sad and looking out the window at the rain

Addiction is a complex condition that may develop in association with several contributing factors. Together, these factors—nature vs. nurture variables that include biological, environmental, and developmental elements—can increase your risk of addiction.8

More specifically, factors that can increase your risk of developing addiction include:8

  • Your biology and genetic predisposition to addiction (e.g., if there is a family history of addiction).
  • Whether you experienced abuse, neglect, or trauma in your environment.
  • Whether you had chronic or early exposure to substances in your home.
  • Environmental stress.
  • Whether you use drugs or alcohol at an early age.

Get Help for Drug Addiction at Sunrise House

If you find yourself struggling with addiction to any substance, get the help you need as soon as possible. Sunrise House Treatment Center is a drug rehab in Lafayette, New Jersey, and has staff available to you 24 hours a day, 7 days a week to assist with rehab admissions, questions, or any other needs you may have.

By calling , you can speak to an admissions navigator who can help determine whether your insurance covers rehab and/or what other rehab payment options are available to you. You can also verify your insurance coverage online. At Sunrise House Treatment Center, we provide comprehensive services and offer different levels of addiction treatment. You don’t have to live with addiction any longer. Get the help you need today.

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