Addictive drugs each are dangerous in their own way. Yet what makes on worse than the other? The truth is that it’s a really difficult question to answer, with many factors and countless different interpretations. While we do possess the data to quantify how some drugs are more dangerous than others, the bigger picture is important as well – the most dangerous drug is the one you’re hooked on, and it’s the one that’s most likely to kill you.
For anyone worried about addiction when considering drug use, there’s only one appropriate answer: don’t use them. All addictive drugs possess a risk of addiction, and that risk varies tremendously from person to person. As for mortality, a similar issue arises – there’s a clear ranking for what drugs kill the most people, but the most dangerous drugs are also the most limited, so they aren’t at the top of that list.
The one study that comes to mind when discussing the dangers of drug use is a UK study performed in 2010 that had a panel of experts assign a number value to each addictive drug based on a series of factors largely split between factors that contribute to individual harm, and factors that contribute to societal harm. However, there’s little inherent use to a study like that, because it mixes opinion with fact, and because the result is a ranking that is flawed in many ways.
Some drugs are definitely more dangerous than others. But any definitive ranking will change based on how the danger is defined. Rather than try to definitively decide which drug is the worst, we’ve opted for a nuanced approach: below is a crude ranking of the world’s most dangerous and most commonly used addictive substances, in no particular order, with details to help take note of why each substance can be life-threatening in its own way (and why some substances are far more dangerous both to individuals and communities than others).
As far as addictive and/or illegal drugs go, one particular drug to note is marijuana. This is because marijuana has long been the focal point in a debate about decriminalization, and next to tobacco and alcohol, it is one of the most commonly used drugs in the country – while being statistically less harmful than both.
Experts agree that, if marijuana replaced alcohol as the most common recreational intoxicant in the country, we would all be better off. But that doesn’t make it a ‘good’ drug. Marijuana can still be dangerous, and there’s research that shows that being high still comes with a risk over being sober: driving while high doubles your risk of a car accident versus being sober, for example (in comparison, alcohol raises your risk of a car accident by nearly 14 times).
Other research seems to indicate that long-term heavy use, as well as early use (especially in a person’s formative years) can have negative cognitive effects on a person, enough that experts agree that younger adults should stay away from marijuana.
It’s possible to argue that marijuana is wrongly vilified, or even among the least dangerous in a group of highly dangerous substances. But it shouldn’t be taken lightly, either. And yes, marijuana is addictive, even if it isn’t as addictive as other substances.
When discussing psychedelics, the two substances that most commonly spring to mind include lysergic acid diethylamide (LSD) psilocybin and (magic mushrooms). These drugs are not addictive, but they make the list because they are commonly grouped with other drugs.
In terms of long-term effects, nothing seems to suggest that these substances are in any way dangerous. While they can cause an overdose and potentially death, it would be quite difficult to cause serious harm with a magic mushroom or with LSD. However, the dangers of psychedelics aren’t their direct effect on the human body, but how that body reacts with the rest of the world while ‘tripping’.
Without proper care or supervision, the symptoms of psychedelic use can be dangerous. Users can experience hallucinations, delusions, and panic. Mushroom or LSD use can be very disorienting. Furthermore, when buying off the street or the black market, you can never be too sure of what you get. Psilocybin is a particular kind of mushroom, but there are poisonous Psilocybe lookalikes, and other hallucinogens can be mixed with unwanted substances.
Most pure hallucinogens – particularly the two mentioned above – are not addictive, and not dangerous in a clinical setting. But whether they’re therapeutic is still up for debate. Mushrooms as well as LSD are being studied for their potential in treating post-traumatic stress disorder, anxiety, and other conditions, in conjunction with professional guidance and proper therapy. When taken recreationally, hallucinogens can be very dangerous.
Cocaine, amphetamines, and methamphetamine are all highly dangerous and highly addictive drugs, with methamphetamine ranking as one of the most dangerous drugs in the country both in terms of mortality and availability, while amphetamines (usually prescription drugs like Adderall and Ritalin) and cocaine have lower mortality, but are still highly potent substances.
Stimulants, or ‘uppers’, can severely damage the heart and liver and raise a person’s risk of stroke. Methamphetamine is also often ‘cooked’ impurely and cut with various other substances to drive up profits, which can lead to accidental overdoses and a variety of different health conditions.
Taken recreationally in the form of Valium, Xanax, Diazepam, Diastat, Ativan, and a wide range of other ‘benzos’, benzodiazepine is a family of depressant substances designed to drive down the central nervous system and reduce symptoms of panic and anxiety.
However, benzodiazepines affect the brain similarly to alcohol, and can cause addiction, as well as severe withdrawal symptoms. The effects of a benzodiazepine drug are additive when taken with alcohol, meaning that overdoses are possible. Their popularity as a party drug marks them as one of the most dangerous drugs in the country.
Bar none, tobacco leads to the most deaths of any drug, illegal or legal, as per the CDC. This is due to the rate at which cigarette smoke causes and spreads cancer not only among smokers, but among nearby individuals as well. The risk of heart disease and lung cancer soars with smoking, and nicotine addiction is incredibly common.
Nearly half a million people die from tobacco use every year, because tobacco is directly involved in the development of cancer, heart disease, stroke, diabetes, and chronic pulmonary illnesses in 16 million Americans.
This is due to tobacco’s widespread availability and popularity, as well as nicotine’s potent addictiveness. While cigarette smoking has declined, vaping has become more popular. However, vaping shares a completely different risk profile, and the real long-term repercussions of vaping are still being researched. Many of the risks of smoking come from burning tobacco – vaping uses a combination of water and glycerin to produce a theoretically harmless vapor. However, common issues in vaping include heavy metal contamination and nicotine addiction.
Next to tobacco, alcohol is responsible for the second highest death toll among America’s recreational drugs. This is due to alcohol’s ubiquitous nature, as well as the fact that it is deeply ingrained in our culture. Banning alcohol has been historically fruitless, but there’s a big difference between the effects of moderate consumption and heavy use, which has been found responsible for 1 in 10 deaths among adults aged 20-64 years. Alarmingly, alcohol use – particularly binge drinking – is on the rise.
While opioids don’t account for as many deaths as tobacco and alcohol, opioids are also much harder to get, yet still account for the most overdose deaths among all illegal drugs. Heroin and prescription opioid use have led to the nation’s current opioid crisis, fueled by decades of lobbying and reckless advertising from drug companies like the controversial Purdue Pharma, responsible for the meteoric rise of Oxycodone addiction. Among all drugs, opioids are arguably the most dangerous because they are extremely addictive and carry a high mortality rate. Opioid addiction is also very difficult to treat, and often requires the use of medication to help recovering addicts wean off these powerful drugs.
As mentioned previously, it’s important to note that the most dangerous drug is the one you’re addicted to, or the one you’re most exposed to. While drug use doesn’t always imply addiction, the two are most definitely correlated, with heavier drug use leading to a higher risk of drug dependence and substance use disorder.
Regardless of whether you are or aren’t addicted, whether you are or aren’t using, or whether you’re reading this for yourself or for a close loved one, it’s always important to be aware of the difference between how risky something is to the general public, and how risky it is to you.