What Are the Most Common Substance Addictions?
Addiction or Substance Use Disorder (SUD) describes the compulsive use of a substance regardless of social, legal, or health consequences. People struggling with this brain disorder are often psychologically and/or physically dependent on the substance or behavior, making it difficult to stop their addiction.
People often use the term addiction to describe the abuse of drugs or alcohol. Still, certain behaviors (such as shopping, gambling, and sex) can present the same symptoms as substance-based addictions. Regardless of the substance or behavior in question, it’s important to remember that individuals struggling with addiction often have very little control over the compulsions they feel to use.
We often hear about drug statistics related to opioids or heroin, but these numbers don’t always provide a clear picture of addiction in the United States. Many people think of “hard drugs” when considering addiction, but substances normalized by society, like nicotine or alcohol, don’t come up as often.
Regardless of how innocuous some items on this list may seem, each has its dangers and risks. Although it’s crucial to educate loved ones about the serious risks of the illegal substances we hear about in the news, it’s just as vital to be wary of the more commonplace substances.
1. Nicotine Addiction
According to the Substance Abuse and Mental Health Services Administration (SAMHSA), as of 2020, 59.2% of Americans over 12 used nicotine.
Nicotine addiction is by far the most common addiction in the United States. Typically nicotine is consumed through smoking cigarettes, vaping, or chewing tobacco with nicotine. As vaping has increased over the past decade, many cigarette smokers have switched to vaping as a “healthier alternative,” but e-cigarettes often still contain nicotine.
The more you smoke, the more nicotine you need to feel good. When users try to stop, they often experience unpleasant mental and physical symptoms of nicotine withdrawal, like irritability, anxiety, insomnia, and difficulty concentrating. These effects make it difficult for many people to quit.
What is Nicotine?
Nicotine is a legal drug and the primary psychoactive ingredient in tobacco products. Tobacco leaves contain nicotine, which includes cigarettes, cigars, snuff, and chewing tobacco. Vaping products or e-cigarettes do not contain tobacco, but many manufacturers add nicotine to their vape cartridges.
Effects of Nicotine
Nicotine works as a stimulant, releasing endorphins in the reward circuits of the brain that cause a slight, brief euphoria when administered.
Repeated exposure to nicotine through tobacco use or vaping causes long-term changes to the brain, forming a dependence resulting in addiction.
Nicotine Abuse and Risks
Withdrawal symptoms from nicotine can present themselves quickly, making it difficult for users to go very long without it. Many addicts experience withdrawal symptoms like irritability, craving, depression, anxiety, cognitive and attention deficits, sleep disturbances, and increased appetite.
The long-term health risks of consuming nicotine include:
- Blindness, cataracts (eye diseases)
- Congenital disabilities (aka “birth defects”)
- Periodontitis (yellowing teeth, gum disease)
- Heart disease
- Pneumonia and respiratory conditions (shortness of breath, asthma, coughing fits)
- Ectopic pregnancy (in the fallopian tube)
- Male sexual dysfunction
- Rheumatoid arthritis
- Reduced immune function (regular colds and flu)
2. Alcohol Addiction
According to SAMHSA, as of 2020, 79.5% of Americans over 12 used alcohol.
People with alcohol addiction or alcohol use disorder can’t control their drinking habits, regardless of the adverse effects on their life and health. Over time, an addict will need to drink more alcohol to achieve the same result.
Individuals with more severe cases of alcoholism often need medical detox when seeking treatment, as the withdrawal symptoms can be dangerous if left untreated. Alcohol use disorder can cause many long-term health problems and be life-threatening if alcohol poisoning occurs.
What is Alcohol?
Alcohol is a legal ingredient found in beer, wine, and liquor, and is well known for its intoxicating effect. As a central nervous system depressant, alcohol enters the bloodstream and metabolizes through the liver. Unfortunately, the liver can only metabolize a small amount of alcohol at a time, so it’s easy for the body to become overwhelmed when consuming large quantities.
Effects of Alcohol
People with an addiction to alcohol or Alcohol Use Disorder (AUD) often put themselves at risk by drinking too much alcohol. Alcohol interferes with the brain’s communication pathways and can make it harder for the brain to control functions like balance, memory, speech, and judgment. These issues with brain function can lead to serious injury and negative health effects.
Alcohol Abuse and Risks
Alcohol abuse comes with significant consequences to both safety and health. For example, in 2019, the National Institute on Alcohol Abuse and Alcoholism (NIAAA) found that alcohol-impaired driving fatalities accounted for 10,142 deaths (28% of overall driving fatalities).
The long-term health risks of alcohol abuse include:
- Liver disease
- Heart disease
- Stomach bleeding
- Head and neck cancers
- High blood pressure
- Sleep disorders
3. Marijuana Addiction
According to SAMHSA, as of 2020, 45.7% of Americans over 12 used marijuana.
Although marijuana (aka cannabis) has been legalized in many states and has proven tremendously helpful for many health conditions, the potential for abuse still exists. As a hallucinogen that creates feelings of sedation and euphoria, some users develop a dependence on how marijuana makes them feel.
Identifying the fine line between long-term medical use and addiction can be difficult, as many people find genuine relief with cannabis use. However, an addiction may be present when a marijuana user becomes preoccupied with thoughts about using and struggles to maintain work, school, and relationships.
What is Marijuana?
Marijuana or cannabis, while legal recreationally and/or medically in certain states, is still considered illegal in many states. The dried leaves, flowers, stems, and seeds from the Cannabis sativa or Cannabis indica plant create what we know as marijuana. The plant contains the mind-altering chemical THC, which has proven beneficial in treating chronic pain, anxiety, PTSD, and seizure disorders.
Effects of Marijuana
The THC in marijuana activates specific THC receptors in the brain, which creates a “high” feeling. Users often report altered senses, difficulty with thinking and problem-solving, impaired body movement, and hallucinations when taken in high doses. In medicinal use cases, these symptoms can be helpful for specific health issues when prescribed by a doctor and taken as instructed.
Marijuana Abuse and Risks
While marijuana’s medical applications are straightforward, its potential for recreational abuse poses some risks. Marijuana is often used via inhalation (smoking or vaping) or eaten (edibles or tinctures), and both come with potential risks.
The long-term health risks of smoking marijuana include:
- Breathing problems
- Increased heart rate
- Intense nausea and vomiting
The long-term health risks of marijuana abuse in general include:
- Memory impairment
- Temporary hallucinations
- Temporary paranoia
- Worsening symptoms in patients with schizophrenia
- Congenital disabilities or stillbirth
- Cannabinoid Hyperemesis Syndrome (CHS)—a rare condition marked by recurrent bouts of severe nausea, vomiting, and dehydration
4. Opioid Painkiller Addiction
According to SAMHSA, 4.2% of Americans over 12 used opioids in 2020 alone.
Opioid addiction has undoubtedly affected the view of addiction in the public consciousness. Some opioid users had pre-existing addictions to other drugs. Still, other people with no history of addiction found themselves addicted to their prescription opioids after an accident or post-surgery.
As opioid abuse skyrocketed in the 2010s, so did overdoses, leading to a massive effort to place restrictions on opioid prescriptions and who could get them. Unfortunately, prescriptions became harder to obtain, and many people began to seek opioids illegally. Some of these street opioids are contaminated with other drugs (most notably fentanyl), which can be fatal at only two milligrams.
What are Opioid Painkillers?
Opioids are a legal class of drugs derived from the opium poppy plant, although some are lab-made, like fentanyl and methadone. Common opioids such as Codeine, Vicodin, Morphine, and Oxycontin are usually prescribed to treat pain and require a physician’s prescription. These drugs are safe for short-term use to treat pain but can be highly addictive and even fatal when taken incorrectly or long-term.
Effects of Opioid Painkillers
Opioids work by binding to and activating opioid receptors in the brain, spinal cord, and other organs in the body. When opioids attach to these receptors, they block pain signals and release large amounts of dopamine throughout the body. The pleasurable feeling these drugs release can strongly reinforce the act of taking the drug, making the user want to repeat the experience.
Opioid Painkiller Abuse and Risks
Opioid addiction or Opioid Use Disorder (OUD) has unfortunately become a massive problem in the United States.
- Research from the University at Buffalo showed that approximately 25 million people in the United States began nonmedical use of pain relievers from 2002 through 2011. By 2017, the US declared a national emergency for opioid overdose.
- The CDC reported in 2020 that 68,630 overdose deaths involved opioids (74.8% of all drug overdose deaths).
- Roughly 80% of new heroin users in the United States report pills were their initiation to opioid use and subsequent OUD.
The long-term use and withdrawal symptoms of opioid abuse include:
- Nausea, vomiting, and dry mouth
- Dizziness and confusion
- Sexual dysfunction
- Slowed breathing
- Hypoxia (a condition that occurs when too little oxygen reaches the brain)
5. Cocaine Addiction
According to SAMHSA, as of 2020, 14.2% of Americans over 12 used cocaine.
As a highly addictive stimulant, cocaine floods the brain with dopamine, providing feelings of euphoria, energy, and happiness. The high doesn’t last long, prompting many addicts to use it repeatedly to achieve those feelings.
The brain soon becomes dependent on these feelings, thus forming a cocaine dependence. While cocaine can have lasting negative health problems, the danger also lies in the potential for unknown substances to get added to a batch of cocaine. Without testing the drug, users could unknowingly consume amphetamines, ecstasy, fentanyl, etc.
What is Cocaine?
Cocaine is an illegal stimulant drug made from the coca plant leaves native to South America. As a street drug, cocaine is often sold as a white powder, sometimes mixed with cornstarch or flour to increase profits. Some dealers even mix cocaine with other drugs, such as amphetamine or fentanyl, making it extremely dangerous and easy to overdose.
Individuals typically use cocaine by snorting it, rubbing it on their gums, or injecting it into their bloodstream. Cocaine can also be smoked when processed as a rock crystal called crack. Cocaine and crack are the same drug in different forms, although crack can take effect faster and be more potent than powder.
Effects of Cocaine
Like many other drugs on this list, cocaine increases dopamine levels in the brain’s neurotransmitters related to pleasure and reward. Cocaine takes effect almost immediately and lasts from a few minutes to an hour, depending on the method of use.
Users report feelings of extreme happiness, energy, mental alertness, increased sensitivity, irritability, and paranoia during their high. With continued cocaine use, the brain can adapt to the flood of dopamine, resulting in less sensitivity to the drug and higher doses needed to feel high.
Cocaine Abuse and Risks
Cocaine can be highly addictive due to its short-lived high and how quickly the brain can become dependent on its effects. Combined with the risks of mixing with amphetamines or fentanyl, users can be completely unaware of other substances and accidentally overdose.
The long-term health risks of cocaine abuse include:
- Constricted blood vessels
- Raised body temperature and blood pressure
- Fast or irregular heartbeat
- Tremors and muscle twitches
The long-term health risks associated with each method of use:
- Snorting: loss of smell, nosebleeds, frequent runny nose, and problems with swallowing
- Smoking: cough, asthma, respiratory distress, and higher risk of infections like pneumonia
- Consuming by mouth: severe bowel decay from reduced blood flow
- Needle injection: higher risk for contracting HIV, hepatitis C, and other bloodborne diseases, skin or soft tissue infections, as well as scarring or collapsed veins
6. Inhalant Addiction
According to SAMHSA, as of 2020, 9.3% of Americans over 12 used inhalants.
Inhalant addiction can be hazardous, as many popular inhalants are household cleaning products, solvents, and toxic chemicals. Some substances can lead to brain damage after only short-term abuse or death.
Because inhalants cause euphoria and sedation, people using them may view them as a cheap way to get high and develop a dependence on their effects. The largest group of individuals abusing Inhalants are teens, with the average age among first-time users in 2012 being about 17 years old.
What are Inhalants?
Inhalants refer to any solvents, aerosols, gases, or nitrites individuals will inhale to get high. It’s called different names depending on the substance and equipment used, but standard terms include “sniffing,” “bagging,” and “huffing.”. For example, “huffing” usually describes breathing from an inhalant-soaked rag stuffed in the mouth or inhaling from balloons filled with nitrous oxide.
Common inhalants include:
- Paint thinners
- Glue or markers
- Hair or deodorant sprays
- Vegetable oil sprays
- Whipped cream aerosols or dispensers (also called whippets)
- Nitrous oxide
- Room odorizer
Effects of Inhalants
Most inhalants affect the central nervous system (CNS) and slow brain activity. As a result, many people report having slurred or distorted speech, lack of coordination, dizziness, and feelings of euphoria. Nearly all non-nitrite inhalants produce euphoric effects by depressing the CNS, while nitrites expand and relax blood vessels, often used to enhance sexual pleasure.
Inhalant Abuse and Risks
The most significant risk associated with inhalants is other toxins in abused household products. For example, highly concentrated chemicals in certain solvents or aerosol sprays can cause irregular and rapid heart rhythms, even leading to fatal heart failure within minutes.
Known as “sudden sniffing death,” this deadly effect occurs particularly with the abuse of butane, propane, and chemicals in aerosols.
The long-term health risks of inhalant abuse include:
- Liver and kidney damage
- Hearing loss
- Bone marrow damage
- Loss of coordination and limb spasms
- Delayed behavioral development
- Brain damage
- Asphyxiation or choking on vomit
- Convulsions or seizures
7. Methamphetamine Addiction
According to SAMHSA, as of 2020, 5.6% of Americans over 12 used methamphetamine.
Methamphetamine (aka “crystal meth”) is a highly addictive stimulant with numerous negative consequences for the health of those addicted to it. Long-term use of this illicit drug can cause significant physical and mental damage.
Dependence on meth can happen quickly, sometimes even after one use. Individuals with a history of substance use disorder or mental illness are at heightened risk for developing an addiction to meth.
What is Methamphetamine?
Methamphetamine, used initially to keep WWII soldiers awake, was often prescribed for depression and weight loss. Only one methamphetamine medication remains on the market, but it’s rarely prescribed.
The methamphetamine or crystal meth sold on the street today has no medical use and will often be snorted, smoked, swallowed, or injected. The manufacturing process, usually in underground laboratories or homemade “meth labs,” is notoriously dangerous and poses a risk of large explosions.
Effects of Methamphetamine
Methamphetamine increases the amount of dopamine in the brain, and people report feeling increased energy, decreased appetite, and a rush of euphoria. Because meth’s high starts and fades quickly, addicts often take repeated doses in a “binge and crash” pattern. Some people will binge doses, also known as a “run,” not eating or sleeping to take the drug every few hours for several days.
Methamphetamine Abuse and Risks
Studies have shown that continued methamphetamine use causes changes in the brain that lead to reduced coordination and impaired verbal learning. In addition, individuals who abuse meth have an increased risk of HIV/AIDS and Hepatitis due to needle sharing and risky behavior. Meth abuse can also worsen existing HIV/AIDS symptoms.
The long-term health risks of meth abuse include:
- Extreme weight loss
- Severe dental problems and tooth loss
- Intense itching, leading to skin sores from scratching
- Liver damage
- Nerve damage
- Increased risk of contracting HIV/AIDS and Hepatitis through risky behavior
- Memory loss
- Hallucinations, paranoia, and psychosis
8. Heroin Addiction
According to SAMHSA, as of 2020, 2.3% of Americans over 12 used Heroin.
Considered by many to be one of the most addictive drugs in the world, heroin addiction can completely consume its victims. Heroin is an opioid made from morphine, making it a potent substance that provides intense pleasure and euphoria.
Like many other drugs on this list, people who regularly use heroin often build up a tolerance to its effects, and this causes them to need higher and more frequent doses to achieve the same high.
What is Heroin?
Heroin is an illegal opioid drug made from morphine, typically sold as a white or brown powder or a black sticky substance known as black tar heroin. Users snort or smoke more pure heroin, while impure or crudely processed black tar heroin usually gets dissolved, diluted, and injected into veins, muscles, or under the skin.
People often compare prescription opioid painkillers and heroin due to their similar effects. According to research from the National Institute of Drug Abuse (NIDA), the abuse of prescription opioids may open the door to heroin use. NIDA has found that many users reported switching to heroin as it’s cheaper and easier to obtain than prescription opioids.
Effects of Heroin
When an individual uses heroin, it binds to and activates specific receptors in the brain called mu-opioid receptors (MORs). When these receptors activate in the brain’s reward center, they stimulate the release of dopamine, which causes a surge of pleasurable sensations. The high heroin causes can become incredibly addictive, and the brain can quickly become dependent on the substance, requiring larger doses each time to achieve the same feelings.
Heroin Abuse and Risks
Repeated heroin changes the physical structure and physiology of the brain, and these changes are not easily reversed. Due to the deterioration of the brain’s white matter, heroin use can affect decision-making abilities, the ability to regulate behavior, and responses to stressful situations.
Withdrawal from heroin can occur even a few hours after the last use, bringing restlessness, muscle and bone pain, insomnia, diarrhea, vomiting, and cold flashes. In addition, injecting heroin comes with risks such as HIV/AIDS, Hepatitis B and C, and other infectious agents due to sharing needles or fluids.
The long-term health risks of heroin abuse include:
- Constipation and cramping
- Collapsed veins (when injecting the drug)
- Damaged tissue inside the nose (when snorting the drug)
- infection of the heart lining and valves
- Abscesses (swollen tissue filled with pus)
- Liver and kidney disease
- Lung complications, including pneumonia
- sexual dysfunction for men
9. Benzodiazepine Addiction
According to SAMHSA, 1.7% of Americans over 12 used benzodiazepines in 2020 alone.
Benzodiazepines are prescription sedatives that are unfortunately abused often for their sedative, pleasurable effects. Individuals who abuse benzodiazepines typically build a tolerance to these effects, requiring higher doses over time.
Getting off benzos can be tricky, as withdrawal symptoms from quitting “cold turkey” can be dangerous. Treatment for benzodiazepine addiction will often include medical detox with medical supervision to ensure the addict remains safe.
What are Benzodiazepines?
Benzodiazepines or “benzos” are a type of prescription tranquilizer known as Central Nervous System (CNS) depressants. Common benzos include Valium, Xanax, and Klonopin. They are some of the most commonly prescribed medications in the United States and can be incredibly helpful for those with anxiety or panic disorders.
Effects of Benzodiazepines
Benzos work by increasing the activity of the GABA neurotransmitter, a chemical responsible for inhibiting brain activity. This action causes the user to experience calming effects, drowsiness, and euphoria. Though benzodiazepines are considered safe when taken as prescribed, their sedating effects can easily lead to abuse and addiction.
Benzodiazepine Abuse and Risks
One of the biggest dangers of long-term benzo abuse is the risk of seizures if the user abruptly stops using the drug. Because of the withdrawal risk, it’s essential to taper off benzos under medical supervision to avoid dangerous side effects.
In addition, when benzos are mixed with other “downers” like alcohol or opiates, the risk of coma or death becomes even more significant.
The long-term health risks of benzodiazepine abuse include:
- Sleep disorders
- Difficulty breathing
- Muscle spasms
10. Barbiturate Addiction
SAMHSA states over 10 million Americans over 12 used barbiturates in 2020 alone.
Despite how rarely medical professionals prescribe barbiturates, this drug still carries the potential for abuse and addiction. Their effects are similar to benzos but with an increased danger of overdose.
People with barbiturate addiction can quickly put themselves at risk for harmful effects and even overdose if they take more than their prescribed dosage. This risk compounds if they purchase the drug illegally without knowing the actual dose.
What are Barbiturates?
Barbiturates belong to the sedative-hypnotic class of medications known as CNS depressants. Barbiturates aren’t prescribed as often due to their risk of abuse and side effects, but these drugs were once commonly used to treat anxiety and insomnia.
Because minimal changes in dose could lead to extreme results, benzodiazepines have become the preferred medication for anxiety over barbiturates. However, doctors may prescribe barbiturates to treat seizures and high cerebrospinal fluid pressure inside the skull. Barbiturates are also sometimes used as pre-anesthesia sedation for anxious patients.
Effects of Barbiturates
Barbiturates are similar to benzodiazepines in their ability to inhibit the activity of the GABA neurotransmitter, a chemical responsible for inhibiting brain activity. People usually experience drowsiness, sedation, and feelings of euphoria, but the margin for error in dosage can make barbiturates a mixed bag. If the dose is slightly too high, the risk of intoxication or overdose can quickly create a dangerous situation.
Barbiturates Abuse and Risks
Barbiturates are sometimes called “downers” and may be used to counteract the excitement from stimulant drugs like cocaine and meth. Because barbiturates are such an old drug, younger people may be unaware of the risks associated with abusing them. However, like benzos, withdrawal symptoms from barbiturates can be life-threatening, so great care should be taken when tapering off these drugs.
The long-term health risks of barbiturate abuse include:
- Trouble breathing
- Slowed heart rate
- Confusion and paranoia
- Nausea and vomiting
- Suicidal thoughts
Getting Help for Addiction
If you or a loved one struggles with addiction to one or more of these substances, there are treatment options for you. Just as each individual is unique, the treatment for each substance can vary.
When you or your loved one are ready to commit to sober living, treatment centers are ready to help you get there. Your treatment plan will depend on the substance you’re addicted to and your unique situation.
Frequently Asked Questions About the Most Common Drug Addictions
What causes addiction?
Addiction occurs when an individual develops a dependence on a substance or behavior that creates a positive feeling or “high” in the brain. As this behavior repeats, the person will begin to crave the drug or behavior, thus creating an addiction. Genetic factors and upbringing can make some people more predisposed to addiction.
Who is at risk of developing addiction?
Individuals with a history of addiction in their family are at higher risk of developing an addiction in their lifetime. Finding out if addiction runs in your family can be a great way to be aware of your risk level.
Can you be addicted to more than one substance?
Yes. It is common for people to develop addictions to multiple substances, especially if the effect is similar.
Does addiction cause mental illness?
Addiction or substance use disorder can contribute to the development of mental illness. Often people with addiction have co-occurring mental illnesses related to mood, personality, or impulse control.
What are the signs of drug addiction?
Common signs of addiction can include cravings for the drug, withdrawal from activities abuse drugs, financial issues, unkempt appearance, and extreme changes in weight, mood, or personality.
How can I help a loved one struggling with addiction?
Getting your loved one to realize the dangers of their addiction and motivating them to seek treatment is the best way to help. Unfortunately, you can’t force someone to get help when they’re not ready, so focus on helping them realize treatment is the right choice for their future.
What are the negative side effects of addiction?
Each substance has unique risks, whether to physical health, mental health, financial stability, work, or school. Many drugs can lead to irreparable damage, coma, and even death.
What is the most common type of addiction in the United States?
Nicotine is the most common type of addiction in the US, although many disregard its significant effects.
Can addiction be cured?
Addiction cannot be cured, but recovery from active addiction is possible with the right treatment plan and a strong support system.
How do I know if I have an addiction?
Common signs of addiction include intense cravings for a drug, extreme changes in personality or behavior, lack of care for hygiene or appearance, and financial instability from purchasing drugs.
Do I have to go to a residential rehab clinic for my addiction?
It depends on the substance and the severity of your addiction. For some addicts, complete removal from familiar environments and temptation is necessary to break the cycle of drug abuse. Others may do well with outpatient treatment or therapy.
Be honest about the severity of your addiction with your medical provider so they can formulate the most successful treatment plan for you.