The United States is in the middle of an opioid epidemic, with drugs like heroin and fentanyl topping charts of the most dangerous and most abused drugs. The National Institute of Drug Use and Health estimates that some 18.7 million Americans struggle with a substance use disorder, often in co-occurrence with mental illnesses, economic hardship, childhood trauma, and behavioral problems ranging from risk-taking to sugar
These addictions also cover nearly every kind of addictive substance including alcohol, tobacco, marijuana, cocaine, opioids, hallucinogens, tranquilizers, stimulants, and benzodiazepines. But addiction isn’t solely linked to chemical dependence inducing substances, as many individuals are addicted to sugar, fitness, gaming, Netflix, etc., creating a marked behavioral element of any addiction. Addictions are complex, often based on very personal problems and situations, and stemming from a variety of problems ranging from self-medication to peer pressure. Understanding why some drugs are harder to kick than others often requires a deep understanding of personality, genetics, epigenetics, behavior patterns, and how those substances impact the brain and central nervous system.
Substance use disorder is a behavioral disorder and different people will always react differently than others. Some users will sail through quitting a drug that another person simply cannot quit. Issues such as economic situation, stress levels, job, peer pressure, mental health, physical health, genetics, epigenist, and social standing all heavily impact how a user will be impacted by drug use.
However, exposure is still the most consistent factor in drug addiction. This means most people will react in predictable ways to similar levels of drug use in similar circumstance. This was documented by one 2007 study, which categorized drugs based on the following factors:
- Ease of acquiring physical dependence
- Severity of physical withdrawal symptoms
- Difficulty (mental) of quitting
These drugs are ranked in order from 1-7 based on that study.
Nicotine is the second most popular intoxicating substance in America, just behind alcohol. Today, an estimated 34 million people smoke and a surprising 30 million of them want to quit. Yet, 85% of smokers who attempt to quit never succeed. Why? Nicotine is famous for quickly moving from inhalation to the brain, where it releases dopamine and serotonin. Users have a strong motivation to continue using in physical dependence and lack of real negative consequences (other than physical health problems and expenses) and so many don’t. Instead, they feel the vague need to quit because of social pressure and medical scares. But, with 16 million Americans living with a smoking-related disease, smoking is undoubtedly deadly. Many smokers also fail to seek out professional help when rehabilitating, instead relying on going “cold turkey” and detoxing at home or using patches. These can help with physical dependence but do little to tackle the behavioral problems underlying any kind of substance dependence. In short, nicotine is difficult to quit because users don’t take it seriously enough to actually seek out the right help.
Benzodiazepines were once the most prescribed drug in the United States. Today, they’re still in the top 20. A lot has changed over the last 10 years ago, when Valium and Xanax could be handed out with no real limit on prescription length. We now know that benzos are one of the most addictive drugs out there, resulting in mental and physical reliance in patients. New prescriptions are often limited to just 5 weeks. But, benzodiazepines are still seen as an essential drug, used even in drug rehabilitation programs to reduce the risk of seizures for alcohol withdrawal. How do you withdraw from a withdrawal drug? The answer, with difficulty. Benzodiazepines have one of the most difficult withdrawal profiles out there thanks to their effect on the GABA and dopamine receptors of the brain. Users face weeks of debilitating symptoms including emotional and psychological trauma, aggression, panic attacks, seizures, and heavy cold and flu symptoms. It’s impossible to safely go “Cold turkey”.
This means that kicking benzodiazepines, even a prescription, requires using a tapering schedule or other drugs to reduce withdrawal symptoms. It’s important to undergo either with medical supervision, which is why regular visits to your doctor or medical monitoring in a detox facility are important.
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Cocaine is not highly addictive, but once you become addicted, it’s intensely difficult to quit. The drug is abused by an estimated 1.5 million people in the United States, but many users never become addicted. Once you do, cocaine functions much like nicotine in that it changes the dopamine and serotonin receptors to respond to the drug. Users experience emotional blunting, where overstimulated dopamine and serotonin receptors simply stop responding to natural levels of neurotransmitters produced by the brain, leading to the user simply not feeling anything at all. This means that heavy users go from an emotional and physical high to simply feeling nothing and depression, which can result in severe emotional and psychological dependence.
Cocaine users can also see harsh withdrawal symptoms characterized by a crash, depression and anxiety, agitation and aggression, and mood swings. For this reason, it may be important to seek out psychological care during detox. Users with a history of heart problems also want to seek out medical monitoring to ensure their continued safety throughout cocaine detox and rehab.
4) Crack Cocaine
Crack Cocaine is made by isolating the active components of cocaine to create a drug offering a shorter, more intense high than cocaine. While made from the same Coca plant, crack cocaine is significantly more dangerous and more addictive than cocaine. Crack cocaine is typically smoked, hitting the brain in seconds, and lasting for just 5-10 minutes. This results in patterns of heavy and intensive use, as smokers must continue using to maintain a high.
Addiction and withdrawal patterns and risks are very similar to those of cocaine, but with a higher incidence of addiction.
Amphetamines ranging from prescription drugs like Adderall and Myadis to methamphetamine are among the most addictive drugs on the planet. They’re also some of the most prescribed, and are used to treat depression, obesity, anxiety, ADHD, and much more. Amphetamines impact the brain through the dopamine, norepinephrine, and GABA receptors, creating in a long-lasting adrenaline rush, alongside increased energy, happiness, and euphoria.
As a result, the drug is often used in recreational and party settings through both illegal street drugs like meth or crystal meth and illicitly used prescription medications. Both are incredibly difficult to kick but can result in physical dependence after just a few weeks.
Like cocaine, amphetamines also punish users for not continuing use with crashes resulting in depression, lethargy, emotional blunting, and lack of motivation. This creates strong encouragement to take more of the drug to feel okay again and very little motivation to quit. Amphetamine can be dangerous to kick because central nervous system interaction can result in seizures. For that reason, most users are recommended to quit using a tapering schedule in a medically supervised environment.
6) Prescription Opioids
The U.S. opioid epidemic mostly revolves around prescription opioids including fentanyl, morphine, and similar drugs. Opioids are an important part of the U.S. medical system, used to treat pain following surgeries and accidents and to treat chronic pain. Today, an estimated 20 million people are addicted to prescription opioids, and over 70,000 people die of overdoses each year.
Unfortunately, prescription opioids are difficult to quit for both recreational and prescription users. While many prescription users receive a Risk Evaluation and Management Schedule to prevent addiction and abuse, many still become hooked and have to struggle with physical dependence and addiction when quitting.
Quitting opioids is not easy. Intense withdrawal symptoms include depression, cold and flu symptoms, pain, mood swings, anxiety, and intense paranoia. While not often dangerous, these symptoms can be traumatic. After detox, users still have to face intense behavioral addictions, often relating to self-medication for pain and stress management. For this reason, it’s crucial to seek out a specialized opioid rehab program when attempting to quit an opioid dependency.
Heroin is estimated to be responsible for 10% of all opioid related deaths in the United States, making it second only to prescription drugs like fentanyl. Heroin is an illegal street opioid, typically sourced by users as a cheaper and more accessible alternative to prescription pain medications. This means that the addiction profile and withdrawal symptoms are similar, and the drug is similarly difficult to quit. However, heroin is manufactured without any standards, meaning strength, dosage, quality, and additives vary considerably, which can change how individuals react to the drug.
If you or a loved one is struggling with a substance abuse problem, it’s important to get help. At the end of the day, it doesn’t matter how difficult your drug is to quit, providing you have the right help. A rehab center will offer the personalized support to help you detox. Most will also offer personalized support for recovery, including behavioral therapy and counseling designed around the person and their background including behavior, social and economic factors, health, and past history of trauma. Detox is just the first part of recovery and often, the part that individuals can repeat on their own. Moving into a facility that offers long-term support to prevent relapse is the best way to stay clean after you kick your habit.
If you have any questions concerning addiction treatment for yourself or a loved one, contact us at Truvida Recovery. Call 877-228-1102 to speak in confidence with an experienced treatment advisor now.