Are Some Drugs Worse than Others?—An Honest Look at Different Substances

Bags with different drugs

Sometimes we hear this idea tossed around that, “Not all drugs are created equal,” or “Not all drugs are the same, some are worse than others.” We have to be careful with this concept because it precludes the general fundamental truth that all drugs are unhealthy and risky. We want to maintain the stance that any kind of illicit drug use is negative, risky, dangerous and potentially habit-forming and many legal drugs carry just as great of a risk. If we start to compare one drug to the next, if there is a “worse” drug, that means that there is also a “less bad” drug. That’s a slippery slope to justifying using the “less bad” drug.

But at the same time, we need to recognize that drugs are different, one to the next, and different drugs will carry with them different risks.

In this article, we’ll take a look at the five most commonly used drugs in the United States. We’ll talk a little bit about them, their characteristics, their likelihood of causing fatalities, and the kinds of risk factors that they create in various areas of life. And rather than slapping labels on them, we’ll let the readers decide which ones are riskier than the others. But remember that, at the end of the day, no type of drug use is ever okay or sensible.

Alcohol—“The Most Addictive Drug in the World”


Alcohol has often been labeled as the most addictive drug in the world. This title certainly has a lot of shock value, as it not only calls out alcohol as being a drug (correct), but it also labels alcohol as the most addictive of them all (incorrect). We can’t label one substance as being the “most addictive” substance in the world for a few reasons. For one, different substances react differently on different people. What is highly addictive to one may have a reduced impact on another.

But alcohol is highly addictive, and it is very harmful to the user’s health. Alcohol is perhaps the best-promoted of all drugs because it is legal, it is very easy to access, and it is strongly advertised and glorified our society. But that doesn’t change the fact that, according to the National Institute on Alcohol Abuse and Alcoholism, about fifteen million Americans meet the criteria for an alcohol addiction, and about eighty-thousand people die every year from alcohol-related causes. Alcohol addiction also might have the worst economic burden of all substances, costing our nation about two-hundred and fifty-billion dollars a year in damages and expenses.

Heroin—“Chasing The Dragon”

Heroin drug

One of the more exotic sounding ways in which Heroin is used is known as "Chasing the Dragon". In this method, individuals vaporize pure heroin on tin foil resulting in large plumes of smoke which require the user to chase the smoke with a tube in order to inhale the vapor. It is an intense high that does not require needles. The method provides an insight into what addiction to heroin is like. Initially the heroin high is intense and exciting, but as with the plume of smoke that must be chased, it leads to a lessened effect, until it is more like chasing a ghost than a dragon.

That, in a nutshell, is a perfect depiction of the pain and the imprisoning effect of heroin use. Heroin is immensely habit forming, creating strong chemical dependencies and powerful psychological habits. According to the National Institute on Drug Abuse, 2016 saw about nine-hundred and forty-eight thousand heroin addicts, with many more now likely hooked on the drug in the years since. For that same year, the Centers for Disease Control and Prevention estimated that about fifteen-thousand, five-hundred Americans died from overdoses on heroin.

Cocaine—“The Gentleman’s Drug”

Cocaine drug

Cocaine used to be called the gentlemen’s drug because it had always been a relatively expensive drug. But since the innovation of crack cocaine back in the 1980s, a drug user can now get high off of crack for pennies on the dollar compared to what powdered cocaine costs. And even now, costs for powdered cocaine are being driven down due to manufacturing processes to dilute the drug by mixing in other substances and thus be able to sell more of it. Demand for other drugs has also caused the price of cocaine to decrease.

Cocaine is highly addictive. Some researchers believe that, upon a user's first exposure to cocaine, they have about a seventy-five percent chance of becoming addicted to the drug. This is quite high, as drugs go. Most drugs only have a fifty-fifty chance of addicting the person after the first use. But not cocaine. Three out of four times, all it takes is one use to get hooked.

According to the National Survey on Drug Use and Health, there are about 1.5 million Americans in the United States who use cocaine on a regular basis. And since 2002, anywhere between four thousand and seven thousand Americans have died from cocaine overdoses every year.

Methamphetamine—“The Soldier Drug Brought Back to the States”

Methamthetamine Drug

Not many people know the history of methamphetamine, but though this drug did not make its grand appearance on the stage of drug use in America until the last few decades, this drug has actually been around since World War II. Methamphetamine was first innovated by Japanese and German Axis scientists during the war. It was synthesized as a battle-aid to give to Axis soldiers to make them fight harder, for longer periods of time, and to allow them to ignore serious injuries. It also influenced the mental faculty of soldiers, allowing them to confront the prospect of suicide missions more easily.

Methamphetamine is highly addictive and now quite relevant in the U.S.According to the National Survey on Drug Use and Health, there are approximately 1.2 million people in the U.S. who use methamphetamine. Methamphetamine use is also a rapidly growing issue, with about one-hundred and thirty-thousand new users every year. The average age of a person’s first exposure to methamphetamine use is nineteen years old. According to the Centers for Disease Control and Prevention, at least three-thousand people die every year from meth use.

Prescription Drugs—“The Biggest Ponzi Scam of the 21st-Century”

Capsule drugs

A Ponzi Scheme is when “investors” (in this case American patients) are convinced into putting their trust and faith in an entity (the pharmaceutical industry in this case), with the promise of a payout at a later date (better health). But the entity simply takes the investors’ money and runs off with it.

This is sort of like what happened with the advent of the pharmacological approach to just about all of our health issues. This is especially true with prescription opioids. The pharmaceutical approach to pain is a highly flawed one, with prescription opioids being just as addictive as heroin is, and very similar in their chemical construction too. Basically, the American people were duped into taking pills as “solutions” to their medical conditions, and half the time, they just became addicted to those pills instead.

According to the National Survey on Drug Use and Health, about two million Americans use their pills for non-medical reasons newly each year, and there are currently about fifty-four million Americans total who have experimented with their pills at least once in their lives. The same organization estimates that several million Americans are chronically addicted to their meds. citation:

In Conclusion…

With few exceptions, the use of any mind-altering substance carries with it a risk of abuse and addiction. Any drug carries with it a set of side effects or undesired effects that grow worth with increased usage. While it's certainly true some drugs save lives and should be used when necessary, it is also true that many drugs are overused, and serve no health benefit.

The focus of the article is on mind-altering substances used recreationally or therapeutically that fundamentally create a risk for abuse. It is sometimes hard to draw a line between medical necessity and needless medication. It's not the intent of this article to give you medical advice or advise you not to take a certain medication. It is, however, our intent to put more attention on the use of mind-altering substances.


Clinical Review by Claire Pinelli, LADC, CCS, ICAADC, MCAP



After working in addiction treatment for several years, Ren now travels the country, studying drug trends and writing about addiction in our society. Ren is focused on using his skill as an author and counselor to promote recovery and effective solutions to the drug crisis. Connect with Ren on LinkedIn.