The 5 Most Commonly Abused Substances other than Alcohol

The 5 Most Commonly Abused Substances other than Alcohol

Substance abuse and drug addiction continue to be national scourges, killing tens of thousands every year. Many more lives are left shattered in the wake of addiction. Try to imagine this statistic: more Americans died in 2016 of drug overdoses than died in the Vietnam War (64,000 and 58,220, respectively). Everyone’s familiar with alcoholism, but what about other substances? Prescription drug abuse is at an all-time high, and painkiller addiction is causing a wave of deaths by overdose that’s skyrocketed since 2015. So many people are addicted to pain pills, it’s being referred to as an epidemic.

A brief introduction to drug abuse and addiction

Substance abuse occurs when a person consumes a drug repeatedly, even though the consequences of doing so are negative. Drug addiction refers to a complex state of physical and psychological dependence on a drug, which develops because of substance abuse. Addiction usually doesn’t happen overnight, but it can burgeon rapidly, depending on the substance in question. Addicts don’t want to be addicted. They continue to abuse drugs even when they want to stop. That’s the peril of addiction. After a time, a person becomes addicted whether they want to or not. A person’s willpower has little to nothing to do with addiction.

Signs of physical addiction include tolerance, cravings, and withdrawal. Tolerance is a state in which a person requires increasing amounts of a drug to get the same effects a much smaller initial dose produced. An example is a person taking 50 mg of hydrocodone to get the same feeling, or same effect that 10 mg once provided.

During active addiction, the addict will continue abusing drugs, even though the consequences are dire. In part, that’s due to drug cravings. Cravings are intense urges to use drugs that override all sense, all logic, and all values. If the addict doesn’t get their drug, the fierce need for the drug gets more powerful. Eventually, a person feels as if they’ll soon die, if they can’t get their fix. Cravings are initially physical, but over time, they also influence a person psychologically, to the point where an addict will say or do anything to get their drug.

Drug Dependence

When we talk about drug dependence, we’re referring to a physical state. It happens when the brain and body can no longer function normally, or even adequately, without drug abuse. Of course, a drug-dependent person can’t keep up substance abuse indefinitely.

Withdrawal is a physical syndrome caused by the absence of drugs. Withdrawal can be fatal, either directly or indirectly. Signs of withdrawal include increased heart rate, nausea, vomiting, high blood pressure, and anxiety. More severe symptoms include:

Confusion, increased anxiety, jumpy

A crawling sensation on, or inside the skin.

Hallucinations, often scary.

Shakes, tremors, or trembling

Opioids and Opiates

Opioids and opiates are the most effective and powerful painkillers known. Opiates occur naturally; opioids are synthetic. Functionally, opiates and opioids are identical. Codeine, hydrocodone, and oxycodone are among the most common of these pain relievers. They operate on a molecular level in the brain, causing a pleasure-boosting and pain-alleviating neurochemical, dopamine, to flood brain tissue. It’s a double effect of suppressing the feeling of pain, while increasing the sensation of well-being. They’re also profoundly addictive, and don’t have to be abused for long before addiction gets its hooks into a person. Opioid addiction is running rampant in the USA these days, in large part due to their being overprescribed. Opioids are effective for pain ranging from mild to profound break-through pain. People of all ages are finding themselves addicted to pain pills.

Opiate addiction is dangerous. It’s not a good idea for anyone to try to quit opioids on their own. Quitting abruptly can be lethal at worst, and at best, it’s anyway from painful to agonizing.

People overdose on opioids and opiates easily. Overdoses are so often lethal because these drugs lower a person’s rate of breathing. With too high a level of opioids in the blood, a person “shallows out,” stops breathing, and dies.


Benzodiazepines (benzos) are anxiolytics; they reduce or eliminate anxiety. Unfortunately, they can’t do this indefinitely. Tolerance builds up, forcing a person to take ever-rising amounts of the benzo just to get the same effect a small dose originally offered. Benzo addiction is the result, and it’s common. Benzo rehab often takes place as an outpatient, although there are treatment programs that do offer a residential option. The decision whether or not to go inpatient must be made by a physician, as people can suffer severe seizures by attempting to stop using benzos “cold turkey”.

Benzos include:

Valium (diazepam)

Xanax (alprazolam)

Klonopin (clonazepam)

Ativan (lorazepam)



Heroin’s effects are much like the opioids discussed above, but it’s not legal. A Schedule I drug, it’s powerfully addictive, causing blissful euphoria and a profound sense of well-being. It’s a close relative of morphine, although often more powerful, as hard as that is to imagine. Heroin addiction all too often leads to death. Fatalities from heroin and opioids sold on the street show no signs of leveling off. They’re high and getting higher, in part due to heroin being cut with the synthetic opiate fentanyl. Fentanyl’s potency outmatches heroin by 100 to 1000 to 1. Heroin addicts buy what seems to be a normal amount for their dose, when it reality, it’s so potent it’s fatal within the hour. Heroin rehab must take place inside a treatment facility that has a medical detox unit. While people can and do quit heroin abruptly, that’s dangerous. There’s a high potential for seizures in doing so.



Cocaine is a powerful stimulant, with effects like those of legal amphetamines. A big difference between amphetamines and cocaine is their length of activity. Cocaine’s effects last around an hour, whereas amphetamines can last for many hours. Cocaine addiction develops rapidly. It’s one of the fastest-addicting of all illicit drugs.

Although typically inhaled, cocaine can be injected. Inhalation sends coke right to the brain, boosting awareness, mood, and energy levels, but briefly, and at the cost of an over-revved cardiovascular system. Heart problems kill cocaine addicts before brain damage can, but cocaine addiction is associated with some kinds of dementia.

Methamphetamine (crystal meth, meth)


Amphetamines are stimulants. They cause the nervous system to go into overdrive. Crystal methamphetamine is highly concentrated, rapidly addictive, and damaging to the body. Meth rehab, like the other substances in this article, often requires a medically supervised detox. Detoxification refers to the process of getting all the drug out of one’s system. It takes from a couple of days to sometimes as long as a week. Some substances, like alcohol and all opioids, as well as heroin and benzos, have to be treated with a physician and medical staff present. People in detox need medication to help their bodies adjust to no longer having the drug in their system. These medications can’t be safely given on an outpatient basis.

If you or someone you know is struggling with an addiction problem, help is a phone call away. Live Your Best Life:

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Medically Reviewed: September 25, 2019

Dr Ashley

Medical Reviewer

Chief Editor


All of the information on this page has been reviewed and verified by a certified addiction professional.

Dr Ashley Murray obtained her MBBCh Cum Laude in 2016. She currently practices in the public domain in South Africa. She has an interest in medical writing and has a keen interest in evidence-based medicine.

All of the information on this page has been reviewed and verified by a certified addiction professional.