THE ONE YOU’RE ON –
July 6, 2026 – Alcohol and nicotine are the most harmful drug, but opioids, methamphetamine, and cocaine are most addictive. If determination of the most addictive drug is restricted to illegal drugs, heroin has highest addiction liability, with cocaine and methamphetamine close behind.
Studies examining first drug experiences reveal that heroin and cocaine produce the highest persistent memory of the drug, drive for next use, and reinforcement scores, meaning initial exposure strongly predicts later drug-seeking and use.
Let’s zero in on cocaine, since I recently highlighted its renewed popularity.
For years, my work focused on the dopamine hypothesis. The dopamine (DA) surge from cocaine is far greater than DA increases from food, sex, or social interactions. The brain interprets cocaine use as extraordinarily valuable, cementing this association and reinforcing the behavior producing it.
