Warning: include_once(../article_type.php): failed to open stream: No such file or directory in /home/suxhorbncfos/public_html/pbsij/PBSIJ.MS.ID.555778.php on line 120
Warning: include_once(): Failed opening '../article_type.php' for inclusion (include_path='.:/opt/alt/php56/usr/share/pear:/opt/alt/php56/usr/share/php') in /home/suxhorbncfos/public_html/pbsij/PBSIJ.MS.ID.555778.php on line 120
Use and addiction to various drugs such as alcohol, nicotine and opioids (heroin) have caught the attention of scholars and experts, and many studies have been directed to this area because of the effects of drug use and subsequent addiction. The global increase in the usage and abuse of illegal drugs both contribute and reflect international tensions, according to the National Institute on Drug Abuse  . Some of the causes of these tensions are obvious and they include reduced community and family cohesiveness, increased crime rates, political realignments, increased underemployment and unemployment, and social and economic marginalization. For instance, alcohol, nicotine and heroin cost the US government around $740 billion annually in terms of crime, healthcare and lost productivity Degenhardt et al. . Drug use is defined as the use of illegal drugs such as tobacco, heroin and cocaine while drug misuse refers to unhealthy or improper use of drug prescriptions. Addiction is defined as a chronic mental disorder that affects brain activities and is usually characterized by the user’s inability to control the desire or need for the drug even when negative side-effects develop Hall, Carter & Forlini . Drug addicts strive to get and use the drug despite their harmful effects. Owing to the severity of the drug menace, scholars and experts have redirected their efforts and resources towards this issue. To categorize these drugs in terms of their addiction, five criteria are used because there is no single way of comparing the addictive scales of the illicit drugs. Drug use disorders were classified as severe, mild or moderate using the DSM diagnostic criteria. Nevertheless, these criteria are not conclusively since they do not permit a comparative rating of drugs according to their level of addiction.
However, using relevant research materials, this paper will primarily examine the scale of addiction for nicotine, alcohol, and opioids. This paper attempts to establish among the three drugs, which drug is over abused and more addictive than the others. To develop a comparative addiction rating scale for nicotine, opioids (heroin), and alcohol, this paper will consider the following key words:
Hasin and Grant  reason that the deteriorating living conditions have forced some individuals to result to drug and substance abuse, with the hope of finding consolation in these drugs. The rising cases of drug and substance use and abuse have created a drug menace among different countries and societies. There is an urgent need to address the drug menace to save the current and future generations before the situation blows out of hand and proportion.
There are varied misconceptions across the United States regarding drug and substance abuse and scale of addiction. For instance, a big number of people argue that addiction is a personal choice or is caused by criminal or deviant behaviors. Abuse  notes that these misconceptions have created a lot
of stigmatization on people struggling with addiction, and this is making it quite hard for the affected people to seek help and assistance from professionals.
On the other hand, researchers have come up with several addiction theories and causes to clear these misconceptions. The first theory or approach dwells on the neurobiological impacts of drug addiction and it is based on biological factors. The psychological approach concentrates on individual differences and behavioral models. The sociocultural approach explains addiction based on environmental and cultural factors Wise & Koob . In this paper, a variety of different approaches that answer the question of why people become addicted to drugs will be explored in depth, to have a clear understanding of the scale of addiction
To facilitate this study, data was collected primarily
using secondary research techniques. Most of the data was
obtained from the National Institute on Drug Abuse (NIDA) .
Furthermore, some scholarly articles and publications were
utilized to supplement this data. Information on the addictive
potential of various drugs such as heroin, nicotine, and alcohol
were generated by Hall, Carter and Forlini  from the Scientific
Research Society. Similarly, Hasin and Grant  obtain data about
drug and alcohol dependence from the National Epidemiologic
Survey on Alcohol and Related Conditions (NESARC). Likewise,
National Survey on Drug Use and Health (NSDUH) was also
incorporated in this research paper. Government, hospital and
other private organizations’ websites and portals were used to
provide a more compelling medical outlook, prevalence, and
addiction rates. Finally, mathematical calculations were done
using the cumulative probability/frequency technique, a metaanalysis
approach, and estimation method.
As earlier stated, drug addiction is indeed a complicated
mental condition that can arise from several environmental,
biological and developmental reasons. These causative
factors include peer pressure, individual biology or genetics,
experimenting with drug use at an earlier age, family history,
co-occurring mental states, and unprofessional medical
practices among other factors Wise and Koob . Most of the
materials employed in this research seem to indicate that there
is no straightforward way of establishing which drug between
alcohol, nicotine, and opioids is more addictive than the other.
In general, the issue of addiction has many gray areas when
it comes to ascertaining if an individual suffers an addiction
disorder, and there is no standard definition of addiction Hasin
and Grant . There is no consensus yet on a common definition
and interpretation on addiction.
Therefore, there is no established way of measuring the scale
of addiction in a substance or drug. Nevertheless, researchers
and medical experts have come up with a five-factor measure of
ranking drugs based on their scale of addiction. These factors
include dependence, tolerance, intoxication, withdrawal, and
reinforcement. Using these criteria, we can start discussing how
addictive some of the illicit and legal drugs are compared with
one another. The focus of this paper was on nicotine, alcohol, and
Wise and Koob’s  definitions of these criteria were quite
useful for this research. For instance, withdrawal refers to the
presence and seriousness of obvious withdrawal symptoms.
Tolerance entails the amount of the drug required to settle rising
cravings and the level of satisfaction that is finally attained.
Reinforcement, on the other hand, measures the ability of the
drug to make users consume it over and over, and the level of
preference compared to other drugs. Despite not having been
considered an addiction measure, the level of intoxication affects
addiction and increases the social and personal damage a drug
brings. Finally, dependence involves the difficulty of quitting, the
number of users who finally become addicted, the rate of relapse,
the significance users give to the drug and the extent to which
the drug continues to be used even if it is found or classified to
be harmful Wise and Koob .
The following comparative rating scale for alcohol, heroin, and
nicotine was developed from the research conducted. The scale
of addiction is between 1 to 10. A lower score or value denotes
a less serious addiction level, while a higher score denotes more
serious addiction cases. Furthermore, the five addiction factors
are represented using different colors as shown in the graph
below. Blue denotes dependence, red denotes tolerance, green
denotes withdrawal, and vibrant purple denotes intoxication
while light blue denotes reinforcement (Table 1) (Figure 1).
Data obtained from the National Council on Alcoholism and
Drug Dependence shows that about 17.6 million US citizens
suffer from alcohol addiction Hasin and Grant . However,
considering that alcohol a legal substance and socially accepted,
it will be unfounded to conclude that it is the most addictive
drug. Alcohol is quite hard to quit since it is easily accessible,
and active marketing campaigns also contribute largely to this.
Compared to nicotine and opioids (heroin), alcohol ranks the
least addictive drug in this category.
Most people develop alcohol tolerance at a moderate rate.
Even casual drinkers may find that they need a little more
alcohol to get drunk compared to when they started drinking.
Nevertheless, it is hard to measure tolerance because the level of
intoxication is also influenced by many external factors such as
what one ate that same day.
Compared to heroin and nicotine, alcohol ranks the worst
when considering withdrawal. In the most severe instances,
alcohol withdrawal can be lethal because it produces delirium
tremens that can rapidly develop to seizures and irregular
heartbeat, which are sometimes deadly.
Before reaching a level of overdose, alcohol intoxication is
very high. Furthermore, the psychological and physical impacts
of alcohol intoxication are always varied and rather severe. It is
always easy to tell when someone has drunk too much alcohol.
Additionally, alcohol has been found to lower inhibitions, and
this can lead to alcohol levels that increase the probability of
addiction. On the scale of intoxication, alcohol out-performs all
the other drugs Abuse .
On this scale, alcohol is relatively lower than cocaine and
heroin. Fatseas et al.  attest this to the fact that although
alcohol intoxication is a pleasant thing, it does not generate
the intensive high euphoric feelings caused by the hard drugs.
However, it has a reinforcement score higher than that of
nicotine because it is physically addictive.
On this scale alone, nicotine is the most addictive
drug compared to the rest of other common drugs, even
outperforming alcohol and heroin. This is quite surprising given
that it does not cause similar problems attested to alcohol and
heroin. Despite the serious health risks associated with nicotine,
most individuals who begin smoking tobacco end up addicted,
and they it rather difficult to quit the habit totally. For instance,
the report published by the Centers for Disease Control and
Prevention estimates that nearly 480,000 people die annually
from cigarette smoking Degenhardt et al. .
It seems that tolerance to nicotine products builds up quickly.
After the first instance of using nicotine, many people tend to
take it several times every day simply because it has a high
dependence level. In effect, the increased rate and frequency of
use of nicotine builds tolerance very quickly, thus increasing the
risk of addiction. In fact, nicotine ranks only second to heroin in
terms of tolerance.
According to various research findings, nicotine withdrawal
is more moderate when comparing to alcohol and heroin,
despite being troublesome. Emotional effects such as irritability
and cravings are quite prominent among nicotine users, but it is
unlikely to see it confine people to bed with flu-like symptoms
and pain for a week.
Nicotine is only associated with mild stimulant side-effects;
hence its scale of intoxication is relatively mild compared to
alcohol and heroin. This explains why only a sizeable number of
users go back to get more.
In the reinforcement scale of addiction, nicotine ranks
the lowest compared to alcohol and heroin, according to data
derived from Abuse . This is mainly because among new
users, nicotine does not generate the same kind of high euphoric
feelings like alcohol and heroin. This denotes that only a small
number of first-time users of nicotine become addicted because
many of them do not bother to try it again. Nevertheless, this
is the same reason that makes nicotine rank the highest in the
Heroin has a very high dependency rate because nearly 23%
of its users have been found to become addicted to it Abuse
. One of the most severe problems associated with heroin is
relapses, and many of people who used to take this drug and quit at some point in life, die from cases of overdose immediately after
resuming its use. Furthermore, withdrawal symptoms coupled
with this euphoric sensation cause users not to contemplate
quitting. Fatseas et al.  outline that cravings for heroin are the
most intense compared to any other drug.
Tolerance to heroin also builds rather quickly, hence most of
its users claim that they find it hard to re-experience their first
euphoric feeling once it recedes. As a result, they keep on chasing
this sensation, which may take many years. Therefore, heroin
is considered a very dangerous drug. After all, addicted users
contemplate mixing it with other drugs to get a higher and better
feeling of being high, once they develop tolerance. Therefore, the
risk for overdosing is quite high among heroin users.
Withdrawing from using any opioid is a terrible experience
for many users even though the drug itself is not directly
dangerous. Addicted users usually complain of intense malaise,
relapse, terrible flu symptoms, and terrible pains. Consequently,
different medications are used to treat this addiction and help
the addicted people overcome these symptoms. According to
Hall, Carter and Forlini  the success rate for overcoming this
type of addiction and quitting opioids altogether is estimated
at a mere level of 5-10 percent. Therefore, it is critical to offer
professional assistance and medications to the addicts.
It is only alcohol addiction that beats heroin in terms of
intoxication. Most importantly, addicts of heroin report a
significant level of intoxication after experiencing the euphoria,
an in most cases they will be seen nodding their heads even
when the conversation is in the middle.
Heroin reports a higher level of reinforcement compared to
alcohol and nicotine because of the intense feeling of euphoria.
Even when the drug is tested on animals, the animals will come
back for more once the initial euphoric feeling fades away.
In most instances, heroin creates a bingeing habit in which
users crave for more once the initial feeling wears off, and this
increases the risk of addiction.
The drug menace is becoming a thorny issue among the
political, social, economic, and demographic aspects of the
modern world. Different theories have been put forward
to provide a deep understanding of the addiction problem.
Furthermore, biological, psychological and developmental
factors have been found to facilitate the rise in drug and
substance abuse. However, there are varied perceptions on this
issue, hence there is no standard definition or way of establishing
which drug or substance is more addictive than the other.
Different scaling criteria on addiction have been developed
to facilitate this work. Many scholars, experts, and scientists
have agreed on using withdrawal, tolerance, dependence,
intoxication, and reinforcement has measures of identifying the
addictive qualities of various drugs. From the research, it was
difficult, to sum up these measures and come up with a standard
answer as to which drug between heroin (opioids), nicotine and
alcohol is more addictive than the other. To compare the degree
of addiction among different drugs should, therefore, be done
using these five criteria. This creates a room for future studies
and ways of generalizing the scale of addiction among various
drugs. Therefore, I recommend that further efforts be directed