Addictive Qualities of Popular Drugs
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| Comparing Addictive Qualities of Popular Drugs (Higher score indicates more serious effect) |
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| Drug | Dependence | Withdrawal | Tolerance | Reinforcement | Intoxication |
| Nicotine | 6 | 4 | 5 | 3 | 2 |
| Heroin | 5 | 5 | 6 | 5 | 5 |
| Cocaine | 4 | 3 | 3 | 6 | 4 |
| Alcohol | 3 | 6 | 4 | 4 | 6 |
| Caffeine | 2 | 2 | 2 | 1 | 1 |
| Marijuana | 1 | 1 | 1 | 2 | 3 |
Withdrawal: Presence and severity of characteristic withdrawal symptoms.
Reinforcement: A measure of the substance's ability, in human and animal tests, to get users to take it again and again, and in preference to other substances.
Tolerance: How much of the substance is needed to satisfy increasing cravings for it, and the level of stable need that is eventually reached.
Dependence: How difficult it is for the user to quit, the relapse rate, the percentage of people who eventually become dependent, the rating users give their own need for the substance and the degree to which the substance will be used in the face of evidence that it causes harm.
Intoxication: Though not usually counted as a measure of addiction in itself, the level of intoxication is associated with addiction and increases the personal and social damage a substance may do.
Source: Jack E. Henningfield, PhD for NIDA, Reported by Philip J. Hilts, New York Times, Aug. 2, 1994 "Is Nicotine Addictive? It Depends on Whose Criteria You Use."
Annual Causes of Death in the United States
| Tobacco | 430,7001 |
| Alcohol | 110,6402 |
| Adverse Reactions to Prescription Drugs | 32,0003 |
| Suicide | 30,5754 |
| Homicide | 18,2725 |
| All Licit & Illicit Drug-Induced Deaths | 16,9266 |
| Non-Steroidal Anti-Inflammatory Drugs Such As Aspirin | 7,6007 |
| Marijuana | 08 |
- (Average 1990-1994) According to the US Centers for Disease Control, from the beginning of 1990 through 1994 "2,153,700 deaths (1,393,200 men and 760-400 women; total annual average: 430,700 deaths) were attributed to smoking (19.5% of all deaths)." The CDC notes that "Cigarette smoking remains the leading preventable cause of death in the United States."
Source:(1996): "Smoking-Attributable Mortality and Years of Potential Life Lost," Morbidity and Mortality Weekly Report (Atlanta, GA: Centers for Disease Control, 1997), May 23, 1997, Vol. 46, No. 20, p. 449.
- According to the federal National Institute on Alcohol Abuse and Alcoholism, in 1996 an estimated 110,640 people in the US died due to alcohol.
Source: "Number of deaths and age-adjusted death rates per 100,000 population for categories of alcohol-related (A-R) mortality, United States and States, 1979-96," National Institute on Alcohol Abuse and Alcoholism, from the web at http://www.niaaa.nih.gov/databases/armort01.txt, last accessed Feb. 12, 2001, citing Alcohol Epidemiologic Data System, Saadatmand, F., Stinson, FS, Grant, BF, and Dufour, MC, "Surveillance Report #52: Liver Mortality in the United States, 1970-96" (Rockville, MD: National Institute on Alcohol Abuse and Alcoholism, Division of Biometry and Epidemiology, December 1999).
- (Average 1982-1998): According to Canadian researchers, approximately 32,000 hospitalized patients (and possibly as many as 106,000) in the USA die each year because of adverse reactions to their prescribed medications.
Source: Lazarou, J, Pomeranz, BH, Corey, PN, "Incidence of adverse drug reactions in hospitalized patients: a meta-analysis of prospective studies," Journal of the American Medical Association (Chicago, IL: American Medical Association, 1998), 1998;279:1200-1205, also letters column, "Adverse Drug Reactions in Hospitalized Patients," JAMA (Chicago, IL: AMA, 1998), Nov. 25, 1998, Vol. 280, No. 20, from the web at http://jama.ama-assn.org/issues/v280n20/ffull/jlt1125-1.html, last accessed Feb. 12, 2001.
- (1998): The US Centers for Disease Control reports that in 1998, there were a total of 30,575 deaths from suicide in the US.
Source: Murphy, Sheila L., "Deaths: Final Data for 1998," National Vital Statistics Reports, Vol. 48, No. 11 (Hyattsville, MD: National Center for Health Statistics, July 24, 2000), Table 10, p. 53, from the web at http://www.cdc.gov/nchs/data/nvs48_11.pdf .
- (1998): The US Centers for Disease Control reports that in 1998, there were a total of 18,272 deaths from homicide in the US.
Source: Murphy, Sheila L., "Deaths: Final Data for 1998," National Vital Statistics Reports, Vol. 48, No. 11 (Hyattsville, MD: National Center for Health Statistics, July 24, 2000), Table 10, p. 53, from the web at http://www.cdc.gov/nchs/data/nvs48_11.pdf .
- (1998): "In 1998 a total of 16,926 persons died of drug-induced causes in the United States (Table 20). The category 'drug-induced causes' includes not only deaths from dependent and nondependent use of drugs (legal and illegal use), but also poisoning from medically prescribed and other drugs. It excludes accidents, homicides, and other causes indirectly related to drug use. Also excluded are newborn deaths due to mother's drug use." The total number of deaths in the US in 1998 was 2,337,256.
Source: Murphy, Sheila L., Centers for Disease Control, "Deaths: Final Data for 1998,", National Vital Statistics Reports, Vol. 48, No. 11 (Hyattsville, MD: National Center for Health Statistics, July 24, 2000), pp. 1, 10, from the web at http://www.cdc.gov/nchs/data/nvs48_11.pdf .
- (1996): "Each year, use of NSAIDs (Non-Steroidal Anti-Inflammatory Drugs) accounts for an estimated 7,600 deaths and 76,000 hospitalizations in the United States." (NSAIDs include aspirin, ibuprofen, naproxen, diclofenac, ketoprofen, and tiaprofenic acid.)
Source: Robyn Tamblyn, PhD; Laeora Berkson, MD, MHPE, FRCPC; W. Dale Jauphinee, MD, FRCPC; David Gayton, MD, PhD, FRCPC; Roland Grad, MD, MSc; Allen Huang, MD, FRCPC; Lisa Isaac, PhD; Peter McLeod, MD, FRCPC; and Linda Snell, MD, MHPE, FRCPC, "Unnecessary Prescribing of NSAIDs and the Management of NSAID-Related Gastropathy in Medical Practice," Annals of Internal Medicine (Washington, DC: American College of Physicians, 1997), September 15, 1997, 127:429-438, from the web at http://www.acponline.org/journals/annals/15sep97/nsaid.htm, last accessed Feb. 14, 2001, citing Fries, JF, "Assessing and understanding patient risk," Scandinavian Journal of Rheumatology Supplement, 1992;92:21-4.
- An exhaustive search of the literature finds no deaths induced by marijuana. The US Drug Abuse Warning Network (DAWN) records instances of drug mentions in medical examiners' reports, and though marijuana is mentioned, it is usually in combination with alcohol or other drugs. Marijuana alone has not been shown to cause an overdose death.
Source: Drug Abuse Warning Network (DAWN), available on the web at http://www.samhsa.gov/; also see Janet E. Joy, Stanley J. Watson, Jr., and John A. Benson, Jr., "Marijuana and Medicine: Assessing the Science Base," Division of Neuroscience and Behavioral Research, Institute of Medicine (Washington, DC: National Academy Press, 1999), available on the web at http://www.nap.edu/html/marimed/; and US Department of Justice, Drug Enforcement Administration, "In the Matter of Marijuana Rescheduling Petition" (Docket #86-22), September 6, 1988, p. 57.
A John Hopkins study published in May 1999, examined marijuana's effects on cognition on 1,318 participants over a 15 year period. Researchers reported "no significant differences in cognitive decline between heavy users, light users, and nonusers of cannabis." They also found "no male-female differences in cognitive decline in relation to cannabis use." "These results ... seem to provide strong evidence of the absence of a long-term residual effect of cannabis use on cognition," they concluded.
Source: Constantine G. Lyketsos, Elizabeth Garrett, Kung-Yee Liang, and James C. Anthony. (1999). "Cannabis Use and Cognitive Decline in Persons under 65 Years of Age," American Journal of Epidemiology, Vol. 149, No. 9.
"Current marijuana use had a negative effect on global IQ score only in subjects who smoked 5 or more joints per week. A negative effect was not observed among subjects who had previously been heavy users but were no longer using the substance. We conclude that marijuana does not have a long-term negative impact on global intelligence. Whether the absence of a residual marijuana effect would also be evident in more specific cognitive domains such as memory and attention remains to be ascertained."
Source: Fried, Peter, Barbara Watkinson, Deborah James, and Robert Gray, "Current and former marijuana use: preliminary findings of a longitudinal study of effects on IQ in young adults," Canadian Medical Association Journal, April 2, 2002, 166(7), p. 887.
The DEA's Administrative Law Judge, Francis Young concluded: "In strict medical terms marijuana is far safer than many foods we commonly consume. For example, eating 10 raw potatoes can result in a toxic response. By comparison, it is physically impossible to eat enough marijuana to induce death. Marijuana in its natural form is one of the safest therapeutically active substances known to man. By any measure of rational analysis marijuana can be safely used within the supervised routine of medical care.:
Source: US Department of Justice, Drug Enforcement Agency, "In the Matter of Marijuana Rescheduling Petition," [Docket #86-22], (September 6, 1988), p. 57.
The World Health Organization released a study in March 1998 that states: "there are good reasons for saying that [the risks from cannabis] would be unlikely to seriously [compare to] the public health risks of alcohol and tobacco even if as many people used cannabis as now drink alcohol or smoke tobacco."
Source: Hall, W., Room, R. & Bondy, S., WHO Project on Health Implications of Cannabis Use: A Comparative Appraisal of the Health and Psychological Consequences of Alcohol, Cannabis, Nicotine and Opiate Use, August 28, 1995, (contained in original version, but deleted from official version) (Geneva, Switzerland: World Health Organization, March 1998).