Addiction has long been seen as a public health issue and substances have been regulated or banned accordingly. In America, there are tens of thousands of people in prisons for possession of banned substances. A hundred thousand more individuals are incarcerated for other drug-related offenses, such as the sale of substances.
This focus on banning certain substances has contributed to the perception that addicts are criminals. At the very least, they acquired drugs illegally, right? Actually, this is one of the biggest myths about addiction.
While illegal drugs can be extremely dangerous, the vast majority of people become addicted to legal substances. These substances are regulated to different degrees, but nonetheless lead to tens of millions of cases of addiction and hundreds of thousands of preventable deaths each year.
Here are some of the most addictive substances in the world… which are totally legal.
Alcohol: The Most ‘Socially Acceptable’ Drug
Let’s start with the obvious. Alcohol is legal for people over the age of twenty-one. We’re all aware that it can lead to addiction, but did you know that it’s one of the five most addictive substances? That’s right, alcohol is more addictive than fentanyl or crystal meth!
The statistics paint a grim picture. Over 28 million Americans were estimated to have an alcohol use disorder over the past year. According to the CDC, excessive alcohol use causes 178,000 deaths every year – shortening the lives of those individuals by an average of 24 years.
Alcohol is particularly dangerous as an addictive substance because of how socially acceptable it is. It is easily accessible and its presence at homes and events is normal. Addiction to alcohol is so common that many people don’t realize it’s a problem or consider treatment. In fact, fewer than 10% of people addicted to alcohol get treatment.
Tobacco: The Biggest Killer
When asked about the deadliest substance, most people would name drugs like fentanyl or crack cocaine. But while those drugs can lead to rapid death by overdose, the biggest killer is actually tobacco. Legal for anyone over the age of twenty-one, it contains nicotine which is more addictive than most illicit drugs.
In contrast to alcohol, with which one may face professional and legal consequences for its excessive use, there are no such restrictions on the use of tobacco. Whether you smoke one cigarette or fifty, you are still permitted to drive and welcomed into the office.
It’s been common knowledge just how deadly smoking is since the middle of the twentieth century, with life expectancy for smokers ten years lower than for non-smokers. Nonetheless, it is still the leading cause of premature, preventable death. In 2024, more than 16 million Americans lived with a disease caused by smoking, and more than 480,000 tobacco-related deaths were reported.
Opioid Painkillers: The Not-So-Silent Epidemic
Heroin is believed to be the most addictive substance in the world. For this reason, it has been illegal for almost a century. However, its main component, opium, is still used to manufacture painkillers. This has led to the well-publicized opioid epidemic.
Legal opioids are far more regulated than alcohol and tobacco. You cannot legally purchase these painkillers without a prescription. Unfortunately, with false assurances from manufacturers that their products were not addictive, doctors overprescribed painkillers in the past and many continue to do so.
People tend to trust their doctors and therefore assume that it is safe to use prescription painkillers. While the best medical professionals take measures to prevent addiction and warn patients about the risks, not all doctors take on the responsibility.
Over 2 million Americans are addicted to opioids and the number is rising. Although drugs like fentanyl have gained a public reputation for being addictive and deadly, they are legal and still commonly prescribed.
Benzodiazepines: The Impact of Sleeping Pills
Benzodiazepines, often called benzos for short, are the class of prescription drugs used for anxiety, panic attacks, and insomnia. They’re popular for their rapid effects and have been prescribed by medical professionals for decades. There are, unfortunately, not many alternatives for people who struggle to fall and stay asleep.
But a good night’s sleep can come at a heavy cost. Benzos are among the most addictive substances in the world. They are also dangerous when used inappropriately. Since they slow a person’s reaction times and can cause a person to doze off, driving under the influence of benzos can be deadly to oneself and others. They can cause dangerous mistakes in jobs involving machinery and physical labor, and can lead to catastrophic errors in jobs where lives are at stake, such as that of a surgeon.
It is estimated that over 2 million people were addicted to benzodiazepines over the past year.
Should These Substances be Banned?
With many of these substances, the high rates of addiction are connected to their accessibility. Alcohol and tobacco in particular are easy to acquire and socially acceptable to use. Should they be made illegal?
There is no easy answer to this question. Alcohol is used by so many people that any ban is unlikely to succeed. Furthermore, many people use it responsibly and it plays a role in various cultural rites. Although tobacco can’t be used in a healthy way, there are already tens of millions of people who ‘can’t live without it’.
Opioid painkillers and benzodiazepines, on the other hand, are necessary in many cases, especially when pain, anxiety, insomnia, and other issues are severe and chronic. Banning them completely is not an option.
As such, it is up to individuals to take care when considering using these substances. Ask yourself whether it is worth risking your wellbeing. Put safeguards in place to prevent yourself from excessive use.
Most importantly, don’t assume that the legality of these substances makes them safe!
Sources
CDC: Facts About U.S. Deaths from Excessive Alcohol Use
PPI: Mass Incarceration: The Whole Pie 2025
CDC: Alcohol Use and Your Health
The Lancet: Development of a rational scale to assess the harm of drugs of potential misuse
