Why is it that the most addictive substances are also the most dangerous? Shouldn’t those two factors be independent?
In: Chemistry
because it’s the addiction that causes the harm.
taken in moderation, heroin for example is basically harmless. but being able to take it in moderation is quite difficult.
Many of the addictive drugs aren’t *that* bad for you if you dose it properly and don’t do it consistently.
Fentanyl is used in the hospital all the time. Same with oxycodone, morphine, etc.
The problem is that they are a little bit bad for you, your liver needs to process it, it can raise blood pressure which affects your heart. Things like that, among many more.
Like alcohol. It’s not good for your liver, your heart, but having a drink every now and then isn’t going to instantly destroy your liver.
Every once in a while it’s not too bad, but addictive drugs are often used by users, well, often. Every day. Multiple times per day. This all adds up, and in the end it damages your body a lot.
This also isn’t to mention to overdose angle. Drugs usually are dangerous when used in too high of doses. But that’s true with many things. The problem with drugs is that people like them a lot and want to get higher, so they take a lot of it. If you take too much, it can kill you right then and there.
While that’s true with many things, you don’t usually see people taking insanely high doses of Tylenol or aspirin. Because there’s no gain to be had from doing so.
One final point, drugs that are illegal are not made by regulated companies. So you do not know exactly what you are getting. It is extra dangerous to do illegal drugs because there might be something else in there that you don’t know, and you can accidentally overdose very easily. Very easily. Thousands die every year because of that.
We call harmless or beneficial addictive substances “necessities”. People don’t complain about how everybody craves oxygen or water even though nobody would voluntarily go without them. Even things like sugar or mental stimulation or sex only get called addiction in the most severe cases, where it interferes with other necessities of life. Marijuana and alcohol are “habit forming”, it’s only harder drugs like heroin or meth that are addictive. Nicotine and cocaine moved from cool pick-me-ups to addictions as the political winds changed against them.
The two factors *are* independent, our terminology is not.
There’s no ELI5 to be had because your premise is false. The factors are independent.
Caffeine and nicotine are 2 of the most widely consumed and addictive substances known to man, yet are not very dangerous, especially compared to other stimulants. On the other hand, Zolpidem (aka ambien) is highly addictive, even to the level of benzos in humans, but is much less dangerous and much harder to OD on.
Your title’s (false) assumption primarily stems from reporting bias. If a substance is addictive but not dangerous, it won’t make big waves in the media—e.g. caffeine. Similarly, if it’s dangerous but not addictive, people will rarely use it and instead opt for a safer (or more addictive) alternative. Take benzene & toluene, one of which is a carcinogen and the other is very neurotoxic. Why would you ever huff those when you could huff the much safer and more widely available whippets?
Substances that are both dangerous and addictive are the ones you see terrible statistics about on the news people because their addictive potential means people won’t stop using them despite the terrible consequences. But that doesn’t mean non-addictive-but-dangerous and safe-but-addictive substances don’t exist.
A good analogy is the electromagnetic spectrum. People who remember their high school physics know that visible light is but a tiny fraction of all the wavelengths of electromagnetic radiation that exist. But for a man without that knowledge, he only sees visible light and will assume that’s all there is.
It’s the addiction that is the danger. People need to care about more than just one thing in their lives. If your sole source of happiness is whether you have cocaine or alcohol or meth in your system, it skews the way you think about everything else. Small mounts of also and even cocaine, heck even heroin, aren’t that dangerous to most people, but warping your emotional landscape to the point where it’s all you care about (and therefore generally aren’t ingesting small amounts) is the problem.
Botox is very dangerous and it’s not addictive. It’s just that some of the things that are addictive are also dangerous and it’s easy to overdose if your organism craves more of the addictive stuff. But your body does not crave radium so it’s definitely not addictive – yet, it’s extremely dangerous.
The answer is that they aren’t. At least not really.
The most addictive drugs would be things like cocaine or fentanyl. Those have estimated LD50 of 96mg/kg and about 1mg/kg, respectively. Very deadly, but not even close to being the most deadly substances out there.
The most lethal substance we know of, botulinum toxin, has an LD50 of only 2-3 *nanograms* per kilogram when inhaled. That’s nearly a million times more deadly than fentanyl.
I agree with with what others said that it is actually isn’t the case. However, there is one thing particularly in drugs that might have a causation.
Many drugs are insecticides made by the plant and attack the insect’s nerve system. It makes sense that this could be inherently dangerous to any organism.
They are independent as others noted. But there’s another aspect of how dangerous a drug is, which is the difference between effective and lethal dose, and how you get your dose. Caffeine has a pretty low effective dose, while it would be rather difficult to drink enough coffee or energy drinks get a lethal dose. Realistically you’d have to slam a bunch of caffeine pills to overdose. LSD is another, rather low effective dose in micrograms, and the lethal dose is way more than that, very difficult to accidentally overdose.
But things like heroin and fentanyl have lethal doses that aren’t all that much higher than the effective dose, and it’s not hard to accidentally take the lethal dose.
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