| This is a question that people often ask but | | | | Benowitz rating cocaine. |
| is actually a very difficult one to answer. | | | | |
| Addiction is not just one single and simple | | | | The fourth criterion is dependence. This is |
| process, it is a complex process that has | | | | defined as the difficulty in quitting, or |
| both physical and psychological aspects. | | | | staying off the drug, usually measured by the |
| Nevertheless despite this complexity two | | | | number of users who eventually become |
| attempts have been made to determine the most | | | | dependent. For many dependence is viewed as |
| addictive drug. Independently Dr. Jack E. | | | | the hallmark of addiction and how 'addiction' |
| Henningfield of the National Institute on | | | | is usually measured by the medical |
| Drug Abuse and Dr. Neal L. Benowitz of the | | | | profession. For this criterion both |
| University of California at San Francisco, | | | | researchers are again in agreement as they |
| ranked six psychoactive substances, nicotine, | | | | rate nicotine highest for dependence. For the |
| heroin, cocaine, alcohol, caffeine and | | | | other drugs they both rated them in the same |
| marijuana, on the five criteria they felt | | | | order that is highest for dependence, |
| were most important in addiction. | | | | nicotine, then heroin, cocaine, alcohol, |
| | | | caffeine and last marijuana. |
| The first of these criteria was withdrawal. | | | | |
| This is defined as the severity of withdrawal | | | | The final criterion is intoxication. This is |
| symptoms produced by stopping the use of the | | | | the degree of intoxication produced by the |
| drug. Both researchers rated alcohol as | | | | drug in typical use. Again the researchers |
| having the most severe withdrawal symptoms, | | | | are in agreement and rate alcohol as the most |
| for example hallucinations and convulsions, | | | | intoxicating of the drugs. |
| and the fact that withdrawal from alcohol is | | | | |
| the only one of the included drugs that is | | | | Given the complexity of the addictive process |
| potentially fatal. | | | | it is not surprising that there is not a |
| | | | clear 'winner' in all criteria. What some may |
| The second criterion is reinforcement, that | | | | find surprising is that for both researchers |
| is the drug's tendency to induce users to | | | | caffeine ranked higher than marijuana on a |
| take it again and again. This is influenced | | | | number of the criteria and indeed Berowitz |
| by the feelings that taking the drug brings, | | | | rates caffeine higher than marijuana for |
| that is whether it is a pleasurable high or | | | | dependence. |
| not, obviously if the feelings are negative | | | | |
| there will be little incentive to repeat the | | | | These results have been quoted many times by |
| experience. Again both researchers were in | | | | many researchers, commentators and reporters. |
| agreement and rated cocaine as the most | | | | They are usually interpreted as nicotine, or |
| reinforcing. | | | | tobacco smoking, being named the most |
| | | | addictive substance purely on the definition |
| The third criterion was tolerance, this is | | | | of the difficulty in refraining. What the |
| defined as the user's need to have | | | | results do show is that addiction is a |
| ever-increasing doses to get the same effect. | | | | complex and multi-facetted activity and that |
| For the first time the researchers disagree | | | | it is impossible to reduce it to a simple |
| with Henningfield rating heroin first and | | | | metric. |