"When observed within approximately 1 to 12 months after heroin onset, an estimated 23% to 38% of new heroin users have become dependent on heroin. Rank-order correlation and post hoc exploratory analyses prompt a hypothesis of recently increased odds of becoming dependent on heroin.
Addictive Properties of Drugs
"The issues of measurement and conceptualization described above in relation to efforts to screen for problematic or harmful cannabis use highlight the shortcomings of ‘one-size-fits-all’ approaches to screening.
Alternative Analysis of the Relative Risk from MDMA Use: "Nutt et al. (2007) attempted to compare the relative dangers of the main types of psychosocial drug, using a series of subjective rating scales. Heroin and cocaine were graded as the two most harmful drugs, whereas Ecstasy/MDMA emerged as one of the least harmful (18th out of 20). Unfortunately, it was unclear how this low harm rating score for Ecstasy/MDMA was given, as they cited no empirical research studies or reviews. Instead, Nutt et al.
"In a large, nationally representative sample of US adults, the cumulative probability of transition to dependence was highest for nicotine users, followed by cocaine users, alcohol users and, lastly, cannabis users. The transition to cannabis or cocaine dependence occurred faster than the transition to nicotine or alcohol dependence. Furthermore, there were important variations in the probability of becoming dependent across the different racial-ethnic groups. Most predictors of transition were common across substances.
"The 1988 Surgeon General’s report lists the following general 'criteria for drug dependence,' including nicotine dependence (USDHHS 1988, p. 7):
"• Highly controlled or compulsive use
"• Psychoactive effects
"• Drug-reinforced behavior
Cannabis and Addiction
Estimated Prevalence of Cannabis Dependence: "Some 4.3 percent of Americans have been dependent on marijuana, as defined in the Diagnostic and Statistical Manual of Mental Disorders, 4th Edition, Text Revision (DSM-IV-TR; American Psychiatric Association, 2000), at some time in their lives. Marijuana produces dependence less readily than most other illicit drugs. Some 9 percent of those who try marijuana develop dependence compared to, for example, 15 percent of people who try cocaine and 24 percent of those who try heroin. However, because so many people use marijuana, cannabis dependence is twice as prevalent as dependence on any other illicit psychoactive substance (cocaine, 1.8 percent; heroin, 0.7 percent; Anthony and Helzer, 1991; Anthony, Warner, and Kessler, 1994)."
According to the Substance Abuse and Mental Health Service's Treatment Episode Data Set, in 2015 in the US there were 213,001 admissions to treatment with marijuana reported as the primary substance of abuse out of the total 1,537,025 admissions to treatment in the US for those aged 12 and older for all substances that year. This is the lowest number of marijuana admissions and total treatment admissions in at least a decade: marijuana admissions peaked in 2009 at 373,338, and total admissions peaked in 2008 at 2,074,974.
"In 2015, approximately 20.8 million people aged 12 or older had an SUD in the past year, including 15.7 million people who had an alcohol use disorder and 7.7 million people who had an illicit drug use disorder (Figure 27). An estimated 2.7 million people aged 12 or older had both an alcohol use disorder and an illicit drug use disorder in the past year (Figure 28). Thus, among people aged 12 or older in 2015 who had an SUD in the past year, nearly 3 out of 4 had an alcohol use disorder, and about 1 out of 3 had an illicit drug use disorder.
Addictive Potential: "Of the people who sample a particular substance, what portion will become physiologically or psychologically dependent on the drug for some period of time? Heroin and methamphetamine are the most addictive by this measure. Cocaine, pentobarbital (a fast-acting sedative), nicotine and alcohol are next, followed by marijuana and possibly caffeine. Some hallucinogens—notably LSD, mescaline and psilocybin—have little or no potential for creating dependence."