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According to a 1988 article, cocaine is the most dangerous drug on the streets today. While others would have you believe heroin is the most dangerous drug, the Drug Enforcement Administration (DEA) wants you to know that fentanyl is the most dangerous drug they've ever seen. They also point to methamphetamine as a strong contender for second place. Others would have you believe it's nicotine. Tobacco, by the way, is rumored to claim more lives than all other drug overdoses, car accidents, and homicides combined. Still, others insist alcohol is the most dangerous drug. Graphs are included showing how much harm alcohol is to the world compared to any other drug, if you're interested.
Given that alcohol claims up to 95,000 lives each year, the only debatable question might be whether you consider alcohol a drug or not. And yes, some will even tell you that marijuana is the most dangerous drug. So which one? You can certainly argue against any of them, but one of them has to be the most dangerous, right? Let's find out!
Fentanyl and carfentanil
Fentanyl has become public enemy number one in the drug world over the past decade. Although the drug is prescribed to treat chronic pain, such as in cancer patients, and it helps many, the illicit use of laboratory-produced fentanyl has received widespread media coverage and has become something of a bogeyman for those unfamiliar with it.
In 2017, the Centers for Disease Control and Prevention (CDC) began declaring fentanyl a public health threat. By 2020, the CDC published data showing that of the 92,000 drug overdose deaths, nearly two-thirds were caused by opioids, and the majority of those were caused by fentanyl. Other data suggests that fentanyl is responsible for up to 70% of all overdose deaths.
In 2022, the number of overdose deaths rose to nearly 108,000. Nearly 74,000 of these were caused by synthetic opioids such as fentanyl. Conflicting data, again from the CDC, points to 84,000 opioid overdose deaths in 2022, but a decline to 81,000 in 2023.
One of the main problems associated with fentanyl is media intimidation, largely fueled by police. Police overreaction to what they perceive as fentanyl exposure has become a chronic problem. Beginning in 2016, police officers across America were given fentanyl-handling instructions that contained a wealth of misinformation about its dangers and how easily one can be exposed. This led to numerous stories of officers believing they had been exposed and overdosed, when in fact they were merely experiencing panic attacks.
To be clear, you won't die if you touch fentanyl. You won't pass out in the street or have a heart attack unless you have a severe allergic reaction.
Because no drug is so deadly that it can't be made even more deadly, fentanyl has somewhat given way to carfentanil as the most terrifying opioid on the market. As its name suggests, carfentanil is closely related to fentanyl. In fact, it's a derivative, but far more potent. You've probably heard, correctly or not, how dangerous fentanyl is. Carfentanil is 100 times more potent.
So why do we even need a drug like carfentanil? Well, for example, to euthanize elephants in emergency situations. And not just for routine euthanization, but for emergency situations where an elephant needs to be euthanized quickly. This substance wasn't originally intended for humans, but we shouldn't underestimate the human desire to test our limits.
Keep in mind that opioid abuse is essentially an American pastime. It's been going on for over a century. Fentanyl just replaced heroin, which replaced morphine, which replaced opium, which became a problem in the 1870s. Keep this in mind whenever you hear about attempts to combat the "opioid crisis." After 150 years, it hasn't worked.
Nitazenes
Never heard of nitazenes? You should pay attention. They may be "even worse" than fentanyl. And, like fentanyl, they've been around for decades, but until recently, no one cared about them. They're another type of synthetic opioid similar to fentanyl, and as fentanyl becomes the sole focus of law enforcement and government attention, nitazenes are beginning to fill that void.
Nitazens were developed in the 1950s as a morphine replacement, but the problem was that they were so strong that the FDA didn't approve them due to their high overdose potential, which is why you probably don't know about them. Furthermore, they are approximately 40 times more potent than fentanyl, and law enforcement began spotting them on the streets around 2019.
Since 2019, approximately 2,000 people have died from nitazen overdoses. This number is obviously much lower than that of fentanyl overdoses, but there are concerns it could rise sharply as law enforcement continues to combat this more well-known drug. Back in 2020, the chief scientific officer at NMS Labs called nitazen "the most persistent and prevalent new opioid" on the streets.
In addition to being highly effective, meaning they require only a small dose, these drugs are cheaply produced and often mixed with other medications, including counterfeit prescriptions, which increases the risk of overdose.
The fentanyl ban in China has brought nitazenes back into the spotlight, as drug manufacturers, seeking to avoid harsh penalties for fentanyl production, explored other opioids and found their new star. One of the problems with nitazenes is that multiple variations of its composition can be developed, not just one. This makes it difficult to identify and test.
The number of overdoses involving nitazene remains extremely low compared to substances like fentanyl. However, as the fight against fentanyl continues, we should expect these other synthetic opioids to become much more widespread. And, because they are much more potent, a surge in overdoses is likely in the near future.
Heroin and methadone
It's hard to discuss the opioid problem without mentioning heroin and methadone. For many, heroin seems outdated. Fentanyl has largely replaced it. Yet, in 2021, 9,173 heroin overdose deaths were recorded in America. This is far from an insignificant number.
Heroin was long used as a medicine before its addictive properties and overdose potential were fully understood. Heroin was available as a cough treatment.
Methadone, if you're unfamiliar, is a synthetic opioid created to help people withdraw from other drugs, such as heroin. While methadone is supposed to help you kick your addiction, it's also extremely dangerous. In fact, in one year, twice as many people died from methadone overdoses in Ireland as from heroin. Between 2007 and 2021, more than 55,000 people died from methadone overdoses in the United States, or about 4,000 per year.
Cocaine and crack
In the 1980s, cocaine and its less-sexy cousin, crack, were the feared drugs hyped by the media to intimidate suburbanites. In 1986, the US Congress literally held hearings on the "crack cocaine crisis." By 1991, government documents described it as an "epidemic.".
Crack was cheaper, which obviously made it more dangerous, but also less pure. Crack was cut with substances like baking soda or ammonia.
As the saying goes, everything old becomes new again. Cocaine use declined significantly in the early 1990s. However, over the past 25 years, it has increased significantly in places like England and Wales. In 1993, there were 11 cocaine-related deaths in England and Wales, the lowest number for that period. In 2023, that number rose to 1,118.
A similar trend, but on a larger scale, was observed in America. In 2000, only 3,544 cocaine overdose deaths were recorded in America. In 2022, this number peaked at 27,569. Half of all overdose deaths in New York City are attributed to crack and cocaine.
The price of cocaine in the 1980s was incredibly high, while crack was a cheaper, albeit dirtier, alternative for many. In the mid-1980s, a gram of cocaine cost $600. By 2007, it had dropped to $135. In 2020, it cost around $120 in America. A gram of crack, on the other hand, could cost around $65, and a dose as little as $15. This low price, combined with its lethal potential, is what makes it similar in danger to opioids even after all these years.
Synthetic and modified marijuana
Despite some fringe opinions, most people agree that marijuana is one of the least dangerous drugs you can use. After all, it's legalized in many places. There's simply not much evidence that it has dangerous side effects. However, there is a difference between regular, everyday marijuana and counterfeit marijuana. If you're not buying real, pure marijuana, it can be very dangerous.
Several years ago, the press was quite fascinated with zombie stories. Initially, they were reported to be the result of people consuming "bath salts," another type of synthetic drug. In one case, several dozen people ingested cannabis laced with fentanyl and caffeine. They were dubbed "zombies" because of their behavior afterward.
Synthetic marijuana, sometimes called "spice," has also been linked to psychosis. In other cases, rat poison contamination has led to hemorrhaging and death among users of the synthetic product.
The sheer list of potential side effects from synthetic marijuana use is staggering. Some people have died from cardiac arrhythmia, liver failure, kidney failure, and seizures. This has also been indirectly linked to deaths from hypothermia. Side effects include intracranial hemorrhage, coma, nausea and vomiting, bleeding gums, internal bleeding, nosebleeds, suicidal ideation, and a host of mental health problems that can persist for a month or more after using synthetic marijuana. And these are just a few of the side effects.
In Africa in 2024, news spread of another drug known as "Kush." It was another synthetic cannabinoid, mixed with nitazens, disinfectants, and, if the stories were to be believed, crushed human bones. Those who smoked it were said to experience a kind of detachment from reality, essentially leaving them motionless in a hypnotic state, unable to do anything for hours. Once again, they were described as zombie-like. At least this time, they were consuming actual human remains.
Cannabis is believed to have killed thousands of people in Sierra Leone alone, and from there, it spread throughout Africa. The situation was so dire that a national emergency was declared, and the death toll rose so high that mass cremations were necessary, as bodies were simply abandoned on the streets.
Which drug is the most dangerous?
Almost every drug can be considered the most dangerous. Fentanyl kills thousands. Alcohol kills thousands. Tobacco kills thousands. Heroin, methadone, cocaine, synthetic marijuana. People die all over the world from overdoses, from poor-quality drugs, from dangerous behavior, and much more.
History shows that drug use tends to follow a cyclical pattern. Once something is banned, it goes underground. There, it can remain widespread for decades, while other substances emerge and become increasingly popular. Over time, the cycle repeats, and what is considered the most dangerous today will be replaced by something else tomorrow.
Perhaps the most dangerous drug is one that is used irresponsibly and causes harm in the moment.
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