As a licensed alcohol and drug counselor (LADC), people often ask me what the worst drug is and my answer is often unexpected. My response is that all drugs can be dangerous and all, in some way, can be considered the worst.

In my line of work, drugs are not defined as “worst” or “best.” All drugs have the potential to produce negative health effects and can often lead to a dangerous situation, both in the short or long term. While it is true that some drugs can cause serious health issues such as a life-threatening overdose, much depends on how much someone uses, how the drug is consumed, along with other factors. Let’s not forget that even over-the-counter drugs (OTC) can be dangerous when not consumed as directed. 24/7 Wall Street conducted a study that lists the top 25 most dangerous drugs as well as drug mixtures. These findings included side effects and death rates that were tracked by the government, and potential risk of drug combinations that were measured by using medical information through organizations and various reputable internet sources including the American Medical Association (AMA). A key take-away is that while some of the drugs on this list are often considered to be safe when taken as prescribed and/or as directed, all drugs can be fatal when used improperly or combined with other substances. 

When students ask me directly about which drug is considered the worst, I am reminded that more often than not they are asking about what is most popular on the streets, in school, and possibly among friends. When I can, I remind students that nicotine and alcohol tend to be the worst drugs when looking at the statistics: long-term health effects of cigarette smoking are responsible for more than 480,000 deaths per year (approximately 1,300 deaths every day) and alcohol is often involved in deadly car crashes where nearly one person died every 52 minutes from drunk driving crashes in 2019. Yet, the one drug that I am most concerned about is fentanyl. Back in December, I shared a blog about pressed pills, pointing out that they can often be laced with fentanyl. Knowing that this synthetic opioid is one of the most powerful drugs available, my concern is around the fact that while this is a prescription drug used often for pain management, it is also made and used illegally. Due to the strength of fentanyl, drug dealers often mix it with other substances to boost the high, thus creating the urge to repeat for the user and repeat customers for the drug dealer. Again, when someone takes a pill that is not prescribed to them, they risk ingesting something deadly and put themselves at risk for an unintended, often deadly, overdose. This past September, the DEA launched a “One Pill Can Kill” campaign. I encourage you to read and learn as much as you can in the hopes that the more we know, the more we can educate students about the dangers of fentanyl and substance use. 

Another concern I have with categorizing drugs as “good or bad” is that it can lead to  misperceptions. For example, let’s look at marijuana. Students (and adults) often believe that marijuana is not bad for you since it is a plant-based substance. Many also refer to the legalization of marijuana in many states believing that if it is legal, it can’t be that bad. If you search the internet on the use of marijuana, you can get pages of misinformation, often misleading and lacking the necessary information needed in order to make a well-informed decision on its use. Again, I refer back to a previous blog that highlights the concerns around marijuana use for our students.

In closing, I hope you can see that it is not that easy to say that one drug is better than another or that one is safer than another. So much depends on the reason behind the use (was it prescribed?), how one uses the drug (is it being used as prescribed?), and the reasons for the use (is it being used to deal with other issues?). For those that find themselves struggling with substance use, finding someone to help you navigate through your life challenges is key in living a life free from use.

As always, my hope is that you have enough information at your fingertips to help your student and if given the opportunity, you can say, “Let’s Talk About It!” As parents and caregivers, you are on the frontline of educating your child. We are here to help.

Colleen O’Neil, LADC, CPP
Anoka-Hennepin School District Chemical Health Prevention Specialist
Phone: 763-506-1145
Email: colleen.oneil@ahschools.us