It’s no secret that drug use is rampant in America, with a staggering 70 million Americans admitting to the regular use of mind altering drugs. 100 people overdose on drugs every day in the United States, with a number of the most dangerous drugs available toeing the line of legality- some drugs with high abuse potential are available through a prescription. Here, from least to most fatalities, are the twelve most dangerous drugs in America.

12. Solvents

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The use of these vaporized, inhaled or smoked drugs, otherwise known as huffing, is highly unsafe. Huffing involves the inhalation of a harsh chemical not intended for human consumption, such as gasoline or solvent glue. While this act has made headlines for its role in American teen drug use fatalities in recent years, it first became popular in the US in 1920 when Prohibition was enacted, banning alcohol use.

11. Amphetamine

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Known most frequently for its use in treating Attention Deficit Hyperactivity Disorder, amphetamine is a stimulant with many medical utilities. The ease of availability makes the drug a popular choice for recreational use, but has a high tolerance threshold. At high doses, mania, convulsions, coma and death are possible. The first pharmaceutical amphetamine, Benzedrine, was intended as a treatment to enlarge nasal passages in allergic patients, but its abuse potential became obvious in the 1950s and prescription use became more regulated.

10. Buprenorphine

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Used most commonly in its Suboxone form, this drug is a semi-synthetic opioid. This drug, often administered in trans-dermal patches, is intended as a replacement therapy for more dangerous drugs like heroin and Oxycodone in serious addicts. Though used by doctors to prevent the initial severe withdrawal symptoms of those opioids and prevent the use of unsafe street drugs, Buprenorphine also has serious abuse potential and can lead to fatal overdoses.

9. Tobacco

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Though it is legal and widely available, the hardy plant has an abuse and addiction potential that is very serious. It is not possible to overdose on tobacco, but it has caused over 100 million deaths from cancer in the 20th century, making it one of the deadliest abused substances of all time. Tobacco is the only drug that, when used, can have long term fatal effects not only to the user, but the people around them being exposed to secondhand smoke.

8. Benzodiazepine

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Prescribed in several forms, Benzodiazepine is a drug with anxiolytic, hypnotic, sedative and muscle relaxant effects among others. While it can be safely used in the short term in small doses, long term use is unhealthy and the drugs bearing this classification have serious abuse potential. Withdrawal symptoms themselves may lead to fatality among serious Benzodiazepine users. Often used in conjunction with other recreational drugs, doctors hesitate to prescribe the these drugs to known addicts because of frequent comorbid fatalities and potential of abuse.

7. Ketamine

A dissociative anesthetic medication used at the onset of surgery, Ketamine is a popular recreational drug among young addicts. It has hallucinogenic properties and is often used by a specific sect of drug user who seeks out hallucinogenic experiences. Unlike typical psychedelic drugs, it has a high potential for fatality when abused. Despite this, its undeniable medical utility has placed it on the World Health Organization’s List of Essential Medicines, a list of medications which should be present in every health care system.

6. Alcohol

With use first noted in 10,000 BC, it is safe to say that alcohol is a staid presence in global culture. America is no exception to this rule, with 17.6 million citizens reporting alcohol abuse or dependence. Made with ethanol and served in a variety of preparations, libations have the potential to be fatal in both the short and long term. Fatal alcohol poisoning can be caused by short term excessive consumption, and long term abuse can lead to organ failure.

5. Methadone

Like Suboxone, Methadone is a drug which is commonly used as a less dangerous substitute for heroin and prescription narcotics. Unlike its counterpart, it triggers receptors in the brain in a similar way to more dangerous narcotics, making the potential for abuse much higher. Abuse is frequent, and overdose rates have steeply increased in the past few years as a result of a national heroin use epidemic. Like Ketamine, Methadone is considered an essential medication by the World Health Organization.

4. Barbiturates

Though they are used very sparingly in modern medicine, barbiturates are approved to treat epilepsy, anxiety and insomnia. Drugs of this type have largely been replaced with others which can treat these conditions with fewer contraindications and less risk of addiction and fatal overdose. During the 1950s and beyond, high profile fatalities of celebrities like Marilyn Monroe and Judy Garland and frequent fatalities made the problems associated with the drug evident.

3. Cocaine

Derived from leaves taken from the coca plant, cocaine gives powerful stimulation to the central nervous system, triggering severe addiction. While the effects of the drug are extremely potent, they last for a short time, resulting in addicts using a large amount over an extended period of sleeplessness, which can lead to fatal cardiac arrest. Interestingly, trace amounts of cocaine were present in the original recipe for popular soft drink Coca Cola.

2. Oxycodone

Widely known to be one of the most addictive and dangerously fatal drugs available, oxycodone is a prescription opioid which can quickly become addictive. It is a common prescription for those with acute pain, but can lead to a serious addiction, with addicts often eventually replacing the drug with heroin- this is ironic, as it was manufactured by Bayer to replace it in their lineup.

1: Heroin

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Steep increases in heroin overdoses have been in headlines across the US in recent years. Originally designed by Bayer in 1874 as a treatment for pain, the drug is derived from the seeds of the opium poppy. Recent steep increases in overdoses have been traced by many sociologists by the over-prescription of legal opiates for pain management. Their wide availability leads to street sale, with many addicts eventually switching to heroin. Heroin fatalities are common due to overuse, batches cut with fatal ingredients and variations in strength between batches of the drug.