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drug dependence - substance abuse - commonly smoked drugs - nicotine dependence - cannabis use - nicotine and marijuana - smoke - gateway drug - gateway drugs

What are the 2 Most Commonly Smoked Drugs?

The Two Most Commonly Smoked Drugs

The 2 top drugs most commonly smoked are:

  1. Nicotine including vaping
  2. THC/Marijuana

The top 2 drugs most commonly smoked are also the top 2 gateway drugs leading to harder drugs, including:

  1. Opioids
  2. Alcohol
  3. Stimulants
  4. Sedatives
  5. Hallucinogens
  6. Other legal and illegal drugs

And their estimated numbers of fatal casualties each year is:

  1. 30,000 drug overdoses other than opioids
  2. 40,000 opioid overdoses
  3. 88,000 alcohol related
  4. 450,000 nicotine related
  5. 490,000 Addictive lifestyle-related including oxidized food misuse disorder (OFMD)

Drugs Have Since Become a Politically-Focused Issue, Not Just a Social One

See how the opioid epidemic may have become politicized?

With 40,000 opioid overdoses each year, but nearly half of million deaths attributed to addictive lifestyle related circumstances, how can we ignore addiction in and of itself? The impact is massive. Why is there an absence of boisterous people over the:

  1. Alcohol epidemic?
  2. Nicotine & vape epidemic?
  3. OFMD epidemic?

Perhaps corporate/political factors have prevented the disease concept of nicotine dependence from being widely accepted by addictions experts, departments of justice and the public at large.

Even after a wave of publications beginning in 1991 had generated overwhelming evidence that compelled addictions experts, departments of justice and the populous to all emerge from their denial of these inconvenient truths that the disease concept of nicotine dependence was very real (1-4), nicotine addiction remains a leading killer. While vape manufactures are having a profitable field day.

Do They Both Have Medication-Assisted Detox?

One excellent outcome of the nicotine dependence expose of the early 1990s was not only medication-assisted treatment for nicotine, but that nicotine researchers found utility in the treatment of other medical illnesses.

That’s because clinical researchers simultaneously pioneered, documented and in some cases patented a buffet of nicotine detoxification methods and went on to explore and find novel nicotine-replacement or medication-assisted treatments for medical diseases other than nicotine use disorders, including:

  • Alzheimer’s disease 5
  • Depression 6
  • Anxiety 6
  • Attention deficit disorder (ADD) or attention deficit hyperactive disorder (ADHD) 6,7
  • Appetite reduction 8
  • Weight reduction 8
  • Cannabis dependence 9

Indeed, we discovered that nicotine-replacement reduced THC cravings in a relatively small group of cannabis dependent subjects.

Our schedules evidently did not permit publication of those findings and so cannabis dependence continued to remain orphaned from the large family of substances that have corresponding medication-assisted treatment10,11,  until now12.

Medication-assisted treatment for marijuana abuse and addiction has arrived in states where it is legal, however, like legal alcohol, Royal Life Centers professes abstinence from cannabinoids during detoxification, rehabilitation, and aftercare.

So the answer is; The 2 most commonly smoked drugs, both gateways, are nicotine and cannabis, and they both have medication-assisted treatment which is usually office based and not associated with a comprehensive recovery-sensitive lifestyle.

Reach Out

If you or a loved one wants to learn more about our substance abuse programs, please reach out to us today. Our admissions team is available 24 hours a day, 7 days a week at (877)-RECOVERY to answer your questions. Because We Care.



  1. Cocores JA, Goias PR, Gold MS. Treatment of Nicotine Dependence in the Workplace. Annals of Clinical Psychiatry, (1) 237-240, 1989.
  2. Cocores, JA, Pottash AC. Outpatient Treatment, In: The Clinical Management of Nicotine Addiction, Cocores, JA/Editor, Springer International, New York, 1991.
  3. Cocores JA. The Clinical Management of Nicotine Addiction, In: A Handbook of Drug and Alcohol Addiction, Miller NS/Editor, Marcel-Dekker, New York, 1991.
  4. Cocores, JA: Nicotine Dependence: Diagnosis & Treatment, In: Recent Developments in Alcohol & Drug Disorders, Psychiatric Clinics of North American, W.B. Saunders Company, 1993.
  5. Cocores JA, Varenicline and Alzheimer’s Disease. Psychiatry 2007, December, 2007.
  6. Cocores JA. Transdermal nicotine in adult ADHD with depression and anxiety. Primary Care Companion Journal of Clinical Psychiatry. 2008;10(3):253-4.
  7. Cocores JA, Gold MS. Varenicline and adult ADHD. Journal of Neuropsychiatry & Clinical Neuroscience. 2008 Fall;20(4):494-5. doi: 10.1176/appi.neuropsych.20.4.494-a.
  8. Cocores JA, Gold MS. Varenicline, appetite, and weight reduction. Journal of Neuropsychiatry & Clinical Neuroscience. 2008 Fall;20(4):497-8. doi: 10.1176/appi.neuropsych.20.4.497.
  9. Cocores JA, Gold MS. Varenicline in the clinical management of marijuana abuse and dependence. Unpublished manuscript 2009.
  10. Miller NS, Klahr AL, Gold MS, Sweeney K, Cocores JA, et al. Cannabis diagnosis of patients receiving treatment for cocaine dependence. Journal of Substance Abuse. 1990;2(1):107-11.
  11. Miller NS, Klahr AL, Gold MS, Sweeney K, Cocores JA. The prevalence of marijuana (cannabis) use and dependence in cocaine dependence. New York State Journal of Medicine. 1990 Oct;90(10):491-2.
  12. Lintzeris N, Bhardwaj A, Mills L, Dunlop A, Copeland J, et al. Nabiximols for the Treatment of Cannabis Dependence. JAMA Internal Medicine, 2019; DOI: 10.1001/jamainternmed.2019.1993
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