We are in the middle of one of the largest drug epidemics in history and the problem seems to be getting worse. According to the New York Times, overdose deaths have risen 19 percent between 2015 and 2016. Each year for more than a decade, the overdose death rates have been climbing exponentially. It’s worth noting that not all drugs are inherently deadly. For instance, most fatalities caused by marijuana and most psychedelics are due to accidents. However, some drugs cause life-threatening reactions in the body, become toxic in high amounts, or even rot away your flesh. Here is a list of the 5 deadliest drugs that you should avoid at all costs.

5 Deadliest Drugs in the World

deadliest drugs - NBome#5 – N-Bombs

N-bomb, or 25I-NBOMe, is one of many synthetic psychedelic drugs designed to mimic the effects of LSD or MDMA. Like ecstasy, N-bomb causes a feeling of heightened empathy and body high, but it may also induce hallucinations. Most psychedelics, like LSD, DMT, and mushrooms, have very low overdose potential, but some synthetic options like N-bombs can be fatal at high doses. Overdoses can result in seizure, heart attack, respiratory arrest, and death.

What Makes it Deadly?

N-bombs aren’t deadly because of widespread overdoses from drugs like opioids or alcohol. However, they are prime candidates for a dangerous case of mistaken identity. 25I-NBOMe resembles drugs of the 2C family in both its effects and its appearance. In fact, 2C-I also shares the nickname ‘smiles’ with N-bomb. All this makes it easy to mistake one for the other.

The problem is the appropriate dosage. 2C-I is active after 2 to 5 mg, and it’s common for users to take up to 20 mg. However, 25I-NBOMe is active after 50 micrograms and takes much less to achieve desired effects. Someone taking N-bomb thinking they have 2C-I may take a fatal dose. In 2013, the deaths of 19 young adults were linked to N-Bombs and were possible cases of mistaken identity.

#4 – Krokodil

Krokodil is a street name for a homemade heroin substitute called desomorphine. It’s made on the street using eye drops that contain codeine and an assortment of common chemicals including industrial cleaner, lighter fluid, and sometimes gasoline.

The opioid epidemic isn’t a problem exclusive to the U.S. Russia has more heroin users than any other country and, in the more desolate cities of Siberia, heroin might be hard to find. When heroin becomes too expensive to maintain an addiction, desperate times call for desperate measures. Users turn to a more volatile alternative, which places krokodil squarely on the list of the world’s deadliest drugs.

What Makes it Deadly?

Users who start taking krokodil rarely live longer than a few more years. Desomorphine produced on the streets with dangerous chemicals is hardly pure. Toxic substances are left in the mixture and lead to a host of severe health problems. The name krokodil (Russian for crocodile) comes from the fact that the drug can cause gangrene, abscesses, and flesh rotting to the bone. The scaly, peeling skin resembles the skin of a crocodile. After continued use, the flesh, veins, and organs of a krokodil user begin to fail, eventually leading to medical complications and death.

#3 – Gray Death

Grey Death Deadliest Drug

Gray Death is an opioid cocktail that’s so powerful that it deserves its own spot on the list of deadliest drugs. It’s a combination of different drugs most of which do not belong inside the human body. It’s unknown what ingredients make up a definitive hit of gray death because each seized batched is different. However, most have a dangerous synthetic opioid compound called U-47700 that was synthesized in the 70s and never tested on humans.

Other opioids are also added to the mix, like heroin, fentanyl, and carfentanil. Together, they make a deadly combination. In fact, a combination of U-47700 and fentanyl may have led to the death of pop singer Prince.

What Makes it Deadly?

Gray Death is among the deadliest drugs because of its raw potency. On its own, fentanyl is 100 times more potent than morphine. Carfentanil is used as an elephant tranquilizer and can be 100,000 times more powerful than morphine. But mixed in a cocktail of other drugs, it can be deadly to even hardened opioid users. In fact, it can even kill on contact. The drugs in Gray Death can be absorbed through the skin. Since a lethal dose of Gray Death is smaller than the tip of your pinky finger, you can overdose after having just touched a small amount.

#2 – Opioids

No list of the deadliest drugs is complete without the class of drug that’s driving the overdose numbers to record levels. Opioids cover a wide range of drugs including prescription pain medication like OxyContin, street drugs like heroin, and illegally produced synthetic drugs like fentanyl. Sometimes people start with a simple prescription after surgery or broken bones. If they have a high propensity for addiction, they develop dependence. After pills become too difficult or expensive to acquire, they turn to heroin to placate their addiction. Hydrocodone, methadone, morphine, fentanyl, oxycodone, and heroin are the leading killers of opioid users.

What Makes it Deadly?

The numbers speak for themselves. According to the Centers for Disease Control and Prevention (CDC), 33,000 people died in 2015 because of opioid overdose. Heroin caused approximately 13,000 of those deaths. And, it was reported that the majority of heroin users started by abusing prescription opioids. Heroin and other opioids are extraordinarily addictive, and as you develop a dependence, you begin to need more to achieve the same high. Overdose can occur when encountering an unusually pure hit of heroin, relapsing after a period of sobriety, or after taking a more powerful opioid like fentanyl.

deadliest drugs - alcohol#1 – Alcohol

It’s no question why alcohol makes the top of the list of deadliest drugs. Approximately six people in the U.S. die because of alcohol poisoning every day, which adds up to nearly 2,200 deaths each year. When you count drunken driving with alcohol’s death toll, the number inflates to over 10,000 annual deaths. Alcohol poisoning can cause confusion, vomiting, seizures, slow and irregular breathing, hypothermia, and unconsciousness. Chronic excessive drinking can cause damage to the heart, liver, pancreas, and stomach. It can also make you more likely to develop cancer in the mouth, throat, and esophagus.

What Makes it Deadly?

The fact that it’s legal may lead some to believe that alcohol is not as dangerous as other drugs. However, alcohol can be incredibly addictive and can lead to fatal poisoning after binge drinking. While college parties and frat houses are a big part of drinking culture, the most alcohol poisoning deaths happen to middle-aged men. Because of the wear and tear alcohol can do to your liver, years of excessive drinking can lead to liver failure. Because alcohol is more or less just as dangerous as other drugs and much more ingrained in cultures all over the world, alcoholism is prevalent.

Are You Caught in The Throes of Addiction?

As terrifying as these drugs may be, there is hope for those that are struggling with a life-threatening addiction. No one is immune to addiction, and many of these drugs are claiming thousands of lives each year in the U.S. Don’t let your next hit be your last.