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The hidden risk of sugar: Is it really more addictive than opioid drugs such as cocaine?

We often hear about the negative effects of sugar on our teeth and waistline, but research has shown that the impact of sugar may extend to something even more serious: addiction.

Foods with Hidden Sugars

Before we dive into the research, it's essential to recognize that sugar lurks in unexpected places. Here are some common foods with hidden sugars that may surprise you:

  • Pasta Sauces: These can contain several teaspoons of sugar per serving.

  • Granola Bars & Breakfast Cereals: Marketed as healthy, these often contain significant amounts of added sugars.

  • Yogurt & Instant Oatmeal: Even seemingly healthy versions can have hidden sweeteners.

  • Salad Dressing, Cole Slaw & Ketchup: Savory doesn’t mean sugar-free.

  • Energy Drinks, Packaged Fruits, Tea & Dried Fruit: All often contain added sugars, leading to higher consumption than we realize.

Now, let's explore the studies that connect sugar with addiction, similar to certain drugs.

The Addiction to Sugar: A Closer Look

(1) Sugar and the Brain's Reward System

Recent studies, including a review published in the *British Journal of Sports Medicine*, liken the effect of sugar on the brain to that of addictive drugs such as cocaine. Research on rats has found striking similarities between consuming sugar and drug-like effects, including bingeing, craving, withdrawal, dependence, and reward. Sugar's ability to alter mood and induce pleasure was comparable to the way cocaine impacts the brain.

In experiments involving lab rats, unrestricted access to a diet rich in carbohydrates leads to extreme behaviors, akin to addiction. The rats are willing to cross an electrified surface, enduring painful shocks, to reach their desired junk food. One particular study showed that when given access to this unhealthy diet for only an hour daily, the rats consumed nearly two-thirds of their daily caloric intake in that short time, feasting until the food was taken away.

(2) Lack of Aversion Signal

Unlike salt, sugar lacks an 'aversion signal.' This means that our bodies don’t naturally tell us when we’ve had enough sugar, leading us to consume more than needed. Some scientists believe that sugar can override our self-control mechanisms, trapping us in a cycle that might be referred to as a 'sugar fix.'

As observed in the lab rat studies, the body's response to sugar, specifically, can occur rapidly. In just a week, these rodents were able to increase their sugar intake fourfold. The process is similar to the way heroin addiction forms; only a small amount is initially needed to trigger addiction. Upon consuming sugar, dopamine receptors in the brain are activated, leading to a pleasure response. As sugar consumption increases, the brain becomes less responsive to dopamine, requiring even more sugar to achieve the same pleasure sensation. The parallel between sugar addiction and drug addiction in these studies underlines the complex and powerful effects that certain foods can have on the body and brain.

(3) Withdrawal Symptoms and Health Impact

Withdrawal from sugar, according to some researchers, may lead to symptoms such as dopamine deficiency in the brain. This could further contribute to conditions like attention deficit hyperactivity disorder (ADHD) and depression.

Specific to the lab rat studies mentioned above, once the food was removed, the rats displayed withdrawal symptoms reminiscent of substance addiction. They would huddle into a protective position, exhibit signs of nervous anxiety, and demonstrate heightened sensitivity and jitteriness. Their cravings for this high-carbohydrate food led them to exhibit physical symptoms similar to withdrawal from heroin.

The United States is the biggest consumer of sugar on the globe. According to sources, the country's per capita sugar consumption is 126.4 grams daily. That is approximately 102 POUNDS OF PROCESSED SUGAR PER YEAR! The excessive consumption of sugar contributes to obesity, heart disease, type 2 diabetes, stroke, and certain cancers.

Why sugar is so addictive
Sugar Addiction Cycle

But Is There Any Nutritional Value to Sugar? And What about Fruit Sugars?

No. Nutritionally, all experts agree on the importance of reducing or eliminating the intake of processed sugar. While some suggest completely cutting out sugar to avoid addiction, others advocate for more nutritional food choices instead of sugar-filled options.

Also, there is a difference between processed sugar (sucrose) and fructose. After counseling a patient family about sugar, there can sometimes be confusion, and they will ask: what about fruit sugars? While in an exceedingly clean, balanced, near "perfect" diet, one may want to be conscious of total fruit consumption (more on this later). But for the vast majority of my patient families who just want to eat a more healthy diet, I explain that eat fruit sugars in the form of whole fruits is perfectly fine, and a child can eat as much as they want. When coupled with the phytonutrients and fiber in fruit (and with the mechanical chewing and cleansing properties of eating crisp fruits), this is a VERY healthy habit that should be encouraged and supported. Where families need to be cautious is fruit juices. When the fiber is removed and the sugar content is concentrated, more can be consumed and the juice itself can get between teeth and predispose a child to cavities.

So it is my recommendation to eat as much whole fruits as a person wants, eliminate all processed sugars, and eliminate or greatly reduce all fruit juices. Use natural sweetening agents like honey, dates, and maple syrup. And if a family really wants to incorporate some juice into their routine, then try to avoid juices with added sugars (read the label!), try to water down the juice so it is 50:50 with water, and try to go for freshly pressed juices that are coupled with vegetables.

What If My Child or I Really Crave Sugar?

This could be a combination of a few variables, and without a comprehensive history review and exam, we cant say for sure. But what I see most commonly in my patients is one or a combination of the following:

  • History of sugar addiction: Just like a drug, the more you have, the more you crave. A tolerance is built over time, so more is needed to satisfy the "fix".

  • Gut microbiome dysbiosis: A poor diet changes the environment of your gut and can cause harmful bacteria, fungus, and other pathogens to thrive that chemically alter your craving patterns. Until you are able to reestablish homeostasis, this craving will continue to be an issue.

  • Sleep-disordered breathing: Undiagnosed or misdiagnosed sleep and breathing disorders can mean that a person is lacking the restorative rest they need to fully function and compensate by supplementing their diet with foods with high glycemic index to spike their energy levels and keep them awake. Until we address the root cause of this condition, then this may make it very challenging for a patient to make permanent, healthy changes to their diet.

Why Do Schools Serve Products with Processed Sugar?

I don't have the secret answer on this. I think it's tragic that many schools make processed sugar so accessible, especially considering the massive amount of data that demonstrates how harmful this ingredient is to children's behavior, learning, and physical and mental health. I'm not trying to pick a fight with any of the local schools, but I am disappointed that I find many of my patient families who are striving to have healthy diets voice a frustration that despite what they do at home, their child can still get access to cookies, sports drinks, and other sugary items while at school.

I assume there are a few issues that are associated with this problem. I'm certainly no expert in this space, but I am encouraged by the work from "alternative" schools here in the US (for example, the Browns Mill School) and foreign schools (Western Europe, New Zealand, Australia, among others) that have incorporated nutrition as a fundamental component of their curriculum. When gardening, food preparation, nutritional sciences, and meal time are a component of education, this has been shown to major improvements in children's performance in other areas of their lives.

What Can You Do to Improve Your Family's Relationship with Sugar?

(1) Don't have it in the house. Your 8 year old doesn't have a car and can't go to the grocery store to buy apple juice and cookies. If it's not available, they will eventually make other options.

(2) Be a good example. Kids do what you DO not what you SAY. It's important that parents make good choices because your child mirrors your behavior. Set them up for success at a young age.

(3) Create positive relationships with healthy eating habits. Having kids involved in food choices and purchasing (e.g. going to the farmers market, searching for new recipes to try) and food preparation are great ways to get them involved and helping them understand that good foods make us feel good.

(4) Eliminate negative relationships with poor eating habits. Rewarding kids with a special treat for a good report card and consoling them with ice cream on a bad day are ways in which parents are inadvertently teaching kids that junk food is a good coping mechanism or reward system. Parents may not even be self-aware that they have these seem bad habits. So I would encourage you to replace these ideas with a healthier option... having a bad day? Let's go for a walk or bike ride outside. Did something really great happen? Let's plan a fun adventure that you've been wanting to do.

(5) Find alternatives to sweets wherever they pop up. This not only means subbing for natural sweeteners in recipes (fruit, honey, dates), but it also means getting rid of sweets at celebration times. I'm not trying to be a buzzkill. But this is a community effort. If EVERYONE brings donuts to school for a birthday celebration, then we're ALL eating garbage. If EVERYONE throws a birthday party with cake and candy, then we're ALL going home with a belly ache and low energy. To quote Ghandi, "Be the change you wish to see in the world." Be the first person to host a birthday or holiday party with no processed sugar. If we're all doing it, then we're all going to be healthier for it, and behave better! Adults too!

(6) Challenge your schools to make changes. I do not have school aged children yet, so I fully acknowledge that I don't know what I don't know about the challenges of navigating school systems and ALL that goes into having older kids. However, I do know with certainty how important nutrition is to overall mental and physical health, and it seems as if a school is not prioritizing this as part of the curriculum, the parents are only going to be helping their children if they advocate for these changes. Removing candy and cookies from the cafeteria. Having extra curricular programs where children can be engaged in food prep or gardening would teach lifetime skills. And having parents who are passionate about these choices volunteer to supplement as needed to get them off the ground is the epitome of leading by example.

(7) Learn to read food labels. This is a great lesson for parents and children alike. You should be able to recognize and pronounce every ingredient that is in your food. If you can't, then it likely shouldn't be something that you put in your body. And you will likely be surprised by not only the amount of added sugar in most products but in the variety of products that include sugar that you otherwise wouldn't think (see list above of "healthy" foods with commonly hidden sugars).

(8) Get a comprehensive exam and history review. If you or your child are really struggling with eliminating processed sugar from your diet, then there is likely something else going on. Our clinicians have advanced education on nutrition and functional health, so we encourage you to schedule a consultation with our team to review what might be going undetected that might be influencing this addictive behavior.

Is Total Elimination Processed Sugar Too Extreme?

Some argue with me that eliminating processed sugar is too severe, at least for children. And that they need to figure out how to live in a world where those things are around them and have them in moderation. But I would argue that this is a naive opinion when considering our deep neurophysiology does not allow us to have a "healthy" and "balanced" relationship with these types of substances.

I don't think any parent would argue that a child should have a moderate and balanced exposure to cocaine? Especially since it is available in life and they need to understand how to make good choices? Right? Of course not! So why should anyone take a more relaxed approach to a substance that has been demonstrated to be MORE addictive?! It doesn't make sense. Especially during the pediatric phase of development where the brain is actively growing and changing. Don't get them hooked on this junk when they're young.

Additionally, having "cheat meals" can encourage binging and can foster negative relationships with unhealthy foods. And even less frequent exposures to processed sugars can alter the gut microbiome for a poorer outcome.

A Holistic Approach to Health

Understanding the addictive potential of sugar and recognizing hidden sugars in everyday foods is a crucial step towards overall well-being. Eating mindfully and opting for a balanced diet not only protects your teeth but may also safeguard you from potential health risks that extend beyond simple cravings.

At our holistic dental clinic, we believe in treating the whole person. We encourage our patients to consider their dietary choices as a vital part of their dental and overall health. Whether sugar is indeed more addictive than certain drugs is still under debate, but what's clear is that minimizing sugar consumption is a healthy choice for both your teeth and your body.

Feel free to consult with our team for personalized advice on a diet that suits your unique dental and overall health needs.


  • Ahmed SH, Guillem K, Vandaele Y. Sugar addiction: pushing the drug-sugar analogy to the limit. Curr Opin Clin Nutr Metab Care. 2013 Jul;16(4):434-9. doi: 10.1097/MCO.0b013e328361c8b8. PMID: 23719144.

  • Public Health England. "Sugar Reduction: The evidence for action." October 2015.

  • Avena, N.M., Rada, P., & Hoebel, B.G. "Evidence for sugar addiction: Behavioral and neurochemical effects of intermittent, excessive sugar intake." *Neuroscience and Biobehavioral Reviews*, 2008.

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