Gateway Drug Theory
Gateway drugs are substances that, when consumed, give way to harder, more dangerous drugs. These milder substances, such as nicotine or alcohol, are believed to open the door to drugs such as meth, heroin and cocaine, which can lead to addiction.
Marijuana, alcohol, nicotine and other gateway drugs boost dopamine levels, which increases pleasure. The dopamine boost caused by gateway drugs during adolescence makes the brain release less dopamine during adulthood. This leads people to seek harder drugs that cause more dramatic dopamine releases, according to the gateway drug theory.
Gateway drugs also prime or prepare the brain for a response to other substances, a process known as cross-sensitization. This heightens brain activity and could make users more likely to seek stronger substances.
Overall, drug use behavior is caused by a variety of genetic and environmental factors. A person’s genetic makeup, family history, living environment and community affect their likelihood of trying drugs. Gateway drugs may be one factor that affects a person’s risk of trying more dangerous substances.
History of Gateway Drugs
The idea that drug use can occur in stages took root in the mid-20th century. TV shows such as “The Terrible Truth” suggested marijuana use led to heroin addiction. Researchers began using the term “gateway drug” in the 1980s to describe substances that initiate these stages.
National anti-drug programs such as Drug Abuse Resistance Education (D.A.R.E.) specifically outline the consequences of three potential gateway drugs: marijuana, alcohol and tobacco.
Studies were conducted soon thereafter. In 1985, a report published in the Journal of Youth and Adolescence found alcohol to be a steppingstone to use of heavier drugs. Research on gateway drugs blossomed during the next three decades.
Since the 1980s, educators have warned students about the dangers of gateway drugs. National anti-drug programs such as Drug Abuse Resistance Education (D.A.R.E.) specifically outline the consequences of three potential gateway drugs: marijuana, alcohol and tobacco. Through the years, middle school health educators have made gateway drugs a staple in their teachings. However, the controversy surrounding the concept has led some to reconsider using the term.
Controversy Surrounding Gateway Drugs
D.A.R.E. officials now admit that most people who smoke pot do not move on to harder drugs, according to the New York Times. Critics believe that marijuana use may prevent other drug use, but little credible evidence exists to prove that assertion.
Critics also say the gateway drug theory is flawed because it often relies on animal studies. They also say that drug use rates in other countries aren’t affected by the prevalence of marijuana. There’s also evidence that genetic differences at birth may increase a person’s risk of drug use.
A person who tries weed may have always been more likely to try hard drugs because their brains are wired to be more likely to take chances than other people.
The Gateway Drug Hypothesis
For decades, supporters and critics have argued that certain substances, such as pot, are gateway drugs. Critics claim that no evidence exists to support the theory.
They also cite other risk factors that influence whether a person abuses illicit drugs.
Risk factors for illicit drug use:
- Social life
- History of abuse
- Vision Problems
Some reports support this argument. For example, most young marijuana smokers quit using the drug upon entering adulthood, per the National Institute on Drug Abuse.
Supporters refer to ample research that strengthens the theory. For example, in 2016 the National Center on Addiction and Substance Abuse found that teens who use gateway drugs are 266 times more likely to develop a cocaine addiction than those who do not.
The study, based on a survey by the NIDA, also found that nearly all cocaine users tried marijuana, cigarettes or alcohol first. Nearly 90 percent tried all three substances first.
- Children who use marijuana are 85 times more likely to use cocaine than non-marijuana users.
- Children who drink are 50 times more likely to use cocaine than nondrinkers.
- Adults who used marijuana as children are 17 times more likely to be regular cocaine users.
- Adults who drank as children are six times more likely to be regular cocaine users.
“Our results suggest that cannabis use appears to be associated with an increased vulnerability to developing an alcohol use disorder, even among those without any history of this,” the study’s lead author Renee Goodwin, PhD, said in a Columbia University press release. “Marijuana use also appears to increase the likelihood that an existing alcohol use disorder will continue over time.”
A 2017 study by Columbia University researchers found that rats who were exposed to alcohol were much more likely to seek cocaine than rates who weren’t exposed to alcohol. The study, which was published in Science Advances, also found genetic changes in the brains of the rats that increased their risk of cocaine use.
Although no evidence confirms the gateway drugs theory, many trends lend credence to it.
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What Are Common Gateway Drugs?
Alcohol, marijuana and nicotine are commonly talked about as gateway drugs. In recent years, illicit opioids, prescription drugs and other common substances have joined the category.
Alcohol is a central nervous system depressant that impairs brain function and motor skills. In 2014, nearly 88 percent of adults reported drinking alcohol at some point in their lives, and nearly 25 percent reported binge drinking in the past month.
Alcohol is probably a gateway drug, according to the results of multiple studies.
A University of Florida study found that students who used alcohol were 16 times more likely to use illicit substances, such as cocaine and amphetamines, down the road. Many students began with socially acceptable substances such as alcohol or cigarettes before transitioning to marijuana, then harder drugs.
Adam E. Barry, who co-authored the study, told UF News the findings “add further credence to the literature identifying alcohol as the gateway drug to other substance use.”
Illicit substances linked to alcohol use include:
Multiple studies reveal drinking at a young age affects drug use later in life. A 2016 study published in the Journal of School Health found sixth-graders went on to try nearly two illicit drugs later in life.
A Substance Abuse and Mental Health Services Administration survey revealed underage drinkers were more likely to use illicit drugs within two hours of alcohol use than legal drinkers. A majority of teen drinkers consumed illicit drugs, such as marijuana.
Marijuana is a substance that alters a person’s attention, motivation, memory and ability to learn. More than 22 million people reported using marijuana in the past month in 2014, per NIDA, making it the most used illicit drug in the U.S.
Weed is commonly recognized as a gateway drug. However, its association to harder drugs has been widely debated.
Many believe marijuana builds a person’s tolerance to stronger drugs, and certain studies back up this idea. A study published in the International Journal of Drug Policy found that nearly 45 percent of regular marijuana smokers used another illicit drug later in life.
One of those drugs is heroin. Studies suggest the majority of heroin users began with alcohol or marijuana. In fact, marijuana users are three times more likely than nonusers to abuse heroin, according to the Centers for Disease Control and Prevention.
Illicit substances linked to marijuana use include:
Adolescents who smoke marijuana are more likely to use harder drugs, according to a report by the U.S. Drug Enforcement Administration.
Teens who reported heavy marijuana use in the past month were:
- 30 times more likely to use crack cocaine.
- 20 times more likely to use ecstasy.
- 15 times more likely to abuse prescription painkillers.
- 14 times more likely to abuse over-the-counter medications.
Another study, by the Journal of the American Medical Association, found that individuals who used marijuana by age 17 were two to five times more likely to experience substance abuse later in life than those who did not.
The study also found that alternative factors, such as depression, social anxiety and parental conflicts, had a minimal impact on the results. This goes against the idea that environmental factors are the leading cause of substance abuse.
However, a report by the Journal of Health and Social Behavior found that marijuana’s influence as a gateway drug is contingent on factors such as employment status and other life events. It does suggest a moderate relationship between marijuana use and other illicit drug abuse.
Prescription drug abuse has exploded in popularity. About 52 million Americans 12 and older have used prescription drugs non-medically in their lifetime, per NIDA. Opioids are the most abused prescription drugs.
Prescription drugs are linked to heroin use. Heroin is a synthesized opioid that can be cut with other prescription drugs, such as fentanyl, to achieve a more potent high. Many prescription drugs have similar effects to heroin, which has led to many opioid abusers transitioning to the substance. The substances are extremely dangerous. Heroin and fentanyl have been linked to thousands of overdose deaths in recent years.
Illicit substances linked to prescription drug use:
Opioid users are 40 times more likely to abuse heroin than nonusers, per the CDC. In comparison, people addicted to alcohol were two times more likely to abuse heroin than nonusers. Marijuana users were three times more likely to abuse heroin.
Also, nearly half of young heroin users surveyed in three studies reported abusing prescription opioids first, according to NIDA. In fact, many opioid abusers switch to heroin because it is a cheaper option.
Ritalin, a prescription medication administered to children with ADHD, has been linked to cocaine use. Both drugs are stimulants, which increase alertness and productivity. Both have similar properties and increase dopamine levels. Consequentially, former Ritalin users are more susceptible to cocaine abuse, per Utah’s Genetics Science Learning Center.
Researchers have long recognized tobacco products as gateway drugs. In 2011, scientists fed rats nicotine-laced water for seven consecutive days. The results, published in Science Translation Medicine, revealed that the critters had an increased response to cocaine afterward.
Illicit substances widely linked to nicotine use include:
The study also found that nicotine increased levels of FosB, a gene in the brain linked to cocaine addiction. Researchers believe a similar effect can occur in humans, who share the gene, and that children are particularly at risk.
Furthermore, children who smoke daily are 13 times more likely than children who smoke less often to use heroin, according to the National Center on Addiction and Substance Abuse. They are also 19 times more likely than nonsmokers to use cocaine.
Other Gateway Drugs
Many substances, legal or illicit, can increase dopamine levels and potentially act as a gateway drug.
A 2008 report by the National Inhalant Prevention Coalition found that many 12- and 13-year-olds who abuse inhalants, such as shoe polish or glue, move on to illicit drugs. The findings revealed that 21 percent of 593,000 inhalant users consumed marijuana or prescription painkillers the year prior.
A study published in Annals of Epidemiology revealed ecstasy may be a gateway drug to cocaine and methamphetamine. This is partly due to poly-drug use within the rave culture. Ecstasy use at a younger age increases the risk of using harder drugs later in life.
Individuals who use steroids risk an opioid addiction. A report published in the New England Journal of Medicine found that 9 percent of patients with an opioid addiction at a nearby treatment center had a history of steroid use. None of the patients had a drug addiction prior to steroid use.
Energy drinks contain high levels of caffeine, which increases energy and alertness. A study published in the Journal of Addiction Medicine revealed teens who consumed energy drinks were two to three times more likely to pick up an illicit drug than those who did not. Marijuana and amphetamines were common choices.
Gateway Drug Statistics and Studies
Several studies have looked at the relationship between the use of specific drugs, such as how marijuana use leads to alcohol use. These studies reveal that the use of gateway drugs may not only increase the risk of any drug use, but they may increase the risk of specific types of substance abuse.
Marijuana and Alcohol
Researchers say marijuana use could lead to an alcohol use disorder. A study published in Drug and Alcohol Dependence found adults who used marijuana for the first time to be five times more likely to develop an alcohol use disorder than nonusers.
Another study, published in JAMA, used a larger sample size but found similar results. Adults who used pot for the first time were nearly three times more likely to abuse alcohol three years later.
Nicotine, Alcohol and Marijuana
In 2013, teens who had smoked cigarettes in the past month were 11 times more likely than those who had not smoked cigarettes to use marijuana, per SAMHSA. Those who drank alcohol and smoked cigarettes were 25 times more likely than those who did neither to use marijuana.
Furthermore, nearly half of binge drinkers — consuming five or more drinks on one occasion, one to four days a month — were marijuana users, according to the report.
Prescription Drugs and Alcohol
Individuals who self-medicate have a tendency to combine prescription drugs with alcohol. Both substances have numbing agents and are dangerous when taken together. Abusing either drug could lead to an addiction.
Those with an alcohol use disorder are 18 times more likely than nondrinkers to use prescription drugs recreationally, per a NIDA-funded study. The report also found that individuals with an alcohol use disorder represented 9 percent of the survey, yet constituted more than two-thirds of nonmedical prescription drug users.
Marijuana and Prescription Drugs
Youth are vulnerable to pot, as their brains are still developing. A rise in dopamine levels can alter the way their brains react to other substances. Marijuana addiction at an early age has been linked to opioid abuse later in life.
Prevention and Treatment Options
Understanding the consequences of softer drugs could prevent the use of stronger ones. Parents can educate teens about drug use. Those who fall victim to soft or hard drugs should immediately seek treatment.
Allison Walsh of Advanced Recovery Systems describes how talking to family members, learning about substances before we use them and eliminating stigma can prevent addiction.
Youth Prevention Education
Youths who use gateway drugs could pick up harder drugs later in life. In response, researchers have spent decades trying to identify effective approaches to prevent youth drug use.
Teaching drug prevention tactics to teens in a school setting has proved effective. Students learn the effects and dangers of drug use, how to avoid peer pressure and the benefits of a drug-free life. Many teachers include drug abuse prevention in their curriculum.
Health care professionals, community leaders and policymakers can also provide the education and funding needed to increase awareness among youth.
Successful school-based prevention approaches:
- Make students aware of misconceptions and social pressures that exist.
- Avoid fear-based tactics, which have proved ineffective.
- Talk about the most effective ways to say no.
- Include information on how to respond to media messages.
- Use peer leaders, such as older students, to talk to students.
Each gateway drug presents a different set of treatment options. Treatment is always specific to the individual. Many rehab methods combine medication, behavioral and group therapy, and moral support to help people combat addiction.
Prescription drug addictions are often treated with medications, such as methadone, naltrexone and buprenorphine. These medications curb the effects of a drug, alleviate withdrawal symptoms and help prevent relapse.
Treatment for marijuana addiction, the most controversial gateway drug, is unique. There are no FDA-approved medications for marijuana addiction, but counseling and therapy options include:
Cognitive behavioral therapy
These methods aim to change a person’s behavior and prevent relapse.
The goal of treatment is to rid people of a substance, change their behaviors and steer them toward a drug-free life. If you or someone you know is suffering from an addiction, contact a drug and alcohol treatment center. Each facility is equipped with trained professionals who cater to an individual’s needs.