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Gateway drug effect

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had previously reported cannabis use were associated with a five times greater odds of being diagnosed with AUD than those who had not. After adjustment for select confounders (age, race, marital status, income, and education), these odds were reduced to two times greater risk. Another sample of self-reported data from 2,121 persons included only those who had already been diagnosed with AUD. In this sample, it was found that those who had reported cannabis use in the past year (416 people) were associated with 1.7 greater odds of AUD persistence three years later. After adjustment for the same confounders as before, these odds were reduced to 1.3.
387:(who share approximately 100% of their genes) and non-identical twins (who share approximately 50% of their genes) separately and adjusted for additional confounders such as peer drug use. It found, after confounder adjustment, that the associations with later hard drug use existed only for non-identical twins. This suggests a significant genetic factor in the likelihood of later hard drug usage. The study suggested that a causal role of cannabis use in later hard drug usage is minimal, if it exists at all, and that cannabis use and hard drug use share the same influencing factors such as genetics and environment. 370:), a number of personal, social, genetic and environmental factors can lead to a generally increased interest in various drugs. The sequence of first-time use would then depend on these factors. Violations of the typical sequence of first-time drug usage give credit to this theory. For example, in Japan, where cannabis use is uncommon, 83.2% of the people who used illicit substances did not use cannabis first. The concept received additional support from a large-scale genetic analysis that showed a genetic basis for the connection of the prevalence of cigarette smoking and cannabis use during the life of a person. 4482: 2676:
Degenhardt, L; Dierker, L; Chiu, W. T.; Medina-Mora, M. E.; Neumark, Y; Sampson, N; Alonso, J; Angermeyer, M; Anthony, J. C.; Bruffaerts, R; De Girolamo, G; De Graaf, R; Gureje, O; Karam, A. N.; Kostyuchenko, S; Lee, S; Lépine, J. P.; Levinson, D; Nakamura, Y; Posada-Villa, J; Stein, D; Wells, J. E.;
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Another twin study (of 510 same sex twin pairs) also examined the association of earlier cannabis use and later hard drug use. Like other studies it examined later drug use differences between siblings where one sibling had used cannabis early and the other had not. The study examined identical twins
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presented indications that familial genetic and familial environmental factors do not fully explain these associations, and are possibly only relevant for sequences of some drugs. In 219 same-sex Dutch identical and non-identical twin pairs, one co-twin had reported cannabis use before the age of 18
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A study involving self-reported data from a sample of 27,461 people examined the relationship of cannabis use and AUD. These respondents had no prior diagnosis of AUD. Of the 27,461 people, 160 had reported cannabis use within the past year. At the end of a three-year period, it found that those who
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On the other hand, the 2018 report issued by the National Institute of Justice states "that the current state of research on this issue is limited, and the studies that have been conducted suffer from difficulties in collecting information and applying the findings to a larger population. The report
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of later reported use of party drugs was four times higher and the lifetime prevalence of later reported use of hard drugs was seven times higher than in the non-cannabis group. The authors concluded that at least family influences – both genetic and social ones – could not explain the differences.
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The role of cannabis use in regard to alcohol use and Alcohol Use Disorder (AUD) is still not fully understood. Some studies suggest better alcohol treatment completion for those who use cannabis, while other studies find the opposite. A 2016 review of 39 studies which examined the relation between
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Stringer, S; Minică, C. C.; Verweij, K. J.; Mbarek, H; Bernard, M; Derringer, J; Van Eijk, K. R.; Isen, J. D.; Loukola, A; MacIejewski, D. F.; Mihailov, E; Van Der Most, P. J.; Sánchez-Mora, C; Roos, L; Sherva, R; Walters, R; Ware, J. J.; Abdellaoui, A; Bigdeli, T. B.; Branje, S. J.; Brown, S. A.;
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Because a sequence of first-time use can only indicate the possibility – but not the fact – of an underlying causal relation, different theories concerning the observed trends were developed. The scientific discussion (state of 2016) is dominated by two concepts, which appear to cover almost all
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From a sample of 6,624 people who had not used other illegal drugs before their cannabis consumption the overall probability of later use of other illegal drugs was estimated to be 44.7%. Subgroup analyses showed that personal and social conditions, such as gender, age, marital status, mental
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In rats, alcohol increased the probability of later addiction to cocaine and again relevant alterations in the reward system were identified. These observations thus correspond to the epidemiological findings that the consumption of alcohol in humans is coupled to a later increased risk of a
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further notes that although many of the reviewed studies found statistically significant associations between cannabis use and the users' later use of other illicit drugs, there is currently no conclusive evidence that cannabis use caused the later use of harder illicit drugs."
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use disorder within 3 years; people who used marijuana and already had an alcohol use disorder at the outset were at greater risk of their alcohol use disorder worsening." They further claimed that marijuana use "is also linked to other substance use disorders including
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cannabis use and alcohol use found that 16 studies support the idea that cannabis and alcohol are substitutes for each other, 10 studies found that they are complements, 12 found that they are neither complementary nor substitutes, and one found that they are both.
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papers cited in the report claims that while "some studies have found that use of legal drugs or cannabis are not a requirement for the progression to other illicit drugs most studies have supported the "gateway sequence"." However, a 2018
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addiction." While stating that their "findings are consistent with the idea of marijuana as a "gateway drug"", they conceded that "the majority of people who use marijuana do not go on to use other, "harder" substances", and that
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is not unique to marijuana. Alcohol and nicotine also prime the brain for a heightened response to other drugs and are, like marijuana, also typically used before a person progresses to other, more harmful substances."
961: 181:. As to the interpretation of the observed trends, it is important to note the difference between sequence and causation. Both may – but need not – be coupled, a question which is subject of further research, e.g., by 383:
The study noted that, besides a potential causal role of cannabis use, non shared environment factors could play a role in the association such as differing peer affiliations that preceded the cannabis use.
66:), alterations in the brain due to earlier substance exposure, as well as similar attitudes of people who use different substances, and therefore experience a "common liability to addiction". In 2020, the 2440:"Probability and predictors of transition from first use to dependence on nicotine, alcohol, cannabis, and cocaine: results of the National Epidemiologic Survey on Alcohol and Related Conditions (NESARC)" 276:
possible causal connections if appropriately combined. These are the theories of biological alterations in the brain due to an earlier drug use and the theory of similar attitudes across different drugs.
2679:"Evaluating the drug use "gateway" theory using cross-national data: Consistency and associations of the order of initiation of drug use among participants in the WHO World Mental Health Surveys" 320:, the importance of the findings from animal studies for the reward system in the human brain in relation to the liability to the use of further drugs has been pointed out in several reviews. 83:, which analyzed 23 peer-reviewed research studies, concluded "that existing statistical research and analysis relevant to the "gateway" hypothesis has produced mixed results", and that "no 1711:
Cadoni, C; Pisanu, A; Solinas, M; Acquas, E; Di Chiara, G (2001). "Behavioural sensitization after repeated exposure to Delta 9-tetrahydrocannabinol and cross-sensitization with morphine".
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have a greater risk of alcohol use disorder, cocaine use and misuse of prescription stimulants. The elevated risk remains after accounting for prior substance use and other risk factors.
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Alcaro A, Panksepp J (2011). "The SEEKING mind: primal neuro-affective substrates for appetitive incentive states and their pathological dynamics in addictions and depression".
354:) in combination with alcohol increased the craving for more alcohol more strongly than alcohol alone. These findings correspond to epidemiological data that people who consume 992: 125:
In 2019, a research report by the National Institute on Drug Abuse determined that marijuana use is "likely to precede use of other licit and illicit substances", and cited a
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of 2018 said that "Because the term 'gateway' has historically been used in colloquial, non-scientific settings and lacks a clear definition, it is not used in this report".
1471:"Is cannabis use associated with an increased risk of onset and persistence of alcohol use disorders? A three-year prospective study among adults in the United States" 3893: 2729:"Genome-wide association study of lifetime cannabis use based on a large meta-analytic sample of 32 330 subjects from the International Cannabis Consortium" 3146: 2615:"Increased alcohol consumption, nonmedical prescription drug use, and illicit drug use are associated with energy drink consumption among college students" 3817: 339:
observations in humans that nicotine consumption is coupled to an increased probability of later use of cannabis and cocaine, as well as other drugs.
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in which "adults who reported marijuana use during the first wave of the survey were more likely than adults who did not use marijuana to develop an
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Lynskey, M. T.; Vink, J. M.; Boomsma, D. I. (2006). "Early onset cannabis use and progression to other drug use in a sample of Dutch twins".
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A study of drug use of 14,577 U.S. 12th graders showed that alcohol consumption was associated with an increased probability of later use of
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Fergusson, D. M.; Boden, J. M.; Horwood, L. J. (2006). "Cannabis use and other illicit drug use: Testing the cannabis gateway hypothesis".
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Bruinenberg, M; Casas, M; Esko, T; Garcia-Martinez, I; Gordon, S. D.; Harris, J. M.; Hartman, C. A.; Henders, A. K.; et al. (2016).
1231: 1173:"Patterns of cannabis use during adolescence and their association with harmful substance use behaviour: findings from a UK birth cohort" 236:
from 2015 and 2017 showed an association between cannabis use and an increased probability of later disorders in the use of other drugs.
2895:"Understanding the association between adolescent marijuana use and later serious drug use: gateway effect or developmental trajectory?" 1947:"Preclinical Studies of Cannabinoid Reward, Treatments for Cannabis Use Disorder, and Addiction-Related Effects of Cannabinoid Exposure" 4407: 3977: 1018:"The rise of e-cigarettes, pod mod devices, and JUUL among youth: Factors influencing use, health implications, and downstream effects" 194:
disorders, family history of substance use, overlapping illegal drug distribution channels, alcohol use disorder, nicotine dependence,
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people seeking both soft and hard drugs (meaning people who use one drug are likely to use another drug due to personality and that
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released a research report which supported allegations that marijuana is a "gateway" to more dangerous substance use; one of the
2308:"Prior alcohol use enhances vulnerability to compulsive cocaine self-administration by promoting degradation of HDAC4 and HDAC5" 3829: 3930: 3030: 3007: 2981: 2959: 1270: 1253:
National Academies of Sciences, Engineering, and Medicine (2018). Stratton, Kathleen; Kwan, Leslie Y; Eaton, David L (eds.).
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The scientific and political discussion has intensified since 1975 after the publications of several longitudinal studies by
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is coupled to an increased probability of the use of further substances. Possible reasons for the connection include
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Smoking stokes cocaine cravings: Molecular mechanism found for controversial 'gateway drug' hypothesis
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Goode, Erich (1974). "Marijuana use and the progression to dangarous drugs". In Miller, Loren (ed.).
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in the 1980s, the underlying ideas had already been discussed since the 1930s by using the phrases
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link between cannabis use and the use of other illicit drugs can be claimed at this time."
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is based on observations that the sequence of first-time use of different drugs is not
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alteration in the brain. The biological changes in mice correspond to the
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Stages and Pathways of Drug Involvement: Examining the Gateway Hypothesis
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Stages and Pathways of Drug Involvement: Examining the Gateway Hypothesis
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it's not the initial drug that leads to the use of another drug
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of the brain. Because the reward system is anatomically,
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(2012). 831: 3703:List of deaths through alcohol 3521:Epidemiology of binge drinking 3325:Subjective response to alcohol 2996:Is marijuana a "gateway drug"? 2984:, chapt. 10, pp. 104–114. 2843:Agrawal A, Lynskey MT (2014). 2104:Canadian Journal of Psychiatry 2062:10.1016/j.brainres.2014.11.034 1666:10.1016/j.biopsych.2012.04.026 642: 618: 423: 13: 1: 4188:Sweat alcohol content monitor 3223:Alcoholism in rural Australia 3055:National Institutes of Health 3015:State of research before 1974 1375:10.3109/10826084.2016.1170145 606:National Institute of Justice 417: 368:common liability to addiction 81:National Institute of Justice 4111:Adult Children of Alcoholics 3899:Drunk driving law by country 3315:Long-term effects of alcohol 3233:Disease theory of alcoholism 3218:Alcoholism in family systems 3208:Alcohol and Native Americans 3047:Is marijuana a gateway drug? 2631:10.1097/ADM.0b013e3181aa8dd4 2275:10.5811/westjem.2019.7.41661 2000:Nature Reviews. Neuroscience 1994:Parsons LH, Hurd YL (2015). 880:10.1016/j.drugpo.2014.07.011 551:10.1016/j.drugpo.2014.07.011 7: 4517:Substance-related disorders 3838:International whisk(e)y day 3152:Driving under the influence 2970:Is cannabis a gateway drug? 2968:, Rosalie Liccardo Pacula: 2683:Drug and Alcohol Dependence 2257:Ren M, Lotfipour S (2019). 1475:Drug and Alcohol Dependence 1128:Drug and Alcohol Dependence 1022:Drug and Alcohol Dependence 654:Miller, Loren, ed. (1974). 390: 10: 4538: 4354:Christian views on alcohol 3960:List of alcohol laws of US 3238:High-functioning alcoholic 2519:10.1016/bs.pbr.2015.07.009 1363:Substance Use & Misuse 402:Substance abuse prevention 152:Sequence of first-time use 90: 27:Substance-related disorder 4476: 4420: 4374: 4344: 4268: 4253:Alcoholic spirits measure 4238:Low-alcoholic malt drinks 4152: 3996: 3968: 3919:Ignition interlock device 3861: 3852: 3808:Drunken monkey hypothesis 3741: 3670: 3641:Routes of administration 3422: 3333: 3302: 3270:Alcohol congener analysis 3252: 3213:Alcoholism in adolescence 3198: 3135: 3124: 2911:10.1017/S0954579408000308 2800:10.1007/s10519-005-9023-x 1424:10.1007/s40429-017-0149-8 1412:Current Addiction Reports 1091:10.1007/s40429-017-0133-3 1079:Current Addiction Reports 288:repeatedly injected with 270: 2733:Translational Psychiatry 2226:10.2105/AJPH.2016.303128 2116:10.1177/0706743716645288 1189:10.1136/jech-2016-208503 969:Journal of School Health 280:Alterations in the brain 4433:Alcohol and spaceflight 4175:Alcohol server training 4048:Managed alcohol program 3626:Binge drinking devices 3320:Pharmacology of ethanol 2677:Kessler, R. C. (2010). 1951:Neuropsychopharmacology 1760:Neuropsychopharmacology 1610:Neuropsychopharmacology 1308:Subbaraman, MS (2014). 701:10.1126/science.1188374 412:Tobacco and other drugs 217:serves as a gateway to 179:statistical probability 56:environmental influence 4038:Alcohol rehabilitation 4006:Alcohol detoxification 3909:Field sobriety testing 3794:Health effects of wine 3762:International Beer Day 3526:Holiday heart syndrome 2332:10.1126/sciadv.1701682 1623:10.1038/sj.npp.1301127 1314:Alcohol and Alcoholism 407:Substance use disorder 219:traditional cigarettes 113:progression hypothesis 52:psychoactive substance 44:progression hypothesis 4290:Disulfiram-like drugs 3830:Ritual use of alcohol 3799:Wine and food pairing 3784:Apéritif and digestif 3435:Adulterated moonshine 3282:Blood alcohol content 3244:Seeing pink elephants 2177:10.1056/NEJMsa1405092 1904:Neurosci Biobehav Rev 1854:Neurosci Biobehav Rev 1725:10.1007/s002130100875 1326:10.1093/alcalc/agt182 807:10.2105/ajph.83.6.851 758:10.2105/ajph.74.7.668 109:escalation hypothesis 105:stepping-stone theory 46:) is a comprehensive 40:escalation hypothesis 36:stepping-stone theory 4512:Substance dependence 4359:Alcohol in the Bible 4346:Religion and alcohol 4312:General anaesthetics 4105:Alcoholics Anonymous 4063:List of mixed drinks 3516:Alcohol intoxication 3431:Adulterated alcohol 2989:Lay scientific books 2942:Scientific textbooks 1963:10.1038/npp.2017.193 333:molecular biological 290:tetrahydrocannabinol 226:longitudinal studies 175:longitudinal studies 4438:Gateway drug effect 4224:Low-alcohol drinks 4053:Non-alcoholic drink 3988:Temperance movement 3970:Alcohol prohibition 3693:Gilbert Paul Jordan 3683:Dionysian Mysteries 3467:on college campuses 3462:Alcohol advertising 3180:Public intoxication 3083:, January 16, 2015. 3081:Columbia University 2444:Drug Alcohol Depend 2324:2017SciA....3E1682G 1895:Panksepp J (2011). 1772:10.1038/npp.2013.16 1234:on 18 February 2020 693:1975Sci...190..912K 457:Drug Alcohol Depend 380:lifetime prevalence 141:cross-sensitization 32:gateway drug effect 4507:Alcohol and health 4270:Addiction medicine 4213:Get Your Sexy Back 4153:Alcohol limitation 4129:Sober living house 4095:Twelve-step groups 4028:Brief intervention 4021:Open-container law 3983:Neo-prohibitionism 3943:Legal drinking age 3749:Alcoholic beverage 3650:Alcohol inhalation 3565:Drinking in public 3543:Blackout Wednesday 3401:Beverage-specific 3118:Alcohol and health 2998:In: Same authors: 2972:In: Same authors: 2827:2019-05-24 at the 2745:10.1038/tp.2016.36 1713:Psychopharmacology 917:Movement Disorders 463:(Suppl 1): S3–17. 221:and cannabis use. 189:Examples of trends 127:longitudinal study 4494: 4493: 4416: 4415: 4366:Islam and alcohol 4300:Calcium carbimide 4170:Alcohol education 4058:List of cocktails 4033:Designated driver 4011:Alcohol-free zone 3914:Hip flask defence 3848: 3847: 3789:Hangover remedies 3733:Whiskey Rebellion 3723:Six o'clock swill 3511:Austrian syndrome 3450:Surrogate alcohol 3440:Denatured alcohol 3412:Red wine headache 3060:Virginia Gewin: 3049:, website of the 3032:978-1-4832-5811-9 3008:978-0-19-983138-8 2982:978-0-521-80024-2 2960:978-0-521-78969-1 2861:10.1111/add.12436 2778:Behavior Genetics 2582:10.1002/bdr2.1177 2576:(20): 1640–1648. 2570:Birth Defects Res 2395:10.1111/ejn.14170 1822:10.1002/cne.22735 1530:(12): 1493–1504. 1272:978-0-309-46834-3 1228:www.drugabuse.gov 929:10.1002/mds.26142 850:978-0-521-78969-1 687:(4217): 912–914. 665:978-1-4832-5811-9 637:978-0-521-78969-1 539:Int J Drug Policy 373:The results of a 250:about the use of 95:While the phrase 79:conducted by the 77:literature review 16:(Redirected from 4529: 4484: 4483: 4283:Chlordiazepoxide 4233:Low-alcohol beer 3877:Alcohol monopoly 3859: 3858: 3779:Drinking culture 3772:Women in brewing 3655:Vodka eyeballing 3622:Passive drinking 3133: 3132: 3111: 3104: 3097: 3088: 3087: 3036: 2931: 2930: 2890: 2884: 2882: 2872: 2840: 2831: 2819: 2793: 2773: 2767: 2766: 2756: 2723: 2717: 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M. 1510: 1461: 1418:(2): 184–193. 1398: 1349: 1300: 1271: 1263:10.17226/24952 1245: 1212: 1183:(8): 764–770. 1163: 1114: 1065: 1008: 952: 903: 874:(2): 135–142. 854: 830: 801:(6): 851–855. 781: 752:(7): 668–672. 732: 671: 664: 641: 617: 588: 525: 492: 436: 421: 419: 416: 415: 414: 409: 404: 399: 392: 389: 363: 360: 281: 278: 272: 269: 259: 256: 190: 187: 158: 155: 153: 150: 92: 89: 26: 9: 6: 4: 3: 2: 4534: 4523: 4520: 4518: 4515: 4513: 4510: 4508: 4505: 4504: 4502: 4487: 4479: 4478: 4475: 4469: 4466: 4464: 4461: 4459: 4456: 4454: 4451: 4449: 4446: 4444: 4443:Mood disorder 4441: 4439: 4436: 4434: 4431: 4429: 4426: 4425: 4423: 4419: 4409: 4406: 4404: 4401: 4399: 4396: 4394: 4391: 4389: 4388: 4384: 4380: 4379: 4377: 4373: 4367: 4364: 4360: 4357: 4356: 4355: 4352: 4351: 4349: 4347: 4343: 4335: 4332: 4330: 4327: 4326: 4325: 4322: 4318: 4317:Nitrous oxide 4315: 4314: 4313: 4310: 4306: 4303: 4301: 4298: 4296: 4293: 4292: 4291: 4288: 4284: 4281: 4280: 4279: 4276: 4275: 4273: 4271: 4267: 4259: 4256: 4254: 4251: 4250: 4248: 4244: 4241: 4239: 4236: 4234: 4231: 4229: 4228:Fermented tea 4226: 4225: 4223: 4221: 4218: 4214: 4211: 4210: 4208: 4206: 4203: 4201: 4198: 4196: 4193: 4189: 4186: 4184: 4181: 4180: 4178: 4176: 4173: 4171: 4168: 4166: 4163: 4161: 4158: 4157: 4155: 4151: 4145: 4142: 4140: 4137: 4135: 4132: 4130: 4127: 4125: 4124:Sober curious 4122: 4120: 4117: 4112: 4109: 4106: 4103: 4101: 4098: 4097: 4096: 4093: 4091: 4088: 4086: 4083: 4081: 4078: 4074: 4071: 4069: 4066: 4064: 4061: 4059: 4056: 4055: 4054: 4051: 4049: 4046: 4044: 4041: 4039: 4036: 4034: 4031: 4029: 4026: 4022: 4019: 4017: 4014: 4013: 4012: 4009: 4007: 4004: 4003: 4001: 3999: 3995: 3989: 3986: 3984: 3981: 3979: 3976: 3975: 3973: 3971: 3967: 3961: 3958: 3954: 3951: 3949: 3946: 3945: 3944: 3941: 3939: 3936: 3932: 3929: 3928: 3927: 3924: 3920: 3917: 3915: 3912: 3910: 3907: 3905: 3902: 3901: 3900: 3897: 3895: 3892: 3890: 3887: 3883: 3880: 3879: 3878: 3875: 3872: 3869: 3868: 3866: 3864: 3860: 3857: 3851: 3839: 3836: 3835: 3833: 3831: 3828: 3824: 3821: 3820: 3819: 3816: 3814: 3813:Ladies' night 3811: 3809: 3806: 3800: 3797: 3796: 3795: 3792: 3790: 3787: 3785: 3782: 3781: 3780: 3777: 3773: 3770: 3768: 3765: 3763: 3760: 3758: 3755: 3754: 3752: 3750: 3747: 3746: 3744: 3740: 3734: 3731: 3729: 3726: 3724: 3721: 3719: 3716: 3714: 3713:Rum Rebellion 3711: 3709: 3706: 3704: 3701: 3699: 3696: 3694: 3691: 3689: 3686: 3684: 3681: 3679: 3676: 3675: 3673: 3669: 3663: 3660: 3656: 3653: 3651: 3648: 3646: 3645:Alcohol enema 3643: 3642: 3640: 3636: 3633: 3631: 3628: 3627: 3625: 3623: 3620: 3618: 3615: 3613: 3610: 3608: 3607: 3603: 3601: 3598: 3596: 3595:Flaming drink 3593: 3591: 3590:Dutch courage 3588: 3586: 3583: 3581: 3578: 3576: 3575:Drunk walking 3573: 3571: 3570:Drunk dialing 3568: 3566: 3563: 3559: 3556: 3554: 3551: 3550: 3549: 3548:Drinking game 3546: 3544: 3541: 3539: 3536: 3532: 3529: 3527: 3524: 3522: 3519: 3517: 3514: 3512: 3509: 3508: 3507: 3504: 3502: 3499: 3497: 3494: 3492: 3489: 3487: 3484: 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Index

Gateway drug
catchphrase
psychoactive substance
environmental influence
impulsive
it's not the initial drug that leads to the use of another drug
National Institute on Drug Abuse
peer-reviewed
literature review
National Institute of Justice
causal
Robert DuPont
Denise Kandel
longitudinal study
alcohol
nicotine
cross-sensitization
random
trends
longitudinal studies
statistical probability
physiological
ethnicity
urbanicity
tobacco
cannabis
vaping
traditional cigarettes
longitudinal studies
U.K.

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