Gateway Drugs

Are you concerned about the risky behaviors of a child, friend, or other loved one and worried that they may become engaged in increasingly dangerous behaviors?  Is it true that the use of a readily available drug like alcohol or marijuana may open the door to the abuse of or addiction to stronger drugs?  Are you interested in the current debate over the legalization of marijuana and the argument that smoking pot may predispose young people to abuse more powerful substances?

What are gateway drugs?

Tobacco, alcohol, and marijuana are commonly considered to be gateway drugs—substances that can potentially lead to the use of harder drugs like heroin, crystal meth, cocaine, and crack especially when experimented with by young people. 

A slippery slope?

The gateway hypothesis is controversial in the medical community.  On the one hand, some researchers argue that the use of these drugs can increase the brain’s vulnerability to other drugs.  Additionally, the use of an illegal substance like marijuana can introduce young people to other people engaged in other illicit activities, enhancing their acceptance of drug use and offering them access to harder drugs.  Furthermore, people open to experimenting with consciousness-altering substances may also be willing to check out other substances when given the opportunity.  On the other hand, other authors claim that the dangers of marijuana, in particular, have been greatly overstated in the debate over legalizing this drug; neither alcohol nor tobacco serve any clear medical purpose and remain legal substances despite their potential for abuse.  These authors point to the fact that while many people who use other drugs have also tried marijuana, the majority of those who sample cannabis do not go on to try other illegal drugs. However, although tobacco and alcohol are legal in the U.S. and marijuana is readily available here, it is a sobering fact that each of these substances is associated with a variety of short- and long-term health risks and can lead to addiction.

How dangerous is marijuana?

The most widely discussed substance in the debate over the gateway hypothesis, marijuana is also the most frequently used illicit drug in the US.  According to the 2009 National Survey on Drug Use and Health, over four million Americans are addicted to or abuse marijuana.  In addition, approximately 30% of the nation’s teens have tried pot at some point in the course of their lifetimes.  Although intermittently using marijuana is not likely to leave lasting harmful effects, marijuana does have potent psychological and physical effects that generally subside within a few hours but can linger for a day; these include euphoria, magical thinking, and short-term memory loss, as well as increased heart rate, blood pressure, and breathing, red eyes, increased appetite, and slowed reaction times.  The heavy use of pot can cause withdrawal symptoms, and indeed more and more adults are now seeking treatment for marijuana addiction.  How likely it is that smoking pot will lead to the use of cocaine and heroin, however, is debatable.  A 2010 study published in the Journal of Health and Social Behavior found that ethnicity (Whites are more likely to use drugs than Hispanics and Blacks), stress levels, and employment status were stronger indicators of harder drug use.

What about tobacco and alcohol?

Of all of the gateway drugs, young teens are most likely to try tobacco first.  In addition to nicotine’s highly addictive nature and the severe health risks involved with smoking, smoking tends to be associated with the use of other substances.  Alcohol dependent people also tend to be nicotine dependent, and one recent study found that teens who smoke by age 12 are 26 times more likely to try marijuana by age 17.

Are prescription painkillers the new gateway drugs?

Prescription drug abuse has reached the level of an epidemic in the U.S., and the Drug Enforcement Administration has responded accordingly with increased physician education, drug take-back programs, and increased enforcement of suspected “pill mill” operations. A 2010 survey of recovering opiate addicts found that most of them first became involved with drugs through the abuse of prescription painkillers, suggesting that prescription painkillers. Any time you are prescribed a new medication, ask your physician about the drug’s potential for abuse and, if you have a family history of addiction or are concerned for other reasons, enlist the help of someone else to hold you accountable.

When should I seek help?

If you or someone you care about is abusing any of these gateway substances, do not hesitate to seek professional help from your primary care physician, a psychiatrist, or a therapist.  Although there seems to be a lesser social stigma surrounding the use and abuse of these substances, intervening earlier can decrease the chances of encountering more severe problems with these or other drugs later.