A gateway drug is a substance believed to promote progression to the use of more harmful substances.
Per the gateway drug definition, softer substances like alcohol, nicotine, and marijuana are believed to open the door to harder substance abuse like with meth, cocaine, and heroin.
Researchers have been exploring the gateway hypothesis since the 1970s. The gateway hypothesis suggests that experimentation with tobacco, alcohol, and marijuana during adolescence can escalate to the use of more addictive substances in later life.
Research has delivered mixed results. Some studies show an association between licit and illicit drug use while other studies show no association. Despite this, the concept of gateway drugs remains hotly debated today.
What is a Gateway Drug?
Stages and Pathways of Drug Involvement examines the gateway hypothesis of substance abuse, reporting that the use of a softer substance increases your risk profile for the abuse of other addictive substances.
Alcohol, tobacco, and marijuana are most commonly labeled gateway drugs by proponents of this theory.
The concept of gateway drugs became popular during the 1980s. During the War on Drugs in the United States, marijuana was singled out as a gateway drug to shine a light on the growing problem of substance abuse in general.
More recently, as marijuana use is being legalized in more and more states for both medical and recreational purposes, the gateway hypothesis is re-entering public discourse. Many politicians opposing the relaxation of cannabis laws cite the gateway hypothesis.
Supports of the gateway hypothesis for substance abuse isolate two conditions that could make those using some substances (alcohol, tobacco, and marijuana) more susceptible to abusing other substances:
- Gateway drugs alter certain brain neural pathways. According to various animal models of addiction, animals that use certain substances at a young age are more likely to later develop addictive behaviors when using other substances. Studies have illustrated changes to the reward system of the brain in those animals, leading to increased vulnerability to subsequent substance abuse. Similar data are observed in human studies.
- Addiction has genetic and environmental components. Twin studies point to a significant genetic component in drug abuse, a trend that continues among those who abuse more than one substance (polysubstance abuse). Polysubstance abuse also involves environmental factors. According to the gateway hypothesis, the interaction of those factors could produce scenarios that promote the gateway theory of substance abuse.
NIDA (National Institute on Drug Abuse) states that environmental factors may be responsible for increased drug use in some people. NIDA also reports that those vulnerable to substance abuse may begin by taking easily available substances like alcohol, tobacco, and marijuana. This could explain why those who use tobacco are more vulnerable to using more harmful substances in later life.
The common liability model, also known as the shared factors model, views the relationship between co-occurring disorders as a non-specific liability, meaning that someone with one type of mental health disorder is at heightened risk of developing additional mental health disorders. Per the gateway hypothesis, the relationship is specific, with the use of one substance leading to the use of a harder and more harmful substance.
Opponents of the gateway hypothesis of drug addiction highlight the following problems with the concept:
- Animal models of behavior do not always generalize with humans
- Correlation doesn’t infer causation – associations cannot be used as evidence supporting causal relationships
- Biological models of behavior focusing on altered brain pathways does not allow for any element of choice
- There is a complex relationship between co-occurring disorders, with social, genetic, and environmental variables all playing a role
- The common liability model offers a clearer explanation of these relationships by refusing to isolate specific substances like marijuana as gateway drugs
What Are Examples of Gateway Drugs
National anti-drug campaigns like DARE (Drug Abuse and Resistance Education) isolated the following substances as gateway drugs:
The New York Times published an article on the gateway hypothesis in which DARE officials now claim that most people who smoke marijuana do not move on to use harder drugs.
The use of tobacco is associated with both the use and abuse of other substances.
As the leading cause of disability and death in the United States, the use of tobacco is also associated with both the use and abuse of other substances.
Many studies suggest that using tobacco early in life can lead to substance use and abuse in later life.
Alcohol is also commonly flagged as a gateway drug. Many studies show that the majority of polysubstance abuse occurs in those who consumed alcohol prior to abusing other addictive substances.
Changing marijuana laws have promoted a resurgence of opinion suggesting that cannabis is a gateway drug.
While a large study spanning 25 years suggests that early cannabis use is strongly associated with subsequent and more frequent substance use and abuse, the issue is nuanced. Is marijuana really a gateway drug, then?
Is Marijuana a Gateway Drug?
There is some research suggesting that marijuana use is likely to predate the use of other addictive substances, both licit and illicit.
In this study, adults reporting marijuana use during the first wave of the longitudinal study were more likely to develop alcohol use disorder within three years than those who did not use marijuana. Among participants who used marijuana and had alcohol use disorder from the onset of the study, there was an increased risk of their alcoholism worsening.
Additionally, cannabis use is linked to other substance use disorders, including nicotine addiction (tobacco use disorder), the most common substance use disorder in the U.S.
Animal research shows that adolescent rodents exposed to cannabinoids experience decreased reactivity to dopamine in adulthood. If these findings generalize, this could explain the increased vulnerability to addiction in later life among those who start using marijuana early in life.
Other animal experiments show that THC (the cannabinoid in marijuana that gets you high) can prime the brain, enhancing its response to other substances. Rats exposed to THC demonstrate heightened behavioral responses when exposed to other substances like morphine. This phenomenon is called cross-sensitization.
While there are many findings consistent with the concept of marijuana as a gateway drug, most people who use marijuana do not progress to using harder drugs like heroin, meth, and cocaine.
Beyond this, the phenomenon of cross-sensitization does not apply uniquely to marijuana. Both nicotine and alcohol can also prime the brain, inducing a heightened response to other addictive substances. Someone who uses harmful addictive substances is likely to have already experimented with alcohol, nicotine, or marijuana first, but this does not mean that marijuana use leads to the use of hard drugs.
More research is needed in this area to reconcile conflicting theories.
Is Alcohol a Gateway Drug?
Research indicates that twelfth-graders in the U.S. who used alcohol in sixth grade reported using illicit drugs more often than those who did not start drinking alcohol until ninth grade.
NIDA reports that alcohol, like marijuana and nicotine, can prime the brain, enhancing the response to other drugs (cross-sensitization). NIDA also asserts that most people will use alcohol, tobacco, and marijuana before using other addictive drugs. That said, the National Institute on Drug Abuse also states that many other factors could also increase the likelihood of an individual abusing substances.
This means it is challenging to claim that alcohol is a gateway drug in the sense that it does not necessarily cause someone to try other drugs – environmental, social, and biological variables all come into play.
Some addiction specialists claim that the early use of alcohol can act as a gateway to developing alcohol use disorder. NIAAA (National Institute on Alcohol Abuse and Alcoholism) also states that using alcohol early in life is a risk factor for developing alcohol use disorder.
As with all addictions, though, many other factors increase the risk of developing alcohol use disorder. These are as follows, according to NIAAA:
- Mental health disorders (those with depression, PTSD, and ADHD are more likely to develop alcohol use disorder)
- Sustained alcohol abuse
- Childhood trauma
Fight Drug Addiction at The District Recovery
Here at The District Recovery Community, we can help you combat drug addiction however you started out using drugs and however your addiction has progressed. Additionally, we offer gender-specific outpatient programs for the treatment of alcohol use disorder, mental health disorders, and co-occurring disorders.
Many people with milder substance use disorders (the clinical term for drug addiction) find a standard outpatient program offers enough structure and support for recovery. For anyone requiring more time commitment, we also provide IOPs (intensive outpatient programs) and PHPs (partial hospitalization programs).
Every addiction is unique, meaning that the best addiction treatment is personalized. At TDRC, your treatment team will draw from evidence-based therapies and holistic treatments, including:
- Individual counseling
- Group counseling
- Talk therapy (psychotherapies like CBT or DBT)
- MAT (medication-assisted treatment)
- Family therapy
- Experiential adventure therapy
After unpacking the physical and psychological aspects of drug addiction, you’ll either step down to a less intensive form of treatment or transition back into sober living. With robust relapse prevention and aftercare plans in place, you’ll be ready to embark on a journey of ongoing sobriety.
Get started today by reaching out to the friendly District team at 844.287.8506.