The Gateway 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. The theory does have its opponents but it is still referred to frequently in research, literature and treatment.

Marijuana, alcohol, nicotine and other gateway drugs boost dopamine levels, which increases pleasure. The dopamine boost caused by gateway drugs during adolescence has been linked to decreased reactivity of brain dopamine reward centres later in adulthood . This may lead 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 behaviour 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.

What Are Common Gateway Drugs?

Alcohol, marijuana and nicotine are commonly talked about as gateway drugs. In recent years, opioids, prescription drugs and other common substances have joined the category.

Alcohol

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 considered to be 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:

• Cocaine
• Heroin
• Opioids
• Marijuana

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

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 at that time.

Weed is commonly recognized as a gateway drug by proponents of the theory. However, its association to harder drugs has been widely debated especially since it has been legalised in many states in the USA and decriminalised in South Africa by the country’s Constitutional Court for personal consumption by adults in private abodes.

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 Centres for Disease Control and Prevention.

Illicit substances linked to marijuana use include:

• Cocaine
• Heroin
• Ecstasy
• Marijuana

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 Behaviour 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 drugs

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:

• Cocaine
• Heroin

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.

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.

Nicotine

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 animals had an increased response to cocaine afterwards.

Illicit substances widely linked to nicotine use include:

• Cocaine
• Heroin
• Marijuana

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.

Conclusions

The relationship between early alcohol use and later use of other drugs has the strongest evidence to suggest that it may be a gateway drug; however, the gateway theory suffers from a number of potential methodological flaws. At the current time, it is unable to specify a causal relationship between early use of any drug and the potential to use or abuse other drugs later. Instead, these relationships may be more consistent with the common liability model.

Although The Gateway Theory has its opponents, there is evidence that using some substances early in development does result in a greater probability that an individual will abuse other substances; however, the reason for this is not well understood. This condition may represent some combination of inherent factors (e.g., genetic) and the interaction of environmental factors (e.g., peers, learning, stress, etc.).

If you or a loved one needs assistance with substance abuse – know that help is readily available. The road to recovery is not always an easy one but getting yourself or your loved one the best possible care from the team at Crossroads Recovery Centre, provides you with a map to sober, healthy living. No matter how bad things seem, there is hope and it’s only a phone call away. If you or anyone close to you needs help with an addiction to sex, gambling, substances, alcohol or food, please contact us for a free assessment.

www.crossroadsrecovery.co.za

074 89 51043 JHB

012 450 5033 PTA

RESOURCES

https://americanaddictioncenters.org/the-addiction-cycle/gateway-drugs https://www.drugrehab.com/guides/gateway-drugs/

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