What are Gateway Drugs?

May 8th, 2023

By P. Casey Arrillaga, LCSW, LCDC

The term “gateway drug” has been around for some time now and has entered the popular imagination. This is the idea that using a more accepted drug leads to using “harder” drugs later in life. In the scientific world, this “gateway hypothesis” has supporters and detractors and the debate can be pretty intense. Some opponents argue accurately that an association between two things doesn’t prove that one causes the other, and that there are many other factors that contribute to moving from one drug to another, such as genetic vulnerability and peer groups. Meanwhile, many addiction professionals worry that dropping the idea of gateway drugs altogether will lead to more addiction and ignores the long-term costs for those who might move from less-harmful to more-harmful substances over time. Given all this, we’d like to take a look at what we actually know and what we don’t about the idea of gateway drugs.

Do Some Drugs Really Lead to Others?

Of all the drugs named in the gateway hypothesis, marijuana is the one most commonly imagined as a gateway drug. This has led to much controversy as it is increasingly accepted and legalized in the United States, and people who want it legalized cry out that the gateway hypothesis is part of an old smear campaign against a harmless, all-natural substance. It doesn’t help that some of the people who want to do away with the gateway hypothesis stand to make a lot of money through legalization and acceptance of marijuana, while some who support the hypothesis stand to benefit politically or perhaps financially through funding for anti-drug campaigns and research.

What we know so far is that marijuana use in adolescents may increase the risk of using “harder” drugs as they grow into young adults, but that it isn’t a simple straight line from one to the other. There appear to be some changes in brain chemistry due to early marijuana use that leave the users more vulnerable to other drugs later, particularly opiates such as hydrocodone, heroin, and fentanyl. Besides these basic chemical changes, marijuana has been shown to increase the risk of mental illness such as schizophrenia in some users, and mental illness also puts people at greater risk of opiate use. On the other hand, the studies done suggest that the gateway effect is not strong enough to say that prohibition of marijuana will save people from using opiates or experiencing mental illness. Also, there is little evidence that marijuana leads to using any other drugs, such as methamphetamine or cocaine.

For that, we look to cigarettes. That’s right, there is evidence that cigarette smoking increases risk of stimulant use, with greater risk coming to those who start smoking earlier. This leaves nicotine, the active ingredient in cigarettes, as both the deadliest drug as measured by worldwide deaths each year, and also a gateway to other drugs that are less socially acceptable and potentially life-altering or deadly themselves.

The other legal gateway drug contender is alcohol. Alcohol may be called a gateway drug for two reasons: first is that people who use alcohol earlier in life are more likely to try other drugs as the grow older, and second is that alcohol is famous for lowering inhibitions, and this can leave people more likely to try another drug while under the influence of alcohol. As with all the other potential gateway drugs, many people never try anything else, especially if alcohol is getting them the effect they want. For instance, if it dispels a small amount of social anxiety, and the person drinking it just wants to relax so they can dance and chat, things may never go further than that.

Some people may be looking for more, though. This is especially true in adolescence. They might want to escape their feelings most of the time, or they may be looking for a way out of their depression. Alcohol may not feel like enough, but drinking it can make taking something to feel different seem normal, and it may lower those inhibitions enough to try cocaine, heroin, various pills, or anything else that will make their emotional discomfort go away.

Alcohol is also the drug most often found mixed in the bloodstream with other drugs in emergency room admissions. Since higher blood alcohol content is found in people with a greater variety of substances in their system, it would be an easy guess that the drunker someone gets, the more likely they are to use other drugs as well. 

The Bottom Line

While we can’t say that using one drug will lead inevitably to another, “harder”, drug, it’s clear that using some drugs creates some greater risk of using others. This risk is increased the younger somebody starts drug use. While it isn’t a sure thing, the idea of gateway drugs seems to merit both more research and greater awareness in those who use any substance and those who love them.

About The Author

P. Casey Arrillaga is the Team Leader for Education at Windmill Wellness Ranch, and he is the author of books including “Realistic Hope: The Family Survival Guide for Facing Alcoholism and Other Addictions”. His books, podcast, videos, etc. can be found at CaseyAuthor.com

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