Legality of Cannabis by U.S. Jurisdiction

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The '''reverse gateway theory''' posits that earlier regular cannabis use predicts later tobacco initiation and/or nicotine dependence in those who did not use tobacco before.<ref name=Peters2012>{{cite journal |author=Peters EN, Budney AJ, Carroll KM |title=Clinical correlates of co-occurring cannabis and tobacco use: a systematic review |journal=Addiction |volume=107 |issue=8 |pages=1404–17 |date=August 2012 |pmid=22340422 |pmc=3377777 |doi=10.1111/j.1360-0443.2012.03843.x |type=Review}}</ref>
The '''reverse gateway theory''' posits that earlier regular cannabis use predicts later tobacco initiation and/or nicotine dependence in those who did not use tobacco before.<ref name=Peters2012>{{cite journal |author=Peters EN, Budney AJ, Carroll KM |title=Clinical correlates of co-occurring cannabis and tobacco use: a systematic review |journal=Addiction |volume=107 |issue=8 |pages=1404–17 |date=August 2012 |pmid=22340422 |pmc=3377777 |doi=10.1111/j.1360-0443.2012.03843.x |type=Review}}</ref>

== Sequence of first-time use ==
=== General concept ===
The concept of ''gateway drug'' is based on observations that the sequence of first-time use of different drugs is not [[Randomness|random]] but shows [[Linear trend estimation|trends]]. On the basis of established techniques of [[Longitudinal study|longitudinal studies]] such trends can be described precisely in terms of [[Frequentist probability|statistical probability]]. 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 [[Physiology|physiological]] experiments.<ref> [[Denise Kandel|D. B. Kandel]] (Ed.): ''Stages and Pathways of Drug Involvement: Examining the Gateway Hypothesis'', Cambridge University Press, 2002, ISBN 978-0-521-78969-1, pp. 3-10.</ref>

=== Examples of trends ===
From a sample of 6,624 persons who had not used other illegal drugs before their cannabis consumption the overall probability of later use of further illegal drugs was estimated to be 44.7 %. Subgroup analyses showed that personal and social conditions, such as gender, age, [[Ethnicity]], [[Urbanicity]], and educational attainment influenced the height of probability.<ref name="PMID25168081">R. Secades-Villa, O. Garcia-Rodríguez, C. J. Jin, S. Wang, C. Blanco: ''Probability and predictors of the cannabis gateway effect: a national study.'' In: ''The International journal on drug policy.'' Vol 26, nr 2, February 2015, pp.&nbsp;135–142, {{DOI|10.1016/j.drugpo.2014.07.011}}, PMID 25168081, {{PMC|4291295}}.</ref>

In a sample of 27,461 persons who showed no signs of [[Alcoholism|alcohol use disorder]] (AUD) before their cannabis consumption a second examination three years later revealed a five times higher rate (500 %) of AUD compared to a control group that had not consumed cannabis. In another sample of 2,121 persons who already had AUD at the first examination the rate of persistence of AUD three years later was 74 % higher in the group of Cannabis consumers than in the group of non-consumers.<ref name="PMID26875671">A. H. Weinberger, J. Platt, R. D. Goodwin: ''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.'' In: ''Drug and alcohol dependence.'' Vol 161, April 2016, pp.&nbsp;363–367, {{DOI|10.1016/j.drugalcdep.2016.01.014}}, PMID 26875671.</ref>

A study of drug use of 14,577 US 12th graders showed that alcohol consumption was associated with an increased probability of later use of tobacco, cannabis, and other illegal drugs.<ref name="PMID22712674">T. Kirby, A. E. Barry: ''Alcohol as a gateway drug: a study of US 12th graders.'' In: ''The Journal of school health.'' Vol 82, nr 8, August 2012, pp.&nbsp;371–379, {{DOI|10.1111/j.1746-1561.2012.00712.x}}, PMID 22712674, [http://www.mamacultiva.org/wp-content/uploads/2015/pdf/A8%20-%20Alcohol%20as%20a%20Gateway%20Drug%20A%20Study%20of%20US%2012th%20Graders.pdf PDF] (accessed May 26, 2016).</ref>


==Cannabis==
==Cannabis==
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[http://www.drugabuse.gov The National Institute on Drug Abuse] have noted that while most cannabis users do not go on to use "harder" substances, reported data is consistent with the theory that cannabis is a gateway drug. However, they also suggest an alternative explanation. It may be that some individuals are more prone to using drugs and that these people are more likely to start with readily available substances such as cannabis, tobacco, and alcohol.<ref>{{cite web|title=Is marijuana a gateway drug?|url=http://www.drugabuse.gov/publications/marijuana/marijuana-gateway-drug|website=drugabuse.gov|publisher=National Institute of Drug Abuse}}</ref>
[http://www.drugabuse.gov The National Institute on Drug Abuse] have noted that while most cannabis users do not go on to use "harder" substances, reported data is consistent with the theory that cannabis is a gateway drug. However, they also suggest an alternative explanation. It may be that some individuals are more prone to using drugs and that these people are more likely to start with readily available substances such as cannabis, tobacco, and alcohol.<ref>{{cite web|title=Is marijuana a gateway drug?|url=http://www.drugabuse.gov/publications/marijuana/marijuana-gateway-drug|website=drugabuse.gov|publisher=National Institute of Drug Abuse}}</ref>

== Alcohol and tobacco ==
Alcohol tends to precede cannabis use, and it is rare for those who use hard drugs to not have used alcohol or tobacco first; the 2005 National Survey of Drug Use and Health (NSDUH) in the United States found that, compared with lifetime nondrinkers, adults who have consumed alcohol were statistically much more likely to currently use illicit drugs and/or abuse prescription drugs in the past year.<ref name="oas.samhsa.gov">[http://www.oas.samhsa.gov/2k4/alcDU/alcDU.htm Illicit Drug Use among Lifetime Nondrinkers and Lifetime Alcohol Users], NSDUH, 2005</ref> Effects were strongest for cocaine (26 times more likely), cannabis (14 times more likely), and psychedelics (13 times more likely). In addition, lifetime drinkers were also six times more likely to use or be dependent on illicit drugs than lifetime nondrinkers.<ref name="oas.samhsa.gov"/>

According to the [[National Institute on Drug Abuse|NIDA]], "People who abuse drugs are also likely to be cigarette smokers. More than two-thirds of drug abusers are regular tobacco smokers, a rate more than triple that of the rest of the population."<ref>[http://web.archive.org/web/20051103184120/http://www.nida.nih.gov/nida_notes/NNVol15N5/Craving.html The National Institute on Drug Abuse (NIDA), part of the [[NIH]], a component of the U.S. Department of Health and Human Services.] – Nicotine Craving and Heavy Smoking May Contribute to Increased Use of Cocaine and Heroin {{Citation needed|date=February 2007}} – Patrick Zickler, NIDA NOTES Staff Writer. Retrieved October, 2006.</ref>


==Electronic cigarettes as gateway to smoking==
==Electronic cigarettes as gateway to smoking==

Revision as of 16:33, 26 May 2016

The gateway drug theory (also called gateway theory, gateway hypothesis and gateway effect) states that use of less deleterious drugs precedes, and can lead to, future use of more dangerous hard drugs[1] or crime.[2] It is often attributed to the earlier use of one of several licit substances, including tobacco or alcohol, as well as cannabis.[1]

The reverse gateway theory posits that earlier regular cannabis use predicts later tobacco initiation and/or nicotine dependence in those who did not use tobacco before.[3]

Sequence of first-time use

General concept

The concept of gateway drug is based on observations that the sequence of first-time use of different drugs is not random but shows trends. On the basis of established techniques of longitudinal studies such trends can be described precisely in terms of statistical probability. 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 physiological experiments.[4]

Examples of trends

From a sample of 6,624 persons who had not used other illegal drugs before their cannabis consumption the overall probability of later use of further illegal drugs was estimated to be 44.7 %. Subgroup analyses showed that personal and social conditions, such as gender, age, Ethnicity, Urbanicity, and educational attainment influenced the height of probability.[5]

In a sample of 27,461 persons who showed no signs of alcohol use disorder (AUD) before their cannabis consumption a second examination three years later revealed a five times higher rate (500 %) of AUD compared to a control group that had not consumed cannabis. In another sample of 2,121 persons who already had AUD at the first examination the rate of persistence of AUD three years later was 74 % higher in the group of Cannabis consumers than in the group of non-consumers.[6]

A study of drug use of 14,577 US 12th graders showed that alcohol consumption was associated with an increased probability of later use of tobacco, cannabis, and other illegal drugs.[7]

Cannabis

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See also: Cannabis (drug) and Cannabis dependence

The hypothesis is that the use of soft drugs like cannabis leads to the use of harder drugs via a sequence of stages.[1] This is based on the observation that many consumers who use cocaine or heroin have previously used cannabis, and most have used alcohol or tobacco; the hypothesis is that progression of drug use initiation continues from there to other drugs like cocaine or heroin.[1] Some research supports that cannabis use predicts a significantly higher risk for subsequent use of "harder" illicit drugs, while other research does not.[1] Some research finds that even alcohol represents a "gateway" drug, leading to the use of tobacco, marijuana, and other illicit substances.[8]

While some research shows that many hard drug users used cannabis or alcohol before moving on to the harder substances, other research shows that some serious drug abusers have not used alcohol or cannabis first.[1] The latter is evident in Japan, where the overwhelming majority of users of illicit drugs do not use cannabis first.[1] One study finds no evidence that medical marijuana laws lead to an increase in cocaine or heroin usage.[9]

The risk factor for using drugs in cannabis users may be higher because few people try hard drugs prior to trying cannabis, not because cannabis users increasingly try hard drugs such as certain substituted amphetamines (e.g., methamphetamine). For example, cannabis is typically available at a significantly earlier age than other illicit drugs.

Jacob Sullum analyzed the "gateway" theory in a 2003 Reason magazine article, noting that the theory's "...durability is largely due to its ambiguity: Because it's rarely clear what people mean when they say that pot smoking leads to the use of "harder" drugs, the claim is difficult to disprove.":

"Notice that none of these interpretations involves a specific pharmacological effect of the sort drug warriors seem to have in mind when they suggest that pot smoking primes the brain for cocaine or heroin. As a National Academy of Sciences panel observed in a 1999 report, 'There is no evidence that marijuana serves as a stepping stone on the basis of its particular drug effect.' Last year the Canadian Senate's Special Committee on Illegal Drugs likewise concluded that 'cannabis itself is not a cause of other drug use. In this sense, we reject the gateway theory.'"[10]

The National Institute on Drug Abuse have noted that while most cannabis users do not go on to use "harder" substances, reported data is consistent with the theory that cannabis is a gateway drug. However, they also suggest an alternative explanation. It may be that some individuals are more prone to using drugs and that these people are more likely to start with readily available substances such as cannabis, tobacco, and alcohol.[11]

Electronic cigarettes as gateway to smoking

Much of the literature on electronic cigarettes has expressed fears that they would, especially if marketed by big tobacco, be a gateway to smoking tobacco for young people. In 2015 a report commissioned by Public Health England, a government agency, examined the evidence for this, and concluded that "We strongly suggest that use of the gateway terminology be abandoned until it is clear how the theory can be tested in this field",[12] They quoted a study which concluded that: "Although the concept of the gateway theory is often treated as a straightforward scientific theory, its emergence is rather more complicated. In effect, it is a hybrid of popular, academic and media accounts – a construct retroactively assembled rather than one initially articulated as a coherent theory”.[13]

Prohibition

Another theory is that prohibition itself is a gateway to "hard" drug use. Many support this theory referencing the introduction to the black market. Once utilizing the black market, sellers have incentive to sell higher margin products, unrestricted by greater regulation on more harmful substances.[14] The research has found an increase of drug-related incidents in counties of the United States that ban alcohol as well. [15][16]

Criticisms

Alternative explanations for the correlation between the use of soft drugs (e.g., marijuana) and the use of hard drugs (e.g., cocaine, heroin) include, but are not limited to:

  • The Common Liability to Addiction theory (CLA) argues that a person's involvement with drugs and its various degrees, including potential development and severity of addiction, are based on biobehavioral mechanisms that are largely not drug-specific. Within the CLA framework, the sequence of drug use initiation - the essence of the "gateway theory" - is opportunistic and trivial: the "gateway" drugs, that is, the substances used first, are merely those that are (usually) available at an earlier age (thus usually licit) than those used later (usually, hard drugs). In an extensive review addressing the CLA and the "gateway" theory, it was pointed out (Vanyukov et al., 2012) that the "gateway" sequence applies only to the initiation of use of different drugs rather than different levels or extent of drug involvement (from use to dependence), questioning its relevance to addiction as a medical problem. Despite that, the "gateway theory" has significantly and, arguably, adversely influenced policy formation, intervention, and research.[1]
  • Teenagers' trust of adults erodes when authority-figures exaggerate or make up the dangers of the "gateway" drugs, leading teenagers to regard all anti-drug messages as nonsense.[17]
  • The peer environments in which "gateway" drugs are used can sometimes overlap with the ones in which harder drugs are used, especially in societies that prohibit the substances or impose very high age-limits.[17]

See also

References

  1. ^ a b c d e f g h Vanyukov MM, Tarter RE, Kirillova GP, et al. (June 2012). "Common liability to addiction and "gateway hypothesis": theoretical, empirical and evolutionary perspective". Drug Alcohol Depend (Review). 123 Suppl 1: S3–17. doi:10.1016/j.drugalcdep.2011.12.018. PMC 3600369. PMID 22261179.
  2. ^ Pudney, Stephen (December 2002). "The road to ruin? Sequences of initiation into drug use and offending by young people in Britain" (PDF). Home Office Research Study 253. London: Home Office Research, Development and Statistics Directorate. ISBN 1-84082-928-1. ISSN 0072-6435. Retrieved 2009-04-04.
  3. ^ Peters EN, Budney AJ, Carroll KM (August 2012). "Clinical correlates of co-occurring cannabis and tobacco use: a systematic review". Addiction (Review). 107 (8): 1404–17. doi:10.1111/j.1360-0443.2012.03843.x. PMC 3377777. PMID 22340422.{{cite journal}}: CS1 maint: multiple names: authors list (link)
  4. ^ D. B. Kandel (Ed.): Stages and Pathways of Drug Involvement: Examining the Gateway Hypothesis, Cambridge University Press, 2002, ISBN 978-0-521-78969-1, pp. 3-10.
  5. ^ R. Secades-Villa, O. Garcia-Rodríguez, C. J. Jin, S. Wang, C. Blanco: Probability and predictors of the cannabis gateway effect: a national study. In: The International journal on drug policy. Vol 26, nr 2, February 2015, pp. 135–142, doi:10.1016/j.drugpo.2014.07.011, PMID 25168081, PMC 4291295.
  6. ^ A. H. Weinberger, J. Platt, R. D. Goodwin: 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. In: Drug and alcohol dependence. Vol 161, April 2016, pp. 363–367, doi:10.1016/j.drugalcdep.2016.01.014, PMID 26875671.
  7. ^ T. Kirby, A. E. Barry: Alcohol as a gateway drug: a study of US 12th graders. In: The Journal of school health. Vol 82, nr 8, August 2012, pp. 371–379, doi:10.1111/j.1746-1561.2012.00712.x, PMID 22712674, PDF (accessed May 26, 2016).
  8. ^ Peters EN, Budney AJ, Carroll KM (August 2012). "Clinical correlates of co-occurring cannabis and tobacco use: a systematic review". Addiction. 107 (8): 1404–17. doi:10.1111/j.1360-0443.2012.03843.x. PMC 3377777. PMID 22340422.{{cite journal}}: CS1 maint: multiple names: authors list (link)
  9. ^ Chu, Yu-Wei Luke (2015-05-01). "Do Medical Marijuana Laws Increase Hard-Drug Use?". Journal of Law and Economics. 58 (2): 481–517. doi:10.1086/684043.
  10. ^ Sullum, Jacob (24 Jan 2003), Marijuana as a "gateway" drug, Reason, retrieved 2014-04-01 {{citation}}: Italic or bold markup not allowed in: |publisher= (help)
  11. ^ "Is marijuana a gateway drug?". drugabuse.gov. National Institute of Drug Abuse.
  12. ^ McNeill, A, SC (2015). "E - cigarettes: an evidence update A report commissioned by Public Health England" (PDF). www.gov.uk. UK: Public Health England. p. 38. Retrieved 24 August 2015.{{cite web}}: CS1 maint: multiple names: authors list (link)
  13. ^ Bell, K. and H. Keane, "All gates lead to smoking: The ‘gateway theory’, e-cigarettes and the remaking of nicotine"., Social Science & Medicine, 2014. 119, quoted McNeill, pp. 37-38
  14. ^ "Prohibition Is the Real "Gateway Drug"". The Huffington Post. 29 September 2015.
  15. ^ Fernandez, Jose M. and Gohmann, Stephan and Pinkston, Joshua C., Breaking Bad: Are Meth Labs Justified in Dry Counties? (August 25, 2015). Available at SSRN: http://ssrn.com/abstract=2650484 or http://dx.doi.org/10.2139/ssrn.2650484
  16. ^ Conlin, Michael; Dickert-Conlin, Stacy; Pepper, John. "Effect of Alcohol Prohibition on Illicit-Drug-Related Crimes, The." Journal of Law and Economics 48.1 (2005): 215-234.
  17. ^ a b Brecher, Edward M. (1972). "Heroin on the youth drug scene - and in Vietnam". Licit and illicit drugs; the Consumers Union report on narcotics, stimulants, depressants, inhalants, hallucinogens, and marijuana - including caffeine, nicotine, and alcohol. Boston: Little, Brown. ISBN 0-316-10717-4. {{cite book}}: External link in |chapterurl= (help); Unknown parameter |chapterurl= ignored (|chapter-url= suggested) (help)

Further reading

  • D. B. Kandel (Ed.): Stages and Pathways of Drug Involvement: Examining the Gateway Hypothesis, Cambridge University Press, 2002, ISBN 978-0-521-78969-1.
  • Wayne Hall, Rosalie Liccardo Pacula: Is cannabis a gateway drug? In: Same authors: Cannabis Use and Dependence. Public Health and Public Policy, Cambridge University Press, Cambridge, UK, New York, USA, 2003, ISBN 978-0-521-80024-2, chapt. 10, pp. 104-114.
  • Mark A.R. Kleiman, Jonathan P. Caulkins, Angela Hawken: Is marijuana a "gateway drug"? In: Same authors: Drugs and Drug Policy. What Everyone Needs to Know, Oxford University Press, 2011, ISBN 9780199831388, chapt. 4, question 8, 3 pages.

External links

source: https://en.wikipedia.org/w/index.php?title=Gateway_drug_effect&diff=prev&oldid=722205770