A man is prescribed hydrocodone (Vicodin®) by his doctor for pain management purposes after a necessary surgery. The man takes the medication as directed by his doctor and uses it when he feels it’s necessary to manage the post-op pain. The man knows that hydrocodone has a certain reputation with substance use and addiction, but he doesn’t seem to get any strange or unusual feelings after taking it and is able to cease use of the medication without complications once he no longer needs it.
The man passes some of his leftover medication to a friend of his who recently burned her hand on the stove. Since he had no issues with the medication, he assumes his friend shouldn’t have any problems either. The woman takes some of the hydrocodone to help manage the pain from her burned hand. Once her hand is healed however, she continues to take hydrocodone even when she’s not in pain. She found that she liked the euphoric feeling it gave her and began continuing to use the drug in times of stress and constantly turned toward it to help distract her from troubling family matters.
Eventually, taking hydrocodone to self-medicate and deal with stress and anxiety was a normal part of her routine. After some time passed, she began using other substances as well and they became a normal part of her life. Once she ran out of a desired substance, she wanted to obtain more of it and ended up in jail for robbery for attempting to steal in order to support her self-medicating habit.
How could two people who took the same substance have such different outcomes?
A gateway drug is a term that is commonly used in reference to particular substances that are thought to open the way to using more dangerous or harder drugs such as heroin or cocaine. Gateway drugs are also commonly thought to increase the likelihood of developing an addiction, either to the gateway drug itself or to a stronger substance.
The term “gateway drug” is not a medical term. Instead, it is a colloquial phrase to encompass the idea that certain substances will lead to a severe addiction or an increase in substance use.
The gateway drug effect is a controversial idea. There are a number of statistics and studies that indicate that individuals who smoke marijuana, for example, are not conclusively related to substance use of any other drugs in the future. Later on, we’ll examine this idea in more detail.
Although there is not necessarily one main consensus or master list of every agreed upon gateway drug, there are several substances that are commonly indicated as leading towards a path to addiction and illicit substance use.
Alcohol is one of the most visible substances. It’s often consumed in social settings and is generally viewed as the least taboo to consume out of these four substances due to social standards and expectations.
Prescription pills are some of the most accessible substances to the average person. When you get prescribed medication for an injury or surgery, strong pain medications can end up lingering in cabinets after the medication is not needed anymore. Like the other three substances, prescription pills are very easy to access for many people, increasing the likelihood of use for someone seeking relief and escape from stresses, anxieties, or other worries.
In some ways, labeling specific substances as a gateway drug can be misleading and misrepresent the realities of the situation.
Referring to a specific substance as a gateway drug often gives the impression that a severe addiction and eventual use of more dangerous drugs is unavoidable and will happen at some point. However, this notion can be quite misleading. The issue of gateway drugs is highly contested and debated in addiction treatment programs, circles of medical professionals, and drug education programs like D.A.R.E.
Many individuals believe that the theory of the gateway effect is effectively debunked. However, that same group does not necessarily doubt that some individuals may be susceptible to a path that leads to harder substances, but the general consensus appears to be that the issue is not so cut and dried. Not every person who uses nicotine, marijuana, alcohol, or prescription pills will automatically graduate to using harder substances—but some people may.
From this conclusion, the term gateway drug in its most well known definition and connotation is a bit outdated. Because the term was used to classify substances that would definitively lead to harder substance use, it is difficult to change the widespread societal understanding of what a gateway drug is.
As we will explore further in the next section, a gateway drug does not necessarily create an unchangeable destiny towards substances like heroin and cocaine. For some individuals, this may be true, but the path towards harder substances is not simply due to a gateway drug. There are many factors that contribute to using more dangerous substances that include access, availability, and social acceptance.
The issue of whether gateway drugs actually lead to the use of harder and more dangerous substances like heroin or cocaine is debatable, although in recent decades, there has been mounting evidence against the original conclusions established by the gateway theory.
According to an article by The New York Times, drug education programs like D.A.R.E., aimed especially at children in public schools during the 80s and 90s, have admitted that “that the overwhelming majority of people who smoke pot or drink never graduate to pills and powders.”
The same article cites a 1999 report by the Institute of Medicine of the National Academy of Sciences that concluded that “there is no conclusive evidence that the drug effects of marijuana are causally linked to the subsequent abuse of other illicit drugs.”
Additionally, it can be helpful to compare the circumstances and cases of addiction between countries to spot differences and similarities. As The New York Times reported, a study published by the U.S. Department of Health and Human Services examined the gateway theory between various countries. Japan, for example, is a country with overall lower marijuana use rates than in the United States or many Western nations. The study observed that 83% of Japanese illicit drug users did not begin by smoking marijuana.
Instead of looking for the root causes of harder substance use amongst these softer gateway drugs, another study published by the U.S. Department of Health and Human Services suggests that gateway drugs are not the only entry points to harder substance use and addiction. Instead, there are numerous factors such as poverty, aggressive crime, and social environment that play a major role.
In our hypothetical story, the man had no problems tapering off hydrocodone, but his friend developed a dependency over time and eventually graduated to using harder substances. As always, substances can affect different people differently due to numerous factors, both social and physical. While the majority of people who use substances like nicotine, marijuana, alcohol, and prescription pills do not go down the road to harder substance use, it remains a possibility for some individuals.
Treatment is available for individuals who suspect they have difficulties with any kind of substance use or addiction. At SUN Behavioral Health Ohio, we understand that tackling these issues can be a very hard and complicated process. We are here to provide you with the best possible support and treatment that will suit your needs. Contact us anytime at 614-706-2786 for treatment.
What are the top gateway drugs?
Usually, there are three or four main drugs that are often given the title of gateway drug. These include: nicotine (from smoking), alcohol, marijuana, and prescription pills. All of these substances are fairly accessible to the general public, which is why they may serve as an individual’s first encounter with a drug or substance.
Is marijuana a gateway drug?
For a few individuals, marijuana may serve as a gateway drug. However, there are more factors besides the drug of choice that affect whether or not an individual will develop a severe dependency or graduate to harder drugs.
Do gateway drugs lead to addiction?
Gateway drugs themselves do not necessarily lead to addiction in every case. The concept built up around the term gateway drug implies that by simply using a certain substance, you will automatically go down a path of severe addiction and eventually wind up using harder substances. Although certain substances may serve as entry points for a small portion of individuals, not every person who uses a so-called gateway drug will wind up using harder substances.
It’s also important to remember that gateway drugs alone are not the cause of a severe addiction or harder substance use for that small portion of individuals. Addiction is a result of many factors including access, availability, social acceptance, and environment, to name a few.