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Is Pot a Gateway Drug?

There was a scathing letter to the editor in the Honolulu Star-Advertiser published last week. The writer said they were an addiction specialist and claimed that marijuana was a gateway drug. “94 percent of patients I worked with started their chemical use with marijuana,” wrote Jo Breeden.

Jo continues by linking the legalization of marijuana to a probable increase in addiction to more serious substances as the initial highs from marijuana are no longer enough for the addict. This is the classic idea behind a gateway drug. It’s also disputed.

Why might the idea not hold up? In the first place, Jo would necessarily only see those who went on from marijuana to become full blown addicts. Those that aren’t having a problem with drugs wouldn’t be in a treatment program. Anyone who smoked marijuana and either stopped using it or didn’t go on to anything stronger would be invisible to Jo.

But what about the 94 percent who started with marijuana? It’s hard to say without more data, but does it sound reasonable that the first drug they tried was weed? What about alcohol or tobacco? Or caffeine?

And there’s the rub. Since alcohol and caffeine aren’t illegal, they aren’t counted. But these substances don’t know they are illegal, it’s only a preference on our part that classes marijuana as a gateway and cigarettes as not. Addiction is too complex a disease to explain it with a such a simple idea.

Are there gateway drugs? In a sense, there are. A recent phenomenon is people who become addicted to prescription narcotics who move to heroin as a replacement when they can’t get their pills. But here, we have one opioid replacing another, not a switch from one type of drug to another. In practice, addicts try many different substances until they settle on a favorite. Once they find their “drug of choice,” that’s where they tend to stay. It doesn’t matter in what order they go drug shopping and it’s obvious they’d try the most readily available drug first and then harder to get drugs later on.

If marijuana is a gateway, it may be a gateway into the illegal drug culture and the contacts that can supply other drugs – something legal drugs do not do. But making marijuana legal would cut off this mechanism. In a way, saying marijuana is a gateway drug then becomes an argument for legalization, not against it.

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