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What is GATEWAY DRUG THEORY? What does GATEWAY DRUG THEORY mean? GATEWAY DRUG THEORY meaning



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What is GATEWAY DRUG THEORY? What does GATEWAY DRUG THEORY mean? GATEWAY DRUG THEORY meaning – GATEWAY DRUG THEORY definition – GATEWAY DRUG THEORY explanation.

Source: Wikipedia.org article, adapted under https://creativecommons.org/licenses/by-sa/3.0/ license.

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Gateway drug theory (alternatively, stepping-stone theory, escalation hypothesis, or progression hypothesis) is a comprehensive catchphrase for the medical theory that the use of a psychoactive drug can be coupled to an increased probability of the use of further drugs. Possible causes are biological alterations in the brain due to the earlier drug and similar attitudes of users across different drugs (common liability to addiction). Scientific investigation of the possible causes is considered important for health policy concerning education and law making.

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.

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, marital status, mental disorders, family history of substance abuse, Ethnicity, Urbanicity, and educational attainment influenced the height of probability.

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.

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.

Because a sequence of first-time use can only indicate the possibility – but not the fact – of an underlying causal relation, different theories concerning the observed trends were developed. The scientific discussion (state of 2016) is dominated by two concepts, which appear to cover almost all possible causal connections if appropriately combined. These are the theories of biological alterations in the brain due to an earlier drug use and the theory of similar attitudes across different drugs.

In animals it is relatively simple – compared to humans in clinical studies – to determine if the consumption of a certain drug increases the later attraction of another drug. In rats, cannabis consumption – earlier in life – increased the self-administration of heroin (results based on 11 male rats), morphine (study based on 12 male rats) and also nicotine (34 rats). There were direct indications that the alteration consisted of lasting anatomical changes in the reward system of the brain. The importance of these findings for the reward system in the human brain in relation to the liability to the use of further drugs has been pointed out in several reviews.

In mice nicotine increased the probability of later consumption of cocaine and the experiments permitted concrete conclusions on the underlying molecular biological alteration in the brain. The biological changes in mice correspond to the epidemiological observations in humans that nicotine consumption is coupled to an increased probability of later use of cannabis and cocaine.

According to the concept of similar attitudes across different drugs (common liability to addiction) several personal and environmental factors can lead to a generally increased interest in various drugs. The sequence of first-time use would then depend on the given social and economic conditions. The concept received support from a large-scale genetic analysis that showed a genetic basis for the connection of the prevalence of cigarette smoking and cannabis use during the life of a person….

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