Wednesday, September 7, 2011

Has Medical Marijuana Been Proven to Be a Gateway Drug?

By Lawrence Greene, MD


There exists a gateway theory to marijuana which used to be called the stepping stone theory. The theory states that even if marijuana itself is not super dangerous, using it will lead to other drugs that are more dangerous. Over the years marijuana has been theorized as a gateway to LSD, Heroin, or Cocaine. Should medical marijuana be considered a gateway drug then?

In reality, the theory doesn't pass muster. People who use cocaine are in fact likely to have used marijuana, which is more popular by far than cocaine. Medical marijuana does not lead people to use LSD, cocaine, or heroin.

An excellent analogy is riding a motorcycle vs riding a bicycle. Comparing to riding motorcycles (in this example is cocaine use), a lot more people have ridden a bicycle (in this example is marijuana use). The amount of individuals who ride motorcycles (use cocaine) who have also ridden a bicycle in the past (smoked marijuana) is exceptionally high. However bicycle riding does not cause motorcycle riding, and if more people start riding bicycles in the US it will not lead to a then proportionately higher incidence of motorcycle riders. This analogy spreads to the fact that an increase in marijuana smoking will not result in more usage of hard drugs like cocaine.

All the analogy describes is a typical sequence in which events occur, not a causation. Just as riding a bicycle does not lead to motorcycle usage, medical marijuana usage does not lead to cocaine - it's simply a typical sequence based on a high prevalence activity (smoking marijuana) versus a low prevalence activity (heroin, cocaine, or lsd use).

Some animal studies have also looked at a theorized association between THC and an increase in the brain's dopamine. Researchers thought that maybe marijuana "primes" the brain for eventual cocaine and/or heroin use. However, research has never actually shown any "priming" of this nature and animals with THC injections do not have an increased desire to self-administer heroin or cocaine.

Studies from the National Institute on Drug Abuse have shown that of the 72 million Americans who have used marijuana (probably more like 100 million since the studies were done), only 17% used cocaine more than one hundred times. This means that for every 100 marijuana users, only one currently uses cocaine.

Marijuana is by far the most commonly used illegal drug in the US today. People who have used less popular illicit drugs, like heroin, cocaine, or LSD, are likely to have also utilized marijuana. The vast majority of marijuana users never use any other illegal drug and marijuana is typically an end drug, not a gateway drug.




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