Friday, July 13, 2012

Is Alcohol Really a Gateway Drug?

While the "gateway drug" theory has historically been associated more with cannabis than any other substance, many of the theory's proponents have also fingered alcohol and tobacco as possible culprits in somehow inducing hapless youth to "graduate" to harder drugs and eventually become hopeless junkies, tweakers, and/or crackheads.  In this post we revisit the decades-old theory with a fairly new twist.

A new study of high school student survey data claims to find that alcohol, as opposed to cannabis or tobacco, is the real "gateway" drug.  The study found that of all of the numerous psychoactive substances asked about in the Monitoring the Future (MTF) survey, alcohol was the one that was the single most likely to predict (statistically) the use of the others with the greatest accuracy.  Ergo, if there is such a thing as a gateway drug, alcohol would most likely be it.

If there is such a thing, that is.  And that's a pretty big "if" if you ask us.  For starters, the historical background of the gateway theory has a rather tainted pedigree.  The gateway theory as applied to cannabis turns out to be a virtually whole-cloth fabrication in the early 1950s by Harry Anslinger (the man responsible for cannabis being federally banned in 1937) who needed a justification for its continued ban and even harsher laws against it after the original Reefer Madness claims (murder, rape, insanity, and death) had been debunked by the La Guardia Committee Report in 1944.  So he flip-flopped and claimed that cannabis led its users to heroin addiction, which even he himself actually said was not the case in the 1930s.  But it turns out that a more general version of the theory is even older than that.  It can be traced back to at least 1910, when it was believed that indulging in smaller pleasures (such as eating spicy food) would lead one to crave larger pleasures (such as opium).  And that in turn would eventually lead one to the drunkard's grave.   Thus, the latest manifestation of the gateway theory, besides being recycled garbage, has actually come full circle (with alcohol at the start of the sequence rather than the end).  And nearly every major study of drugs and drug policy for the past century has been far more likely to refute the theory than to support it.

If not a causal relationship between alcohol (or cannabis) and later use of harder drugs, what explains the apparently strong association between the two?  One study by RAND in 2002 found that there was a more parsimonious explanation based on a mathematical model of:  1) the age at which each substance was typically first available to an individual, 2) individuals' propensity to use substances, which varies and is assumed to be normally distributed among the population, and 3) chance or random factors.  This explanation was equally accurate at predicting drug use progression compared with a model that assumed a causal relationship.  In the case of cannabis, another likely alternative explanation of the supposed gateway effect is the black market itself, as users are exposed to harder drugs through many of the same dealers who sell them their weed.  This was one of the reasons why the Netherlands adopted their policy of tolerance for cannabis (which can be purchased in "coffeshops" in many towns), and to this day the Dutch have significantly less of a problem with hard drugs than the USA and many other Western nations. 

Additionally, when young people are lied to about the dangers of alcohol and cannabis, they may eventually assume that all anti-drug messages are bunk and experiment accordingly.  Unfortunately, honest alcohol and drug education is not nearly as commonplace as it should be in this country.

So where does the issue of the 21 drinking age figure into all of this?  For starters, the authors of the study that links alcohol with subsequent use of other substances predictably claim that the longer alcohol use is delayed, the fewer problems there will be with not just alcohol abuse but the abuse of other substances as well, and they recommend zero tolerance for teen drinking.  This study would thus most likely be seen as vindication for the pro-21 crowd.  However, one can also look at the study's results a bit differently and see that the supposed gateway effect occurs despite (or perhaps even because of) the 21 drinking age.  For example, forcing alcohol underground makes it more likely to be used in the same environment as other substances, thus increasing young drinkers' exposure to the other substances.  The fact that "underage" drinkers are already breaking the law may encourage them to break other laws as well.   Also, at least some 18-20 year olds may find other substances easier to get than beer, and will thus be more likely to use them as substitutes.  In fact, a recent study found that when alcohol retreats, cannabis advances (and vice versa), and that is discussed in a previous post on this blog.  Therefore, one could say that the 21 drinking age acts as a "social gateway" to other drugs in a somewhat similar manner as cannabis prohibition, albeit much more modestly since there is not much of a real black market in alcohol (save for the modern-day speakeasies known as frat houses).  Indeed, it may not be a coincidence that American teens are more likely to use illicit drugs than their European counterparts despite being less likely to drink or smoke cigarettes.

In other words, we ought not to put too much stock in the rather dubious gateway theory, except to note how it could be one more way that the 21 drinking age yet again does more harm than good.

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