cigarettes or alcohol are more likely to use other drugs, including cannabis, than people who never use a..." /> cigarettes or alcohol are more likely to use other drugs, including cannabis, than people who never use a..." />

Alcohol May Not Be the Gateway to Further Drug Use

Alcohol is often regarded as a gateway drug. Individuals who initiate substance use with cigarettes or alcohol are more likely to use other drugs, including cannabis, than people who never use alcohol or tobacco at all. But the research in this area has neglected to thoroughly examine the trends of various ethnic groups. Although this theory may hold true for European Americans (EA), it may not be true for African-Americans (AA), and women in particular. Therefore, Carolyn E. Sartor of the Department of Psychiatry at the Yale School of Medicine recently conducted a study comparing cannabis use and problems to alcohol use and problems in a sample of AA and EA women.

Sartor analyzed over 4,000 clinical interviews of women who were part of either a larger twin study or a family study aimed at high risk families. She assessed their level of use for cannabis and alcohol, any cannabis- or alcohol-related problems, and development of cannabis use disorder (CUD). She looked at childhood sexual abuse (CSA) as a risk factor, as well as psychiatric issues. She found that even after she controlled for ethnicity and psychiatric issues, the AA women were more likely to use cannabis before or instead of alcohol, while the EA women usually first tried alcohol. When she looked at the trajectory of use in both groups, Sartor found that women who used cannabis progressed at the same rate to problem use as the women who used alcohol. This finding suggests that the progression of use is not unique to alcohol use or cannabis use.

The study also revealed that the first substance used, cannabis for AAs and alcohol for EAs, was the substance that produced the most negative symptoms over time. Also, individuals who reported using only one substance had the fewest symptoms. This indicates that women who use more than one substance are at increased risk for negative outcomes. Finally, CSA was linked to cannabis use but not alcohol use as it related to eventual misuse. In conclusion, Sartor believes that the gateway theory may not be universal, and should be viewed in light of ethnic and cultural differences. She added, “Prevention programs should be tailored to the various patterns of cannabis use and relative contributions of risk factors to the development of cannabis-related problems in different ethnic groups.”

Sartor, C. E., et al. (2013). Cannabis or alcohol first? Differences by ethnicity and in risk for rapid progression to cannabis-related problems in women. Psychological Medicine 43.4 (2013): 813-23. ProQuest. Web.

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  • Nik l

    March 29th, 2013 at 3:56 AM

    There are certain activities that will naturally feed into one another. I think that historically it has been assumed that drinking alcohol would be one of those. But I think that there are some people who don’t always need to try something new and different to get a better high, that the one thing that they begin with continues to be enough for them to maintain that feeling that they are looking for. And I think that the thing about alcohol is that eventually if you drink enough, it is a great number that allows you to feel no pain anymore. I am not condoning that or saying that this is a good thing, it’s simply that for many this is what they are searching for so there is never really any need to go searching for something else.

  • ShanE

    March 29th, 2013 at 11:30 PM

    The gateway theory – its like saying drinking milk in childhood leads to drug usage later in life. All drug users must have been milk users in the past. So milk is one the most widely used gateway substance, no?!

  • jade

    March 30th, 2013 at 5:57 AM

    Very interesting that different genders or even ethnicities could have a different way of dealing with the same problem. I, before reading this, just thought that sure, starting off with alcohol and cigarettes would just lead to then trying something else heavier when the newness of the one drug wore off.
    But now I see this in a totally different light. That this could be the case with some people but then not with others. The problem that you then run into is then knowing who is going to progress beyond these substances and who is going to forever be content with stopping right there. And then you get in even further and realize that it is hard to pinpoint, you really do have to continue to take each case in a one on one unique kind of basis.

  • larry.k

    March 30th, 2013 at 11:59 PM

    Alcohol does not push you into drug use. Alcohol only makes you act stupid and if in that elongated stupidity you do decide to try drugs it is totally your fault.


  • Diane E

    March 31st, 2013 at 7:45 AM

    So what if it is not the gateway drug that it was once considered or thought to be. That does not make the abuse and irresponsible use of it any less dangerous. I think that by stating that it does not necessarily lead to other drug usage then some would take that to mean that it is okay for them to use it when we know that there are just some people who should not ever start drinking, period. I am happy that there continues to be study about this, but I would never wish for that to imply that we can all drop our defenses and just assume that it is alright. Because I think that we all know that there are always going to be some people who cannot handle drinking and should not ever even start.

  • ellis

    April 1st, 2013 at 5:10 AM

    So it may not be the gateway to other drug abuse that we once thought. . .
    but it could be. . .
    so why take that chance?

  • Jackie

    April 4th, 2013 at 7:44 AM

    The headline is very misleading. ALL mind altering substances have a high potential for being a “gateway” for vulnerable populations. The headline implies that alcohol is “okay”. Since many people only read the headlines, this is bad journalism.

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