Sequence of drug use among serious drug users: typical vs atypical progression

Mackesy‐Amiti, Mary Ellen; Fendrich, Michael; Goldstein, Paul J.

doi:10.1016/s0376-8716(97)00032-x

Cited by 88 publications

(82 citation statements)

References 27 publications

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“…Furthermore, individuals who smoke cigarettes before the age of 15 are estimated to be eighty times more likely to use illegal drugs than those who do not [11]. Such findings have led to the hypothesis that tobacco may serve as a 'gateway' to illegal drug use [29], although this concept has been disputed [35].…”

Section: Introductionmentioning

confidence: 96%

Low dose nicotine treatment during early adolescence increases subsequent cocaine reward

McQuown

Belluzzi

Leslie

2007

Neurotoxicology and Teratology

100

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Adolescence is a critical period for the initiation of drug use, starting with tobacco and alcohol and progressing to marijuana and other illicit drugs. These findings have led to the suggestion that tobacco and alcohol are 'gateway' drugs that sensitize maturing reward pathways to the effects of illicit substances such as cocaine. To test this hypothesis, we have examined whether low-dose nicotine pretreatment alters acquisition of cocaine self-administration in adolescents more than in adults. Male and female Sprague-Dawley rats, aged postnatal day (P) 28 or P86, were given two daily intravenous injections of nicotine (0.03 mg/kg/0.1 ml) or saline for four days. At P32 and P90, rats were placed in self-administration chambers and tested for acquisition of cocaine (0.2 or 0.5 mg/kg/inj) for five days. Data were collapsed across cocaine dose and sex since there was no significant effect of these variables. Adolescent rats pretreated with nicotine exhibited significantly greater cocaine-reinforced responding as compared to saline controls or adults (p < 0.01). This drug pretreatment effect did not generalize to all rewards, since nicotine did not increase responding for sucrose pellets in adolescents. These findings provide evidence that the adolescent brain is uniquely vulnerable to the effects of nicotine on subsequent drug reward.

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Section: Introductionmentioning

confidence: 96%

Low dose nicotine treatment during early adolescence increases subsequent cocaine reward

McQuown

Belluzzi

Leslie

2007

Neurotoxicology and Teratology

100

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“…Further, since all of our respondents use ecstasy, we cannot establish causality as we may have been able to had our sample included non-users. However, this sample is important in its own right, despite these weaknesses, because drug use trajectories of active ecstasy users may differ from those of experimental or non-users (12).…”

Section: Study Proceduresmentioning

confidence: 99%

“…Kandel's seminal research identified marijuana as the key gateway substance between adolescent cigarette smoking and alcohol consumption and the subsequent use of hard drugs (1,(3)(4)(5)(6). Other scholars have provided further support for the gateway theory as it pertains to other drug pathways (7)(8)(9)(10)(11)(12)(13)(14)(15).…”

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confidence: 99%

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Ecstasy and Gateway Drugs: Initiating the Use of Ecstasy and Other Drugs

Reid

Elifson

Sterk

2007

Annals of Epidemiology

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Purpose-The main purposes of this study are to examine if, and to what extent, ecstasy use serves as a gateway to the use of hard drugs such as cocaine, heroin, and methamphetamine and to compare the age of onset of alcohol and marijuana use and subsequent use of cocaine, heroin, and methamphetamine among young adult ecstasy users.Methods-Face-to-face surveys were conducted with 268 young adult ecstasy users in Atlanta, Georgia. Subjects were solicited using the community identification process, including targeted sampling and guided recruitment. Data analysis involved discrete-time, event history analysis.Results-Results suggest that the age of onset of ecstasy use influences the initiation of cocaine and methamphetamine for our sample of active ecstasy users. In addition, alcohol and marijuana use precedes the initiation of cocaine and methamphetamine, but only marijuana influences the initiation of heroin. Conclusions-The sequential progression of drug use proposed in the gateway literature is not immutable. Researchers must take into account the changing popularity of drugs over time, such as the emergence of ecstasy use, when identifying patterns of drug use onset. KeywordsMDMA; Ecstasy (Drug); 3,4-Methylenedioxymethamphetamine; street drugsThe nature of the developmental progression of drug use trajectories remains a hotly debated topic, often focusing on the validity of the gateway theory (1). This theory assumes that the use of specific drugs is related to a sequential pattern of initiation, although the causal mechanisms that drive this sequential trajectory are often unclear (2). Kandel's seminal research identified marijuana as the key gateway substance between adolescent cigarette smoking and alcohol consumption and the subsequent use of hard drugs (1,(3)(4)(5)(6). Other scholars have provided further support for the gateway theory as it pertains to other drug pathways (7-15).Studies guided by the gateway theory are not without critics. One critique is that such studies are often derived from population-based samples, which are known to exhibit low prevalence of hard drug use (12,(16)(17). When examining findings from targeted samples of drug users, results show that hard drug users often do not initiate their trajectory with alcohol use, but with marijuana (18-21). A second critique of studies based on the gateway theory is that most are limited to adolescents. There is little evidence that adolescents who initiate the use of hard drugs necessarily become regular users (16,21). A final critique of the theory is that there is Publisher's Disclaimer: This is a PDF file of an unedited manuscript that has been accepted for publication. As a service to our customers we are providing this early version of the manuscript. The manuscript will undergo copyediting, typesetting, and review of the resulting proof before it is published in its final citable form. Please note that during the production process errors may be discovered which could affect the content, and all legal disclaimers that apply to...

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“…[3][4][5][6][7][8][9][10][11][12][13] Only a few published studies have documented populations in which a substantial percentage of youths followed a different sequence; these studies examined high-risk populations within inner-city New York. [14][15][16] Consequently, many consider alcohol, tobacco, and marijuana to be gateway drugs, and 2 ideas have obtained political currency [17][18][19] : (1) reducing or postponing youthful initiation of alcohol, tobacco, and marijuana use can reduce subsequent hard drug abuse; and (2) recent increases in youthful tobacco and marijuana use may foreshadow an impending epidemic of hard drug use.…”

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confidence: 99%

Variation in youthful risks of progression from alcohol and tobacco to marijuana and to hard drugs across generations

Golub

Johnson²

2001

Am J Public Health

124

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OBJECTIVES: Much research has documented that youthful substance use typically follows a sequence starting with use of alcohol or tobacco or both and potentially proceeding to marijuana and then hard drug use. This study explicitly examined the probabilities of progression through each stage and their covariates. METHODS: A secondary analysis of data from the National Household Survey on Drug Abuse (1979-1997) was conducted with particular sensitivity to the nature of substance use progression, sampling procedures, and reliability of self-report data. RESULTS: Progression to marijuana and hard drug use was uncommon among persons born before World War II. The stages phenomenon essentially emerged with the baby boom and rose to a peak among persons born around 1960. Subsequently, progression risks at each stage declined. Progression risks were also higher among younger initiators of alcohol, tobacco, or marijuana use. CONCLUSIONS: The recent increase in youthful marijuana use has been offset by lower rates of progression to hard drug use among youths born in the 1970s. Dire predictions of future hard drug abuse by youths who came of age in the 1990s may be greatly overstated.

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Sequence of drug use among serious drug users: typical vs atypical progression

Cited by 88 publications

References 27 publications

Low dose nicotine treatment during early adolescence increases subsequent cocaine reward

Low dose nicotine treatment during early adolescence increases subsequent cocaine reward

Ecstasy and Gateway Drugs: Initiating the Use of Ecstasy and Other Drugs

Variation in youthful risks of progression from alcohol and tobacco to marijuana and to hard drugs across generations

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