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The Gateway Drug Theory of Substance Abuse

Stop me if you’ve heard this one before: Marijuana is a gateway drug, that is, if you use it, you will go on to use other drugs. I first remember hearing that theory on an episode of Dragnet in the 1960s, where Joe Friday claimed that whenever they arrested a young person for heroin or LSD, they also found marijuana. (Distrust information you learn from a preachy 1960s TV program.)

The theory doesn’t only apply to marijuana. Nicotine and alcohol also are (sometimes) considered gateway drugs, but because they are legal, taxed and have an army of lobbyists on their side, they don’t get as much attention. So for all practical purposes, it was considered a marijuana issue.

The theory had actually fallen out of favor as marijuana use became more accepted for medical uses and more former users grew up without becoming heroin addicts themselves. Even the National Institute on Drug Abuse says “Further research is needed to explore this question.” The evidence is scarce because research involving marijuana is hard to conduct, given its illegal status, but the gateway drug theory has been contradicted by many studies. It even seems to have a reverse effect, with some opioid addicts reporting less or no opioid abuse after beginning to take marijuana.

But Attorney General Jeff Sessions, White House Chief of Staff John Kelly and Opioid Commission Chair Chris Christie have all said they believe in the gateway drug theory, and would like to enforce federal laws against marijuana, maybe even for medical uses.

There are real concerns about marijuana use, especially among the young. Some evidence suggests that before the age of 25 or so, marijuana can harm the adolescent brain, lowering IQ, social skills, learning and memory. The young brain may also be prone to addiction in general. Other research finds no such harm, or that it is temporary harm. Opponents to legalization argue that we should find out what harm, if any, before legalization.

A more nuanced approach is needed. Change marijuana’s federal status so that it may be researched more easily and used for legitimate medical purposes. Increase access to and research into cannabidiol, also known as CBD oil, a component of marijuana that has no euphoric effects and few (if any) of the harms associated with marijuana. Maybe restrict legal marijuana use to those 25 and older.

It looks like opponents are facing a losing battle. The legalization floodgates are open. Prohibition isn’t working. Let’s try a scientific, evidence-based, harm reduction approach.