Global: Gateway Theory Flipped? Maybe not?

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Sure, Cannabis Is a “Gateway Drug”–Leading Toward Less Use of Other Drugs SESSI KUWABARA BLANCHARD FEBRUARY 7, 2019

As more and more prohibitionist cannabis policies are reversed in North America, a long-peddled, if long-debunked, perception that weed is a “gateway drug” to other substances is increasingly being challenged. More than that, a growing body of evidence indicates that it can be an “exit drug.”

Research suggests that cannabis can serve as an “exit drug” for substances ranging from opioids to benzodiazopines, tobacco and alcohol. A recent study in Harm Reduction Journal surveyed 2,000 respondents on the impact of their cannabis use on their use of other substances. The respondents were all registered with a federally licensed medical cannabis provider in Canada, which recently legalized recreational use and has offered medical cannabis for two decades.

Additionally, some participants reported “exiting” alcohol (45 percent) and tobacco use (30 percent).

Hmmm???  Opiods & Cannabis – Fast Facts

“The opioid crisis appears to be worsening where marijuana has been legalized.” – JAMA INTERNATIONAL MEDICINE JOURNAL, 2018

“There is moderate evidence of a statistical association between Cannabis use and the development of substance dependence and/or a substance abuse disorder for substances including alcohol, tobacco and other illicit drugs!”
National  Academies of Sciene (2017)

Associations between cigarette smoking and cannabis dependence: Aims

Conclusions: Cigarette smoking is related to concurrent cannabis dependence independently of cannabis use frequency. Cigarette smoking also mediates the relationship between cannabis use and cannabis dependence suggesting tobacco is a partial driver of cannabis dependence in young people who use cannabis and tobacco.

A number of studies, including two published just last month, have also found that cannabis can impact a person’s use of benzodiazepines. One found that 45 percent of participants ceased their benzo use by the end of the study period; the other saw 22 percent of participants substituting weed for benzos.

These findings challenge a longstanding misconception.

“[W]e recommend avoiding medical marijuana certification in a patient prescribed high-dose opioids. Given the dearth of evidence for long-term opioid therapy for chronic pain, adding more uncertainty with marijuana seems unwise.” (Mayo Clinic 2016)

“Prescription opioids were seen as a wonder drug, especially for pain management.” We should not repeat history with yet another wonder drug installed before proper evidence.” (Addiction 2018)

“There is compelling and enduring evidence that marijuana is not a gateway drug,” write researchers at the Benjamin Center for Public Policy Initiatives at SUNY New Paltz. “Yet, non-evidence-based political factors on both the left and the right remain the reason for the persistence of the gateway myth.”

The Federal Bureau of Narcotics spawned the theory in the 1960s, and it was heavily utilzed to justify an escalating drug war in the decades that followed.

GATEWAY DRUG: The term “gateway drug” is used to illustrate the tendency of cannabis to introduce the user to other illicit drugs, and arguments for and against the hypothesis have a long history.

There are multiple studies that have reached a conclusion in support of the gateway hypothesis (see Kandel, 1992 and 1996; Clayton, 1992; Bailey, 1992; Poikolainen et al, 2001). Specifically, the Centre on Addiction and Substance Abuse (CASA) at Columbia University found that children who use drugs, including cannabis, are up to 266 times more likely to use cocaine than those who do not use any of the gateway drugs identified (cannabis, tobacco and alcohol). Further, a study on 311 sets of same-sex twins, in which only one twin smoked cannabis before age 17, found that early cannabis smokers were up to five times more likely than their twin to move on to harder drugs (Lynskey, 2003). Also, Hurd (2006) concluded that findings supported the gateway hypothesis when she conducted a study on rats. Hurd found that rats trained to self-administer heroin would administer greater doses if they had previously been exposed to THC. A further study of 75,000 adolescents and young adults found teenage cannabis smokers had a 50% higher risk of developing an alcohol-use disorder and specifically stated “Addictive drugs all act on a part of the brain that is described as the central reward circuitry. Once this system is exposed to one drug, the brain may become more sensitive to the effects of other drugs, as demonstrated by a number of rodent studies” (Gruzca, 2006).

In summary, as Kandel states (1992), very few try illicit drugs other than cannabis without prior use of cannabis.

(Cannabis — suicide, schizophrenia and other ill-effects – A research paper on the consequences of acute and chronic cannabis use – Drug Free Australia)

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