Facts & Myths About Gateway Drugs

Elena Hill, MD, MPH profile image
Medically Reviewed By Elena Hill, MD, MPH • Updated Feb 21, 2023 • 6 cited sources

The concept of “gateway drugs” is somewhat controversial. Gateway drugs may exist, but the evidence isn’t nearly as strong as many assume. The idea of gateway drugs can also often override other important topics in the discussion around how to reduce drug misuse. 

What Is a Gateway Drug?

A gateway drug is a somewhat controversial idea that proposes that using certain comparatively “safe” drugs (marijuana or alcohol) can significantly increase the risk that a person will then use “harder,” more dangerous drugs later. It is usually discussed in the context of children or young adults using relatively common drugs, such as marijuana, alcohol, and nicotine products, and then taking up the use of more dangerous drugs, such as heroin. 

The evidence that gateway drugs truly exist is mixed and highly dependent on the substance being discussed.

Key Facts About Gateway Drugs

These are some facts to keep in mind about gateway drugs:

  • This concept is significantly under-researched compared to how prevalent the idea is in discussions around drug use and regulations.
  • The research that does exist suggests the gateway hypothesis is highly drug dependent and generally only one of many factors that can contribute to a person’s risk of long-term issues with drug use, including their risk of trying harder drugs and developing an addiction.[1]

Factors that increase a person’s risk of drug use can be present early in life, meaning at least some early drug use that might seem to lead to later drug use can instead be attributed to a person being in one or more risk groups for heavy drug use for an extended period of time.

Myths About Gateway Drugs

Myths & Misperceptions About Gateway Drugs

There are many myths about gateway drugs. It can have a real, harmful impact on the way drug use is perceived and regulated when these myths are believed by the public and lawmakers. For example, many people believe marijuana is a dangerous gateway drug that can lead to the use of hard drugs like heroin and cocaine. The evidence doesn’t seem to support this.[2]

There’s often a heavy emphasis on getting teens and young adults to avoid gateway drug use in various drug awareness campaigns, with many young people being told often very poorly cited facts about this kind of drug use. The reality is that the contributing factors that often lead to real issues with drugs are more complicated than these programs make them out to be. This focus on gateway drugs can cause other important information backed by greater levels of evidence to be minimized or not discussed at all.

Facts About Gateway Drugs

One of the most important facts when discussing gateway drugs is that correlation does not equal causation. 

For example, many people who struggle with drugs later in life also used drugs earlier in life. That correlation is logical. Individuals who have a genetic predisposition to addiction are also likely to struggle with their mental health, have easy access to drugs, and are more likely dealt with some or all of those issues throughout their life. Factors that can contribute to problems with drug use don’t just begin in adulthood.

This doesn’t mean early drug use can’t contribute to later drug use, including the use of harder drugs. But it means researchers must be careful to rule out other possibilities, and data that is gathered must be taken in context. 

It’s also important to note that whether a drug is truly a gateway drug isn’t the sole factor in whether it is problematic for people, especially young people, to use. A drug can still have misuse potential, negative health impact, and potentially cause addiction without being a gateway drug. 

Teens and young adults especially have developing bodies that can be more vulnerable to drug use. They should generally avoid using recreational drugs of any kind regardless of whether they increase their risk of future use of stronger drugs.

Is Cannabis a Gateway Drug?

Evidence that cannabis could be called a “gateway drug” is fairly mixed, with the majority of people who use marijuana-related products not going on to use harder drugs.[3] However, people who started using marijuana at an early age and use it frequently do have a notably higher risk of developing dependence or addiction later in life. The evidence here is not clear. 

Is Nicotine a Gateway Drug?

There is some evidence that nicotine may contribute to a person’s risk of cocaine addiction. A national survey has shown that 90% of adult cocaine users smoked cigarettes before beginning their cocaine use.[4]  Once again, this shows a correlation between nicotine and cocaine use, but not necessarily a causation.

Is Alcohol a Gateway Drug?

One study of 12th graders in the U.S. linked alcohol use to later use of tobacco, marijuana, and other illicit substances.[5] However, other studies contradict the point made in that study, not finding increased rates of later drug use with early alcohol use.[1]

Is the Gateway Drug Hypothesis Valid?

It depends. It does seem that at least some drugs may contribute to the use of stronger drugs later in life, but the evidence is also often mixed, and is highly dependant on the individual and their personal risk factors for progressing to more serious drug use. Early drug use is rarely the only or necessarily the most important contributing factor to a person’s drug use later in life.

Factors Contributing to Substance Use Disorder Risk

Some notable factors known to contribute to a person’s risk of developing a substance use disorder (SUD) include the following:

  • Family history of drug use
  • A contributing mental health disorder, such as anxiety or depression
  • Peer pressure to engage in drug use
  • Loneliness or social isolation
  • Lack of family involvement
  • Drug availability
  • Low socioeconomic status

Any efforts to combat drug addiction should focus on mitigating these contributing factors moreso than simply focusing on preventing “gateway” drug use. These factors often have significantly more evidence linking them to issues with long-term drug use.

The Bottom Line

  • The idea of gateway drugs is under-researched.
  • Available evidence is mixed, with some evidence suggesting that early drug use can sometimes lead to harder drug use later in life. Occasionally, contradictory studies say the opposite.
  • The heavy emphasis on avoiding gateway drugs when trying to combat drug misuse is often unhelpful, especially where it impacts legal policy.

It is important to look at the many factors that can contribute to a person’s risk of misusing drugs and developing an addiction, most of which are more complicated than simply which “gateway drugs” they may have used at a younger age. [6] Instead, risk is more likely to be dependent on other factors like adverse childhood events, parents demonstrating substance misuse, personal mental health comorbidities, etc.

Medically Reviewed By Elena Hill, MD, MPH

Elena Hill, MD; MPH received her MD and Masters of Public Health degrees at Tufts Medical School and completed her family medicine residency at Boston Medical Center. She is currently an attending physician at Bronxcare Health Systems in the Bronx, NY where ... Read More

  1. “Gateway Hypothesis” and Early Drug Use: Additional Findings From Tracking a Population-Based Sample of Adolescents to Adulthood. Preventative Medicine Reports. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4929049/. December 2016. Accessed November 2022.
  2. Debunking the “Gateway” Myth. Drug Policy Alliance. https://drugpolicy.org/sites/default/files/DebunkingGatewayMyth_NY_0.pdf. February 2017. Accessed November 2022.
  3. Risk of Using Other Drugs. Centers for Disease Control and Prevention. https://www.cdc.gov/marijuana/health-effects/risk-of-other-drugs.html. October 2020. Accessed November 2022.
  4. Why Nicotine Is a Gateway Drug. National Institutes of Health. https://www.nih.gov/news-events/nih-research-matters/why-nicotine-gateway-drug. November 2011. Accessed November 2022.
  5. Alcohol as a Gateway Drug: A Study of US 12th Graders. Journal of School Health. https://pubmed.ncbi.nlm.nih.gov/22712674/. August 2012. Accessed November 2022.
  6. Risk and Protective Factors of Drug Abuse Among Adolescents: A Systematic Review. BMC Public Health. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8590764/. November 2021. Accessed November 2022.

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