“If you use marijuana, you will end up using more dangerous drugs” is a phrase commonly heard when people talk about substance use problems and how they develop. The notion that the use of a substance viewed as less harmful will lead to the use of harder, more addictive substances is known as Gateway Theory or the Gateway Effect. Caffeine, nicotine, marijuana, and alcohol are among those most commonly labeled as gateway drugs.

Gateway Theory does have merit overall, but substance use issues are complicated and vary with each individual. There are contradictions to the theory, such as persons who have difficulty with prescription opiates, but who have never had smoking or drinking problems. Also, many people use caffeine, nicotine, alcohol, THC, and prescription medications who never develop problems or progress to more potent substances.

Is it possible to avoid substance use problems by avoiding gateway drugs? Unfortunately, itʼs not that simple. Itʼs not the drug that matters so much as the effect that drug has on a person, what the person believes about that effect, and how their decision-making is influenced by their beliefs. People are also influenced by social and cultural beliefs instilled through families, friends, and schools, etc., that tell them how to behave in order to be accepted.

Decision-making plays an important role. One approach proposes decision- making is an “inside job” influenced by our beliefs and that we constantly revise our beliefs to fit with what our experiences telling us. For example, humans have an inherent need to be “part of” something…to share experiences. Itʼs the basic herding instinct we possess that motivates us to seek interactions and relationships with other humans. So, if someone believes that using alcohol will help them fit in with a particular group of people, then that belief influences that personʼs decision-making when they are with that group of people. It doesnʼt matter the belief is accurate. It will be acted upon until sufficiently proven wrong. Furthermore, if that person feels accepted into the group, whether it had to do with drinking or not, the idea that they were accepted because of drinking may become solidified and have an even more pronounced effect on future decision-making.

Itʼs about brain chemistry, too. Nicotine, for instance, promotes the release of dopamine, a neurotransmitter released with activities related to survival (e.g., eating and sex). Dopamine is powerful motivation for the continuation of nicotine use because it calms and stimulates simultaneously. Through this experience, one might say, “When I smoke, I am calm, focused, and alert and I get a lot done.” The person might combine this belief with a common social belief that success is measured through accomplishment. This pairing creates a strong influence on whether that person makes the decision to continue using nicotine or not. Also, when nicotine is processed through the body, the result is a feeling of lethargy combined with restlessness, a not so desirable outcome. Sort of a triple threat. Eventually, the person may start to believe they cannot function properly without nicotine because it continually takes higher doses of nicotine to induce the desired effect. The person might say to themselves, “Nicotine isnʼt working like it used to any longer, I need something stronger.” The personʼs decision-making is different than it was before because it is skewed by the new beliefs that nicotine has saddled them with, not to mention the physical need felt through the withdrawal from it. That person might make the decision to seek out a more powerful substance.

The assumption is that this process could lead to experimentation with cannabis as a replacement, for example. Cannabis contains THC which releases a higher amount of dopamine in the brain creating euphoria in the user. The person again revises their beliefs followed by new decision-making patterns that could lead to trying even more powerful substances. Any abusable substance or behavior could be plugged into this process such as exercise, food, sex, thrill-seeking, gaming, or work because everything we do elicits a chemical response in our brains.

Avoiding “gateway drugs” is not a bad idea, but maybe, itʼs also important to avoid “gateway beliefs.” One needs to pay attention to the underlying motivations that influence the decision to use substances from many perspectives.

Submitted by Marty J. Rein, Ph.D., LPC, CAC III