Drug and Alcohol Dependence
Volume 108, Issue 1 , Pages 84-97 , 1 April 2010

Evaluating the drug use “gateway” theory using cross-national data: Consistency and associations of the order of initiation of drug use among participants in the WHO World Mental Health Surveys

  • Louisa Degenhardt

      Affiliations

    • National Drug and Alcohol Research Centre, University of New South Wales, Sydney, NSW 2052, Australia
    • Corresponding Author InformationCorresponding author. Tel.: +61 2 9385 0230; fax: +61 2 9385 0222.
    • ,
  • Lisa Dierker

      Affiliations

    • The Methodology Center, Penn State University, PA, United States
    • Psychology Department, Wesleyan University, 207 High Street, Middletown, CT, United States
    • ,
  • Wai Tat Chiu

      Affiliations

    • Department of Health Care Policy, Harvard Medical School, 180 Longwood Ave, Boston, MA 02115, United States
    • ,
  • Maria Elena Medina-Mora

      Affiliations

    • Department of Epidemiology, National Institute of Psychiatry, Calzada Mexico Xochimilco, No. 101, Col. San Lorenzo Huipulco, Tlalpan, Mexico City, DF 14370, Mexico
    • ,
  • Yehuda Neumark

      Affiliations

    • Braun School of Public Health and Community Medicine, Hebrew University-Hadassah, PO Box 12272, Jerusalem, Israel
    • ,
  • Nancy Sampson

      Affiliations

    • Department of Health Care Policy, Harvard Medical School, 180 Longwood Ave, Boston, MA 02115, United States
    • ,
  • Jordi Alonso

      Affiliations

    • Health Services Research Unit, Institut Municipal d’Investigacio Medica (IMIM), CIBER en Epidemiología y Salud Pública (CIBERESP), Dr. Aiguader, 88, Barcelona 08003, Spain
    • ,
  • Matthias Angermeyer

      Affiliations

    • Center for Public Health, Untere Zeile 13, A-3482, Gösing am Wagram, Austria
    • ,
  • James C. Anthony

      Affiliations

    • Department of Epidemiology, Michigan State University, B601 West Fee Hall, East Lansing, MI 48823, United States
    • ,
  • Ronny Bruffaerts

      Affiliations

    • Department of Neurosciences and Psychiatry, University Hospital Gasthuisberg, Herestraat 49, Leuven B-3000, Belgium
    • ,
  • Giovanni de Girolamo

      Affiliations

    • Regional Health Care Agency, Emilia-Romanga Region, Via Aldo Moro 21, Bologna 40127, Italy
    • ,
  • Ron de Graaf

      Affiliations

    • Netherlands Institute of Mental Health and Addiction, Da Costakade 45, Utrecht 3521 VS, The Netherlands
    • ,
  • Oye Gureje

      Affiliations

    • Department of Psychiatry, University College Hospital, Ibadan PMB 5116, Nigeria
    • ,
  • Aimee N. Karam

      Affiliations

    • St. George Hospital University Medical Center, Balamand University, Faculty of Medicine, Institute for Development, Research, Advocacy & Applied Care (IDRAAC), 166227 Achrafieh, Beirut 1100 2110, Lebanon
    • ,
  • Stanislav Kostyuchenko

      Affiliations

    • Ukrainian Psychiatric Association, 103a Frunze Street, Kiev 04080, Ukraine
    • ,
  • Sing Lee

      Affiliations

    • Department of Psychiatry, The Chinese University of Hong Kong, Flat 7A, Block E, Staff Quarters, Shatin, HKSAR, People's Republic of China
    • ,
  • Jean-Pierre Lépine

      Affiliations

    • Hospital Fernand Widal, 200 rue du Faubourg Saint Denis, Paris 75010, France
    • ,
  • Daphna Levinson

      Affiliations

    • Director Research & Planning, Ministry of Health, Mental Health Services, 2 Ben Tabal St., Jerusalem 91010, Israel
    • ,
  • Yosikazu Nakamura

      Affiliations

    • Department of Public Health, Jichi Medical School, 3311-1 Yakushiji, Shimotsuke-shi, Tochigi-ken 329-0498, Japan
    • ,
  • Jose Posada-Villa

      Affiliations

    • Colegio Mayor de Cundinamarca University, U. Javerina, Cra. 7 No. 119-14 Cons 511, Bogata, Colombia
    • ,
  • Dan Stein

      Affiliations

    • Department of Psychiatry and Mental Health, University of Cape Town, Cape Town 7505, South Africa
    • ,
  • J. Elisabeth Wells

      Affiliations

    • Department of Public Health and General Practice, University of Otago, Christchurch, PO Box 4345, Christchurch 8140, New Zealand
    • ,
  • Ronald C. Kessler

      Affiliations

    • Department of Health Care Policy, Harvard Medical School, 180 Longwood Ave, Boston, MA 02115, United States

Received 21 November 2008 ,Revised 1 December 2009 ,Accepted 2 December 2009.

References 

  1. Alonso J, Ferrer M, Romera B, Vilagut G, Angermeyer M, Bernert S, et al. The European Study of the Epidemiology of Mental Disorders (ESEMeD/MHEDEA 2000) project: rationale and methods. Int. J. Methods Psychiatr. Res. 2002;11:55–67
  2. American Psychiatric Association (APA) . Diagnostic and Statistical Manual of Mental Disorders. Washington, DC: American Psychiatric Association; 1994;
  3. Angrist J, Krueger A. Instrumental variables and the search for identification: from supply and demand to natural experiments. J. Econ. Perspect. 2001;15(4):69–85
  4. Breslau NN, Scott P, Kessler RC. Psychiatric disorders and stages of smoking. Biol. Psychiatry. 2004;55:69–76
  5. Degenhardt L, Chiu W-T, Sampson N, Kessler R, Anthony J, Angermeyer M, et al. Toward a global view of alcohol, tobacco, cannabis and cocaine use: findings from the WHO World Mental Health Surveys. PLoS Med. 2008;5:e141
  6. Degenhardt L, Chiu WT, Conway K, Dierker L, Glantz M, Kalaydjian A, et al. Does the “gateway” matter? Associations between the order of drug use initiation and the development of drug dependence in the National Comorbidity Study Replication. Psychol. Med. 2009;39:157–167
  7. Ellgren M, Spano SM, Hurd YL. Adolescent cannabis exposure alters opiate intake and opioid limbic neuronal populations in adult rats. Neuropsychopharmacology. 2007;32:607–615
  8. Engels R, Knibbe R, Drop M. Inconsistencies in adolescents’ self-reports of initiation of alcohol and tobacco use. Addict. Behav. 1997;22:613–623
  9. Fergusson D, Boden J, Horwood LJ. Cannabis use and other illicit drug use: testing the cannabis gateway hypothesis. Addiction. 2006;101:556–566
  10. Grau LE, Dasgupta N, Harvey AP, Irwin K, Givens A, Kinzly ML, et al. Illicit use of opioids: is OxyContin a “gateway drug”?. Am. J. Addict. 2007;16:166–173
  11. Hall W. Dissecting the causal anatomy of the link between cannabis and other illicit drugs. Addiction. 2006;101:472–473
  12. Henry B, Moffitt T, Caspi A, Langley J, Silva P. On the “remembrance of things past”: a longitudinal evaluation of the retrospective method. Psychol. Assess. 1994;6:92–101
  13. Iacono W, Malone S, McGue M. Behavioral disinhibition and the development of early-onset addiction: common and specific influences. Ann. Rev. Clin. Psychol. 2008;4:325–348
  14. Kandel D. Stages and Pathways of Drug Involvement: Examining the Gateway Hypothesis. New York, NY: Cambridge University Press; 2002;
  15. Kandel D, Faust R. Sequence and stages in patterns of adolescent drug use. Arch. Gen. Psychiatry. 1975;32:923–932
  16. Kandel DB. Marijuana users in young adulthood. Arch. Gen. Psychiatry. 1984;41:200–209
  17. Kandel DB, Davies M, Karus D, Yamaguchi K. The consequences in young adulthood of adolescent drug involvement. An overview. Arch. Gen. Psychiatry. 1986;43:746–754
  18. Kandel DB, Yamaguchi K, Chen K. Stages of progression in drug involvement from adolescence to adulthood: further evidence for the gateway theory. J. Stud. Alcohol. 1992;53:447–457
  19. Kandel DB, Yamaguchi K, Klein LC. Testing the gteway hpothesis. Addiction. 2006;101:470–472discussion 474–476
  20. Kessler RC, Abelson J, Demler O, Escobar JI, Gibbon M, Guyer ME, et al. Clinical calibration of DSM-IV diagnoses in the World Mental Health (WMH) version of the World Health Organization (WHO) Composite International Diagnostic Interview (WMH CIDI). Int. J. Methods Psychiatr. Res. 2004;13:122–139
  21. Kessler RC, Üstün TB. The World Mental Health (WMH) Survey Initiative Version of the World Health Organization (WHO) Composite International Diagnostic Interview (CIDI). Int. J. Methods Psychiatr. Res. 2004;13:93–121
  22. Labouvie E, Bates M, Pandina R. Age of first use: its reliability and predictive utility. J. Stud. Alcohol. 1997;58:638–643
  23. Morral A, McCaffrey D, Paddock S. Reassessing the marijuana gateway effect. Addiction. 2002;97:1493–1504
  24. Pearl J. Causality: Models, Reasoning, and Inference. New York: Cambridge University Press; 2000;
  25. Rebellon CJ, Van Gundy K. Can social psychological delinquency theory explain the link between marijuana and other illicit drug use? A longitudinal analysis of the gateway hypothesis. J. Drug Issues. 2006;36:515–540
  26. Schenk S. Sensitization as a process underlying the progression of drug use via gateway drugs. In:  Kandel D editors. Stages and Pathways of Drug Involvement: Examining the Gateway Hypothesis. New York: Cambridge University Press; 2002;p. 318–336
  27. Toumbourou J, Stockwell T, Neighbors C, Marlatt G, Sturge J, Rehm J. Interventions to reduce harm associated with adolescent substance use. Lancet. 2007;369:1391–1401
  28. van Ours JC. Is cannabis a stepping-stone for cocaine?. J. Health Econ. 2003;22:539–554
  29. Weiss RD, Mirin SM, Griffin ML, Michael JL. Psychopathology in cocaine abusers. Changing trends. J. Nerv. Ment. Dis. 1988;176:719–725
  30. Wells JE, McGee MA. Violations of the usual sequence of drug initiation: prevalence and associations with the development of dependence in the New Zealand Mental Health Survey. J. Stud. Alcohol Drugs. 2008;69:789–795
  31. World Bank . Sustainable Development in a Dynamic World. Washington, DC: The World Bank; 2003;Available at http://go.worldbank.org/WM2P6M0YZ0
  32. Yamaguchi K, Kandel DB. Patterns of drug use from adolescence to young adulthood. III. Predictors of progression. Am. J. Public Health. 1984;74:673–681

☆ Supplementary information for this article is available. Please see Appendix A for more information.

PII: S0376-8716(09)00421-9

doi: 10.1016/j.drugalcdep.2009.12.001

Drug and Alcohol Dependence
Volume 108, Issue 1 , Pages 84-97 , 1 April 2010

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