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New research suggests alcohol, not cannabis, is the real ‘gateway’ drug 

Researchers say cannabis use before alcohol or tobacco is ‘rare’ and may even protect against future substance misuse issues.



Research found that young people ‘overwhelmingly’ tried alcohol before cannabis.

A first-of-its-kind study seems to dispute claims that cannabis is a ‘gateway’ drug, finding that young people ‘overwhelmingly’ try alcohol first, followed by tobacco.

According to the paper, in 2022 just under half (45%) of the US population lived in a state with some form of legal access to cannabis, with the trend for cannabis reform now rippling across the globe.

However, long standing claims remain that cannabis is a ‘gateway’ drug, amid concerns that increased use among young people may lead to the use of stronger and potentially more high risk substances. 

In what is believed to be the first study of its kind, researchers explored this in more detail, examining how many young people tried cannabis before alcohol and tobacco and whether this was linked to further substance use down the line. 

According to the authors:No studies to our knowledge have examined whether using cannabis before alcohol and tobacco compared to using cannabis at the same age as alcohol or tobacco confers greater risk of reporting current poly-substance use and other drug use.”

Young people ‘overwhelmingly’ try alcohol before cannabis 

Their research found that young people ‘overwhelmingly’ tried alcohol before cannabis or tobacco and using cannabis before either of these substances was rare. 

Researchers analysed data from over 8,000 young people collected through the Population Assessment of Tobacco and Health study, which recorded whether they had ever used alcohol, cannabis, or tobacco and the age at which they first tried them.

They then examined associations between cannabis initiation before, at the same age, or after initiating alcohol or tobacco use, with substance use in the last 30 days.

The results showed that trying cannabis first, before alcohol or tobacco, was ‘relatively uncommon’ (6%).

Only 9% of individuals who said they had ever used cannabis reported initiating cannabis before alcohol and tobacco, however the prevalence of initiating cannabis at the same age that alcohol or tobacco was first tried was more common (21.8%).

In addition, those who tried cannabis first were less likely to have substance misuse issues when compared to those who tried other substances at the same time.

They authors conclude: “Alcohol is overwhelmingly tried before either tobacco or cannabis.

“Cannabis initiation before alcohol and tobacco is uncommon and may even protect against future alcohol use. 

“Those who initiated cannabis before alcohol and tobacco appeared less likely to have a wide constellation of substance use and mental health vulnerabilities compared to those who tried cannabis at the same age as they tried at least one other substance.

“Deterring cannabis initiation with multiple substances could have public health benefits.”

Increasing evidence refutes ‘gateway’ theory

Other studies in this area also contradict the idea that cannabis is a ‘gateway’ drug.

Last year, researchers at the University of Washington, found that young people consumed less alcohol, nicotine, and non-prescribed pain medication, after cannabis was legalised for adult-use. 

Researchers assessed trends in alcohol, nicotine, and non-prescribed pain reliever use among a cohort of over 12,500 young adults (ages 18 to 25) in Washington State following legalisation in 2012.

Contrary to concerns about the detrimental effects on wider society, according to the study, “the implementation of legalised non-medical cannabis coincided with decreases in alcohol and cigarette use and pain reliever misuse.”

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Home » Science » New research suggests alcohol, not cannabis, is the real ‘gateway’ drug 

Sarah Sinclair is a respected cannabis journalist writing on subjects related to science, medicine, research, health and wellness. She is managing editor of Cannabis Health, the UK’s leading title covering medical cannabis and CBD, and sister title and Psychedelic Health. Sarah has an NCTJ journalism qualification and an MA in Journalism from the University of Sunderland. Sarah has over six years experience working on newspapers, magazines and digital-first titles, the last two of which have been in the cannabis sector. She has also completed training through the Medical Cannabis Clinicians Society securing a certificate in Medical Cannabis Explained. She is a member of PLEA’s (Patient-Led Engagement for Access) advisory board, has hosted several webinars on cannabis and women's health and has moderated at industry events such as Cannabis Europa. Sarah Sinclair is the editor of Cannabis Health. Got a story? Email / Follow us on Twitter: @CannabisHNews / Instagram: @cannabishealthmag


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