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Major Studies of Drugs and Drug Policy | ||||
Canadian Senate Special Committee on Illegal Drugs | ||||
Volume I - General Orientation |
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Chapter 6 - Users and uses: form, practice, contextStepping stone
to other drugs?
The stepping stone theory holds
considerable sway in debates on marijuana. In fact, the concern is that
cannabis use leads to the use of other drugs, in particular, the so-called hard
drugs, such as heroin and cocaine. It
logically follows that more people using drugs will increase the number of
people being harmed by them. Cannabis is believed to be the foundation upon
which most young people begin experimenting with illicit drugs. (…) The
“gateway” concept has been around for a long time, and again, although there is
no definitive evidence, the National Institute on Drug Abuse has reported that
neuro-toxicological research suggests that marijuana “may alter the brain in
ways that increase the susceptibility to other drugs.” Many
believe that cannabis use provides the impetus for those people looking to
increase the psychotropic effect a drug has on them. [1][51] We should first define our terms.
The “stepping stone” theory holds that cannabis use inevitably leads to use of
other drugs. In this theory, cannabis use would lead to neurophysiological
changes, affecting in particular the dopaminergic system (also called the
reward system), thus creating the need to move on to the use of other drugs.
This theory has been completely dismissed by research. We share this conclusion
with several international bodies doing drug research, including the British
organization DrugScope: The
Stepping-Stone theory has proved unsustainable and lacking any real evidence
base. The “evidence” that most heroin users started with cannabis is hardly
surprising and demonstrably fails to account for the overwhelmingly vast
majority of cannabis users who do not progress to drugs like crack and heroin.
The Stepping-Stone theory (often confused among the general public for the
Gateway theory) has been dismissed by scientific inquiry. The notion that
cannabis use “causes” further harmful drug use has been, and should be,
comprehensively rejected. [2][52] The “gateway” theory suggests that
users’ trajectories offer them choices as they start their trajectory of use
and that one of these choices is to use other drugs. According to this theory,
certain factors, such as early initiation and more regular and heavier use,
reinforce this possibility. However, these factors themselves, and early
initiation to cannabis in particular, are related to earlier factors, arising
from the family environment and social living conditions, that predispose the
more vulnerable young people to this early initiation and more rapid progress
towards regular and heavy use. The
link between cannabis and other drug use, according to this explanation, is
thus a reflection that there are a number of risk factors and life pathways
that predispose young people to use cannabis and that they overlap with the
life pathways that predispose young people to use other illicit drugs. [3][53] In
addition to these factors that predispose some young people to heavier use of
psychoactive substances – including alcohol and tobacco first of all – the
sociological conditions under which users can obtain cannabis are such that
they are in contact with an environment that is at least marginal if not
criminal. Dealers are often the same people who also sell heroin, crack,
amphetamines, cocaine and ecstasy such that the probability that a young
cannabis user, already more vulnerable due to the factors of his personal
trajectory, would come into contact with these other substances more easily. We
would also add that wholesalers and dealers “cut” or even mix their products;
we were told at times that ecstasy, for example, could contain many things
other than MDMA. Furthermore, if it is true that use
of substances such as heroin and cocaine develops almost necessarily out of
prior use of marijuana, then it also develops out of the use of other
substances, nicotine and alcohol in particular, which are more gateways to a
trajectory of use than cannabis. If we come back to trends in drug
use in the population, while more than 30% have used cannabis, less than 4%
have used cocaine and less than 1% heroin. However, it is true that regular and
heavy users are more likely than occasional users to use other substances. The
study by Cohen and Kaal[4][54] discussed in the previous section
shows for example that more than 90% of long-term cannabis users have also used
tobacco and alcohol during their lifetime. Above all, it also shows that 48% in
Amsterdam and 73% in San Francisco have used cocaine at least once in their
life, and 37% in Amsterdam, 77% in San Francisco and 47% in Bremen have used
hallucinogens at least once. Nevertheless, no regular cannabis users were
regular users of other substances. The authors also show that the most common
sequence is alcohol (around age 14), tobacco (around age 15), cannabis (around
age 17), followed by other drugs in the early 20s. We feel that the available data show
that it is not cannabis itself that
leads to other drug use but the combination of the following factors:
[1][51]
M. J. Boyd, Chair of the Drug Abuse Committee and Deputy Chief of the
Toronto Police Service, Canadian Association of Chiefs of Police, testimony
before the Special Senate Committee on Illegal Drugs, Canadian Senate, first
session of the thirty-seventh Parliament, Issue 14, page 75. [2][52]
DrugScope (2001) Evidence to Home
Affairs Committee Inquiry into Drug Policy. Available on-line at: http://www.drugscope.org.uk/druginfo/evidence-select/evidence.htm [3][53]
Ibid. [4][54]
Cohen and Kaal, op. cit., page
92-93. |