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What Is a Gateway Drug?
January 31st, 2024| Clinically Reviewed by
Key Points
- Nicotine, alcohol, and marijuana are all gateway drugs.
- They're considered to be the “gateway” to using hard drugs like cocaine and heroin.
- But, gateway drug use isn’t the only contributing factor for later hard drug use.
A gateway drug is a legal or more socially acceptable drug that, once used, could lead to illicit drug use and addiction. Notably, gateway drugs and the gateway drug theory refer to adolescent drug use and how abstaining from all drugs in adolescence can help them avoid illicit drug use and addiction as adults.
The gateway drug theory1 suggests using “soft” drugs like alcohol, tobacco, or marijuana in adolescence predisposes teens and young adults to use “hard” drugs like cocaine. Order matters in the theory—cocaine use doesn’t lead to alcohol use, but it can be true the other way around.
Researchers haven’t conclusively agreed on the truth of the gateway theory, since not everyone who drinks or smokes becomes addicted or starts using a harder drug. Some people can use gateway drugs and never struggle with illicit drug use. The real connection, some say, is age of onset, preexisting mental health conditions, and genetic predisposition.
What Are Common Gateway Drugs?
Gateway drugs are almost always legal (in some states), broadly accessible, socially accepted, and easy to ingest. Three primary gateway drugs include:
- Alcohol
Alcohol is a prevalent, easily accessed, and socially promoted substance across all age groups. Teens and adolescents may feel pressure to drink with other peers or want to experiment. Some teens can drink occasionally without issue, but one study also found children ages 12-17 who drank alcohol were 50% more likely to later use cocaine2.
- Nicotine
Cigarettes and vapes contain nicotine, a psychoactive component of tobacco. Daily smoking or vaping was found to lead to marijuana use1 and other hard drugs. Those who smoke were found to be 19x more likely to use cocaine2, compared to teens who didn’t smoke.
- Marijuana
Marijuana (also called weed) is a psychoactive chemical that comes from the cannabis plant. It’s legal in some states but commonly used whether it’s legal or not. Weed can be smoked, eaten, or applied topically. It has a pungent mossy odor.
Some teens who used cannabis were 85x more likely to use cocaine2. Another study found teens who use marijuana usually don’t use harder drugs later on. The connection depends not solely on marijuana use1; age of use, timing, and the teen’s mental state primarily provide the ‘gateway’ effect.
Which Drug Is Often a Gateway to Other Drugs?
One particular drug doesn’t always lead to illicit drug use. Taking any psychoactive substance can increase the likelihood of adult substance use1, particularly stronger drugs like cocaine.
Alcohol and nicotine could be considered more common gateway drugs because both are legal and easy to access, whereas weed isn’t always legal and can be harder to get.
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Are Gateway Drugs Addictive?
Gateway drugs can be addictive. Alcohol, nicotine, and marijuana can all affect and change the brain3, leading to dependence and eventual addiction. Just because they’re legal and common doesn’t mean they’re safe.
For example, about 29.5 million Americans have been diagnosed with alcohol use disorder4. In 2020, alcohol killed more people than COVID-19. Similarly, nicotine is highly addictive5, and the action of smoking/vaping is reinforcing.
Are Gateway Drugs Not as Serious as Other Drugs?
No, gateway drugs are serious. Any psychoactive substance can harm your mind and body, unless taken under clinical advice and supervision.
The World Health Organization (WHO) recently released a statement that “no level of alcohol consumption is safe.”6 Any amount of alcohol, they say, is toxic and has the potential to cause harm and dependence.
Nicotine is one of the most addictive substances7, found to be as addictive as “hard” drugs like heroin and cocaine. Nicotine also takes effect right away (or as soon as you smoke or vape), which can worsen the rewarding effect and prompt frequent redoses. Starting small can quickly turn into an addiction.
Marijuana can affect your brain, heart, lungs, and learning capacity. Issues with memory, concentration, and learning can be permanent. Marijuana and tobacco smoke both contain carcinogens10 too, which can cause cancer.
Gateway Drug Statistics
A survey by the National Household Survey on Drug Abuse2 found some staggering statistics about gateway drugs and stronger drugs (cocaine was the stronger drug in their example, but it could also be opioids, hallucinogens, and various synthetic drugs.)
Other factors can influence the following statistics, like personality, environment, age of onset, and more. Simply taking a “gateway drug” doesn’t mean your teen will start using stronger drugs or develop an addiction.
- 99.9% of people who take cocaine first used alcohol, nicotine, or marijuana
- 90% of teens and adults who take weed first smoked or drank
- An adult who used marijuana as a child is 17x more likely to regularly take cocaine
- An adult who smoked as a child is 3x more likely to take cocaine
- An adult who drank as a child is 6x more likely to use cocaine
- An adult who used all 3 gateway drugs (alcohol, nicotine, and weed) is 323x more likely to take cocaine
- A child who uses all 3 gateway drugs is 266x more likely to take cocaine
Implementing Early Prevention Strategies for Gateway Drugs
Several drug use prevention programs specifically focus on adolescents, including Youth.gov, the STOP Act, and D.A.R.E. The well-known D.A.R.E. movement focused on complete abstinence; more recent preventative strategies focus on community education, mental health treatment, and specifically discouraging marijuana use.
Starting the conversation about alcohol and drugs can help your teen know the consequences of drug use and that they have other coping strategies available (like therapy, hobbies, and connecting to you as a parent).
Treatment for Gateway Drugs
Many teens, young adults, and adults use drugs and alcohol as a coping tool for mental health disorders and emotional distress. Treating the symptoms of mental health conditions can prevent teens from using substances in the first place.
Behavioral therapies like cognitive behavioral therapy (CBT) and dialectical behavioral therapy (DBT) can correct thought distortions and help patients find new coping skills for emotional distress.
Sometimes, teens and adults may need detox and residential treatment for addiction. Detoxing from gateway drugs in a clinical setting safely removes toxins from the body. In residential rehab, patients receive daily monitoring and support, group therapies, and individual therapy to address the root causes of their addiction.
Outpatient levels of care include day treatment, intensive outpatient, and general outpatient treatment. In outpatient, you live at home and go to treatment so you’ll have more time for school and work.
Find The Best Drug And Alcohol Treatment Centers
To find a drug and alcohol treatment center and compare your options, you can browse RehabPath’s collection of rehabs to see photos, reviews, and insurance information.
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Nkansah-Amankra, Stephen, and Mark Minelli. “‘Gateway Hypothesis’ and Early Drug Use: Additional Findings from Tracking a Population-Based Sample of Adolescents to Adulthood.” Preventive Medicine Reports, vol. 4, May 2016, pp. 134–41. PubMed Central. https://doi.org/10.1016/j.pmedr.2016.05.003
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Cigarettes, Alcohol, Marijuana: Gateways to Illicit Drug Use | Office of Justice Programs. https://www.ojp.gov/ncjrs/virtual-library/abstracts/cigarettes-alcohol-marijuana-gateways-illicit-drug-use. Accessed 11 Dec. 2023.
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Abuse, National Institute on Drug. Drugs, Brains, and Behavior: The Science of Addiction: Drugs and the Brain | NIDA. https://nida.nih.gov/publications/drugs-brains-behavior-science-addiction/drugs-brain
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“More People in the U.S. Die of Alcohol-Related Causes than from Opioids and Other Drugs. Psychologists Are Working to Change That.” https://www.Apa.Org, https://www.apa.org/monitor/2023/06/tackling-risky-alcohol-use. Accessed 11 Dec. 2023.
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Abuse, National Institute on Drug. Is Nicotine Addictive? | National Institute on Drug Abuse (NIDA). https://nida.nih.gov/publications/research-reports/tobacco-nicotine-e-cigarettes/nicotine-addictive
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No Level of Alcohol Consumption Is Safe for Our Health. https://www.who.int/europe/news/item/04-01-2023-no-level-of-alcohol-consumption-is-safe-for-our-health. Accessed 11 Dec. 2023.
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Mishra, Aseem, et al. “Harmful Effects of Nicotine.” Indian Journal of Medical and Paediatric Oncology : Official Journal of Indian Society of Medical & Paediatric Oncology, vol. 36, no. 1, 2015, pp. 24–31. PubMed Central. https://doi.org/10.4103/0971-5851.151771
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