![Sample our Health and Social Care journals, sign in here to start your FREE access for 14 days]({"type":"image" , "src" : "/sda/5938/TOC-Subject-Sample-2021-Health-Social-Care.jpg"})
Abstract
The psycho-social observation that the use of some psychoactive substances (“drugs”) is often followed by the use of other and more problematic drugs has given rise to a cluster of so-called “gateway drug hypotheses,” and such hypotheses have often played an important role in developing drug use policy. The current essay suggests that drug use policies that have drawn on versions of the hypothesis have involved an unjustified oversimplification of the dynamics of drug use, reflecting the interests of certain stakeholders rather than wise social policy. The hypothesis should be retired.
GLOSSARY
Drug dependency: Either a process or outcome, registering the effort that would be needed to reverse the use of a psychoactive substance (“drug”). Generally preferable to “addiction”.
Gateway drug: Any of a number of “softer” drugs that causally facilitates the use of “harder” drugs.
Gateway drug hypothesis: A cluster of theories about successive stages in drug use, from less serious (“softer”) to more serious (“harder”).
Risk: The degree of probability that a certain deleterious effect will follow from a certain action. Risk is likely to be multidimensional and risk-taking is likely to be normatively variable.
Soft/hard drugs: A problematic and overlapping distinction that may focus on any or several characteristics –tendency for psychological or physical dependency; effects on human functioning; legality or illegality. Better used comparatively: softer/harder.
Notes
1 Robert L. DuPont, Jr., Getting Tough on Gateway Drugs: A Guide for the Family (Washington, DC: American Psychiatric Press, 1984). DuPont, an influential stakeholder in the drug use(r) intervention area, was the first Director of the National Institute on Drug Abuse (NIDA) from 1973 to 1978 and the second White House Drug Czar.
2 Bob DuPont, Personal Communication, September 24, 2014. Although frequently credited with coining the term, DuPont makes no claim to have done so, even though his 1984 book popularized it.
3 We should not forget that caffeinated drinks were once reviled with the same passion as alcohol and marijuana. See Edward Brecher, Licit and Illicit Drugs: The Consumers Union Report on Narcotics, Stimulants, Depressants, Inhalants, Hallucinogens, and Marijuana—Including Caffeine, Nicotine, and Alcohol (Boston: Little, Brown, & Co., 1973), Ch. 2. Though dated in many respects, this volume remains an important digest of the vagaries of social policy.
4 There is a need to distinguish between a “drug's” pharmacological action, and one's “drug experience,” which is the outcome of the complex interactions between the chemically active substance, the user and where—or the site at which—it is being used. See N.E. Zinberg, Drug, Set, and Setting: The Basis for Controlled Intoxicant Use (New Haven: Yale University Press, 1984). Editor's note.
5 There is great complexity to the ideas of risk and risk-taking, which are all-too-often treated as unidimensional and ethically transparent categories. See, e.g., Nicholas Rescher, Risk: A Philosophical Introduction to the Theory of Risk Evaluation and Management (Lanham, MD: University Press of America, 1983); Sven Ove Hansson, “Risk”, The Stanford Encyclopedia of Philosophy (Spring 2014 Edition), ed. Edward N. Zalta, URL = <http://plato.stanford.edu/archives/spr2014/entries/risk/>.
6 As has been argued in the case of legalizing medical marijuana—resulting in fewer deaths from opioids. See M.A. Bachhuber, B. Saloner, C.O. Cunningham, and C.L. Barry, “Medical Cannabis Laws and Opioid Analgesic Overdose Mortality in the United States 1999–2010,” JAMA Internal Medicine 174, no. 10 (October 2014): 1668–1673.
7 This is not to deny that there may also be genetic factors relating to metabolizing alcohol or other drugs that may make some groups more likely to fall prey to alcoholism.
8 Interesting how we focus on only one side of the supposed ledger.
9 These are mock figures. I suspect that they differ in different social environments for a great variety of reasons. But that is part of my point. Nowhere is the old adage about lies, damned lies and statistics more likely to be exemplified than in an area such as this. The point is not that the figures are mathematically wrong, but that they are misleading without a great deal of interpretation.
10 At a Department of Defense News briefing, available at: http://www.defense.gov/transcripts/transcript.aspx?transcriptid = 2636.
11 My thanks to Shlomo Einstein for many helpful comments.
Additional information
Notes on contributors
John Kleinig
John Kleinig, PhD, is Emeritus Professor of Philosophy in the Department of Criminal Justice, John Jay College of Criminal Justice and in the PhD Program in Philosophy Graduate School and University Center, City University of New York. He is also Professorial Fellow in the Centre for Applied Philosophy and Professional Ethics (Canberra, Australia). Educated in Australia, he taught philosophy at Macquarie University (Sydney) before coming to the United States in 1986. His philosophical interests are in the areas of ethics and social philosophy, with a focus on professional and practical ethics, particularly in the fields of education, bioethics, law, and criminal justice. He is the author or editor of over 20 books and a member of the Editorial Board of Substance Use and Misuse.