USA -- Contrary to popular belief, smoking marijuana need not be a steppingstone between using alcohol and tobacco and experimenting with illegal drugs such as cocaine and heroin.
Researchers led by Ralph E. Tarter, a professor at the University of Pittsburgh's School of Pharmacy, found that nearly a quarter of the young men they studied used marijuana before they began drinking or smoking cigarettes.

It's the reverse of what's known as the "gateway hypothesis," in which drug use is thought to progress from alcohol and tobacco to marijuana to hard drugs.

The researchers determined also that the likelihood of developing a substance abuse problem was similar in youngsters who followed the traditional gateway drug use pattern and those who followed the reverse pattern.

"This is actually quite novel, this idea," Dr. Tarter said. "It runs counter to about six decades of current drug policy in the country, where we believe that if we can't stop kids from using marijuana, then they're going to go on and become addicts to hard drugs."

But the data doesn't support that contention, he noted. The findings were published in this month's American Journal of Psychiatry.

Marijuana was the first drug used by a 26-year-old man from Beaver County who is undergoing addiction treatment at Gateway Rehabilitation Center. He was 15 the first time he tried it, on a Saturday with a group of friends.

At their suggestion, he began smoking cigarettes when he started using marijuana.

"That's how they taught me how to hold in the smoke of the weed, because cigarette smoke is stronger than marijuana smoke," he explained.

Smoking pot soon became a weekend thing.

Then, "I started smoking in the morning before I would go to school," he recalled. "Sometimes I would sneak away and go smoke during lunch. Then after school I would smoke."

Eventually, he was using marijuana "all day, every day," he said. If he didn't smoke, he'd get headaches and have problems sleeping. Two years ago, a friend introduced him to snorting cocaine, and he began using that in addition to smoking pot.

Now married and a father, he realized he was spending all his money on drugs, instead of his family. So he checked himself into rehab in the hope of overcoming his addictions.

In Dr. Tarter's study, which was funded by the National Institute on Drug Abuse, researchers monitored more than 200 young men at intervals from the time they were 10 to 12 years of age until they were 22. They fell into one of three groups: those who used only alcohol or tobacco; those who started with alcohol and tobacco and then used marijuana; and those who used marijuana prior to using alcohol and tobacco.

Among those who used marijuana, nearly a quarter followed the reverse of the gateway pattern. They tended to have less parental supervision and to live in neighborhoods with poor physical environments where illegal drugs were more available.

In general, the marijuana-users were more behaviorally deviant, less involved with school and had friends their parents didn't like, the researchers found.

"That all makes sense to me," said the Gateway Rehab Center patient. "If I had stayed with the crowd I grew up with, I don't think I'd have had this problem. I started to hang with the wrong crowd."

Some of his friends have used harder drugs, such as cocaine, while others used marijuana now and then, but never progressed further into addiction, he said.

It was easier to obtain marijuana than alcohol or cigarettes as a teenager, he added.

"You always had to show a form of ID to get those," he said. "But I could always go to the person who was selling the weed to get it, and they wouldn't ask for ID. It was never hard to get for me."

Gateway's medical director, Dr. Neil Capretto, said a few patients have told him that the first drug they used was heroin, which is "very available now in many neighborhoods, whether it be inner-city Pittsburgh or upper-middle-class suburbs."

He praised the Pitt study, saying "it really shows the complex nature of addiction. What they're showing here is what we've been seeing in practice for years."

Most people who experiment with marijuana do not go on to use harder drugs, Dr. Capretto said.

Still, "the vast majority of people who we see who do cocaine or heroin have done marijuana in the past, or are likely to do it at some time in the future," he noted. But "if we could push a button and all the marijuana would go away, by no means will that stop the drug problem in this country."

Dr. Capretto described the mother of a patient who was relieved that, unlike her other son who was addicted to heroin, her younger boy's dropping grades and mood changes were due to marijuana use.

"I said, 'That's not necessarily good news,' " he recounted. "Something's still wrong. Whether it be a young person on alcohol, tobacco or marijuana, [even] if that's all they ever do, that's a problem right there."

According to Dr. Tarter, drug use prevention messages should minimize "slippery slope" scare tactics and emphasize healthy living. Interventions to foster values and attitudes that resist illegal behaviors and to strengthen parenting skills could be helpful.

It's possible to identify children who are at high risk for drug use years before they begin experimenting, Dr. Tarter said.

"Nothing is carved in stone, especially at this age," he said. "But the longer you wait, the harder it is to change."

Complete Title: Researchers Say Smoking Pot Not Always Path to Hard Drug Use

Source: Pittsburgh Post-Gazette (PA)
Author: Anita Srikameswaran, Pittsburgh Post-Gazette
Published: Tuesday, December 05, 2006
Copyright: 2006 PG Publishing