Sequential Patterns of Drug Use Initiation - Can We Believe In the Gateway Theory?
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Anne L Bretteville-Jensen
Abstract
The gateway, or stepping stone, hypothesis is important as it has had considerable influence on drug policy and legislation in many countries. The gateway hypothesis offers one possible explanation for young people's development of serious drug problems. It simply states that the use of one drug increases the risk of starting to consume another, possibly more harmful, drug later on and that the risk increases with frequency of use (dose-response). The empirical basis for the hypothesis is the common finding that most heavy drug users have started with less dangerous drugs first and that there seems to be a "staircase" from alcohol and solvents via cannabis and tablets to amphetamine, cocaine and heroin. The core question is whether the sequential initiation pattern of drug use is best explained by the gateway hypothesis or whether the phenomenon is better understood by employing the concepts of accessibility and/or transition proneness? Based on unique data from a representative sample of 21-30 year olds in Oslo we have examined the gateway effect of both legal (alcohol) and illegal drugs (cannabis) on subsequent use of cannabis and hard drugs (amphetamine and cocaine). We are the first to use multivariate probit models to examine the hypothesis. The models take into account unobservable individual-specific effects to reduce the possibility of a spurious effect of soft drug use on the onset of hard drug use. The gateway effects are greater when we do not take account of unobserved heterogeneity, but, although substantially reduced, they remain considerable when unobserved factors are accounted for.
©2011 Walter de Gruyter GmbH & Co. KG, Berlin/Boston
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Artikel in diesem Heft
- Advances Article
- How Did SCHIP Affect the Insurance Coverage of Immigrant Children?
- The Shape of Demand: What Does It Tell Us about Direct-to-Consumer Marketing of Antidepressants?
- Stemming the Tide? The Effect of Expanding Medicaid Eligibility On Health Insurance Coverage
- Health Care Economics and Policy: An Introduction
- Contributions Article
- Sequential Patterns of Drug Use Initiation - Can We Believe In the Gateway Theory?
- The Effect of the Consolidated Omnibus Reconciliation Act of 1985 on Health Care Utilization of Employment Separators
- Did 'Targets and Terror' Reduce Waiting Times in England for Hospital Care?
- Mitigating the Problem of Unmeasured Outcomes in Quality Reports
- Advertising, Free-Riding, and Price Differences in the Market for Prescription Drugs
- Patient Welfare under the Legal Standard of Care
