Does the “gateway” sequence increase prediction of cannabis use disorder development beyond deviant socialization? Implications for prevention practice and policy

Tarter, Ralph E.; Kirisci, Levent; Mezzich, Ada C.; Ridenour, Ty; Fishbein, Diana H.; Horner, Michelle S.; Reynolds, Maureen; Kirillova, Galina P.; Vanyukov, Michael

doi:10.1016/j.drugalcdep.2012.01.015

Cited by 35 publications

(24 citation statements)

References 58 publications

(59 reference statements)

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“…This is consistent with problem behavior theory (Jessor & Jessor, 1977) and the common liability model (Vanyukov et al, 2012), and prior research (Donovan & Jessor, 1985; Donovan et al, 1988; Tarter et al, 2012). Analyses further revealed that CCR had a long-term predictive relationship with general problem behavior, which was not moderated by gender.…”

Section: Discussionsupporting

confidence: 87%

Cumulative contextual risk at birth in relation to adolescent substance use, conduct problems, and risky sex: General and specific predictive associations in a Finnish birth cohort

Mason

January

Chmelka

et al. 2016

Addictive Behaviors

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Background Research indicates that risk factors cluster in the most vulnerable youth, increasing their susceptibility for adverse developmental outcomes. However, most studies of cumulative risk are cross-sectional or short-term longitudinal, and have been based on data from the United States or the United Kingdom. Using data from the Northern Finland Birth Cohort 1986 Study (NFBC1986), we examined cumulative contextual risk (CCR) at birth as a predictor of adolescent substance use and co-occurring conduct problems and risky sex to determine the degree to which CCR predicts specific outcomes over-and-above its effect on general problem behavior, while testing for moderation of associations by gender. Methods Analyses of survey data from 6963 participants of the NFBC1986 followed from the prenatal/birth period into adolescence were conducted using structural equation modeling. Results CCR had long-term positive associations with first-order substance use, conduct problems, and risky sex factors, and, in a separate analysis, with a second-order general problem behavior factor. Further analyses showed that there was a positive specific effect of CCR on risky sex, over-and-above general problem behavior, for girls only. Conclusions This study, conducted within the Finnish context, showed that CCR at birth had long-term general and specific predictive associations with substance use and co-occurring problem behaviors in adolescence; effects on risky sex were stronger for girls. Results are consistent with the hypothesis that early exposure to CCR can have lasting adverse consequences, suggesting the need for early identification and intervention efforts for vulnerable children.

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Section: Discussionsupporting

confidence: 87%

Cumulative contextual risk at birth in relation to adolescent substance use, conduct problems, and risky sex: General and specific predictive associations in a Finnish birth cohort

Mason

January

Chmelka

et al. 2016

Addictive Behaviors

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“…Recently, Tarter et al(2012) presented the results of a prospective study that followed people from 10–22 years of age, which were similar to ours regarding cannabis. The most common sequence for experimenting with drugs(i.e., illegal drug use before the use of cannabis) had no effect on the problematic use of cannabis later.…”

Section: Discussionsupporting

confidence: 82%

The role of drug use sequencing pattern in further problematic use of alcohol, tobacco, cannabis, and other drugs

Castaldelli-Maia

Martins

Oliveira

et al. 2014

Journal of Mental Health

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Background There has been considerable debate regarding what typically occurs after experimentation with drugs throughout the life of young people who used various drugs. Aims To evaluate the clinical importance of the most common sequence for the first use of a drug by two models(the ‘gateway model’ and the ‘alternative model’, which is the most popular sequence for Brazilian university students according to a previous study) regarding the problematic use of alcohol, tobacco, cannabis and other illegal drugs, assessed by ASSIST. Method People who had already experimented with three or more drugs across different stages of the two models were selected from a representative sample of university students from 27 Brazilian capitals(n=12, 711). Findings There were no differences regarding the problematic use of the most consumed drugs in Brazil(alcohol, tobacco and cannabis) between the models. Multiple drug seekers and violators had more problematic use of illegal drugs other than cannabis than individuals in the model sequence. However, in the case of violators, this was only evident in the alternative model. Conclusions Multiple drug seekers and violators deserve special attention due to their increased risk of problematic use of other illegal drugs. Declaration of interest None.

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“…This points to the existence of definite use trajectories, also called gateway sequences, which could constitute an independent risk factor for increasing use: a subject who has used a given substance is more liable to subsequent use of another substance, this subsequent use being better explained by the sequence that he (she) has entered than by opportunity for use [7] . However, the gateway hypothesis is increasingly questioned, some alternative use sequences are observed [8][9][10][11][12] , and the order of drug use initiation is not playing a substantial role in the etiology of substance use disorder (SUD) [13][14][15] . RAM was proposed to explain the reverse sequences leading from cannabis to tobacco, suggesting that the shared route by which substances are administered (e.g.…”

Section: Introductionmentioning

confidence: 99%

The Gateway Hypothesis, Common Liability to Addictions or the Route of Administration Model? A Modelling Process Linking the Three Theories

Mayet¹,

Legleye

Beck

et al. 2015

Eur Addict Res

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Background: The aim of this study was to describe the transitions between tobacco (T), cannabis (C) and other illicit drugs (OIDs) initiations, to simultaneously explore several substance use theories: gateway theory (GT), common liability model (CLM) and route of administration model (RAM). Methods: Data from 2 French nationwide surveys conducted in 2005 and 2010 were used (16,421 subjects aged 18-34). Using reported ages at initiations, we reconstituted a retrospective cohort describing all initiation sequences between T, C and OID. Transition probabilities between the substances were computed using a Markov multi-state model that also tested the effect of 2 latent variables (item response theory scores reflecting propensity for early onset and further substance use) on all transitions. Results: T initiation was associated with increased likelihood of subsequent C initiation, but the reverse relationship was also observed. While the most likely initiation sequence among subjects who initiated the 3 groups of substances was the ‘gateway' sequence T → C → OID, this pattern was not associated with substance use propensity more than alternative sequences. Early use propensity was associated with the ‘gateway' sequence but also with some alternative ones beginning with T, C or OID. Conclusion: If the gateway sequence appears as the most likely pattern, in line with GT, the effects of early onset and substance use propensities were also observed for some alternative sequences, which is more in line with CLM. RAM could explain reciprocal interactions observed between T and C. This suggests shared influences of individual (personality traits) and environmental (substance availability, peer influence) characteristics.

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Does the “gateway” sequence increase prediction of cannabis use disorder development beyond deviant socialization? Implications for prevention practice and policy

Cited by 35 publications

References 58 publications

Cumulative contextual risk at birth in relation to adolescent substance use, conduct problems, and risky sex: General and specific predictive associations in a Finnish birth cohort

Cumulative contextual risk at birth in relation to adolescent substance use, conduct problems, and risky sex: General and specific predictive associations in a Finnish birth cohort

The role of drug use sequencing pattern in further problematic use of alcohol, tobacco, cannabis, and other drugs

The Gateway Hypothesis, Common Liability to Addictions or the Route of Administration Model? A Modelling Process Linking the Three Theories

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