Ecstasy and Gateway Drugs: Initiating the Use of Ecstasy and Other Drugs

Abstract

Purpose-The main purposes of this study are to examine if, and to what extent, ecstasy use serves as a gateway to the use of hard drugs such as cocaine, heroin, and methamphetamine and to compare the age of onset of alcohol and marijuana use and subsequent use of cocaine, heroin, and methamphetamine among young adult ecstasy users.Methods-Face-to-face surveys were conducted with 268 young adult ecstasy users in Atlanta, Georgia. Subjects were solicited using the community identification process, including targeted sampling and guided recruitment. Data analysis involved discrete-time, event history analysis.Results-Results suggest that the age of onset of ecstasy use influences the initiation of cocaine and methamphetamine for our sample of active ecstasy users. In addition, alcohol and marijuana use precedes the initiation of cocaine and methamphetamine, but only marijuana influences the initiation of heroin. Conclusions-The sequential progression of drug use proposed in the gateway literature is not immutable. Researchers must take into account the changing popularity of drugs over time, such as the emergence of ecstasy use, when identifying patterns of drug use onset. KeywordsMDMA; Ecstasy (Drug); 3,4-Methylenedioxymethamphetamine; street drugsThe nature of the developmental progression of drug use trajectories remains a hotly debated topic, often focusing on the validity of the gateway theory (1). This theory assumes that the use of specific drugs is related to a sequential pattern of initiation, although the causal mechanisms that drive this sequential trajectory are often unclear (2). Kandel's seminal research identified marijuana as the key gateway substance between adolescent cigarette smoking and alcohol consumption and the subsequent use of hard drugs (1,(3)(4)(5)(6). Other scholars have provided further support for the gateway theory as it pertains to other drug pathways (7-15).Studies guided by the gateway theory are not without critics. One critique is that such studies are often derived from population-based samples, which are known to exhibit low prevalence of hard drug use (12,(16)(17). When examining findings from targeted samples of drug users, results show that hard drug users often do not initiate their trajectory with alcohol use, but with marijuana (18-21). A second critique of studies based on the gateway theory is that most are limited to adolescents. There is little evidence that adolescents who initiate the use of hard drugs necessarily become regular users (16,21). A final critique of the theory is that there is Publisher's Disclaimer: This is a PDF file of an unedited manuscript that has been accepted for publication. As a service to our customers we are providing this early version of the manuscript. The manuscript will undergo copyediting, typesetting, and review of the resulting proof before it is published in its final citable form. Please note that during the production process errors may be discovered which could affect the content, and all legal disclaimers that apply to...

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