Steppingstone and gateway ideas: A discussion of origins, research challenges, and promising lines of research for the future

Abstract

In this discussion of contributed papers for the special issue of DAD, the author draws attention to early American laws concerning cannabis and to statements made about the epidemiology of cannabis smoking and other drug use between 1858 and the contemporary scene, with coverage of opium, heroin, tobacco, alcohol, cocaine, kava, and other drugs. He discusses these steppingstone and gateway processes in relation to political environment and in relation to scientific challenges such as uncontrolled confounding. He provides a critique of between-individual research designs, including co-twin and co-sib designs of behavior genetics, as well as imaging research, where uncontrolled confounding often exists. He highlights the epidemiologic case-crossover design and prevention research experiments as potentially valuable approaches in new directions for research on the steppingstone and gateway processes.

Tobacco smoking and cannabis use in a longitudinal birth cohort: Evidence of reciprocal causal relationships

“…A multi-criteria analysis of drug harm (Nutt et al, 2010) indicates that tobacco and cannabis are among the four most damaging recreational substances in terms of direct and indirect economic costs to society. Furthermore, it has been proposed that tobacco and cannabis may serve as gateway drugs, leading to the use and abuse of other substances (Anthony, 2012). Gateway theory has been the subject of some controversy in the literature, having been criticized in terms of both drug sequence and causal modelling (Baumrind, 1983;Degenhardt et al, 2009Degenhardt et al, , 2010.…”

Age of Sexual Debut and Cannabis Use in the United States

“…Tobacco and alcohol use were assessed by self-report (Anthony, 2012; Brook, Brook, Arencibia-Mireles, Richter, & Whiteman, 2001; Kirby & Barry, 2012; Levine et al, 2011; Vanyukov et al, 2012). Smoking status was categorized as current, former, and never smoker.…”

Understanding Psychiatric Comorbidities and Addictions

“…This is not to say that there was no pertinent work at this intersection before 1988. The idea that drug use might cause psychiatric disorders surfaced before the twentieth century, as did the idea that psychiatric conditions or features of personality might foster drug self-administration (e.g., see Anthony, 2012). Erlenmeyer was one of the many clinicians of the late nineteenth century who were well informed about manias and other mood disturbances that followed onset of cocaine self-administration (e.g., see Anthony, Tien, and Petronis, 1989;Tien and Anthony, 1990;Anthony and Petronis, 1991;Crum and Anthony, 1993;Alvarado, Storr, and Anthony, 2010).…”

“…. hashish is the principal cause of most of the cases of insanity occurring in Egypt" (quoted in Willoughby, 1925;Anthony, 2012).…”