Opening the Gates?: Cannabis Medicalization's Effect on Gateway Drug Patterns

• In Event: Advances in the Sociology of Cannabis

Abstract

Despite the expected predictions of prior gateway drugs theorists, the legalization of cannabis across US states has not resulted in increased rates of ‘hard’ drug use. Using the 2022-2024 waves of the National Survey on Drug Use and Health, I analyze the effect of growing up in a state which allows medical cannabis on chances of experiencing various gateway progressions. Utilizing a multinomial logistic regression approach, I assess chances of experiencing no drug use, only using one drug, going from cannabis to alcohol and/or nicotine, going from alcohol and/or nicotine to cannabis, experiencing a three-step gateway beginning with cannabis, alcohol, or nicotine and ending with heroin, methamphetamine, cocaine, crack cocaine, and/or prescription painkillers; and experiencing any other unconventional gateway sequences. Among respondents aged 12-29 who may have experienced gateway progressions in the medical context, residing in a medical state increases one's chances of cross-trying between cannabis and alcohol/nicotine relative to only using one drug. No significant associations are found between residing in a medical state and experiencing a three-step gateway. Meanwhile, demographic variables are found to have significant effects on these three-step gateways. Theoretically, these results show the market position of cannabis to be shaping gateway patterns between cannabis and legal drugs, with the chances of then transitioning to higher-order drugs being a consequence of one’s generalized risk of addiction stemming from their demographics. The market theory is further supported by analyzing race and place based sub-samples, with groups that had less access to cannabis in the prohibition context (Hispanic people and rural residents) experiencing larger effects stemming from medicalization than groups who historically have had greater access (Black people and urban residents). For public policy, these results show that cannabis can be medicalized without increasing rates of transition to ‘hard’ drugs.

Author

• Aaron Grinberg, The Ohio State University