Evaluating the drug use "gateway" theory using cross-national data: consistency and associations of the order of initiation of drug use among participants in the WHO World Mental Health Surveys

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• dc.contributor.author Degenhardt, Louisa
• dc.contributor.author Dierker, Lisa
• dc.contributor.author Chiu, Wai Tat
• dc.contributor.author Medina Mora, Maria Elena
• dc.contributor.author Neumark, Yehuda
• dc.contributor.author Sampson, Nancy A.
• dc.contributor.author Alonso Caballero, Jordi
• dc.contributor.author Angermeyer, Matthias C.
• dc.contributor.author Anthony, James C.
• dc.contributor.author Bruffaerts, Ronny
• dc.contributor.author Girolamo, Giovanni de
• dc.contributor.author de Graaf, Ron
• dc.contributor.author Gureje, Oye
• dc.contributor.author Karam, Aimee N.
• dc.contributor.author Kostyuchenko, Stanislav
• dc.contributor.author Lee, Sing
• dc.contributor.author Lépine, Jean-Pierre
• dc.contributor.author Levinson, Daphna
• dc.contributor.author Nakamura, Yosikazu
• dc.contributor.author Posada Villa, José
• dc.contributor.author Stein, Dan J.
• dc.contributor.author Wells, J. Elisabeth
• dc.contributor.author Kessler, Ronald C.
• dc.date.accessioned 2019-03-18T13:00:41Z
• dc.date.available 2019-03-18T13:00:41Z
• dc.date.issued 2010
• dc.description.abstract BACKGROUND: It is unclear whether the normative sequence of drug use initiation, beginning with tobacco and alcohol, progressing to cannabis and then other illicit drugs, is due to causal effects of specific earlier drug use promoting progression, or to influences of other variables such as drug availability and attitudes. One way to investigate this is to see whether risk of later drug use in the sequence, conditional on use of drugs earlier in the sequence, changes according to time-space variation in use prevalence. We compared patterns and order of initiation of alcohol, tobacco, cannabis, and other illicit drug use across 17 countries with a wide range of drug use prevalence. METHOD: Analyses used data from World Health Organization (WHO) World Mental Health (WMH) Surveys, a series of parallel community epidemiological surveys using the same instruments and field procedures carried out in 17 countries throughout the world. RESULTS: Initiation of "gateway" substances (i.e. alcohol, tobacco and cannabis) was differentially associated with subsequent onset of other illicit drug use based on background prevalence of gateway substance use. Cross-country differences in substance use prevalence also corresponded to differences in the likelihood of individuals reporting a non-normative sequence of substance initiation. CONCLUSION: These results suggest the "gateway" pattern at least partially reflects unmeasured common causes rather than causal effects of specific drugs on subsequent use of others. This implies that successful efforts to prevent use of specific "gateway" drugs may not in themselves lead to major reductions in the use of later drugs.
• dc.description.sponsorship These activities were supported by the United States National Institute of Mental Health (R01MH070884), the John D. and Catherine T. MacArthur Foundation, the Pfizer Foundation, the US Public Health Service (R13-MH066849, R01-MH069864, and R01 DA016558), the Fogarty International Center (FIRCA R01-TW006481). The ESEMeD project is funded by the European Commission (Contracts QLG5-1999-01042; SANCO 2004123), the Piedmont Region (Italy), Fondo de Investigación Sanitaria, Instituto de Salud Carlos III, Spain (FIS 00/0028), Ministerio de Ciencia y Tecnología, Spain (SAF 2000-158-CE), Departament de Salut, Generalitat de Catalunya, Spain, Instituto de Salud Carlos III (CIBER CB06/02/0046, RETICS RD06/0011 REM-TAP). The World Mental Health Japan (WMHJ) Survey is supported by the Grant for Research on Psychiatric and Neurological Diseases and Mental Health (H13-SHOGAI-023, H14-TOKUBETSU-026, H16-KOKORO-013) from the Japan Ministry of Health, Labour and Welfare. The Mexican National Comorbidity Survey (M-NCS) is supported by The National Institute of Psychiatry Ramon de la Fuente (INPRFMDIES 4280) and by the National Council on Science and Technology (CONACyT-G30544-H). The South Africa Stress and Health Study (SASH) is supported by the US National Institute of Mental Health (R01-MH059575). The Ukraine Comorbid Mental Disorders during Periods of Social Disruption (CMDPSD) study is funded by the US National Institute of Mental Health (RO1-MH61905). The US National Comorbidity Survey Replication (NCS-R) is supported by the National Institute of Mental Health (NIMH; U01-MH60220) with supplemental support from the Robert Wood Johnson Foundation (RWJF; Grant 044708). The work of L. Dierker was supported by a NIDA Center Grant (DA010075) awarded the Methodology Center, Penn State University, grant DA024260 and Investigator Awards from the National Institute on Drug Abuse (DA15454)
• dc.format.mimetype application/pdf
• dc.identifier.citation Degenhardt L, Dierker L, Chiu WT, Medina-Mora ME, Neumark Y, Sampson N et al. Evaluating the drug use "gateway" theory using cross-national data: consistency and associations of the order of initiation of drug use among participants in the WHO World Mental Health Surveys. Drug Alcohol Depend. 2010 Apr 1;108(1-2):84-97. DOI: 10.1016/j.drugalcdep.2009.12.001
• dc.identifier.doi http://dx.doi.org/10.1016/j.drugalcdep.2009.12.001
• dc.identifier.issn 0376-8716
• dc.identifier.uri http://hdl.handle.net/10230/36857
• dc.language.iso eng
• dc.publisher Elsevier
• dc.relation.ispartof Drug and Alcohol Dependence. 2010 Apr 1;108(1-2):84-97
• dc.relation.projectID info:eu-repo/grantAgreement/ES/1PN/SAF2000-158-CE
• dc.rights © Elsevier http://dx.doi.org/10.1016/j.drugalcdep.2009.12.001
• dc.rights.accessRights info:eu-repo/semantics/openAccess
• dc.subject.other Abús de substàncies
• dc.title Evaluating the drug use "gateway" theory using cross-national data: consistency and associations of the order of initiation of drug use among participants in the WHO World Mental Health Surveys
• dc.type info:eu-repo/semantics/article
• dc.type.version info:eu-repo/semantics/acceptedVersion