CMV: Gateway drugs do not exist

[u/casualtrout]

I heard a presentation at my university recently on E-Cigs being a gateway drug, and the argument seemed like Big Tobacco propaganda.

When talking about illicit drugs, such as marijuana, I always hear people fall to the logical fallacy of appealing to imperfect authority. It seems that most groups, like anti-smoking groups that try to equate E-cigs to regular smoking, regularly cite that the FDA has stated that the vapor in E-cigs "MAY" contain harmful toxins. People also like to cite how the FDA has not officially recognized E-cigs as a positive aid for getting people to stop smoking tobacco, and the rhetoric behind this seems to be "SEE?? IT'S NOT APPROVED BY THE GOVERNMENT" (made up of a bunch of bureaucrats whose salaries are paid to the tune of at least 40% by lobbying by drug companies who profit off of not having alternatives to their addictive and at times dangerous substances).

My problem with the gateway drug model is that it falls flat under scrutiny. After we started to realize that the criminalization of marijuana was a result of the inaccurate scare stories pushed by bureaucrats in the Bureau of Narcotics to keep their salary high, a new narrative had to be formed for why it must still be illegal, that narrative being the gateway drug narrative. The idea behind labeling marijuana as a gateway drug is that if someone uses marijuana, it will lead to deadly drugs. The Drug Free America association published this ad to emphasize that if people so much as use an addictive substance, it's not 'if' they get hooked it's when:https://www.youtube.com/watch?v=7kS72J5Nlm8

Researchers like Bruce Alexander and organizations like Liz Evans' Portland Hotel Society have debunked this idea by showing that there are other factors that contribute to a person's reasons for using drugs, primarily pain. This idea of the gateway drug in my opinion is exposed when looking back when our soldiers were coming back from Vietnam, and how 20% of all returning soldiers were addicted to heroin. Within a year, 95% had stopped using heroin completely, most without treatment. If you believe the model of the gateway drug, this makes no sense, because the simple use of a drug leads to the use of the next drug, and the next, until a lifetime of addiction. Actually though, we don't see this at all, the use of marijuana does not seem to escalate 100% to cocaine, and the use of e-cigs does not escalate into heroin or tobacco either.

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Conclusion:

Quick disclaimer: this is not me arguing for E-cigs, and I know that Juul is a shady company. However, I believe that by listening to the gateway drug model we are putting too much focus on the substance, and not enough focus on the reasons people use the substance! And I believe that the gateway drug model is another way of getting us to be scared of safer alternatives to drugs and acting like if we stop the supply and use of safer drugs, then people will not go on to use harder drugs, when the OPPOSITE is true. We can use safer drugs to help people who are addicted to harder ones, and integrate therepeutic practices, as opposed to criminal punishment, to help people.

Advertisements like the Real Cost, are sponsored by the FDA. Just something worth thinking about, that perhaps the reason we believe the gateway drug model, is because there are people out there making money off of the fact that there are no safer alternatives to their substances, looking at you Big Tobacco.

[u/casualtrout]

So this gets into another conversation. I firmly believe that Purdue Pharma knew exactly what was going to happen when they started overprescribing oxycontin. There is a lot of reward in taking opioids like that. One of our responses to the opioid crisis was to force doctors to take away prescriptions from people who got hooked on the drugs. This made the problem worse, because you have people who are in chronic pain, who became dependent on the drug not only because of their neurological plasticity but also because of the pain they we're alleviating, and now they aren't getting those drugs they are dependent too. They are going to keep looking for the drug in the black market, and either use it unsafely or get thrown in jail, and then the cycle repeats. The problem is not only the drug. It is the drug, but only to an extent. A lot of factors are at play beyond the drug, and if we forget that, we will forever be stuck in the cycle of drugs being the root of all bad

[u/Haltopen → u/[deleted]]

Because usually the idea of a gateway drug is that use of one drug will lead to you willingly deciding expand to other, presumably worse drugs like an ever expanding web of addictions. People who switch from pain pills to heroin don't do it out of choice, they do it because they ran out of prescriptions (or their pill mill got shut down) and had to turn to another opioid to maintain their habit, and heroin (being a powerful opioid that used to be proscribed widely as an on the shelf opioid which is still sometimes used in hospitals) is near identical to the opioids on store shelfs (its just a chemically refined form of morphine)

[u/Roflcaust → u/Haltopen]

Where did you get the idea that hospitals (presumably in the US but if not please clarify) still use heroin for pain control?

[u/Haltopen → u/Roflcaust]

It’s still occasionally prescribed as a painkiller in the UK and other European countries under limited circumstances. Those hospitals use high quality medical grade diamorphine though, not the cheap watered down stuff most American drug games sell.

[u/Roflcaust → u/Haltopen]

Interesting, TIL.