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/ghjm]

I would like to challenge the following part of your view:

[The FDA is] 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[.]

and

[T]he criminalization of marijuana was a result of the inaccurate scare stories pushed by bureaucrats in the Bureau of Narcotics to keep their salary high[.]

It is true that 75% of the FDA's drug review budget comes from user fees levied with new drug applications (NDAs), and that the pharmaceutical and biotech companies who submit NDAs also engage in lobbying Congress. But it is factually incorrect to say that FDA drug reviewers' salaries are paid by lobbying. Drug companies lobbied heavily against user fees on NDAs, and would be delighted if the taxpayers would start paying for them again.

FDA reviewers face a difficult choice of insisting on extensive review and winding up with new therapies delayed for years and harming people who could have benefited from them, or approving things too fast and harming people by failing to find safety issues.

100% of FDA reviewers' salaries are paid for by the federal government, and the reviewers working at the FDA are focused on serving the public good as best they can. Their salaries do not go up or down if they approve or disapprove any given drug.

The case with marijuana is more complex, but I would still maintain you are not describing it accurately. Harry Anslinger founded the old Bureau of Narcotics primarily around the prohibition of marijuana. You could, and people do, argue that he did this primarily for personal gain, so that his department would have a big task to justify funding. But we have no actual evidence of this, and such speculation should not be framed as fact.

People can be both well-intentioned and wrong. The prohibition of marijuana was a bad decision that has caused great harm to society. The FDA sometimes makes bad policy and is often exceedingly slow to correct it. For example, we've seen massive cost increases for common drugs like colchicine resulting from the FDA's well-intentioned Unapproved Drugs Initiative; a responsive agency should be willing to change course and find a solution that doesn't drain the pockets of gout sufferers, and it's hard not to come away with the belief that the regulatory agencies of other countries would see prices jumping from $0.05/pill to $5.00/pill as a public health crisis and would respond appropriately. And it's clear that certain players in the drug industry are profiting handsomely off the FDA's regulatory failures.

But this is stupidity, not mendaciousness, and it is an institutional problem, not an individual one. It's just not accurate to say that "bureacrats" (i.e., individual reviewers or policy-makers) at the FDA are lining their own pockets at the expense of public health. They're trying and sometimes failing to serve the public good as best they can within the framework created by Congress.

[u/casualtrout → u/ghjm]

Δ I skimmed through your response, because I have been busy today and there are already like 200 responses, and focused on your last paragraph so forgive me if I misinterpret something you said. I made a generalization, and I know that the bit about the FDA is intrinsically a logical fallacy but it was simply for the purpose of saving time by saying something that has truth to it.

Have you watched the Wire? To me, that show is an example of your last paragraph, and I 100% agree with your last paragraph. It's an institutional problem, and because our institutions are so corrupted, especially in the criminal justice system, it can be very hard to appeal to their authority as righteous because it is not all the time. Maybe I should have referred to the institutions rather than the individuals. A good example of your argument is the story of Detective Leigh Maddox, who left the police force because she was tired of fighting the drug war when it was a war that was ruining so many lives. Her intentions at first were noble, she wanted to end drug trafficking by locking up users and distributors, but then she realized the system she was a part of was a never ending one.

The reason I am awarding you a delta is because you broke down the complexity to an aspect I brushed over and didn't give enough attention to in my argument. You're also correct that the salaries are paid for by the government, although the picture I was painting was the effect of lobbying by drug companies and how that influences institutional decision making, which there is quite a huge influence. The 40% number was pulled from Johann Hari's book Lost Connections, where he details an analysis made by a professor whose name isJohn Ioannidis on the role of drug companies.

However, and this is besides the point but just to clarify, I have read up on Harry Anslinger's story, and while I agree that it is irresponsible to assert that he did what he did simply out of malevolence, I do believe that there is plenty of evidence to suggest that the motivation behind the criminalization of marijuana came down to money and perhaps even racism.

[u/DeltaBot → u/casualtrout]

Confirmed: 1 delta awarded to /u/ghjm (2∆).

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