Is Marijuana a Gateway Drug?
Marijuana does not lead most people to harder drugs: NIDA says most people who use cannabis do not go on to other drugs, though CDC estimates about 3 in 10 people who use it have cannabis use disorder. Still, many people call it a gateway drug. Not just everyday people either. We’re talking about our political leaders.
Back in 2015, New Jersey governor and presidential candidate Chris Christie said that he was against marijuana legalization and would like to see a federal crackdown on states like Washington and Colorado.
His reasoning? “Marijuana is a gateway drug,” he said.
In 2017, then Attorney General Jeff Sessions claimed that marijuana is only “slightly less awful” than heroin, while discussing the opioid crisis (we’ll look at what research says about marijuana and opioids later in the post).
If high-profile government officials still don’t believe in the medicinal value of marijuana, it’s no wonder that people still call marijuana a gateway drug.
But is that even true? Is marijuana a gateway drug?
We at Dr. Green Relief believe in giving patients the information they need so that they can decide whether or not medical marijuana is right for them. We also believe the gateway label oversimplifies the research, and that it can be harmful.
- Politicians who believe that marijuana is a gateway drug may oppose medical marijuana laws, limiting options for patients who might qualify.
- Even in states where medical marijuana is legal, qualifying patients may refuse to consider medical marijuana as a viable treatment because they’re afraid it will somehow lead them down the road to cocaine/heroin/meth addiction.
So if marijuana isn’t a gateway drug, how did this myth become so popular? Where did it even come from?
The Origin of the Gateway Drug Theory
In the 1970s, researchers at Columbia University studied the order in which young people start using drugs, and in 1975 they described it as a series of stages.
Their work is often linked to the term “gateway drug.” The sequence they described began with legal drugs, though it also placed marijuana as a step before other illicit drugs.
The research looked at alcohol and tobacco as well as marijuana.
That wider view mattered.
It found that young people typically use legal drugs such as beer, wine, cigarettes or hard liquor before marijuana.
Later mouse research by the same group, published in 2011 and discussed again in 2014, suggested that nicotine can “prime” the brain’s response to cocaine.
If this is all news to you, it may be because the gateway idea is often repeated without this context.
Nicotine and Alcohol: Are They the “Real” Gateway Drugs?
A 2016 study of 2,835 U.S. 12th graders, published in the Journal of School Health, looked at this question.
The study looked at which substance students used first and in what order. It found:
- Alcohol: the most common first substance
- Tobacco and marijuana: most students who used several substances started them after alcohol
- Early drinking: starting alcohol in sixth grade was tied to more illicit drug use later
These findings echo the 1970s research on the order of drug use.
But Aren’t Marijuana Users More Likely to Use Harder Drugs than Non-Users?
Yes, that is true.
But it’s important that we make a distinction between correlation and causation.
Correlation means that two events are connected to one another.
Causation means that one event actually causes the other event to occur.
When anti-marijuana groups call marijuana a gateway drug, they’re suggesting that there’s something about marijuana that makes people want to try harder drugs. Take away the marijuana, and supposedly, fewer people will use more dangerous substances.
The research points both ways. NIDA says most people who use cannabis do not go on to use other substances, but notes that brain changes from cannabis use may raise the risk of addiction to other drugs.
Although people who use marijuana are more likely to use harder drugs than people who’ve never used marijuana, that doesn’t mean marijuana makes you want to try those drugs.
A Simple Analogy
Look at it this way: children who play with toy swords are probably more likely to grow up and become sword-fighting instructors than children who never played with toy swords.
In other words, if you asked a sword-fighting instructor, “Did you play with toy swords as a child?” the answer will probably be “Yes.” You’d have a difficult time finding a sword-fighting instructor who never touched a toy sword as a kid.
But that doesn’t mean that toy swords are a gateway to becoming a sword-fighting instructor.
We’re willing to bet that most children who play with toy swords don’t become sword-fighting instructors.
Here’s the question we really need to be asking: do the majority of people who use marijuana typically go on to use harder, more addictive substances?
- About 19% of Americans, 52.5 million people, used cannabis at least once in 2021, according to CDC
- Most people who use cannabis do not go on to use other drugs, per NIDA
- About 3 in 10 people who use cannabis have cannabis use disorder, CDC estimates
So is marijuana a gateway drug? For most people it does not lead to harder drugs, but it carries its own risk of addiction.
The risk is higher for people who start young.
NIDA notes that the risk factors for cannabis use are similar to those for other drugs with addiction potential, which helps explain why the two often go together.
So Is Medical Marijuana 100% Safe?
People can and do abuse medicines of all types. Marijuana is no exception. Part of our work is to ensure that our patients use medical marijuana in a safe and responsible manner.
Context is everything. For example, the coca leaf has been used as a natural medicine for thousands of years; it’s only when it’s processed and turned into cocaine that it becomes something extremely dangerous and addictive.
There is currently an opioid epidemic in America, which is why claims about marijuana and opioids deserve a careful look.
Opioid overdoses killed 79,358 people in the U.S. in 2023, according to NIDA. Cannabis carries its own risks, including cannabis use disorder, and is not an approved treatment for opioid addiction.
What Research Says About Marijuana and Opioid Addiction
Some clinicians have explored cannabis for people trying to cut back on opioids, but it is not an approved addiction treatment.
A 2019 randomized trial of CBD in people with heroin use disorder found less craving triggered by drug cues, but it did not test withdrawal, and the link between medical cannabis laws and fewer opioid deaths reversed when data through 2017 were added.
As with the gateway question, a link in state-level data does not show cause.
For now, NIH’s NCCIH says none of the high-quality studies it reviewed in people with pain found that cannabinoids led to decreased opioid use, so anyone with opioid use disorder should work with their care team.
Since April 28, 2026, marijuana in an FDA-approved product or subject to a state medical marijuana license is in federal Schedule III, and all other marijuana stays in Schedule I; both are still federally controlled substances. Neither schedule makes cannabis an approved treatment for opioid addiction.
Beyond the Gateway Label
For decades, marijuana has been stigmatized by the political, medical and media establishments. Calling marijuana a gateway drug has been right up there with the “Just Say ‘No'” campaign.
Thankfully, attitudes are shifting: by 2022, medical cannabis was legal under state law in 38 states and Washington, D.C.
Marijuana is not a gateway for most people, but it is not harmless: it can be addictive, especially for people who start young. Honest information about both sides helps patients decide whether medical marijuana is right for them.
Do you qualify for medical marijuana use in Florida but have safety concerns? Feel free to give us a call, and we’ll be happy to answer any questions you may have. And if you’re ready to apply for a medical marijuana card in Florida, schedule an appointment today.
