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Marijuana and the 'Gateway Theory'

Experts agree that the use of marijuana is not causally linked to the use of other illicit substances

Sequentially, most consumers of illicit substances first experimented with either alcohol or tobacco

Statistically, the overwhelming majority of people to try marijuana do not go on to use other illicit drugs, and most typically cease their use of marijuana by middle age

In jurisdictions where marijuana is legally accessible, adults typically report decreasing their use of other controlled substances. In this sense, marijuana appears to act more as a potential ‘exit drug’ rather than as an alleged 'gateway'

  • "[F]indings on cannabis substitution effect and the biological mechanisms behind it strongly suggest that cannabis could play a role in reducing the public health impacts of prescription and non-prescription opioids. ... The growing body of research supporting the medical use of cannabis as an adjunct or substitute for opioids creates an evidence-based rationale for governments, health care providers, and academic researchers to consider the implementation and assessment of cannabis-based interventions in the opioid crisis."
  • "Among respondents that regularly used opioids, over three-quarters (76.7%) indicated that they reduced their use since they started medical cannabis. This was significantly ( p < 0.0001) greater than the patients that reduced their use of antidepressants (37.6%) or alcohol (42.0%). Approximately two-thirds of patients decreased their use of anti-anxiety (71.8%), migraine (66.7%), and sleep (65.2%) medications following medical cannabis."

In clinical settings, marijuana use is associated with reduced cravings for cocaine and opiates