Format

Send to

Choose Destination
Drug Alcohol Depend. 2012 Jun;123 Suppl 1:S3-17. doi: 10.1016/j.drugalcdep.2011.12.018. Epub 2012 Jan 18.

Common liability to addiction and "gateway hypothesis": theoretical, empirical and evolutionary perspective.

Author information

1
Department of Pharmaceutical Sciences, University of Pittsburgh, Pittsburgh, PA, USA. mmv@pitt.edu

Abstract

BACKGROUND:

Two competing concepts address the development of involvement with psychoactive substances: the "gateway hypothesis" (GH) and common liability to addiction (CLA).

METHOD:

The literature on theoretical foundations and empirical findings related to both concepts is reviewed.

RESULTS:

The data suggest that drug use initiation sequencing, the core GH element, is variable and opportunistic rather than uniform and developmentally deterministic. The association between risks for use of different substances, if any, can be more readily explained by common underpinnings than by specific staging. In contrast, the CLA concept is grounded in genetic theory and supported by data identifying common sources of variation in the risk for specific addictions. This commonality has identifiable neurobiological substrate and plausible evolutionary explanations.

CONCLUSIONS:

Whereas the "gateway" hypothesis does not specify mechanistic connections between "stages", and does not extend to the risks for addictions, the concept of common liability to addictions incorporates sequencing of drug use initiation as well as extends to related addictions and their severity, provides a parsimonious explanation of substance use and addiction co-occurrence, and establishes a theoretical and empirical foundation to research in etiology, quantitative risk and severity measurement, as well as targeted non-drug-specific prevention and early intervention.

PMID:
22261179
PMCID:
PMC3600369
DOI:
10.1016/j.drugalcdep.2011.12.018
[Indexed for MEDLINE]
Free PMC Article

Supplemental Content

Full text links

Icon for Elsevier Science Icon for PubMed Central
Loading ...
Support Center