New Study Flips Everything We Know About Addiction Upside Down

Since the 1970s, countless experts and the US government have sold the public a simple explanation for drug addiction, now clinically called substance abuse disorder: the myth of the gateway drug.

The gateway drug — usually cast as weed, alcohol, tobacco, or inhalants — refers to the theory that the earlier a kid starts using drugs, the more likely they are to get into the harder stuff later in life, like heroin or cocaine. Though the idea was pioneered as early as the 1930s, the policy term was believed to be coined by the psychiatrist Robert DuPont, the first director of the US National Institute on Drug Abuse (NIDA).

Following the gateway drug theory, DuPont’s policies as NIDA director were strict and authoritarian. Though he believed that addiction was a chronic disease, he paradoxically advised Richard Nixon, Gerald Ford, and Jimmy Carter against abatement strategies like harm reduction and decriminalization.

His policy recommendations and clinical opinions formed the ideological undercurrent of the Nixon administration’s devastating War on Drugs, which led to an explosion in the US prison population and an unprecedented expansion of the police state, with little effect on overall drug use.

Now, researchers are chipping away at the gateway drug theory that led to all that.

In a recent study published in the journal JAMA Network Open and flagged by Scientific American, a cohort of psychiatrists and pharmacologists investigated the brain structure of nearly 10,000 teens over three years.

What they found was striking: though the brains of those who messed around with alcohol, tobacco, or weed did show major differences from those that didn’t, they found a crucial question of causality.

Specifically, teens younger than 15 who ended up using drugs later already had bigger brains than those who didn’t, even though they hadn’t yet used drugs when the study began. Their brain profiles were similar to those who had already experimented with substances before the tests started, with both tending to have a larger cortex with more creases.

Those brain traits are typically associated with curiosity, intelligence and “openness to experience,” which previous research has linked to experimenting with drugs.

“The drive to self-medicate is so strong; it’s really striking,” Patricia Conrod, a professor of psychiatry at the University of Montreal who’s conducted similar research, told SciAm. “There really is this discomfort with their inner world.”

It’s a pretty big blow to the gateway theory, which doesn’t take into account the years of life experience or socioeconomic factors that contribute to a teen’s likelihood of trying drugs in the first place, or who goes on to become addicted.

While it’s true that those who start using drugs from a younger age are more likely to become dependent, broader research has shown that the gateway theory serves as a way to dumb down the complex causes of drug use, often for political reasons.

“Maintaining this myth not only wastes resources but actually harms numerous individuals, primarily members of minority groups, who are being criminalized,” said Eve Waltermaurer, an epidemiologist who’s been researching the gateway myth for the better part of a decade.

Crucially, the study only addresses the early use of drugs, as opposed to long-term addiction. It remains to be seen if the same big-brain traits apply to those who become dependent on substances long-term.

Still, studies like this one are already being used to craft effective drug prevention programs — a step in the right direction after decades of criminalization.

More on drugs: Elon Musk Has Reportedly Been Traveling With a Box Full of Drugs

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