an interview with Dr. Andrew L. Golub
The controversial but popular Gateway theory was briefly discussed in Alcohol, Law, and Policy. In the interview reported here, Dr. Andrew Lang Golub, a leading authority on the Gateway and related theories, expands that discussion.
Dr. Golub, could you explain the similarities and differences between the popular Gateway and Stepping Stone theories?
The idea that one behavior leads to another is an old one going back hundreds of years. The Stepping Stone and Gateway theories or metaphors each suggest something slightly different about the nature of substance use progression. There is a theory that youths typically start substance use with alcohol and tobacco which are widely used by adults but whose use is prohibited to youths. Some of these individuals progress to marijuana use and some marijuana users progress to hard drugs. The two different metaphors have different suggestions about the inevitability of the progression.
The Stepping Stone metaphor brings to mind stones leading across a stream. It suggests that once a person takes the first step, crossing the water to the other side is inevitable. Presumably the opposite bank represents hard drug use, hard drug abuse and all of the attendant consequences. Thus, a youth who has had a taste of alcohol or tobacco is destined to smoke marijuana, then go on to hard drugs such as cocaine, crack, heroin and LSD. Additionally, the individual is in grave danger of being swept downstream by the current representing the dangers of substance use progression unless the person returns to the original side, which metaphorically corresponds to non-substance use.
In contrast, the Gateway metaphor suggests a series of gates leading into successive pastures. A person can pass through one gate and spend time in the first field representing alcohol and tobacco use and perhaps never go through subsequent gates leading to marijuana and hard drug use. Passing through each gate exposes the individual to new risks.
So the Stepping Stone theory suggests that the progression to more dangerous substances is inevitable unless the user gives up all the substances (stepping stones) and returns to the safe side (abstinence), never to take even one step across the water?
You got it. By adopting this metaphor as if it were true, many policy advocates have strongly called for abstinence and zero tolerance of any youthful substance use. Indeed, the latest statement of the Nation's drug policy from the White House calls for zero tolerance of under age alcohol and tobacco use.
The Gateway theory seems to be less extreme than the Stepping Stone. It's obvious that using one substance doesn't inexorably result in hard drug use and abuse.
That's right. If you stick to a very literal interpretation of the two metaphors.
Could those who have entered the "hard drug use field" return to the "marijuana field," never to go back to hard drugs like cocaine?
Yes. In fact, the authors of the Monitoring The Future Study, a program which interviews high school seniors every year, have found that individuals cut back and even quit the use of various substances toward the end of young adulthood.
Are these theories supported by evidence from the real world?
At the superficial level, there is much evidence that individuals initiate alcohol and tobacco use at earlier ages than marijuana and hard drug use. However, the evidence is clearly inconsistent with the rigid progression implied by the Stepping Stone metaphor. In fact, several recent studies even suggest a substantial proportion of those individuals who became hard drug users did not follow the gateway sequence. In 1994, I published the results of a study of substance use progression of mostly crack abusers from inner-city New York. It found that these individuals were just as likely to have started with marijuana use as alcohol use and that those individuals born in more recent years were even more likely to have started with marijuana use. Analyses of at least three other samples have also found that a substantial proportion of hard drug users had not followed the gateway sequence. These studies cast doubt on whether experimentation at one stage is necessary to use of substances associated with later stages.
Personally, my preferred metaphor is one that is widely used in the psychology literature, the markers metaphor. I suggest that use of alcohol, tobacco, and marijuana serve as "markers" of those youths who are at increased risk of hard drug use. The image here is that of a network of roadways. Along one path is the typical "gateway" sequence to hard drugs, but there are other paths leading to hard drugs. Most importantly, there are many paths involving adolescent substance use leading to otherwise fine outcomes in young adulthood.
So the popular idea that preventing people from using the first gateway substance is faulty because it wouldn't prevent them from using illegal drugs?
Does the Gateway theory tell us who will pass through one gateway and who won't?
There is much theory about psychological and sociological factors associated with increased risk of substance use and other factors which tend to protect individuals from such use. However, it is important to note that the association here is statistical; progression is not automatic.
There are three central domains which affect an individual's reaction: the substance used, the person's mind set, and the social setting in which use occurs. All three of these factors are important and it is a gross oversimplification to suggest that use of one substance inexorably leads to another. The progression of which substances an individual uses clearly occurs within a cultural context and, importantly, an individual's progress is affected by their place in that culture as well as other personal factors.
Your approach seems to be realistic and based on the actual behavior of people, doesn't it?
Given the obvious inadequacies of the Stepping Stone and Gateway theories, why are they so popular?
I suspect there are a variety of reasons. Graham Allison has indicated that there are three domains--rational, institutional and political--which affect the formation of public policy. The wealth of scientific findings inform the rational perspective. It is convenient to reduce this often dry stack of findings to a simple metaphor. Convenient, but not always correct. The gateway and stepping stone metaphors are particularly compelling because, if they were true, they provide a clear foundation for early substance abuse prevention, a problem of great concern. The true solution to this problem is probably much more complicated as are most problems regarding human behavior and our social condition.
From the institutional perspective, there are many agencies and policies dedicated to preventing adolescent substance use. Making important sounding statements based on the gateway theory provides a useful justification for larger budgets, increased staff, and job security.
From the political perspective, there are varied interest groups which appear to be increasingly intolerant of people taking individual risks. These groups are concerning themselves with a wide range of behaviors, automobile air bags, the use of child seats in cars, second-hand smoke, and adolescent substance use. Supporting a theory, like the gateway theory, helps propel their concerns to the forefront.
You mentioned zero tolerance earlier. How effective is this approach to the problem?
I suspect that even if you could keep youths from using alcohol and tobacco, this would not reduce substance abuse. I say "could" because our nation has been engaging in a "war against drugs" for decades, use of alcohol and tobacco are prohibited for youths, yet most youths experiment with both before reaching the age of legal majority. So, I seriously question whether all youthful substance use could ever be prevented. Moreover, by energetically opposing all use we might actually be promoting abuse. You [David Hanson] have written extensively on the cultural theory of alcohol use. This theory suggests that learning how to drink from responsible members of the community is the best way to assure that individuals will incorporate alcohol use into a functional lifestyle, if they choose to use. Cross-cultural comparisons suggests that in groups that are intolerant of alcohol use, there are more individuals whose use has led to personal and social problems. I suspect that there is much merit to this theory.
You've studied this subject for many years. Based on your expertise, what public or educational policy would you recommend to reduce substance abuse?
I am not happy with the increasing intolerance of youthful substance use. I feel that we are prematurely branding individuals as criminals as opposed to reaching out and trying to help them with their problems. On the other hand, I do not recommend any dramatic changes at this time, like lowering the drinking age. Dramatic social changes can be very disruptive and lead to unintended consequences. I would recommend a policy similar to what has prevailed in the last 30 years and that is grudging tolerance. This would result in an official policy which in effect says we do not condone your substance use; however, if you ever need help in thinking through your problems, we're here for you. Such a policy would allow educators and other professionals to work with youths and to help them in any way they possibly can. The way current policies are moving, a youth would need to pledge abstinence as a precondition to counseling or else risk criminal penalties.
Thank you very much, Dr. Golub, for sharing your expertise.
Dr. Andrew Lang Golub received his Ph.D. in Public Policy Analysis from Carnegie Mellon University. He is currently a Principal Investigator at the National Development and Research Institute in New York City. His research focuses on advancing our understanding of the nature of substance use and abuse through statistical analyses in order to develop appropriate, effective and cost-effective public policies.