RESEARCHERS SAY SMOKING POT NOT ALWAYS PATH TO HARD DRUGS

Contrary to popular belief, smoking marijuana need not be a
steppingstone between using alcohol and tobacco and experimenting with
illegal drugs such as cocaine and heroin.

Researchers led by Ralph E. Tarter, a professor at the University of
Pittsburgh's School of Pharmacy, found that nearly a quarter of the
young men they studied used marijuana before they began drinking or
smoking cigarettes.

It's the reverse of what's known as the "gateway hypothesis," in which
drug use is thought to progress from alcohol and tobacco to marijuana
to hard drugs.

The researchers determined also that the likelihood of developing a
substance abuse problem was similar in youngsters who followed the
traditional gateway drug use pattern and those who followed the
reverse pattern.

"This is actually quite novel, this idea," Dr. Tarter said. "It runs
counter to about six decades of current drug policy in the country,
where we believe that if we can't stop kids from using marijuana, then
they're going to go on and become addicts to hard drugs."

But the data doesn't support that contention, he noted. The findings
were published in this month's American Journal of Psychiatry.

Marijuana was the first drug used by a 26-year-old man from Beaver
County who is undergoing addiction treatment at Gateway Rehabilitation
Center. He was 15 the first time he tried it, on a Saturday with a
group of friends.

At their suggestion, he began smoking cigarettes when he started using
marijuana.

"That's how they taught me how to hold in the smoke of the weed,
because cigarette smoke is stronger than marijuana smoke," he explained.

Smoking pot soon became a weekend thing.

Then, "I started smoking in the morning before I would go to school,"
he recalled. "Sometimes I would sneak away and go smoke during lunch.
Then after school I would smoke."

Eventually, he was using marijuana "all day, every day," he said. If
he didn't smoke, he'd get headaches and have problems sleeping. Two
years ago, a friend introduced him to snorting cocaine, and he began
using that in addition to smoking pot.

Now married and a father, he realized he was spending all his money on
drugs, instead of his family. So he checked himself into rehab in the
hope of overcoming his addictions.

In Dr. Tarter's study, which was funded by the National Institute on
Drug Abuse, researchers monitored more than 200 young men at intervals
from the time they were 10 to 12 years of age until they were 22. They
fell into one of three groups: those who used only alcohol or tobacco;
those who started with alcohol and tobacco and then used marijuana;
and those who used marijuana prior to using alcohol and tobacco.

Among those who used marijuana, nearly a quarter followed the reverse
of the gateway pattern. They tended to have less parental supervision
and to live in neighborhoods with poor physical environments where
illegal drugs were more available.

In general, the marijuana-users were more behaviorally deviant, less
involved with school and had friends their parents didn't like, the
researchers found.

"That all makes sense to me," said the Gateway Rehab Center patient.
"If I had stayed with the crowd I grew up with, I don't think I'd have
had this problem. I started to hang with the wrong crowd."

Some of his friends have used harder drugs, such as cocaine, while
others used marijuana now and then, but never progressed further into
addiction, he said.

It was easier to obtain marijuana than alcohol or cigarettes as a
teenager, he added.

"You always had to show a form of ID to get those," he said. "But I
could always go to the person who was selling the weed to get it, and
they wouldn't ask for ID. It was never hard to get for me."

Gateway's medical director, Dr. Neil Capretto, said a few patients
have told him that the first drug they used was heroin, which is "very
available now in many neighborhoods, whether it be inner-city
Pittsburgh or upper-middle-class suburbs."

He praised the Pitt study, saying "it really shows the complex nature
of addiction. What they're showing here is what we've been seeing in
practice for years."

Most people who experiment with marijuana do not go on to use harder
drugs, Dr. Capretto said.

Still, "the vast majority of people who we see who do cocaine or
heroin have done marijuana in the past, or are likely to do it at some
time in the future," he noted. But "if we could push a button and all
the marijuana would go away, by no means will that stop the drug
problem in this country."

Dr. Capretto described the mother of a patient who was relieved that,
unlike her other son who was addicted to heroin, her younger boy's
dropping grades and mood changes were due to marijuana use.

"I said, 'That's not necessarily good news,' " he recounted.
"Something's still wrong. Whether it be a young person on alcohol,
tobacco or marijuana, [even] if that's all they ever do, that's a
problem right there."

According to Dr. Tarter, drug use prevention messages should minimize
"slippery slope" scare tactics and emphasize healthy living.
Interventions to foster values and attitudes that resist illegal
behaviors and to strengthen parenting skills could be helpful.

It's possible to identify children who are at high risk for drug use
years before they begin experimenting, Dr. Tarter said.

"Nothing is carved in stone, especially at this age," he said. "But
the longer you wait, the harder it is to change."