Alcohol is a psychoactive substance, which means it alters how the brain responds to emotions and stimuli. Some people consider it a “gateway drug,” a substance that increases a person’s risk of trying other drugs.

Alcohol is a common drug used by many people in the United States. In the 2020 National Survey of Drug Use and Health, up to 85.2% of people aged 18 years and above reported trying alcohol at some point in their lives.

Some people may worry that drinking alcohol could cause someone to try other, more dangerous drugs later in life.

This article will discuss the idea of gateway drugs and whether or not alcohol qualifies as one. It will also provide information about alcohol misuse and substance misuse.

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The phrase “gateway drug” refers to any substance a person uses to get “high” that could potentially lead them to use stronger, more dangerous drugs in the future. This is called the gateway theory, or gateway hypothesis.

A 2019 review of studies from 1968–2018 found that nicotine use among teenagers may increase their likelihood of using other drugs later in life, such as cocaine, cannabis, and heroin.

However, evidence to support the gateway theory is mixed. One study from 2016 found no relationship between teenagers using tobacco, alcohol, or cannabis and an increased risk of using illegal drugs later in life.

The National Institute on Drug Abuse (NIDA) states that other factors may be responsible for a person’s increased drug use, such as their social environment.

The organization proposes that people who are more vulnerable to drug use may start by taking more readily available substances, such as cannabis, tobacco, or alcohol.

This could be why some studies find that the early use of substances such as tobacco can increase the risk of using more harmful drugs later in life.

There is no simple answer to this question.

A 2015 study found that, out of a sample of U.S. 12th-graders, those who started using alcohol in sixth grade reported using more illegal drugs more often than those who started using alcohol in ninth grade or later.

According to NIDA, alcohol can prime the brain for a heightened response to other drugs. This is known as cross-sensitization, where a person can replace one substance with another for a stronger reaction.

NIDA also states that a person typically uses alcohol, nicotine, and cannabis before progressing to more harmful substances.

However, NIDA also confirms that many factors increase a person’s likelihood of using drugs. These substances may just be the first step for those already vulnerable to substance use or misuse.

Due to this, it is hard to say whether alcohol is a gateway drug in the sense that it causes someone to try other drugs, as the causes could be due to environmental or social factors.

Find out more about the risk factors for addiction.

Risk of alcohol use disorder

According to the National Institute on Alcohol Abuse and Alcoholism (NIAAA), the early use of alcohol is a risk factor for alcohol use disorder (AUD).

AUD is a medical condition that means a person continues to consume alcohol despite the harmful consequences and impact it may have on their life.

NIAAA states that, according to a recent survey, people who started drinking before age 15 years were 5 times more likely to report having AUD than those who waited until age 21 years or later to begin drinking.

This could suggest that early alcohol use may act as a “gateway” to developing AUD later in life. However, there are other factors that increase a person’s risk of developing AUD. According to NIAAA, these include:

  • Genetics and family history: A person’s risk of developing AUD is higher if one or more of their parents has unhealthy drinking patterns.
  • Mental health conditions: People with depression, post-traumatic stress disorder (PTSD), and attention deficit hyperactivity disorder (ADHD) are more likely to develop AUD.
  • Childhood trauma: People who have experienced trauma may be more vulnerable to developing AUD.
  • Prolonged alcohol misuse: As well as drinking from an early age, misusing alcohol for a long period can increase a person’s risk of developing AUD.

Alcohol misuse is a type of substance misuse. Substance misuse refers to using any drug either in excessive amounts or for a purpose other than its intended use.

It is possible to misuse any substance, regardless of whether it is legal, illegal, prescription, or over-the-counter (OTC).

Alcohol misuse includes heavy drinking and binge drinking. The NIAAA defines heavy drinking as:

  • drinking more than 1 drink per day for females
  • drinking more than 2 drinks per day for males

It defines binge drinking as:

  • drinking more than 4 drinks in one session for females
  • drinking more than 5 drinks in one session for males

If a person’s drinking habits cause issues with personal relationships, health, or their ability to work, they may be experiencing AUD.

Find out more about how to treat alcohol use disorder.

Help is available

Seeking help for addiction may feel daunting or even scary, but several organizations can provide support.

If you believe that you or someone close to you is showing signs of addiction, you can contact the following organizations for immediate help and advice:

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Alcohol misuse is just one type of substance misuse. Other types of substance misuse can involve:

  • prescription medications
  • cannabis
  • opioids
  • cocaine

Like with AUD, there are several risk factors that can potentially influence whether a person will develop a substance misuse disorder. According to NIDA, the risk factors for adolescents misusing substances include:

  • living in poverty
  • high availability of drugs at school
  • peer pressure
  • lack of parental supervision
  • aggressive behavior in childhood

Find out more about the link between depression and substance misuse.

Learn more about peer pressure and drug use.

A person can take steps, both as an individual and as part of a community, to help prevent substance or alcohol misuse.

To help prevent alcohol misuse or AUD, the Centers for Disease Control and Prevention (CDC) recommends:

  • following recommended guidelines for consuming no more than 1 drink per day for females and no more than 2 drinks per day for males
  • making the decision ahead of time to not drink too much
  • not serving alcohol to those who should not be drinking, including those who have already had too much and those under the age of 21 years
  • talking with a doctor and requesting help if drinking becomes an issue
  • joining a community outreach program to help reduce the risk of alcohol misuse in the community

According to NIDA, factors that can protect against substance misuse include:

  • having positive relationships with peers and family members
  • parental monitoring and support
  • school antidrug policies
  • having more community and neighborhood resources

People living with alcohol misuse or substance misuse are not alone. A person can take advantage of several online or local resources to get help with their addiction.

Some places to start include:

  • Healthcare professionals: A person can contact a doctor, therapist, or other healthcare professional if they are worried about alcohol or substance use disorders. They may be able to help by offering treatment options and connecting a person with local support groups and counseling programs.
  • Alcoholics Anonymous (AA): AA offers in-person support groups for people with AUD. A person can search for local groups on the organization’s website.
  • Narcotics Anonymous (NA): NA offers support groups for people living with addiction disorders. A person can use the NA website to find meetings in their area.
  • Reach out to friends and family: Friends and family may be able to provide emotional support to a person who wants to address alcohol or substance misuse.

It is difficult to say whether alcohol is a gateway drug, as many factors influence a person’s likelihood of using drugs.

Some studies show a relationship between early alcohol use and later drug use. This could be because people vulnerable to drug use start with alcohol, which is more readily available than other drugs.

However, drinking alcohol from an early age can increase a person’s risk of misusing alcohol or developing alcohol use disorder. Signs of alcohol misuse can vary, but they often include excessive drinking, impaired thinking, and disrupted personal, social, and work lives.

A person may need additional help and support to treat alcohol or substance misuse. Local community groups, programs, and support networks are available for those who wish to seek help.