Is Alcohol a Gateway Drug?

The Gateway Drug Theory, which is based upon decades of research, suggests that teen substance abuse begins with alcohol and tobacco and then progresses.

Underage drinking is common. In fact, 2019 statistics show that nearly one-fourth of teens aged 14 to 15 had at least one drink that year. Given the high prevalence of teen drinking, many experts have questioned whether alcohol is a gateway drug. Research in the area of addiction science provides some answers, and the Gateway Drug Theory is at the center of much of this research.

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What Is the Gateway Drug Theory?

The Gateway Drug Theory states that when teens experiment with substances like alcohol, tobacco and marijuana, they later go on to abuse more addictive drugs like cocaine, heroin and amphetamines. Based on this theory, many researchers have studied how using drugs or alcohol at certain ages can lead to substance abuse and addiction in adulthood. 

The idea behind Gateway Drug Theory is that certain drugs serve as a gateway for the use of other drugs, in a specific sequence. More specifically, substance abuse begins with a legal drug like alcohol and proceeds to illicit drugs like cocaine.

History of the Gateway Drug Theory 

The Gateway Drug Theory began with several studies conducted in the 1970s, which showed that teenage drug use followed a specific sequence. This sequence began with alcohol and cigarettes and then progressed to substances like marijuana, cocaine and heroin during adulthood. Research in the early 2000s focused on the effects of drugs on animals and found that the use of one drug makes the effects of other drugs stronger. Other studies conducted during the 2000s demonstrated that early marijuana use was linked to increased use of other illegal drugs. 

Denise Kandel is often credited with developing the Gateway Drug Theory, as she and her colleagues conducted long-term studies showing that there is a specific sequence that teens follow when initiating substance use. Her work, which was published in 1975, showed that teens begin by consuming beer or wine, progress to using tobacco and hard liquor and then begin using marijuana. Illegal drug use follows the initiation of marijuana use, according to Kandel’s research. 

Is Alcohol a Gateway Drug?

Given the premise of the Gateway Drug Theory, which says that teens progress from using legal substances to abusing illicit drugs, researchers have focused their attention on alcohol as a potential gateway drug. 

One recent study involving U.S. 12th graders found that the majority of participants who had used multiple substances tried alcohol before beginning tobacco or marijuana use. The study also revealed that people who began using alcohol in sixth grade were more likely to have used illegal drugs during their lives when compared to those who began drinking in ninth grade or later. 

Additional research has shown that using alcohol at age 15 increases the risk that someone will inject drugs during adulthood, offering further evidence of the Gateway Hypothesis. Altogether, the research provides a large body of evidence suggesting that alcohol use begins prior to the use of illegal drugs. This suggests that alcohol is, in fact, a gateway drug. 

Related: Is Alcohol A Drug?

Other Gateway Drugs

Alcohol is frequently cited as a gateway drug, but it is not the only substance that is thought to lead to the use of illegal drugs down the road. These substances are also labeled as gateway drugs.


There has been a great deal of controversy surrounding marijuana as a gateway drug. Despite disagreement on the dangers of marijuana, a recent report found that people who use marijuana are 2.76 times more likely to transition to opioid use and 2.52 times more likely to develop opioid addiction or show signs of opioid abuse. 


There is a large body of research showing that youth often begin smoking before transitioning to the use of illegal drugs. There is also evidence that nicotine primes the brain for addiction to other drugs by increasing the release of the brain chemical dopamine, which makes drug use feel pleasurable. 

One study found that the majority of cocaine users were smokers when they first used cocaine. In addition, the rate of cocaine addiction was higher among those who smoked cigarettes prior to beginning cocaine use, compared to those who used cocaine before cigarettes. 

Prescription Pills

Some experts label prescription pills as gateway drugs, despite the fact that alcohol, tobacco and marijuana are the most commonly cited gateway drugs. Prescription opioids like Vicodin are believed to be gateway drugs, as one study found that 80% of heroin users first abused prescription opioids before progressing to heroin use. 

Do Gateway Drugs Actually Lead to the Use of More Dangerous Substances?

Based on the available research, there is some evidence that the Gateway Drug Theory is true. However, while some studies do support the Gateway Hypothesis, the research is mixed. For example, a recent study found that it isn’t necessarily that gateway drugs directly lead to the use of harder drugs; rather, it is teens’ attitudes toward drugs that explain the Gateway Drug Theory. In the study, having a more accepting attitude toward drugs was linked to the use of harder drugs. The study’s authors concluded that after using gateway drugs, teens may become more accepting of hard drug use and then begin using illegal drugs.

Teens who progress from alcohol, tobacco and marijuana use to the use of illegal drugs may simply be in an environment that is more permissive of drug use. They may also be genetically vulnerable to substance use, so they begin experimenting early with alcohol, tobacco and marijuana and then progress to harder drug use over time. Studies have also shown that there are cross-generational effects, where a parent’s use of gateway drugs increases their child’s risk of using amphetamines and heroin. 

In summary, there is plenty of research evidence showing that gateway drugs like alcohol and marijuana increase the risk that teens will use harder drugs like cocaine. However, this doesn’t necessarily mean that alcohol or other substances classified as gateway drugs directly lead to the use of more dangerous drugs. Substance use and addiction is complex, and there are multiple factors that contribute to the risk of illegal drug use. 

Gateway Drug Statistics

Use of alcohol, tobacco and marijuana can increase the risk of future hard drug use. These gateway drug statistics show how much the risk of illegal drug use increases with gateway drug use:

  • Those who use tobacco are 2.6 times more likely to use marijuana.
  • Teens who use alcohol are 1.56 times more likely to use marijuana.
  • Marijuana users are 2.79 times more likely to use illegal drugs.

These statistics suggest that teens tend to progress from alcohol and tobacco use to marijuana use, which then increases the risk of future hard drug use. However, it’s important to keep in mind that not all teens who use marijuana progress to illegal drug use. As the National Institute on Drug Abuse (NIDA) explains, most marijuana users do not go on to use hard drugs. Instead, it may simply be that people who have more risk factors for drug abuse begin with readily available substances like alcohol and marijuana. 

Other Risk Factors for Illicit Drug Use

Gateway drugs may increase the risk of hard drug use among people who are already vulnerable to substance abuse. Beyond the Gateway Drug Theory, these risk factors can explain why some people use hard drugs and others do not:

  • Environmental factors: Environmental factors, such as growing up in a home where parents use drugs or having parents who have a positive attitude toward drug use, increase the risk of using illegal drugs. Teens who have poor parental supervision are also at increased risk.
  • Genetics: A family history of drug use increases the risk that a teen will use hard drugs. In fact, one study found that genetics explain about 27% of the risk that a teen will initiate drug use. 
  • School/peer-related factors: Teens are at increased risk of illegal drug use based on certain factors related to school and peer relationships. These include association with peers who engage in delinquent behaviors, low school performance and disconnection from school.
  • Other vulnerabilities: Factors like mental health disorders, history of childhood sexual abuse and parental rejection can also increase the risk of substance abuse. 

Treatment For Substance Abuse

Regardless of whether alcohol is a gateway drug, the truth is that alcohol abuse can lead to addiction. Some people may have an addiction only to alcohol, while others may progress to the abuse of other substances. If you are seeking treatment for addiction to alcohol or other drugs, The Recovery Village Cherry Hill at Cooper offers a full range of addiction treatment services. 

We offer comprehensive drug and alcohol rehab in South Jersey, and we are qualified to treat co-occurring mental health disorders like anxiety and depression. Our full range of services includes medical detox, inpatient rehab and outpatient care. Our 90-bed inpatient facility offers a multitude of services, including individual and group therapy, medical support and case management. Amenities found at our rehab center include a fitness facility, yoga room, entertainment lounges and basketball and volleyball courts.

If you or someone you love is struggling with substance abuse and addiction, help is available at The Recovery Village Cherry Hill at Cooper. Contact us today to verify your insurance or begin the admissions process. 

Get Help

If you or someone you love is facing an alcohol use disorder, The Recovery Village Cherry Hill at Cooper can help. We offer medical detox and comprehensive rehab programs that are tailored to suit your needs.

Medical Disclaimer: The Recovery Village aims to improve the quality of life for people struggling with a substance use or mental health disorder with fact-based content about the nature of behavioral health conditions, treatment options and their related outcomes. We publish material that is researched, cited, edited and reviewed by licensed medical professionals. The information we provide is not intended to be a substitute for professional medical advice, diagnosis or treatment. It should not be used in place of the advice of your physician or other qualified healthcare provider.