Behavior Genetics

, 36:195 | Cite as

Early Onset Cannabis Use and Progression to other Drug Use in a Sample of Dutch Twins

  • Michael T. LynskeyEmail author
  • Jacqueline M. Vink
  • Dorret I. Boomsma

One possible explanation of the commonly reported associations between early onset cannabis use and elevated risks of other illicit drug use is that early onset cannabis use increases access and availability to other drugs. It was this argument that in part motivated policy changes in the Netherlands that led to the de facto legalization of cannabis there. This study examines, using a co-twin control design, whether previously observed associations between early onset cannabis use and elevated lifetime rates of other illicit drug use would also be observed in a sample of 219 same sex Dutch twin pairs discordant for cannabis use before age 18. After adjustment for covariates, rates of lifetime party drug use (OR=7.4, 95% CI=2.3–23.4), hard drug use (OR=16.5, 95% CI=2.4–111.3), but not regular cannabis use (OR=1.3, 95% CI=0.3–5.1) were significantly elevated in individuals who reported early onset cannabis use, relative to their co-twin who had not used cannabis by age 18. The elevated odds of subsequent illicit drug use in early cannabis users relative to their non early using co-twins suggests that this association could not be explained by common familial risk factors, either genetic or environmental, for which our co-twin methodology provided rigorous control.


Cannabis other illicit drug use twins, gateway theory The Netherlands 



This work was supported by the Netherlands Organization for Scientific Research (NWO 985-10-002 and NWO 575-25-006) and by grant DA18660 from the NIH.


  1. Achenbach, T. M. (1997). Manual for the Young Adult Self Report and Young Adult Behavior Checklist, Burlington, VT: University of Vermont Department of Psychiatry.Google Scholar
  2. Australian Institute of Health and Welfare. (1999). 1998 National Drug Strategy Household Survey: First Results, Canberra: Australian Institute of Health and Welfare.Google Scholar
  3. Baumrind, D. (1983). Specious causal attribution in the social sciences: The reformulated steeping stone hypothesis as exemplar. J. Pers. Soc. Psychol. 45:1289–1298.CrossRefPubMedGoogle Scholar
  4. Boomsma, D. I., Vink, J. M., Beijsterveldt, C. E. Mv. et al. (2002). Netherlands twin register: A focus on longitudinal research. Twin Res. 5:401–406.CrossRefPubMedGoogle Scholar
  5. Cadoni, C., Pisanu, A., Solinas, M., Acqua, E., and Di Chiara, G. (2001). Behavioural sensitization after repeated exposure to Δ9 – tetrahydrocannabinol and cross-sensitization with morphine. Psychopharmacol. 158:259–266.CrossRefGoogle Scholar
  6. Collins, L. M. (2002). Using latent transition analysis to examine the gateway hypothesis. In D. B. Kandel (ed.), Stages and pathways of drug involvement: Examining the gateway hypothesis, Cambridge, UK: Cambridge University Press, pp. 254–269.Google Scholar
  7. Cottler, L. B., Robins, L. N., and Helzer, J. E. (1989). The reliability of the CIDI-SAM: A comprehensive substance abuse interview. Br. J. Addict. 84:801–814.CrossRefPubMedGoogle Scholar
  8. DeWit, D. J., Hance, J., Offord, D. R., and Ogborne, A. (2000). The influence of early and frequent use of marijuana on the risk of desistance and of progression to marijuana-related harm. Prev. Med. 31:455–464.CrossRefPubMedGoogle Scholar
  9. Ellickson, P. L., Hayes, R. D., and Bell, R. M. (1992). Stepping through the drug use sequence: Longitudinal scalogram analysis of initiation and regular use. J. Abnorm. Psychol. 101:441–451.CrossRefPubMedGoogle Scholar
  10. Fergusson, D. M., and Horwood, L. J. (1997). Early onset cannabis use and psychosocial adjustment in young adults. Addiction 92:279–296.CrossRefPubMedGoogle Scholar
  11. Fergusson, D. M., and Horwood, L. J. (2000). Does cannabis use encourage other forms of illicit drug use? Addiction 95:505–520.CrossRefPubMedGoogle Scholar
  12. Graham, J. W., Collins, L. M., Wugalter, S. E., Chung, N. K., and Hansen, W. B. (1991). Modeling transitions in latent stage-sequential processes: A substance use prevention example. J Consult Clin Psychol. 59:48–57.CrossRefPubMedGoogle Scholar
  13. Grant, B. F., Harford, T. C., Dawson, D. A., Chou, P. S., and Pickering, R. P. (1995). The alcohol use disorder and associated disabilities interview schedule (AUDADIS): Reliability of alcohol and drug modules in a general population sample. Drug Alc. Depend. 39:37–44.CrossRefGoogle Scholar
  14. Kandel, D.B. (1975). Stages in adolescent involvement in drug use. Science 190:912–914.CrossRefPubMedGoogle Scholar
  15. Kandel, D. B., and Faust, R. (1975). Sequences and stages in patterns of adolescent drug use. Arch. Gen. Psych. 32:923–932.Google Scholar
  16. Kandel, D. B., and Yamaguchi, K. (2002). Stages of drug involvement in the US population. In D.B. Kandel (ed.), Stages and pathways of drug involvement: Examining the gateway hypothesis, Cambridge, UK: Cambridge University Press, pp. 65–81.Google Scholar
  17. Kandel, D. B., Yamaguchi, K., and Chen, K. (1992). Stages of progression in drug involvement from adolescence to adulthood: further evidence for the gateway theory. J. Stud. Alcohol 53:447–457.PubMedGoogle Scholar
  18. Kleiman, M. (1992). Against Excess: Drug Policy for Results. New York: Basic Books.Google Scholar
  19. Kosterman, R., Hawkins, J. D., Guo, J., Catalaon, R. F., and Abbott, R. D. (2000). The dynamics of alcohol and marijuana initiation: Patterns and predictors of first use in adolescence. Am. J. Pub. Hlth. 90:360–366.CrossRefGoogle Scholar
  20. Lamarque, S., Taghouzti, K., and Simon, H. (2001). Chronic treatment with Δ9 – tetrahydrocannabinol enhances the locomotor response to amphetamine and heroin. Implications for vulnerability to drug addiction. Neurophamacology 41:118–129.CrossRefGoogle Scholar
  21. Lynskey, M. T., Heath, A. C., Bucholz, K. K. et al. (2003). Escalation of drug use in early-onset cannabis users versus co-twin controls. JAMA 289:427–433.CrossRefPubMedGoogle Scholar
  22. MacCoun, R. (1998). In what sense (if any) is marijuana a gateway drug? FAS Drug Policy Anal. Bull. Issue 4(
  23. Morral, A. R., McCaffrey, D. F., and Paddock, S. M. (2002). Reassessing the marijuana gateway effect. Addiction 97:1493–1504.CrossRefPubMedGoogle Scholar
  24. Parra, G. R., O’Neill, S. E., and Sher, K. J. (2003). Reliability of self-reported age of substance involvement onset. Psychol. Addict. Behav. 17:211–218.CrossRefPubMedGoogle Scholar
  25. SAS Institute Inc. (1996). SAS/ STAT Software: Changes and Enhancements for Release 6.12. Cary, NC: SAS Institute Inc.Google Scholar
  26. StataCorp. (1999). Stata Statistical Software: Release 6.0. College Station, TX: Stata Corporation.Google Scholar
  27. Tanda, G., Pontieri, F., and Di Chiara, G. (1997). Cannabinoid and heroin activation of mesolimbic dopamine transmission by a common μ1 opioid receptor mechanism. Science 276:2048–2050.CrossRefPubMedGoogle Scholar
  28. Vega, W. A., Aguilar-Gaxiola, S., Andrade, L., et al. (2002). Prevalence and age of onset for drug use in seven international sites: Results from the international consortium of psychiatric epidemiology. Drug Alcohol Depend. 68:285–297.CrossRefPubMedGoogle Scholar
  29. Verhulst, F. C., Ende van de, J., Koot, H. M., and Handleiding, voor de. (1997). Youth Self-Report. Rotterdam: Afdeling Kinder- en Jeugdpsychiatrie, Sophia Kinderziekenhuis/Academisch Ziekenhuis Rotterdam/Erasmus Universiteit Rotterdam.Google Scholar
  30. Wagner, A. F., and Anthony, J. C. (2002). Into the world of illegal drug use: Exposure opportunity and other mechanisms linking the use of alcohol, tobacco, marijuana, and cocaine. Am. J. Epidemiol. 155:918–925.CrossRefPubMedGoogle Scholar
  31. Wilcox, H. C., Wagner, F. A., and Anthony, J. C. (2002). Exposure opportunity as a mechanism linking youth marijuana use to hallucinogen use. Drug Alcohol Depend. 66:127–135.CrossRefPubMedGoogle Scholar
  32. Yamaguchi, K., and Kandel, D. B. (1984). Patterns of drug use from adolescence to young adulthood: III. Predictors of progression. Am. J. Pub. Hlth. 74:673–681.Google Scholar

Copyright information

© Springer Science+Business Media, Inc. 2006

Authors and Affiliations

  • Michael T. Lynskey
    • 1
    • 3
    Email author
  • Jacqueline M. Vink
    • 2
  • Dorret I. Boomsma
    • 2
  1. 1.Department of PsychiatryWashington University in St LouisSt LouisUSA
  2. 2.Dept of Biological PsychologyVrije UniversiteitAmsterdamThe Netherlands
  3. 3.Department of PsychiatryWashington University in St LouisSt LouisUSA

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