Relationship between Adolescent Marijuana Use and Young Adult Illicit Drug Use


We examined three components of the “gateway theory” in relation to marijuana use: (1) whether adolescent marijuana use predicts young adult drug use, (2) whether this association persists when controlling for similar family background, (3) whether common genetic or environmental factors contribute to the association. The three components were tested in adolescents from the National Longitudinal Study of Adolescent Health assessed twice during adolescence and then re-interviewed 5 years later. Component 1 was tested in 18,286 subjects, component 2 in sibling pairs (n=360) discordant for marijuana use, and component 3 in a genetically informative sub-sample (n=4846). Marijuana use was defined as any use during adolescence, and drug use was defined as self-reported past year use of other illicit drugs besides marijuana. Marijuana users were twice as likely to use illicit drugs as young adults than non-users. Shared environmental factors mediated much of the relationship between adolescent marijuana use and young adult drug use. The association remained, however, even when controlling for familial environmental and other measured factors.

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  1. Agrawal A., Neale M. C., Prescott C. A., Kendler K. S. (2004). Cannabis and other illicit drugs: comorbid use and abuse/dependence in males and females. Behav. Genet. 34:217–228

    Article  PubMed  Google Scholar 

  2. Chantala K. (2001). Constructing weights to use in analyzing individuals from Add Health data. Carolina Population Center, University of North Carolina, Chapel Hill

    Google Scholar 

  3. Crowley T. J., Riggs P. D. (1995). Adolescent substance use disorder with conduct disorder and comorbid conditions. NIDA Res Monogr. 156:49–111

    PubMed  CAS  Google Scholar 

  4. Fergusson D. M., Lynskey M. T., Horword L. J. (1993). Patterns of cannabis use among 13–14-year-old New Zealanders. New Zeal. Med. J. 106: 247–250

    PubMed  CAS  Google Scholar 

  5. Fergusson D. M., Horwood L. J. (1997). Early onset cannabis use and psychosocial adjustment in young adults. Addiction 92:279–296

    Article  PubMed  CAS  Google Scholar 

  6. Fergusson D. M., Horwood L. J. (2000). Does cannabis use encourage other forms of illicit drug use?. Addiction 95: 505–520

    Article  PubMed  CAS  Google Scholar 

  7. Haberstick, B. C., Lessem, J. M., Hopfer, C. M., Smolen, A., Ehringer, M. A., Timberlake, D., and Hewitt, J. K. (2005). Monoamine oxidase A (MAOA) and antisocial behaviors in the presence of childhood and adolescent maltreatment. Am. J. Med. Genet. B Neuropsychiatr. Genet. 135B: 59–64

    Article  PubMed  Google Scholar 

  8. Johnston L. D., O’Malley P. M., Bachman J. G. (2003). National survey results from the Monitoring the Future Study 1975–2002, Vol. 1. Secondary school students. U.S. Department of Health and Human Services, Public Health Service, National Institutes of Health, Bethesda, MD

    Google Scholar 

  9. Kandel D. B. (1985).On processes of peer influences in adolescent drug use: a developmental perspective. Adv. Alcohol Subst. Abuse 4: 139–163

    PubMed  CAS  Google Scholar 

  10. Kandel D. B., Yamaguchi K., Chen K. (1992). Stages of progression in drug involvement from adolescence to adulthood: further evidence for the gateway theory. J. Stud. Alcohol 53:447–57

    PubMed  CAS  Google Scholar 

  11. Kandel D. B. (2003). Does marijuana use cause the use of other drugs?. JAMA 289: 482–483

    Article  PubMed  Google Scholar 

  12. Lynskey M. (2002). An alternative model is feasible, but the gateway hypothesis has not been invalidated: comments on Morral et al. Addiction. 97(12):1505–1507

    Article  PubMed  Google Scholar 

  13. Lynskey M. T., Heath A. C., Bucholz K. K., Slutske W. S., Madden P. A., Nelson E. C., Statham D. J., Martin N. G. (2003). Escalation of drug use in early-onset cannabis users vs. co-twin controls. JAMA 289: 427–433

    Article  PubMed  Google Scholar 

  14. Morral A. R., McCaffrey D. F., Paddock S. M. (2002). Reassessing the marijuana gateway effect. Addiction 97: 1493–1504

    Article  PubMed  Google Scholar 

  15. Neale M. C., Kendler K. S. (1995). Models of comorbidity for multifactorial disorders. Am. J. Hum. Genet. 57: 935–953

    PubMed  CAS  Google Scholar 

  16. Sieving R. E., Beuhring T., Resnick M. D., Bearinger L. H., Shew M., Ireland M., Blum R. W. (2001). Development of adolescent self-report measures from the National Longitudinal Study of Adolescent Health. J. Adolesc. Health 28(1):73–81

    Article  PubMed  CAS  Google Scholar 

  17. Shrout P. E. (1998). Causal modeling of epidemiological data on psychiatric disorders. Soc Psychiatry Psychiatr Epidemiol. 33(8):400–4

    Article  PubMed  CAS  Google Scholar 

  18. Stenbacka M., Allebeck P., Romelsjo A. (1993). Initiation into drug abuse: the pathway from being offered drugs to trying cannabis and progression to intravenous drug abuse. Scand. J. Soc. Med. 21: 31–39

    PubMed  CAS  Google Scholar 

  19. Substance Abuse and Mental Health Services Administration (2002). Marijuana Treatment Admissions Increase: 1993–1999. SAMHSA

  20. Tourangeau R., Hee-Choon S. (1998). National Longitudinal Study of adolescent health grand sample weight. carolina population center, University of North Carolina, Chapel Hill

    Google Scholar 

  21. Udry, J. R. (2003). The National Longitudinal Study of Adolescent Health (Add Health), Waves I & II, 1994–1996; Wave III, 2001–2002 [machine-readable data file and documentation]. Chapel Hill, NC: Carolina Population Center, University of North Carolina at Chapel Hill

  22. Yamaguchi K., Kandel D. B. (1984a). Patterns of drug use from adolescence to young adulthood: II. Sequences of progression. Am. J. Public Health 74: 668–672

    CAS  Google Scholar 

  23. Yamaguchi K., Kandel D.B. (1984b). Patterns of drug use from adolescence to young adulthood: III. Predictors of progression. Am. J. Public Health 74: 673–681

    CAS  Article  Google Scholar 

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The work was supported by P01-HD31921, DA000357, HD07289, AA07464, DA11015, EY 012562, DA015522, and AA015366.

This research uses data from Add Health, a program project designed by J. Richard Udry, Peter S. Bearman, and Kathleen Mullan Harris, and funded by a Grant P01-HD31921 from the National Institute of Child Health and Human Development, with cooperative funding from 17 other agencies. Special acknowledgment is due Ronald R. Rindfuss and Barbara Entwisle for assistance in the original design. Persons interested in obtaining data from Add Health should contact Add Health, Carolina Population Center, 123 W. Franklin Street, Chapel Hill, NC 27516-2524 (

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Correspondence to Jeffrey M. Lessem.

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Lessem, J.M., Hopfer, C.J., Haberstick, B.C. et al. Relationship between Adolescent Marijuana Use and Young Adult Illicit Drug Use. Behav Genet 36, 498–506 (2006).

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  • Gateway theory
  • genetics
  • illicit drugs
  • Longitudinal Survey of Adolescent Health
  • marijuana