TY - JOUR
T1 - Common liability to addiction and "gateway hypothesis"
T2 - Theoretical, empirical and evolutionary perspective
AU - Vanyukov, Michael M.
AU - Tarter, Ralph E.
AU - Kirillova, Galina P.
AU - Kirisci, Levent
AU - Reynolds, Maureen D.
AU - Kreek, Mary Jeanne
AU - Conway, Kevin P.
AU - Maher, Brion S.
AU - Iacono, William G.
AU - Bierut, Laura
AU - Neale, Michael C.
AU - Clark, Duncan B.
AU - Ridenour, Ty A.
PY - 2012/6
Y1 - 2012/6
N2 - Background: Two competing concepts address the development of involvement with psychoactive substances: the "gateway hypothesis" (GH) and common liability to addiction (CLA). Method: The literature on theoretical foundations and empirical findings related to both concepts is reviewed. Results: The data suggest that drug use initiation sequencing, the core GH element, is variable and opportunistic rather than uniform and developmentally deterministic. The association between risks for use of different substances, if any, can be more readily explained by common underpinnings than by specific staging. In contrast, the CLA concept is grounded in genetic theory and supported by data identifying common sources of variation in the risk for specific addictions. This commonality has identifiable neurobiological substrate and plausible evolutionary explanations. Conclusions: Whereas the "gateway" hypothesis does not specify mechanistic connections between "stages", and does not extend to the risks for addictions, the concept of common liability to addictions incorporates sequencing of drug use initiation as well as extends to related addictions and their severity, provides a parsimonious explanation of substance use and addiction co-occurrence, and establishes a theoretical and empirical foundation to research in etiology, quantitative risk and severity measurement, as well as targeted non-drug-specific prevention and early intervention.
AB - Background: Two competing concepts address the development of involvement with psychoactive substances: the "gateway hypothesis" (GH) and common liability to addiction (CLA). Method: The literature on theoretical foundations and empirical findings related to both concepts is reviewed. Results: The data suggest that drug use initiation sequencing, the core GH element, is variable and opportunistic rather than uniform and developmentally deterministic. The association between risks for use of different substances, if any, can be more readily explained by common underpinnings than by specific staging. In contrast, the CLA concept is grounded in genetic theory and supported by data identifying common sources of variation in the risk for specific addictions. This commonality has identifiable neurobiological substrate and plausible evolutionary explanations. Conclusions: Whereas the "gateway" hypothesis does not specify mechanistic connections between "stages", and does not extend to the risks for addictions, the concept of common liability to addictions incorporates sequencing of drug use initiation as well as extends to related addictions and their severity, provides a parsimonious explanation of substance use and addiction co-occurrence, and establishes a theoretical and empirical foundation to research in etiology, quantitative risk and severity measurement, as well as targeted non-drug-specific prevention and early intervention.
KW - Drug abuse
KW - Drug dependence
KW - Evolution
KW - Genetics
KW - Phenotype
UR - http://www.scopus.com/inward/record.url?scp=84862870911&partnerID=8YFLogxK
U2 - 10.1016/j.drugalcdep.2011.12.018
DO - 10.1016/j.drugalcdep.2011.12.018
M3 - Review article
C2 - 22261179
AN - SCOPUS:84862870911
SN - 0376-8716
VL - 123
SP - S3-S17
JO - Drug and Alcohol Dependence
JF - Drug and Alcohol Dependence
IS - SUPPL.1
ER -