Trauma: The Gateway Drug

Many of us have heard the argument marijuana or cannabis is the gateway drug that often leads individuals to become addicted to other substances.

The argument for a gateway drug to explain addiction has long been championed even to the present day. Proponents of this theory have argued substances such as cannabis are door openers for individuals to intake substances like heroin, methamphetamine, bath salts. What this argument fails to take into consideration is the body of research that looks at contextual factors associated with addiction.

We can trace the trajectory back to the Regan era mindset of “This is your brain on drugs” (insert television public service announcement with nostalgic egg cracking into a frying pan to explain how brains are affected by drug use) and the war on drugs policies and philosophies. It is safe to say this understanding of addiction is grossly misleading and not based in research. If we go back further into the history of drug use, we often find racism and oppression of people of color. Consider the term from the 1930’s “reefer madness” and a movie by that name which denoted an insanity that arose after use of cannabis.

As therapist who works in the addictions field I can say from experience that an overwhelming majority of my clients have experienced trauma. The common theme in their lives is not their drugs of choice but rather overwhelming life events and toxic stress or trauma that have increased their risk taking behaviors. The war on drugs is in reality a war on traumatized individuals.

What is trauma?

In general terms trauma can be defined as a psychological, emotional reaction to an event or experience that is profoundly distressing or disturbing. To understand trauma we must understand how the person experienced the event. Trauma is a subjective experience. Our capacity to integrate experiences vary from one person to the next. For example, being hit by a car might cause one person to be upset, a natural response. Another person in the same situation might have flashbacks, nightmares, and hypervigilance each time they think of driving. It is often difficult to predict what will be a traumatic experience.

A number of studies on childhood development have shown the ways early life experiences program the brain and body to response to its environment. In an animal study on attachment, The Harlow Experiment/the wire monkey experiment, two conditions were set up. Condition one, monkeys were nurtured by a loving, responsive, and tender mother. Condition two contained monkeys given an inanimate surrogate mother made of wire and cloth. Monkeys in condition one excelled at most life tasks to include regulation, behavioral control, and wellbeing. While the second group of monkeys exhibited distancing from socialization, isolation, and lack of impulse control.

This study and countless others show us examples of how environment and attachment shape the brain and subsequent healthy development. In Scared Sick: The Role of Childhood Trauma in Adult Disease, authors Robin Karr-Morse & Merdith S. Wiley, the connection between trauma in early life and diseases of adulthood clearly made. Their research is supported by the ACE Study (Adverse Childhood Experiences study) which also notes the links between overwhelming stress or trauma in early life to increase in the risks for addiction and other high risk taking.

I would like to be clear and say that I am not suggesting that drugs are not harmful to people. What I am suggestion is we open our collects eyes, minds, and hearts to the contextual factors that lead someone use drugs in the first place. It is also important to consider developmental and experiential milestone missed in the individuals life. In my most severe clients I have found early drug use. Taking drugs at 7 or 8 years of age is not what we expect a typical child to do. It is important to start asking questions about what happened in that individual’s life that allowed addiction to be a solution to problems and stress.

Consider the impact of living in an urban environment where violence is common practice. Or living in a place where you remain on edge 24/7 because of the color of your skin. The ACE study makes clear a dose-dependent relationship between severe childhood stress and addiction in later life. A child with an ACE score of six (6) or more is nearly three times more likely to become a smoker as an adult. A child with an ACE score of four (4) or more is likely to develop a severe addiction to alcohol. A boy with an ACE score of four (4) or more is likely to use drugs intravenously forty-six (46) more times later in life than his peer with no severe adverse childhood experiences.

How can we ignore these results? It is time that we move our conversation away from the gateway drug arguments and dig deeper. Arguing about whether alcohol or cannabis lead someone to addiction is avoiding the real issue at hand.

Unresolved trauma and a lack of focus within the current treatment paradigm to repair these wounds are responsible for the overdose deaths in this country. It is time we change the narrative and do the hard work our clients most desperately need and deserve.

Allowing people to suffer can no longer be an option.

What Can We Do?

In my youth and early adulthood I used to be someone who fed into the gateway drug argument. I was naive. I now realize the error of my ways. There is hope to change the implicit paradigm that plays out in the larger society about how best to treat addiction.

I reached a point where I choose to not allow that the gateway drug argument into my mind. Arguing with people does not end well. We all have a choice. We can begin by educating ourselves on how trauma impacts growth and development over the course of the lifespan. We can be our clients best advocates and talk with policy makers about laws and public policies that perpetuate outdated understandings of addiction. Our greatest strength today is the power of technology to extend our reach.

We are not islands onto ourselves.

It is important that we stay grounded and connected with the mission that we can create the change we seek. Let’s reclaim the narrative and honor the impact trauma has had in our collective human experience. In doing this can we begin to heal as a society and see genuine progress.