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Common liability to addiction and gateway hypothesis: Theoretical, empirical and evolutionary perspective

期刊

DRUG AND ALCOHOL DEPENDENCE
卷 123, 期 -, 页码 S3-S17

出版社

ELSEVIER IRELAND LTD
DOI: 10.1016/j.drugalcdep.2011.12.018

关键词

Drug dependence; Drug abuse; Genetics; Phenotype; Evolution

资金

  1. NIDA NIH HHS [P50 DA005605] Funding Source: Medline

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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. (C) 2012 Elsevier Ireland Ltd. All rights reserved.

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