Substances
What is a Gateway Drug, and Is It Addictive?
Medically Reviewed By
Written By
Last medically reviewed March 17, 2025
Substances
Medically Reviewed By
Written By
Last medically reviewed March 17, 2025
The term “gateway drug” refers to any substance that may lead individuals to experiment with more harmful or potent drugs. Common examples include recreational substances such as alcohol and cannabis, as well as prescription medications prescribed to millions of Americans for chronic illnesses or mental health conditions. While these prescribed medications can be beneficial when used as directed, they pose a risk of dependency when misused. Understanding these risks is important when making informed decisions about substance use.
In this guide, you will discover what causes people to transition from using gateway drugs to more addictive substances, learn why some gateway drugs are more addictive than others, and receive guidance on treatment for those struggling with dependency on gateway drugs.
Legal gateway drugs can be categorized into those that are available over-the-counter, such as nicotine and alcohol, and prescription drugs, like Klonopin or Adderall. However, it is important to note that obtaining the latter without a prescription is illegal.
Substances that are banned for use in the United States but dispensed in other countries — such as ecstasy (MDMA) and psilocybin — are considered gateway drugs.[1] These substances are classified as Schedule I under the Controlled Substances Act, indicating that they are not only addictive but also potentially harmful.[2] The use of these drugs often leads individuals to seek out more dangerous substances in an attempt to ease withdrawal symptoms or enhance their high.
The term “gateway drug” refers to a mild substance that is not inherently addictive but can lead individuals to try more addictive substances.[3] According to the gateway hypothesis, these drugs have the potential for abuse and misuse, and some individuals may develop a dependence on them. Additionally, because they are easily accessible to the public, gateway drugs often serve as the first experience many people have with mind-altering substances.
The concept of “gateway drugs” is still considered a hypothesis, leading to ongoing debate about which substances should be classified as gateway drugs and which should not. As a result, the list of current gateway drugs is open to scrutiny and may change over time.
Currently theorized gateway drugs include:[2][4]
Note: There is an ongoing debate regarding whether cannabis should be considered a gateway drug.[5] Some researchers argue that cannabis is non-addictive despite its classification as a Schedule I Controlled Substance.[2] Others contend that marijuana use can lead to abuse and tolerance, which may result in the use of stronger drugs. Additionally, marijuana can be laced or cut with other substances, such as PCP, fentanyl, or codeine, potentially leading users to develop an addiction to these substances while abusing marijuana.[6][7]
One reason the substances listed above are considered gateway drugs is that they can cause users to develop a tolerance.[8] Tolerance occurs when a person’s brain and body become accustomed to a substance, requiring them to use more to achieve the same effects or relief they once experienced. This increase in usage can raise the risk of overdose or encourage individuals to turn to more potent substances to attain similar effects.
Another theory suggests that mental health conditions, such as ADHD or depression, contribute to an increased risk of gateway substance abuse.[9] Research indicates that individuals with these conditions often turn to gateway drugs as a form of self-medication.[10] Consequently, they also face a higher likelihood of cocaine use, marijuana addiction, or abusing multiple substances simultaneously.
Most gateway drugs carry a potential risk of dependency when misused. Misuse occurs when a person uses a substance in a manner that is not prescribed or recommended. This may include taking double doses, increasing the dosage, using the medication for longer than prescribed, or combining it with other substances — for instance, mixing a benzodiazepine with alcohol or smoking marijuana laced with codeine syrup.
Some gateway drugs are more likely to lead to addiction than others, even when used as prescribed. Medications such as oxycodone and hydrocodone pose a high risk of dependency and must be gradually increased and then carefully tapered over time. Understanding the risks associated with these drugs is crucial in preventing addiction.[11]
If you find yourself dependent on gateway drugs like alcohol, nicotine, or prescription medications, it is advisable to consult a medical professional for assistance in quitting. Some of these substances can lead to severe withdrawal symptoms when stopped abruptly, which may result in serious health complications, such as seizures or coma.[12] Your physician may recommend a gradual tapering schedule to help you safely wean off the substance and avoid these complications.
If you’re dealing with an addiction, which is often marked by relapses after attempts to quit, seeking additional support is pertinent to your recovery. Joining a drug or alcohol treatment program can help you uncover the underlying causes of your addiction and provide you with strategies to maintain sobriety. Effective treatment options include medication-assisted detox, cognitive behavioral therapy, and 12-step. Engaging in these programs can significantly reduce the risk of relapse.
Addiction is a daily struggle for millions of Americans — but it is treatable with the right approach to care.
Establish a solid foundation for your addiction recovery at Southeast Detox, GA. Our addiction treatment center provides evidence-based, comprehensive services tailored to support clients’ physical, spiritual, and mental health needs for a comfortable recovery. We offer both inpatient and outpatient programs for substance and alcohol use disorders, which include detoxification, individual behavioral therapy, group activities, peer support, holistic therapies, and more.
Call us today to learn how our services can help you overcome gateway drug addiction.
No, common gateway drugs like nicotine, caffeine, alcohol, and cannabis are legal to use. Additionally, drugs that are commonly prescribed to treat chronic pain and mental health conditions like ADHD are also considered gateway drugs.
Yes. Adderall is theorized to be a gateway drug since it has the potential for abuse and addiction. According to Brigham University, using Adderall without a prescription can fuel the risk of using other illicit substances.[13]
If your physician has prescribed a gateway drug, it is because they have determined that the benefits of using it outweigh the risks.
If you are misusing a gateway drug, it’s important to talk to your healthcare provider about joining a cessation program. Many effective addiction treatment services can help you stop using the drug safely. If you want to learn more about how drug rehab can help, please contact us.
Gateway drugs, such as nicotine and alcohol, can make people feel relaxed. This effect can be appealing to those who are under a lot of stress or dealing with mental health issues like depression or anxiety. At first, these substances may help them feel better, but using them repeatedly can lead to tolerance, meaning they have to consume more to feel the same effects. Even with increased use, they might not feel that initial relaxation anymore. This can push some individuals to try stronger drugs like cocaine or opioids in search of relief.
[1] Australian Government. (2023 Feb 3) Change to Classification of Psilocybin and MDMA to Enable Prescribing by Authorised Psychiatrists. Retrieved from https://www.tga.gov.au/news/media-releases/change-classification-psilocybin-and-mdma-enable-prescribing-authorised-psychiatrists on 2025 Jan 9.
[2] The United States Drug Enforcement Administration. (n.d.) Drug Scheduling. Retrieved from https://www.dea.gov/drug-information/drug-scheduling on 2025 Jan 9.
[3] National Library of Medicine. (2017 Jan 18) Testing the Gateway Hypothesis. Retrieved from https://pmc.ncbi.nlm.nih.gov/articles/PMC5506797 on 2025 Jan 9.
[4] Illinois Library. (n.d.) Gateway Drugs. Retrieved from https://iopn.library.illinois.edu/pressbooks/druguseandmisuse/chapter/gateway-drugs-caffeine-alcohol-tobacco-marijuana/ on 2025 Jan 9.
[5] Centers for Disease Control and Prevention. (2024 Feb 15) Cannabis and Other Drugs. Retrieved from https://www.cdc.gov/cannabis/risk-factors/using-other-drugs.html on 2024 Jan 9.
[6] U.S. Department of Justice. (n.d.) Fry Fast Facts. Retrieved from https://www.justice.gov/archive/ndic/pubs11/12208/12208p.pdf on 2025 Jan 9.
[7] Health Unit Haldiman-Norfolk. (2018 May 16) Warning: Marijuana Laced with Fentanyl. Retrieved from https://hnhu.org/wp-content/uploads/Alert-marijuana-laced-with-fentanyl-may-16-2018.pdf on 2025 Jan 9.
[8] National Institute on Drug Abuse. (2018 June) Understanding Drug Use and Addiction: Drug Facts. Retrieved from https://nida.nih.gov/publications/drugfacts/understanding-drug-use-addiction on 2025 Jan 9.
[9] The Centers for Disease Control and Prevention. (2024 Jun 13) Disrupted Access to Prescription Stimulant Medications Could Increase Risk of Injury and Overdose. Retrieved from https://www.cdc.gov/han/2024/han00510.html 2025 Jan 9.
[10] The Substance Abuse and Mental Health Services Administration (SAMHSA). (2023 Apr 24) Mental Health and Substance Use: Co-Occuring Disorders. Retrieved from https://www.samhsa.gov/mental-health/what-is-mental-health/conditions/co-occurring-disorders on 2025 Jan 9.
[11] University of California San Francisco. (n.d.) Oral Opioids (Hydrocodone, Oxycodone, Hydromorphone, Morphine). Retrieved from https://pain.ucsf.edu/opioid-analgesics/oral-opioids-hydrocodone-oxycodone-hydromorphone-morphine on 2025 Jan 9.
[12] Cleveland Clinic. (2024 Jan 25) Alcohol Withdrawal: Symptoms. Retrieved from https://my.clevelandclinic.org/health/diseases/alcohol-withdrawal on 2025 Jan 9.
[13] Bringham University. (2024 Mar 11) Study Drugs’ Set the Stage for Other Drug Use and Mental Health Decline. Retrieved from https://www.binghamton.edu/news/story/4798/study-drugs-set-the-stage-for-other-drug-use-and-mental-health-decline on 2025 Jan 9.