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No lack of opinions on marijuana

May 1, 2009
by Gary A. Enos, Editor
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I have consistently found that while alcohol remains the most pervasive substance affecting the individuals our readers serve, marijuana elicits the highest number of responses from readers when it is the subject of an editor's query, and the most impassioned replies as well.

Every two weeks on the Addiction Professional Web site ( we post a new poll question to elicit comments from field professionals. The largest response that we've recorded as of this writing followed this question we posted in late March: “Based on your experience in working with substance-dependent clients, do you consider marijuana to be a gateway drug?”

While more than 7 in 10 respondents stated that they consider marijuana a gateway to other substance use, a flurry of written comments accompanying the yes/no answers suggested a wide variety of interpretations on how marijuana use affects later substance-using patterns. Here are some comments from readers who firmly backed the gateway theory:

  • “More than 75% of my clients had used marijuana prior to use of any [other] illicit drugs.”

  • “Marijuana … is the most dangerous substance out there because it removes the inhibitions about hard drug use. It is the gateway drug and it alters the thinking of our impressionable young people.”

  • “I see many young people between the ages of 18 and 35 now addicted to opiates who began with marijuana. Marijuana is the one drug that addicts hesitate to give up.”

Yet other comments offered some different points of view on marijuana's role:

  • “No, I consider opiate drugs, legal and illegal, to be the gateway.”

  • “The most easily accessible and legal drug is alcohol. This is available to all ages and at all locations in this country. Clearly, this is the gateway to the use and abuse of other substances.”

  • “The whole issue is very complex. Addiction is a very individual affliction. I am not sure.”

Many readers appear to agree that marijuana users carry conflicted views about the drug's effects as well, and this can pose a huge challenge when these individuals enter a treatment setting. One reader wrote in response to the poll question, “Most clients don't consider marijuana to be a problem whatsoever, and will tell you it should be legalized.”

However, another respondent placed the perception issue on clinicians: “Marijuana isn't the harmless drug I have heard counselors describe it to be.”

Given that more individuals are presenting with primary marijuana issues, at the same time that varying opinions about the drug's harms continue to exist, what are some of the marijuana-related topics you'd like to see us cover in the magazine? I'm always interested in your ideas about marijuana use and treatment, or any other topic affecting addiction services. Send your thoughts and reactions to me at

Gary A. Enos, Editor Addiction Professional 2009 May-June;7(3):6