I only hear the term in the context of political debate about legalization. Is ‘gateway drug’ a term used by psychiatrists or doctors who deal with addiction or is it just a political term?
I’m skeptical. “Narcotic” turns up 204,000 results in Google Scholar, but my pharmacology professors inform me that it is not a medical or pharmacological term.
Really? I’d have expected that it would at least be an adjective in the vocabulary of pharmacology (as in: substance A, at dosage B, produces a narcotic effect). I’d tend to agree that using it as a noun would strike me as sloppy.
ETA: And I would tend to think of “gateway [drug, effect, theory]” as more of a sociological than a medical term.
If the term “narcotic” is used in peer reviewed pharmacological journals, doesn’t that rather prove that your professors are wrong? Who gets to decide what is a pharmacological term if not the editors, readers and contributors of pharmacological journals?
Just looking at Google scholar, I see “narcotic” used by “PNAS”, “Science”, “Nature” and “The Lancet” amongst others. That makes it hard for me to credit your professors when they say that it is not a medical or pharmacological term. Why believe them over the editors of “Science” or “The Lancet”, who clearly do believe it is a medical or pharmacological term?
Here’s what Mosby’s Medical Dictionary (2009 ed.) has to say about “narcotic”:
The usage by law enforcement people is inaccurate, but it does work as a shorthand for a variety of narcotic and non-narcotic drugs that are either banned outright or strictly controlled.
Right. So even *that *says that your Professors are wrong.
Narcotic may not be a *preferred *term, but it is still a legitimate medical and pharmacological term. There is a huge difference between “not legitimate” and “not preferred”. I can understand your Professors demanding that students not use the less-preferred term, but if they told you that narcotic was not *legitimate *they were very clearly incorrect.
I just finished my psychiatry rotation, where there was obviously much discussion of drug use, saw plenty of patients who were being treated for drug abuse or complications thereof, and I don’t recall hearing the word “narcotic” used once.
It seems that my pharm professors were somewhat inaccurate, because narcotic used to be a widely used term with an accepted specific meaning, and it could still be used that way, but it appears that the term is no longer really used in a medical context.
We were specifically told NOT to call anything a narcotic in nursing school. “Opioid” only. They were pretty vehement about it, and would mark it wrong on a test. One teacher said outright it was a “meaningless law enforcement term”, not a term we should ever use as nurses.
My 2010 Nursing Spectrum Drug Handbook has no index listing for “narcotic”, but it does have “Opioid detoxification, methadone for”, “Opioid overdose and dependence, buprenorphine for” and “Opioid overdose and dependence, managing”.
The listing (in the same book) for Vicodin says, "Pharmacologic class: Opioid agonist/nonopioid analgesic combination Therapeutic class: Opioid analgesic; allergy, cold and cough remedy (anti-tussive). I can’t find the word “narcotic” anywhere.
Drugs.com uses the word “narcotic” in its listing for the laypersonfor codeine, but the medical professional’spage doesn’t; it calls it an opioid
So, I’m not sure why (maybe to reassure people that they won’t get addicted to their morphine in two days use post-op, they don’t want to use the “War On Drugs” name for the thing?), but I’ve got to agree with **Shmendrik **- healthcare educators and reference materials *are *taking active measures to prevent the use as a medical term for the upcoming generation, anyhow.
In fact, I gotta be honest; until this week, I always thought “narcotic” referred to *cocaine *and its derivatives, like crack, while “opiates” or “opioids” referred to, well, opium and its derivatives and copycats, like heroin, morphine and hydrocodone. I have no idea why I thought this, but let’s just blame the War on Drugs again, okay?
I occasionally do research related to drug abuse and the psychiatrists I collaborate with will talk about the “gateway effect” or studying whether a particular substance is a “gateway drug.” So the answer to your question is yes, for some people who are experts in drug abuse (the ones I work with) it is a valid term.
From my perspective (and that of the people I work with) “gateway drug” is a testable hypothesis. For example, do the subjects at time period 2 (18 years old) use more and harder drugs if they used marijuana at time period 1 (14 years old) than if they did not use marijuana at time period 1? That is a difficult question to answer, because people who start using drugs early tend to go on to more and harder drugs. Is that because they picked up a gateway drug, or because they’re so predisposed to drug abuse (for whatever reason) that they start early and get in deep? That of course is more of a discussion of is the gateway effect real.
I did publish one scientific paper where I examined the gateway effect of marijuana. The findings were basically that most adolescents who used marijuana went on to only use marijuana, but that almost all who ended up on harder drugs started with marijuana. My finding was that the odds ratio of marijuana use (versus abstainers) leading to hard drug use was about 1.80. To put that in perspective, the odds ratio of smoking leading to lung cancer (versus non-smokers) is something like 40.
Another study I was associated with, but not lead author, looked at the relationship of marijuana, tobacco, and alcohol in adolescents. We had pretty inconclusive findings as far as a gateway effect, because each drug was a gateway into the others, so regardless of where a subject started, it increased their odds of using the other two.
You could use me as a data point, I smoked weed in high school, but quit because I needed to keep a security clearance and alcohol was legal for me [I skated in under a grandfather clause, I turned 18 a few days before the 21 rule went into effect] and did actually try cocaine [it made my teeth numb. Yippee. I wasn’t about to pay $$$ to make my teeth numb.] I tried mushrooms. Fun, but not worth the money to do them again. Alcohol was still better. Only reason I tried the coke and shrooms was they were available at parties. They also had assorted pills, I guess 74-79 it would have included quaaludes and who knows what [never tried them, I hate swallowing pills.] The dealer I had patronized only carried weed, so there was never any push from him to try anything else, though I did know where to source pretty much everything [except hash. Why weren’t the people in Rochester NY into hash at the time?]
When presented with a need to do something other than weed I simply reverted to the legal alcohol instead of moving to something more powerful and less testable for. And now I am moving from the damned opioid pain meds back to weed because I can use a smaller amount, get pain relief and still function. I do find it funny that if I have to go out and actually drive I can drive on my pain meds but not weed which effects my reflexes less.
OTOH, I had a pt admitted a couple of days ago with a specific physician order of ‘no iv narcotics’. I knew it wasn’t the most precise term, but this is the first I’ve heard that there was a movement to bannish it from medicine.
They (officials and media) like to call MJ a “gateway drug” all the time. Back in the day I toked a bit, and if anything, MJ makes you want to stay away from other drugs. This term was applied to MJ mostly 'cause the government couldn’t figure out why so many teens were hopping from drug to drug, when the answer was actually all around them: crazy teens that can’t control themselves for even a second with a-hole parents that didn’t realize that they were mostly to blame. IMO, “gateway drug” is a sick term slapped inappropriately on MJ to keep it illegal, even with staggering evidence burrying them that says the health benefits of MJ are astronomical. Even cancer researchers are terrified of MJ, supposedly, a person that ingests or smokes it at least once a day will never get cancer, period (don’t know if that’s entirely true). So, that would mean, you guessed it, no more millions of dollars dumped needlessly into cancer research. I know, I should probably put on my tin-foil hat now, but I’d still like to see a cancer research center dig into that one with shovels and let everybody see the results without bias.