Stages of progression in drug involvement from adolescence to adulthood: further evidence for the gateway theory

J Stud Alcohol. 1992 Sep;53(5):447-57. doi: 10.15288/jsa.1992.53.447.


Sequential stages of involvement in alcohol and/or cigarettes, marijuana, other illicit drugs and medically prescribed psychoactive drugs from adolescence to adulthood are investigated in a longitudinal cohort that has been followed from ages 15 to 35. Alternative models of progression are tested for their goodness of fit. Four stages are identified: that of legal drugs, alcohol or cigarettes; marijuana; illicit drugs other than marijuana; and medically prescribed drugs. Whereas progression to illicit drugs among men is dependent upon prior use of alcohol, among women either cigarettes or alcohol is a sufficient condition for progression to marijuana. Age of onset and frequency of use at a lower stage of drug use are strong predictors of further progression.

Publication types

  • Research Support, Non-U.S. Gov't
  • Research Support, U.S. Gov't, P.H.S.

MeSH terms

  • Adolescent
  • Adult
  • Cohort Studies
  • Female
  • Humans
  • Illicit Drugs
  • Male
  • Pharmaceutical Preparations / classification
  • Substance-Related Disorders*


  • Illicit Drugs
  • Pharmaceutical Preparations