Does cannabis use encourage other forms of illicit drug use?

AIMS: To examine the relationship between cannabis use in adolescence and the onset of other illicit drug use. METHOD: Data were gathered over the course of a 21-year longitudinal study of a birth cohort of 1265 New Zealand children. Measures analysed included: (a) frequency of cannabis use and other illicit drugs from 15-21; (b) family, social, educational and behavioural backgrounds of cohort members prior to 15; and (c) adolescent life-style variables. FINDINGS: (i) By 21, nearly 70% of cohort members and used cannabis and 26% had used other illicit drugs. (ii) In all but three cases, the use of cannabis had preceded the use of illicit drugs. (iii) Those using cannabis on more than 50 occasions a year had hazards of other illicit drug use that were 140 times higher than non-users. (iv) After adjustment for covariate factors, including childhood factors, family factors and adolescent life-style factors, cannabis use remained strongly related to the onset of other forms of illicit drug use. Those using cannabis on more than 50 occasions per year had hazards of other illicit drug use that were 59.2 times higher than non-users. CONCLUSIONS: Findings support the view that cannabis may act as a gateway drug that encourages other forms of illicit drug use. None the less, the possibility remains that the association is non-causal and reflects factors that were not adequately controlled in the analysis.