Talk:Gateway drug effect/Archive 2

Archive 1

Archive 2

Cleaned out

This article was a mess of original research based on primary sources (most of them extremely dated to boot) not compliant with our medical sourcing policies.[1] I've cleaned out the primary sources, and identified among the sources now used and in the further reading secondary reviews, that can be used for further expansion. For those who don't understand what a secondary review is or how to find one, Wikipedia:Wikipedia Signpost/2008-06-30/Dispatches may help. We don't do competing analysis and original research on the primary studies ourselves; we let the secondary reviews of those studies do that work. SandyGeorgia (Talk) 03:51, 13 December 2013 (UTC)

Problem with order of substances

The order of the substances here seems calculated/POV. If, as the article claims, "alcohol tends to preceed cannabis use," as a stepping stone in the gateway drug theory, then why is cannabis the first section? The only reason I can think of is that the gateway drug theory tends to be a tool of law enforcement agents rather than medical professionals, so illegal drugs tend to receive more attention than legal drugs.

This raises a third, related problem. Several studies and at least one secondary source have noted that caffeine also satisfies the criteria of a gateway drug. Obviously this has recieved less attention than drugs that are more commonly regarded as unhealthy, but of course caffeine would be the earliest and most consistent stepping stone due to its widespread use by children and teenagers. I intend to add a section for caffeine and possibly re-order the other sections. Thoughts on the ultimate order? 184.100.93.245 (talk) 21:08, 2 November 2014 (UTC)

Revert

Almost none of the changes made over the last few months are supported by WP:MEDRS. The one quality source we had, the review by, Vanyukov et al., 2012, for the most part denounces the gateway theory "The promotion of the erroneous gateway theory ultimately does the public a disservice, including the hindering of intervention", yet our text reflects a very different position. Why is one of the most authoritative sources so underrepresented? Even the NIDA casts doubt on the validity of the gateway theory, that text was also removed, why? It seems most changes made were to paint cannabis as a unique gateway drug which recent medical literature has cast doubt on. I will revert to an earlier version soon. Psyden (talk) 14:02, 18 October 2016 (UTC)

The revert is based on a fundamental misunderstanding. The subject of this article are not possible intentions of discrediting or advocating the use of drugs. It is about epidemiology. The key sentence in the previous version was: "The concept of gateway drug is based on observations that the sequence of first-time use of different drugs is not random but shows trends." So the article is about science not politics. Therefore the previous version is reinstalled. --Saidmann (talk) 19:50, 9 November 2016 (UTC)

The gateway drug theory is a human medical subject. The article contains much original research and synthesis see WP:NOR . Almost none of the claims are supported by reliable sources, see WP:MEDRS . Animal studies should especially not be included, see WP:MEDANIMAL. Psyden (talk) 20:09, 9 November 2016 (UTC)

WP:MEDRS clearly states under which conditions citation of OR is adequate. These conditions are fulfilled in the present article. They are: "Research papers that describe original experiments are primary sources. However, they normally contain introductory, background, or review sections that place their research in the context of previous work; these sections may be cited in Wikipedia with care." And in particular: "If an editor has access to both the original source and the summary, and finds both helpful, it is good practice to cite both sources together." (see here) Though it was not necessary according to these rules to add a secondary source concerning the twin study, I now did so in order strengthen the evidence on this issue. If you think that further such supporting secondary sources would be helpful, please name the concrete case in point. I will then try to deal with the matter.

Re: Twin study. Odds ratios do not translate into relative risk as stated see: https://en.wikipedia.org/wiki/Odds_ratio#Confusion_and_exaggeration Psyden (talk) 23:32, 10 November 2016 (UTC)

In this study the authors did not compare relative risks but incidence rates. Here, the odds ratio DOES directly translate into the incidence rate ratio. Thus the figures given in the earlier version were correct (see here). --Saidmann (talk) 18:40, 12 November 2016 (UTC)

As stated on your link: "when the disease outcome of interest is rare, the odds ratio of exposure can be used to estimate the relative risk". In the case of the twin studies this is far from a rare outcome, rare would be around 10% as covered in this paper: https://www.ncbi.nlm.nih.gov/pubmed/18580722 Reporting it as you did, 7 times, and 18 times, is greatly exaggerating the relative risk. For example as you can see in Table I (http://www.tweelingenregister.org/nederlands/verslaggeving/NTR_publicaties_2006/Lynskey_BG_2006.pdf) the lifetime prevalence of hard drug use was 1.7% for non early cannabis use vs 12.8% for those who used before age 18, the reported prevalence is 7.5 times in this case, not 18 times as stated. Psyden (talk) 19:24, 12 November 2016 (UTC)

According to WP:MEDANIMAL there clearly is no ban on animal studies in articles like this one: They "are invaluable in determining mechanistic pathways and generating hypotheses." The conditions given in these rules for using such material are fulfilled in the present case. --Saidmann (talk) 12:37, 10 November 2016 (UTC)

Please read the rest of the animal subsection: "Where in vitro and animal-model data are cited on Wikipedia, it should be clear to the reader that the data are pre-clinical, and the article text should avoid stating or implying that reported findings hold true in humans. The level of support for a hypothesis should be evident to a reader. Using small-scale, single studies makes for weak evidence, and allows for cherry picking of data. Studies cited or mentioned in Wikipedia should be put in context by using high quality secondary sources rather than by using the primary sources." It should be stated that the results of animal studies often do not replicate in human studies. Also, a 'high quality' secondary source should put these animal studies in context. Psyden (talk) 13:50, 10 November 2016 (UTC)

In the nicotine case the relevance for human epidemiology had already been pointed out. In the cannabis case this has now been added, including 'high quality' secondary sources. --Saidmann (talk) 12:40, 11 November 2016 (UTC)

I still question the relevance of these studies. As you stated gateway theory is in regard to first use of various drugs. The content you have provided is relevant to addiction, not first use. IE. as far as reward pathways are concerned, first use of cannabis cannot make an animal or person more likely to try a drug they have never tried, it may make them more likely to try that other drug again, but this is not the topic of gateway theory, sequence of FIRST use, this is instead related to repeated use, or addiction. Psyden (talk) 21:46, 11 November 2016 (UTC)

The findings are that the altered reward system in the brain entails an altered start-off condition BEFORE further drugs are tried:

"Long-term drug exposure induces lasting neuroadaptations in motivational mechanisms that propel drug-seeking and use."

"Brain EC content is modulated by most drugs of abuse and natural rewards and a robust CB1R influence on the motivation to consume distinct classes of abused drugs ...."

Both from: Parsons and Hurd (2015): Review in Nat Rev Neurosci 2015 Oct; 16(10): 579–594. --Saidmann (talk) 12:32, 12 November 2016 (UTC)