HYBRID EVENT: You can participate in person at Boston, Massachusetts, USA or Virtually from your home or work.

4th Edition of Global Conference on

Addiction Medicine, Behavioral Health and Psychiatry

October 19-21, 2023 | Boston, Massachusetts, USA

GAB 2019

Scott Stevens

Speaker at Global Conference on Addiction Medicine and Behavioral Health 2019 - Scott Stevens
Alcohologist.com, United States
Title : Look what dragged the cat in, Part II Prioritizing the gateway drug


The decade of the 2010's shelled hospitals and first responders with an explosion of opioid-related illness, injury, and death. Preventable drug overdoses tallied 54,793 lives lost in 2016 – an increase of 391 percent since 1999. Accidental drug overdose deaths increased 327 percent over the same period. The majority of OD deaths (38,000) involve opioids, the drug category most frequently involved in opioid overdoses and growing at the fastest pace includes fentanyl, fentanyl analogs, and tramadol. The fentanyl category of opioids accounted for nearly half of opioid-related deaths.

Look What Dragged the Cat In: The Rise of an Opioid Crisis (aka Part I) presented in 2018 looked at the conclusive evidence that EVERY opioid related death is alcohol related. Part II uses data collected for the Monitoring the Future project at the University of Michigan along with results from the American Addiction Centers study on gateway drug use, behaviors, attitudes, and values. Alcohol was clearly the most common first substance used, the most widely consumed, and the one that was initiated the earliest-with some students reporting that their use began as early as the 5th grade. Researchers found that these children typically progressed to trying other illicit drugs in the following years. The notable contrast was children who had not tried alcohol by 12th grade and had almost never attempted using any other substance.

The abuse of drugs, regardless of classification, begins with the permissiveness granted the world's most lethal drug and third-leading cause of all preventable deaths: Alcohol. It's a straight line. Nearly every non-Muslim civilization on this rock has embraced alcohol. As a result, ours is largely a numbing society, especially in the sedation-happy Americas. This is the root. This is the seed of the opium trade that has gone unstemmed since prehistory. There is legit medical use for opium derivatives: What has driven growth is demand – not by the sick but by people who cannot get the mind alteration they desire through alcohol use alone. Alcoholics and non-alcoholics alike drink the first drink for the same reason: To relieve a stress. In the U.S., which has a laissez faire agenda toward alcohol since its prohibition failure, the culture embraces a drinking lifestyle. Western culture normalizes alcohol use. In other words, we normalize drug use. What you ignore, you permit. What you permit, you condone.

The World Health Organization (WHO) indicates that alcohol use is the third leading preventable cause of death. Look What Dragged the Cat In: Part II looks at preventing or delaying first use. In 1967, 72 percent of adult men smoked. Today, 72 percent don't. Prevention works. If there is genuine interest in healthy outcomes and preventing premature death from opioids, permissiveness of the tarter or feeder or gateway or predecessor drug has to be addressed on five levels to reduce demand for all antecessor drugs. One of those ways is not legalizing recreational use of marijuana – no longer prioritized as the gateway drug, but a gateway nonetheless. When we rethink the drink we can douse the pandemic that begat the current opioid crisis. Legislators and treatment experts must lead the transition from managing aftermaths of the current crisis to prevention of the next one. And phase out the ancient alcohol crisis – the elephant in the room – western culture ignores.


Stevens is a journalist, posting regularly on health and alcohol issues for online news services and is a founding influencer at the world's largest medical portal, HealthTap. Stevens blends intensive evidence-based research, wit, journalistic objectivity, blunt personal dialogue and no-nonsense business perspective in his five award-winning health and addiction books.