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Is Cannabis a Gateway to Hard Drugs?

Medical Cannabis Use Adjunct to Standard of Care in a Residential Substance Use Recovery Program: A Pilot Study

22 October, 2025

Canadian clients reported that the cannabis substitution program demonstrated promise to help reduce problematic substance use by reducing drug cravings and assisting with pain and other comorbid symptoms. The program also helped to destigmatise Medicinal Cannabis (MC) use. Staff reports highlighted the importance of MC education, clear guidelines for dispensing MC and an accessible framework for program delivery to facilitate effective uptake of this novel intervention.

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School of Nursing, Thomson Rivers University, Kamloops, British Columbia; School of Medicine, Queen’s University, Kingston, Ontario; Department of Psychology, University of British Columbia–Okanagan Campus, Kelowna, British Columbia, Canada


First use of cannabis compared to first use of alcohol and tobacco: Associations with single and poly-substance use behaviour

1 July, 2023

Alcohol is overwhelmingly tried before either tobacco or cannabis. Cannabis initiation at an earlier age than alcohol and tobacco is un-common. Those who initiated cannabis before alcohol and tobacco appeared less likely to have a wide constellation of substance use and mental health vulnerabilities compared to those who tried cannabis at the same age as they tried at least one other substance.

University of Oklahoma Health Sciences Centre, Oklahoma City, Oklahoma, United States


Trends in Alcohol, Cigarette, E-Cigarette, and Nonprescribed Pain Reliever Use Among Young Adults in Washington State After Legalisation of Nonmedical Cannabis

09 May, 2022

This study assessed,

(1) trends in alcohol, nicotine and nonprescribed pain reliever use, and

(2) changes in associations of cannabis use with these other substances among young adults in Washington State (USA) after nonmedical cannabis legalisation.

…Contrary to concerns about spillover effects, implementation of legalised nonmedical cannabis coincided with decreases in alcohol and cigarette use and pain reliever misuse. The weakening association of cannabis use with the use of other substances among individuals ages 21-25 requires further research but may suggest increased importance of cannabis-specific prevention and treatment efforts.

Centre for the Study of Health and Risk Behaviours, Department of Psychiatry and Behavioural Sciences, School of Social Work, University of Washington, Seattle, Washington; Multnomah County Health Department and Oregon Health Authority Public Health Division, Portland, Oregon, United States.


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