Alcohol: The gateway to other drug use among secondary-school students.

The "stepping-stone" theory of progression into drug use is examined, based on the alcohol and other drug use of over 27,000 seventh-through eighth-grade students in New York State. The data show that students do not use illicit drugs unless they also use alcohol. White, black and Hispanic students all tend to initiate the use of drugs in the following order-alcohol, marijuana, pills, and "hard" drugs. Among blacks and Hispanics, pills are not as important a transition between marijuana and hard drugs as they are among whites. Cigarettes form an important step between alcohol and marijuana use for younger students, particularly for females. Since alcohol serves as the gateway to all other drug use, prevention approaches that control and limit alcohol use among adolescents may be warranted.