Shattuck lecture - A molecular basis for nicotine as a gateway drug

A selection of abstracts of clinically relevant papers from other journals. The abstracts on this page have been chosen and edited by John R. Radford.

Abstract

Those who start using cocaine when smoking may increase the addictive properties of cocaine.

Main

Kandel ER, Kandel DB. N Engl J Med 2014; 371: 932–943

As background, it has been suggested that a gateway drug could lower the threshold for addiction to other agents. The debate as to whether or not marijuana is a gateway drug has been well ventilated. However, the role of nicotine as a gateway drug has not been afforded the same platform. The distinguished scientists (Eric Kandel is a Nobel laureate) who were invited to give this lecture/paper found when using a mouse model, nicotine exerts a priming effect for cocaine through global acetylation in the striatum (sub-cortical part of the fore-brain) that, in turn creates an environment for gene expression. Such a mechanism may also occur in the amygdala (orchestrates emotion) and hippocampus (for spatial memory). Interestingly, they suggest nicotine may prime for cocaine but not cocaine for nicotine. In addition, it is possible that electronic cigarettes may offer a gateway to combustible cigarettes and illicit drugs. But then there is the 'common liability to addiction concept'; those who use drugs have genetic predisposition for all addictive agents. For a critique of this paper, see PubMed Commons.