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The Gateway Hypothesis
of Substance Abuse
By Barbara Spector
Denise Kandel ’52, professor
of sociomedical sciences in psychiatry at Columbia
University and chief of the department of the
epidemiology of substance abuse at the New York
State Psychiatric Institute, is accustomed to
receiving media attention. Journalists and politicians
have commented on her research finding that early
users of alcohol or cigarettes are more likely
later to use marijuana and then progress to other
illegal drugs, compared with those who did not
drink alcohol or smoke cigarettes as adolescents.
Kandel’s ground-breaking
theory — known as the "gateway"
hypothesis, a term coined by former National Institute
on Drug Abuse (NIDA) director Robert DuPont —
has enhanced her reputation as a highly cited
researcher. Yet her work is often misunderstood.
"I myself am not a political person,"
Kandel says. "But you cannot control the
way your work is used."
Consequences of Publicity
The attention given to the
study — which examined a cohort of subjects
at ages 15-16, 24-25, 29-30 and 35-36 — has
had "two consequences," Kandel says.
On the one hand, "It’s brought about
a shift of thinking at NIDA." Because of
her work, "Drug prevention programs targeted
to young people now also address smoking and drinking,"
Kandel says.
When Kandel began her research,
"I was funded only to study marijuana,"
she recalls. "I did not emphasize to my program
officer the fact that I was also asking questions
about smoking and drinking. But it turned out
that that was a very important piece of the study."
The second consequence of
the publicity is that "the so-called gateway
theory has been used by some people to justify
a very conservative drug policy," Kandel
says. For example, her work has been cited by
advocates of tougher penalties for marijuana possession
and of drug testing in schools.
Kandel’s findings have
often been misinterpreted, she notes. "This
doesn’t mean that because you start with
tobacco, you’re going to become a heroin
addict. That’s completely false reasoning.
Many people start smoking. Only a few go on to
use heroin. Use of a drug at a lower stage may
be a necessary but not a sufficient condition
for progressing to a higher stage."
Kandel developed her scientific
proficiency as a psychology major at Bryn Mawr
College, where she learned how to develop a research
instrument, code data and conduct an analysis.
"I had a fantastic experience writing my
thesis," she recalls. "I learned ways
of thinking about data and developed technical
skills."
Coming to America
Kandel received her degree
from Bryn Mawr after only two years. She had emigrated
from France to the United States in 1949, together
with her parents and brother. Her father had escaped
from a French concentration camp and, together
with her mother, had survived the war by hiding
in southwest France. Denise had hidden in a convent,
without knowing where her parents were.
After emigrating, Kandel attended
the Lycée Français de New York for
one year, graduating with a baccalaureate degree.
She came to Bryn Mawr as a junior at age 17. She
recalls the liberating feeling of being accepted
into American society. "It was really a very
positive experience," she says.
Nonetheless, Kandel’s
family encountered "many of the problems
that immigrants faced," she recalls. Her
father, an engineer, had trouble finding a job
in America. "My parents were under great
financial constraints," Kandel says. Their
financial position contributed to her decision
to finish college in two years. "In that
respect, I missed out on a great deal," she
acknowledges.
Graduate Work
After college, she returned
to New York to attend graduate school at Columbia,
where she did Ph.D. research in medical sociology
with renowned theoretician Robert Merton. Her
dissertation focused on how medical students select
areas of specialization. Merton was at once "very
stimulating and very paralyzing," Kandel
says, recalling his penchant to critique and rewrite
students’ manuscripts. "He had the highest
expectations and the highest standards,"
she says.
While in graduate school,
she met her husband, neurobiologist Eric Kandel
(Harvard ’52), who was born in Vienna and
had emigrated to the United States as a child
in 1939. After they married, they moved to the
Washington area, where she finished her dissertation
and he took a position at NIH. In 1960, they moved
to Boston, where he began a residency in psychiatry
at Harvard Medical School. In 1962, they relocated
to Paris so he could take a postdoctoral fellowship,
and returned to Harvard in 1963. "Many of
my earlier career decisions were determined by
what my husband was doing," Kandel says.
Interest in Adolescents
These decisions turned out
to be fortuitous. At Harvard, she worked with
Gerald Lesser — later the creator of Sesame
Street —
at Harvard’s School of Education on a study
comparing Danish and American adolescents. Through
this work, she became interested in adolescent
development in the context of the family.
Kandel changed the design
of the study to incorporate interviews with parents
as well as youths. She and Lesser found parental
influence was more important than peer influence
in the development of lifelong goals and educational
aspirations. The relative influence of parents
and peers on adolescents varied depending on the
issue.
"It seems obvious, but
at the time it was a completely new perspective,"
Kandel says. They continued to collaborate after
the Kandels moved to New York when Eric Kandel
joined New York University’s medical school
in 1965. In 1969, Denise took a position at the
New York State Psychiatric Institute, affiliated
with Columbia.
Drug Abuse Research
In the 1960s, Kandel recalls,
drug abuse was gaining recognition as an important
field of study. Her interest was piqued at a conference
where she met researchers who were undertaking
a study of drug use among high school students.
She wanted to join them as collaborator to continue
her studies of parental and peer influences on
adolescent socialization by focusing on drug use.
They declined her offer to participate because
she wanted to interview parents as well as young
people, a survey design they believed would make
the youths unwilling to cooperate.
Undaunted, Kandel wrote her
own proposal to develop a study from scratch.
The research grew into her influential longitudinal
study of 1,325 subjects. "That turned out
to be a crucial point in my career," she
says.
Her husband, meanwhile, was
also doing landmark research. In 2000, Eric Kandel,
now a University Professor at Columbia, was named
a co-recipient of the Nobel Prize in Medicine
or Physiology for his studies of the molecular
biology of memory.
Nobel Calling
Denise Kandel took the call
from the Nobel committee in Sweden at 5 a.m. on
Oct. 9, 2000. "I didn’t understand what
the person was saying, except for the last word,
‘Stockholm.’ I knew immediately that
this might be the Nobel Prize," she recalls.
Along with the Nobel have
come invitations to high-profile events. But the
excitement carries a price — "the time
that it takes" — Kandel notes. She has
two children. Her son, Paul, Haverford ’83,
married Emily Kaplan, Bryn Mawr ’83. Emily’s
mother is Barbara Goldstein Kaplan, Bryn Mawr
’56. Kandel’s daughter, Minouche, graduated
from Yale in 1987.
About the Author
Barbara Spector writes on
science and technology as well as business topics.
She is the executive editor of Family Business
magazine and former editor of The Scientist.
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