1
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Hinckley JD, Mikulich-Gilbertson SK, He JP, Bhatia D, Ellingson JM, Nguyenkhoa Vu B, Ries Merikangas K, Sakai JT. Cannabis Use Is Associated With Depression Severity and Suicidality in the National Comorbidity Survey-Adolescent Supplement. JAACAP OPEN 2023; 1:24-35. [PMID: 37538853 PMCID: PMC10400070 DOI: 10.1016/j.jaacop.2023.02.002] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 08/05/2023]
Abstract
Objective To investigate the association of cannabis use with major depression and suicidal behavior in adolescence. Method Data are from the National Comorbidity Survey-Adolescent Supplement N = 10 , 123 , a nationally representative survey of adolescents aged 13 to 18 years. Weighted logistic regression and ordinal regression analyses of major depression and suicidal behavior outcomes were conducted on cannabis variables, incorporating sociodemographic characteristics. Results Adolescents with lifetime cannabis use have 2.07 times higher odds of mild/moderate (adjusted odds ratio [aOR]; 95% CI = 1.69 , 2.53 ) and 3.32 times higher odds of severe major depressive disorder (MDD; aOR; 95% CI = 2.31 , 4.75 ). Cannabis use (aOR 6.90, 95% CI = 4.67 , 10.19 ), mild/moderate MDD (aOR 4.10, 95% CI = 2.82 , 5.98 ), and severe MDD (aOR 13.97, 95% CI = 7.59, 25.70) were associated with higher odds of suicide attempt. Past 12-month cannabis use (aOR 3.70, 95% CI = 2.16, 6.32), mild/moderate major depressive episodes (MDE) (aOR 7.85, 95% CI = 3.59 , 17.17 ), and severe MDE (aOR 36.36, 95% CI = 13.68 , 96.64 ) were associated with higher odds of suicide attempt. The frequency of past 12-month cannabis use was associated with higher odds of suicide attempt and with MDE severity, with higher odds among individuals who use cannabis 3 or more days than among individuals who use cannabis less frequently, suggesting a dose effect. Among cannabis users, older age of onset of cannabis use was associated with lower odds of suicidal behaviors. Conclusion Cannabis use is associated with higher odds of depression and depression severity in adolescence. Furthermore, depression and cannabis use are independently associated with higher odds of suicide attempt. Diversity & Inclusion Statement We worked to ensure sex and gender balance in the recruitment of human participants. We worked to ensure race, ethnic, and/or other types of diversity in the recruitment of human participants. The author list of this paper includes contributors from the location and/or community where the research was conducted who participated in the data collection, design, analysis, and/or interpretation of the work. One or more of the authors of this paper self-identifies as a member of one or more historically underrepresented racial and/or ethnic groups in science. We actively worked to promote sex and gender balance in our author group. We actively worked to promote inclusion of historically underrepresented racial and/or ethnic groups in science in our author group.
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Affiliation(s)
| | - Susan K Mikulich-Gilbertson
- University of Colorado School of Medicine, Aurora, Colorado; University of Colorado School of Public Health, Aurora, Colorado
| | - Jian-Ping He
- Genetic Epidemiology Research Branch, Intramural Research Program at the National Institute of Mental Health, Bethesda, Maryland
| | - Devika Bhatia
- University of Colorado School of Medicine, Aurora, Colorado
| | | | | | - Kathleen Ries Merikangas
- Genetic Epidemiology Research Branch, Intramural Research Program at the National Institute of Mental Health, Bethesda, Maryland
| | - Joseph T Sakai
- University of Colorado School of Medicine, Aurora, Colorado
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2
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Gómez Velásquez S, Amaya Heredia ÁM, Bedoya Moncada S, Patiño González JE, Martínez Ramírez JA. Recreational cannabis: Profile of cannabinoids present in marijuana samples supplied by the consuming population. Salud Colect 2023; 19:e4385. [PMID: 37311141 DOI: 10.18294/sc.2023.4385] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2023] [Accepted: 03/16/2023] [Indexed: 06/15/2023] Open
Abstract
As cannabis/marijuana is one of the most consumed psychoactive substances in the world, knowing the composition and type of cannabis sold in urban environments is a necessary input for the design of public health policies based on scientific evidence. This study characterized the main phytocannabinoids of marijuana samples (cigarettes or buds) obtained in urban and rural areas of the city of Medellín in October 2021. Non-probabilistic convenience sampling was carried out in which 87 marijuana samples donated by consumers were collected at different collection points throughout the city, and gas chromatography-mass spectrometry and flame ionization techniques were employed for the characterization of phytocannabinoids. Tetrahydrocannabinol (THC) was found to be the main constituent of circulating marijuana in Medellín, where 67.8% of the samples had a high or higher toxicological range for THC; the foregoing in a context where the deregulated market in practice limits the possibility that consumers have to calibrate or decide the concentration of cannabinoids in their doses.
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Affiliation(s)
- Santiago Gómez Velásquez
- Magíster en Salud Pública. Secretaría de la Juventud de Medellín. Estudiante del Doctorado en Epidemiología y Bioestadística, Universidad CES, Medellín, Colombia
| | | | | | | | - Jorge Ariel Martínez Ramírez
- PhD en Toxicología Forense. Profesor, Departamento de Farmacia, Facultad de Ciencias, Universidad Nacional de Colombia, Bogotá, Colombia
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3
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Loya JM, Tangney JP, Stuewig JB. Are Borderline Personality Disorder Features Differentially Related to Pre-Incarceration Alcohol, Cannabis, Cocaine, and Opioid Dependence Among People Recently Incarcerated in Jail? J Pers Disord 2022; 36:623-640. [PMID: 36181491 DOI: 10.1521/pedi.2022.36.5.623] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
Borderline personality disorder (BPD) and substance use disorders (SUDs) commonly co-occur across various settings. However, little research has examined how BPD features relate to specific types of SUDs. This study examined whether BPD features assessed shortly after incarceration were differentially related to symptoms of dependence on alcohol, cannabis, cocaine, and opioids experienced in the 12 months prior to incarceration among 510 people recently incarcerated in jail. Follow-up multigroup analyses evaluated whether gender or race moderated the relation of BPD features to the four SUDs. Using structural equational modeling, the relationships of BPD features were compared to each of the four preincarceration dependence symptoms. BPD features were significantly related to dependence on each of the four substances, but the link between BPD features and cocaine dependence was stronger than BPD's association with alcohol, cannabis, or opioid dependence. These findings generalized across men and women and across White and Black people.
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Affiliation(s)
- Jennifer M Loya
- Yale School of Medicine, New Haven, Connecticut.,George Mason University, Fairfax, Virginia
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4
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Rosen AS, Hirst RB, Brown C, Arastu S, Hedbabny K. Eyewitness Recall, Lineup Identification, and Verbal and Visual Memory Among Chronic Cannabis Users After a Minimum of 24‐Hours Abstinence. APPLIED COGNITIVE PSYCHOLOGY 2022. [DOI: 10.1002/acp.3962] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Affiliation(s)
| | - Rayna B. Hirst
- Department of Psychology Palo Alto University United States
| | - Colin Brown
- Department of Psychology Palo Alto University United States
| | - Sana Arastu
- Department of Psychology Palo Alto University United States
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5
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Erickson SK, Vorwerk ML. A perspective review of cannabis use and sexual offenses. BEHAVIORAL SCIENCES & THE LAW 2022; 40:225-238. [PMID: 35445434 DOI: 10.1002/bsl.2571] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/14/2021] [Revised: 12/03/2021] [Accepted: 03/31/2022] [Indexed: 06/14/2023]
Abstract
Substance abuse is an established risk factor for crime and violence, including sexual violence. Nevertheless, the link between cannabis use and sexual offenses remains poorly understood. Cannabis use has a broad effect on sexual functioning and can have both acute and lasting adverse effects on psychological functioning, which in turn can elevate the risk of sexual offending behavior. Yet there is a scarcity of studies that have examined the link between cannabis use and sexual offending. To help fill the gap, this perspective review investigates the link between substance use and crime with a particular emphasis on cannabis use and its effects on sexual and psychological functioning. It then explores how these mechanisms may contribute to sexual offenses and recidivism, with a final discussion on how cannabis use should be conceptualized as a risk factor for sexual violence.
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6
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Harris JC, Wallace AL, Thomas AM, Wirtz HG, Kaiver CM, Lisdahl KM. Disrupted Resting State Attentional Network Connectivity in Adolescent and Young Adult Cannabis Users following Two-Weeks of Monitored Abstinence. Brain Sci 2022; 12:brainsci12020287. [PMID: 35204050 PMCID: PMC8870263 DOI: 10.3390/brainsci12020287] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2021] [Revised: 02/12/2022] [Accepted: 02/13/2022] [Indexed: 02/04/2023] Open
Abstract
Background. Numerous neuropsychological studies have shown that cannabis use during adolescence and young adulthood led to deficits in sustained and selective attention. However, few studies have examined functional connectivity in attentional networks among young cannabis users, nor have characterized relationships with cannabis use patterns following abstinence. Methods. Differences in resting state functional connectivity (RSFC) within the dorsal (DAN) and ventral (VAN) attention networks were examined in 36 adolescent and young adult cannabis users and 39 non-substance using controls following two weeks of monitored abstinence. Observed connectivity differences were then correlated with past-year and lifetime cannabis use, length of abstinence, age of regular use onset, and Cannabis Use Disorder symptoms (CUD). Results. After controlling for alcohol and nicotine use, cannabis users had lower RSFC within the DAN network, specifically between right inferior parietal sulcus and right anterior insula, as well as white matter, relative to controls. This region was associated with more severe cannabis use measures, including increased lifetime cannabis use, shorter length of abstinence, and more severe CUD symptoms. Conclusions. Findings demonstrate that regular cannabis use by adolescents and young adults is associated with subtle differences in resting state connectivity within the DAN, even after two weeks of monitored abstinence. Notably, more severe cannabis use markers (greater lifetime use, CUD symptoms, and shorter abstinence) were linked with this reduced connectivity. Thus, findings support public policy aimed at reducing and delaying cannabis use and treatments to assist with sustained abstinence. Future longitudinal studies are needed to investigate causation.
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7
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Abstract
OBJECTIVE Acute Δ9-tetrahydrocannabinol (THC) administration in humans (Lawn etal., 2016) and rats (Silveira, Adams, Morena, Hill, & Winstanley, 2016) has been associated with decreased effort allocation that may explain amotivation during acute cannabis intoxication. To date, however, whether residual effects of cannabis use on effort-based decision-making are present and observable in humans have not yet been determined. The goal of this study was to test whether prolonged cannabis use has residual effects on effort-based decision-making in 24-hr abstinent cannabis using adults. METHOD We evaluated performance on the Effort Expenditure for Reward Task (EEfRT) in 41 adult cannabis users (mean age = 24.63 years, 21 males) and 45 nonusers (mean age = 23.90 years, 19 males). A mixed 2x3x3 ANOVA with age as a covariate was performed to examine the effect of group, probability of winning, and reward amount on EEfRT performance. EEfRT performance was operationalized as % of trials for which the hard (vs. easy) condition was chosen. Pearson's correlations were conducted to test the relationship between EEfRT performance and measures of cannabis use, anhedonia and motivation. RESULTS We found that cannabis users selected hard trials significantly more than nonusers regardless of win probability or reward level. Frequency of cannabis use was positively correlated with amount of % hard trials chosen. There were no significant correlations between % hard trials chosen, self-reported anhedonia, or motivation. CONCLUSIONS These results suggest that unlike acute effects, residual effects of cannabis following 24 hrs of abstinence are associated with greater effort allocation during effort-based decision-making.
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8
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Kesner AJ, Lovinger DM. Cannabis use, abuse, and withdrawal: Cannabinergic mechanisms, clinical, and preclinical findings. J Neurochem 2021; 157:1674-1696. [PMID: 33891706 PMCID: PMC9291571 DOI: 10.1111/jnc.15369] [Citation(s) in RCA: 24] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2020] [Revised: 04/12/2021] [Accepted: 04/12/2021] [Indexed: 12/14/2022]
Abstract
Cannabis sativa is the most widely used illicit drug in the world. Its main psychoactive component is delta-9-tetrahydrocannabinol (THC), one of over 100 phytocannabinoid compounds produced by the cannabis plant. THC is the primary compound that drives cannabis abuse potential and is also used and prescribed medically for therapeutic qualities. Despite its therapeutic potential, a significant subpopulation of frequent cannabis or THC users will develop a drug use syndrome termed cannabis use disorder. Individuals suffering from cannabis use disorder exhibit many of the hallmarks of classical addictions including cravings, tolerance, and withdrawal symptoms. Currently, there are no efficacious treatments for cannabis use disorder or withdrawal symptoms. This makes both clinical and preclinical research on the neurobiological mechanisms of these syndromes ever more pertinent. Indeed, basic research using animal models has provided valuable evidence of the neural molecular and cellular actions of cannabis that mediate its behavioral effects. One of the main components being central action on the cannabinoid type-one receptor and downstream intracellular signaling related to the endogenous cannabinoid system. Back-translational studies have provided insight linking preclinical basic and behavioral biology research to better understand symptoms observed at the clinical level. This narrative review aims to summarize major research elucidating the molecular, cellular, and behavioral manifestations of cannabis/THC use that play a role in cannabis use disorder and withdrawal.
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Affiliation(s)
- Andrew J. Kesner
- Laboratory for Integrative NeuroscienceNational Institute on Alcohol Abuse and AlcoholismCenter on Compulsive BehaviorsNational Institutes of HealthBethesdaMDUSA
| | - David M. Lovinger
- Laboratory for Integrative NeuroscienceNational Institute on Alcohol Abuse and AlcoholismCenter on Compulsive BehaviorsNational Institutes of HealthBethesdaMDUSA
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9
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The why behind the high: determinants of neurocognition during acute cannabis exposure. Nat Rev Neurosci 2021; 22:439-454. [PMID: 34045693 DOI: 10.1038/s41583-021-00466-4] [Citation(s) in RCA: 29] [Impact Index Per Article: 9.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/12/2021] [Indexed: 11/08/2022]
Abstract
Acute cannabis intoxication may induce neurocognitive impairment and is a possible cause of human error, injury and psychological distress. One of the major concerns raised about increasing cannabis legalization and the therapeutic use of cannabis is that it will increase cannabis-related harm. However, the impairing effect of cannabis during intoxication varies among individuals and may not occur in all users. There is evidence that the neurocognitive response to acute cannabis exposure is driven by changes in the activity of the mesocorticolimbic and salience networks, can be exacerbated or mitigated by biological and pharmacological factors, varies with product formulations and frequency of use and can differ between recreational and therapeutic use. It is argued that these determinants of the cannabis-induced neurocognitive state should be taken into account when defining and evaluating levels of cannabis impairment in the legal arena, when prescribing cannabis in therapeutic settings and when informing society about the safe and responsible use of cannabis.
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10
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Ellingson JM, Ross JM, Winiger E, Stallings MC, Corley RP, Friedman NP, Hewitt JK, Tapert SF, Brown SA, Wall TL, Hopfer CJ. Familial factors may not explain the effect of moderate-to-heavy cannabis use on cognitive functioning in adolescents: a sibling-comparison study. Addiction 2021; 116:833-844. [PMID: 32881239 PMCID: PMC7925696 DOI: 10.1111/add.15207] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/04/2020] [Revised: 03/23/2020] [Accepted: 07/20/2020] [Indexed: 01/16/2023]
Abstract
AIMS To examine whether moderate adolescent cannabis use has neurocognitive effects that are unexplained by familial confounds, which prior family-controlled studies may not have identified. DESIGN A quasi-experimental, sibling-comparison design was applied to a prospective, observational study of adolescents with moderate cannabis use. Participants were recruited from 2001 to 2006 (mean age = 17 years). A second wave of data was collected from 2008 to 2013 (mean age = 24 years). SETTING Two US metropolitan communities. PARTICIPANTS A total of 1192 adolescents from 596 families participated in this study. Participants were primarily male (64%) and racially and ethnically diverse (non-Hispanic white = 45%). A sibling in each family was a clinical proband identified due to delinquent behaviors. Whereas prior family-controlled studies have used samples of primarily infrequent cannabis users (mean = 1-2 days/month), participants here endorsed levels of cannabis use comparable to findings from epidemiological cohort studies (mean = 7-9 days/month). MEASUREMENTS Semi-structured clinical interviews assessed drug use, and a neuropsychological battery assessed cognitive abilities. Covariates included age at assessment, gender and alcohol use. FINDINGS After correcting for multiple testing, a greater frequency and earlier onset of regular cannabis use were associated with poorer cognitive performance, specifically on tests of verbal memory. Further, after accounting for familial factors shared by siblings and alcohol use, poorer verbal memory performance was still associated with greater life-time frequency of cannabis use at wave 1 [b = -0.007 (-0.002, -0.012), adjusted P = 0.036]; earlier cannabis use at wave 2 [b = -0.12 (-0.05, -0.19), adjusted P = 0.006; b = -0.14 (-0.06, -0.23), adjusted P = 0.006]; and greater frequency of past 6 months use at wave 2 [b = -0.02 (-0.01, -0.03), adjusted P = 0.002; b = -0.02 (-0.01, -0.03), adjusted P = 0.008]. CONCLUSIONS Moderate adolescent cannabis use may have adverse effects on cognitive functioning, specifically verbal memory, that cannot be explained by familial factors.
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Affiliation(s)
- Jarrod M. Ellingson
- Department of Psychiatry, University of Colorado School of Medicine, Aurora, Colorado,Institute for Behavioral Genetics, University of Colorado Boulder,,Correspondence regarding this article should be sent to: Jarrod Ellingson, Department of Psychiatry, University of Colorado School of Medicine, Aurora, CO 80045,
| | - J. Megan Ross
- Institute for Behavioral Genetics, University of Colorado Boulder
| | - Evan Winiger
- Institute for Behavioral Genetics, University of Colorado Boulder,,Department of Psychology and Neuroscience, University of Colorado Boulder
| | - Michael C. Stallings
- Institute for Behavioral Genetics, University of Colorado Boulder,,Department of Psychology and Neuroscience, University of Colorado Boulder
| | - Robin P. Corley
- Institute for Behavioral Genetics, University of Colorado Boulder
| | - Naomi P. Friedman
- Institute for Behavioral Genetics, University of Colorado Boulder,,Department of Psychology and Neuroscience, University of Colorado Boulder,,Institute for Cognitive Science, University of Colorado Boulder
| | - John K. Hewitt
- Institute for Behavioral Genetics, University of Colorado Boulder,,Department of Psychology and Neuroscience, University of Colorado Boulder
| | - Susan F. Tapert
- Department of Psychiatry, University of California San Diego, San Diego, California,Veterans Affairs San Diego Healthcare System, San Diego, California
| | - Sandra A. Brown
- Department of Psychiatry, University of California San Diego, San Diego, California,Veterans Affairs San Diego Healthcare System, San Diego, California
| | - Tamara L. Wall
- Department of Psychiatry, University of California San Diego, San Diego, California,Veterans Affairs San Diego Healthcare System, San Diego, California
| | - Christian J. Hopfer
- Department of Psychiatry, University of Colorado School of Medicine, Aurora, Colorado,Institute for Behavioral Genetics, University of Colorado Boulder
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11
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Johnson MB, Mechtler L, Ali B, Swedler D, Kelley-Baker T. Cannabis and crash risk among older drivers. ACCIDENT; ANALYSIS AND PREVENTION 2021; 152:105987. [PMID: 33549974 DOI: 10.1016/j.aap.2021.105987] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/12/2020] [Revised: 01/04/2021] [Accepted: 01/06/2021] [Indexed: 06/12/2023]
Abstract
The purpose of this research was to reanalyze data collected from the National Highway Traffic Safety Administration's Drug and Alcohol Crash Risk Study to investigate whether driving under the influence of cannabis (THC-positive) was associated with elevated crash risk for younger and older drivers. The data came from a case-control relative risk study collected from Virginia Beach, VA, over a 20-month period. Data collectors gathered driver information from the scene of vehicle crashes and, in some cases, from hospitals. Non-crash controls were sampled from the same locations, days, and times as crashes. Key data items included driver demographics and oral fluid and blood samples, which were assayed for licit and illicit drugs. We found no overall association between cannabis use and risk of crash involvement. However, when age and age2 were allowed to interact with THC, significant interaction effects emerged. THC was associated with increased risk of crash involvement for older drivers. Difference between THC-positive and sober drivers emerged as significant at age 64. The research underscores the value of examining drugged driving in the context of driver age. Age-related declines in neurocognitive and psychomotor functioning were not measured but might be important in explaining the results.
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Affiliation(s)
- Mark B Johnson
- Pacific Institute for Research and Evaluation (PIRE), 11720 Beltsville Drive, Suite 900, Calverton, MD 20705, USA.
| | - Laszlo Mechtler
- Dent Neurologic Institute, 3980 Sheridan Drive, Amherst, NY 14226, USA
| | - Bina Ali
- Pacific Institute for Research and Evaluation (PIRE), 11720 Beltsville Drive, Suite 900, Calverton, MD 20705, USA
| | - David Swedler
- Pacific Institute for Research and Evaluation (PIRE), 11720 Beltsville Drive, Suite 900, Calverton, MD 20705, USA
| | - Tara Kelley-Baker
- AAA Foundation for Traffic Safety, 607 14th Street, NW, Suite 201, Washington, DC 20005-2000, USA
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12
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Ramaekers JG, Mason NL, Theunissen EL. Blunted highs: Pharmacodynamic and behavioral models of cannabis tolerance. Eur Neuropsychopharmacol 2020; 36:191-205. [PMID: 32014378 DOI: 10.1016/j.euroneuro.2020.01.006] [Citation(s) in RCA: 44] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/29/2019] [Revised: 12/22/2019] [Accepted: 01/12/2020] [Indexed: 02/07/2023]
Abstract
Acute exposure to cannabis comes with neurocognitive impairment, leading to increased risk of human error and injury. Evidence however indicates that such acute effects are less prominent in chronic users, suggesting cannabis tolerance. Models of cannabis tolerance stress the importance of neurobiological or behavioral adaptations following repeated cannabis exposure. The pharmacodynamic model relates neuroadaptive changes in the brain to a blunted response to cannabis. Downregulation of CB1 receptors in chronic cannabis users has been associated with a normalization of dopaminergic output from the ventral tegmental area to the mesolimbic circuit, and a reduction of impairment during acute cannabis exposure. Such neuroadaptions are absent in occasional users, who show strong increments of dopamine and glutamate levels in the striatum, a loss of functional connectivity within the mesolimbic circuit and neurocognitive impairments when exposed to cannabis. Evidence for a behavioral model of cannabis tolerance that poses that users can have volitional control to overcome functional impairment during cannabis intoxication is relatively weak, and at best shows limited control over a limited number of behavioral functions. Cannabis tolerance is most likely to occur in users that consume high doses of cannabis continuously, at a high pace, for a prolonged period of time. Knowledge on frequency, dose and duration of cannabis use that is needed to achieve, maintain or lessen tolerance however is very limited, but will be of importance in the context of cannabis therapeutics and in legal settings when evaluating the impact of cannabis exposure on human function.
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Affiliation(s)
- J G Ramaekers
- Faculty of Psychology and Neuroscience, Department of Neuropsychology and Psychopharmacology, Maastricht University, the Netherlands.
| | - N L Mason
- Faculty of Psychology and Neuroscience, Department of Neuropsychology and Psychopharmacology, Maastricht University, the Netherlands
| | - E L Theunissen
- Faculty of Psychology and Neuroscience, Department of Neuropsychology and Psychopharmacology, Maastricht University, the Netherlands
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13
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Cabeen RP, Allman JM, Toga AW. THC Exposure is Reflected in the Microstructure of the Cerebral Cortex and Amygdala of Young Adults. Cereb Cortex 2020; 30:4949-4963. [PMID: 32377689 DOI: 10.1093/cercor/bhaa087] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/13/2023] Open
Abstract
The endocannabinoid system serves a critical role in homeostatic regulation through its influence on processes underlying appetite, pain, reward, and stress, and cannabis has long been used for the related modulatory effects it provides through tetrahydrocannabinol (THC). We investigated how THC exposure relates to tissue microstructure of the cerebral cortex and subcortical nuclei using computational modeling of diffusion magnetic resonance imaging data in a large cohort of young adults from the Human Connectome Project. We report strong associations between biospecimen-defined THC exposure and microstructure parameters in discrete gray matter brain areas, including frontoinsular cortex, ventromedial prefrontal cortex, and the lateral amygdala subfields, with independent effects in behavioral measures of memory performance, negative intrusive thinking, and paternal substance abuse. These results shed new light on the relationship between THC exposure and microstructure variation in brain areas related to salience processing, emotion regulation, and decision making. The absence of effects in some other cannabinoid-receptor-rich brain areas prompts the consideration of cellular and molecular mechanisms that we discuss. Further studies are needed to characterize the nature of these effects across the lifespan and to investigate the mechanistic neurobiological factors connecting THC exposure and microstructural parameters.
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Affiliation(s)
- Ryan P Cabeen
- Laboratory of Neuro Imaging, USC Stevens Neuroimaging and Informatics Institute, Keck School of Medicine of USC, University of Southern California, Los Angeles, CA 90033, USA
| | - John M Allman
- Division of Biology, California Institute of Technology, Pasadena, CA 91125, USA
| | - Arthur W Toga
- Laboratory of Neuro Imaging, USC Stevens Neuroimaging and Informatics Institute, Keck School of Medicine of USC, University of Southern California, Los Angeles, CA 90033, USA
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14
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Karoly HC, Ross JM, Ellingson JM, Feldstein Ewing SW. Exploring Cannabis and Alcohol Co-Use in Adolescents: A Narrative Review of the Evidence. J Dual Diagn 2020; 16:58-74. [PMID: 31519143 PMCID: PMC7007306 DOI: 10.1080/15504263.2019.1660020] [Citation(s) in RCA: 21] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
Objective: Amidst the evolving policy surrounding cannabis legalization in the United States, cannabis use is becoming increasingly prevalent as perceptions of harm decrease, particularly among adolescents. Cannabis and alcohol are commonly used by adolescents and are often used together. However, developmental research has historically taken a "single substance" approach to examine the association of substance use and adolescent brain and behavior rather than examining co-(or poly-substance) use of multiple substances, such as cannabis and alcohol. Thus, the acute effects of cannabis and alcohol, and the impact of co-use of cannabis and alcohol on the adolescent brain, cognitive function and subsequent psychosocial outcomes remains understudied. This narrative review aims to examine the effects of cannabis and alcohol on adolescents across a number of behavioral and neurobiological outcomes. Methods: The PubMed and Google Scholar databases were searched for the last 10 years to identify articles reporting on acute effects of cannabis and alcohol administration, and the effects of cannabis and alcohol on neuropsychological, neurodevelopmental, neural (e.g., structural and functional neuroimaging), and psychosocial outcomes in adolescents. When adolescent data were not available, adult studies were included as support for potential areas of future direction in adolescent work. Results: Current studies of the impact of cannabis and alcohol on adolescent brain and behavior have yielded a complicated pattern. Some suggest that the use of cannabis in addition to alcohol during adolescence may have a "protective" effect, yielding neuropsychological and structural brain outcomes that are better than those for adolescents who use only alcohol. However, other adolescent studies suggest that cannabis and alcohol co-use is associated with negative health and social outcomes such as poorer academic performance and impaired driving. Conclusion: Variation in study methodologies, policy-level limitations and our limited understanding of the developmental neurobiological effects of cannabis preclude the straightforward interpretation of the existing data on adolescent cannabis and alcohol use. Further research on this topic is requisite to inform the development of effective intervention and prevention programs for adolescent substance users, which hinge on a more comprehensive understanding of how cannabis-and its intersection with alcohol-impacts the developing brain and behavior.
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Affiliation(s)
- Hollis C Karoly
- Institute for Cognitive Science, University of Colorado Boulder, Boulder, Colorado, USA
| | - J Megan Ross
- Institute for Behavioral Genetics, University of Colorado Boulder, Boulder, Colorado, USA
| | - Jarrod M Ellingson
- Department of Psychology and Neuroscience, University of Colorado Boulder, Boulder, Colorado, USA
| | - Sarah W Feldstein Ewing
- Department of Child & Adolescent Psychiatry, Oregon Health & Science University, Portland, Oregon, USA
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15
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Mason NL, Theunissen EL, Hutten NRPW, Tse DHY, Toennes SW, Stiers P, Ramaekers JG. Cannabis induced increase in striatal glutamate associated with loss of functional corticostriatal connectivity. Eur Neuropsychopharmacol 2019; 29:247-256. [PMID: 30553697 DOI: 10.1016/j.euroneuro.2018.12.003] [Citation(s) in RCA: 34] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/29/2018] [Revised: 11/28/2018] [Accepted: 12/01/2018] [Indexed: 12/22/2022]
Abstract
Cannabis is the most commonly used illicit drug and is known to alter state of consciousness and impair neurocognitive function. However, the mechanisms underlying these effects have yet to be fully elucidated. Rodent studies suggest that Δ9-tetrahydrocannabinol (THC) activates dopaminergic neurons in the limbic system, subsequently enhancing dopamine, which is implicated in the rewarding effects of cannabis. Additional evidence suggests that THC may act indirectly on dopamine firing by modulating GABA and glutamate release. This double-blind, placebo-controlled study assessed the acute influence of two doses of THC on brain kinetics of glutamate, GABA, and dopamine, in relation to behavioral outcomes, by using magnetic resonance spectroscopy and functional magnetic resonance imaging. Twenty occasional cannabis users received acute doses of cannabis (300 µg/kg THC) and placebo, in one of two dose regimes (full dose and divided dose), during two separate testing days. Administration of THC increased striatal glutamate concentrations, and dopamine as indicated by a reduction in functional connectivity (FC) between the nucleus accumbens (NAc) and cortical areas. Alterations in glutamate and FC were dose dependent and evident in the full dose group where THC serum concentrations exceeded 2 ng/ml at T-max. Average glutamate changes correlated strongly with FC alterations. Additionally, THC induced changes in FC correlated with feelings of subjective high and decreased performance on an attention task. Taken together, this suggests that THC elicits subjective and cognitive alterations via increased striatal dopaminergic activity and loss of corticostriatal connectivity, which is associated with an increase in striatal glutamate.
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Affiliation(s)
- Natasha L Mason
- Department of Neuropsychology and Psychopharmacology, Faculty of Psychology and Neuroscience, Maastricht University, P.O. Box 616, 6200 MD, Maastricht, The Netherlands.
| | - Eef L Theunissen
- Department of Neuropsychology and Psychopharmacology, Faculty of Psychology and Neuroscience, Maastricht University, P.O. Box 616, 6200 MD, Maastricht, The Netherlands
| | - Nadia R P W Hutten
- Department of Neuropsychology and Psychopharmacology, Faculty of Psychology and Neuroscience, Maastricht University, P.O. Box 616, 6200 MD, Maastricht, The Netherlands
| | - Desmond H Y Tse
- Department of Neuropsychology and Psychopharmacology, Faculty of Psychology and Neuroscience, Maastricht University, P.O. Box 616, 6200 MD, Maastricht, The Netherlands
| | - Stefan W Toennes
- Institute of Legal Medicine, University of Frankfurt, Kennedyallee 104, D-60596, Frankfurt/Main, Germany
| | - Peter Stiers
- Department of Neuropsychology and Psychopharmacology, Faculty of Psychology and Neuroscience, Maastricht University, P.O. Box 616, 6200 MD, Maastricht, The Netherlands
| | - Johannes G Ramaekers
- Department of Neuropsychology and Psychopharmacology, Faculty of Psychology and Neuroscience, Maastricht University, P.O. Box 616, 6200 MD, Maastricht, The Netherlands
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16
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Hurd YL, Manzoni OJ, Pletnikov MV, Lee FS, Bhattacharyya S, Melis M. Cannabis and the Developing Brain: Insights into Its Long-Lasting Effects. J Neurosci 2019; 39:8250-8258. [PMID: 31619494 PMCID: PMC6794936 DOI: 10.1523/jneurosci.1165-19.2019] [Citation(s) in RCA: 103] [Impact Index Per Article: 20.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/25/2019] [Revised: 08/10/2019] [Accepted: 08/12/2019] [Indexed: 12/24/2022] Open
Abstract
The recent shift in sociopolitical debates and growing liberalization of cannabis use across the globe has raised concern regarding its impact on vulnerable populations, such as pregnant women and adolescents. Epidemiological studies have long demonstrated a relationship between developmental cannabis exposure and later mental health symptoms. This relationship is especially strong in people with particular genetic polymorphisms, suggesting that cannabis use interacts with genotype to increase mental health risk. Seminal animal research directly linked prenatal and adolescent exposure to delta-9-tetrahydrocannabinol, the major psychoactive component of cannabis, with protracted effects on adult neural systems relevant to psychiatric and substance use disorders. In this article, we discuss some recent advances in understanding the long-term molecular, epigenetic, electrophysiological, and behavioral consequences of prenatal, perinatal, and adolescent exposure to cannabis/delta-9-tetrahydrocannabinol. Insights are provided from both animal and human studies, including in vivo neuroimaging strategies.
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Affiliation(s)
- Yasmin L Hurd
- Department of Psychiatry and Department of Neuroscience, Icahn School of Medicine at Mount Sinai, New York, New York 10029,
| | - Olivier J Manzoni
- Aix Marseille University, Institut National de la Santé et de la Recherche Médicale, Institut de neurobiologie de la méditerranée, 13273 Marseille, France, and Cannalab, Cannabinoids Neuroscience Research International Associated Laboratory, Institut National de la Santé et de la Recherche Médicale, 13273 Marseille, France
| | - Mikhail V Pletnikov
- Department of Psychiatry and Behavioral Sciences, Solomon H. Snyder Department of Neuroscience, Johns Hopkins University School of Medicine, Baltimore, Maryland 21205
| | - Francis S Lee
- Department of Psychiatry, Sackler Institute for Developmental Psychobiology, Weill Cornell Medical College, New York, New York 10065
| | - Sagnik Bhattacharyya
- Department of Psychosis Studies, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London SE5 8AF, United Kingdom, and
| | - Miriam Melis
- Department of Biomedical Sciences, Division of Neuroscience and Clinical Pharmacology, University of Cagliari, 09042 Cagliari, Italy
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17
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Harms MB, Casement MD, Teoh JY, Ruiz S, Scott H, Wedan R, Quevedo K. Adolescent suicide attempts and ideation are linked to brain function during peer interactions. Psychiatry Res Neuroimaging 2019; 289:1-9. [PMID: 31102892 DOI: 10.1016/j.pscychresns.2019.05.001] [Citation(s) in RCA: 38] [Impact Index Per Article: 7.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/20/2018] [Revised: 05/02/2019] [Accepted: 05/03/2019] [Indexed: 12/30/2022]
Abstract
Understanding the neural correlates of social interaction among depressed adolescents with suicidal tendencies might help personalize treatment. We tested whether brain function during social interaction is disrupted for depressed adolescents with (1) high suicide ideation and (2) recent attempts. Depressed adolescents with high suicide ideation, including attempters (n = 45;HS) or low suicide ideation (n = 42;LS), and healthy adolescents (n = 39;HC), completed a version of the Cyberball peer interaction task during an fMRI scan. Groups were compared on brain activity during peer exclusion and inclusion versus a non-social condition. During peer exclusion and inclusion, HS youth showed significantly lower activity in precentral and postcentral gyrus, superior temporal gyrus, medial frontal gyrus, insula, and putamen compared to LS youth; and significantly reduced activity in caudate and anterior cingulate cortex compared to HC youth. In a second analysis, suicide attempters (n = 26;SA) were compared to other groups. SA adolescents showed significantly higher activity in ACC and superior and middle frontal gyrus than all other groups. Brain activity was significantly correlated with negative emotionality, social functioning, and cognitive control. Conclusions: Adolescent suicide ideation and attempts were linked to altered neural function during positive and negative peer interactions. We discuss the implications of these findings for suicide prevention efforts.
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Affiliation(s)
- Madeline B Harms
- Institute of Child Development, University of Minnesota, Minneapolis, MN, USA
| | | | - Jia Yuan Teoh
- Department of Psychiatry, University of Minnesota, Minneapolis, MN, USA
| | - Sarah Ruiz
- Institute of Child Development, University of Minnesota, Minneapolis, MN, USA
| | - Hannah Scott
- Department of Psychiatry, University of Minnesota, Minneapolis, MN, USA
| | - Riley Wedan
- Department of Psychiatry, University of Minnesota, Minneapolis, MN, USA
| | - Karina Quevedo
- Department of Psychiatry, University of Minnesota, Minneapolis, MN, USA.
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18
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Śledziński P, Zeyland J, Slomski R, Nowak-Terpiłowska A. The adverse effects of marijuana use: The present state and future directions. JOURNAL OF CHILD & ADOLESCENT SUBSTANCE ABUSE 2019. [DOI: 10.1080/1067828x.2018.1561580] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
Affiliation(s)
- Paweł Śledziński
- Department of Biochemistry and Biotechnology, Poznań University of Life Sciences, Poznań, Poland
| | - Joanna Zeyland
- Department of Biochemistry and Biotechnology, Poznań University of Life Sciences, Poznań, Poland
| | - Ryszard Slomski
- Department of Biochemistry and Biotechnology, Poznań University of Life Sciences, Poznań, Poland
- Institute of Human Genetics of the Polish Academy of Sciences, Poznań, Poland
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Okafor CN, Plankey MW, Li M, Chen X, Surkan PJ, Shoptaw S, Martin E, Cohen R, Sacktor N, Cook RL. Association of Marijuana Use with Changes in Cognitive Processing Speed and Flexibility for 17 Years in HIV-Seropositive and HIV-Seronegative Men. Subst Use Misuse 2019; 54:525-537. [PMID: 30700235 PMCID: PMC6443451 DOI: 10.1080/10826084.2018.1495736] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/02/2023]
Abstract
BACKGROUND The long-term effects of marijuana on cognition, particularly in the context of HIV is not clear, as extant research shows mixed findings. OBJECTIVE To determine associations between current and cumulative exposure to marijuana and changes in cognitive processing speed and flexibility in 788 HIV-seropositive (HIV+) and 1,132 HIV-seronegative (HIV-) men followed for up to 17 years in the Multicenter AIDS Cohort Study. RESULTS Among HIV+ men only, current daily marijuana use compared to none-use, was significantly associated with a greater annual percentage decline in cognitive processing speed assessed with the Trail Making Test A (TMTA) (β=-0.41, 95% confidence interval (CI): -0.88, -0.03, p=0.03)] and Symbol Digit Modalities Test (SDMT) (β= -0.14, 95% CI: -0.28, -0.01, p=0.04). Further, monthly marijuana use was associated with greater annual percentage decline in cognitive flexibility assessed with the Trail Making Test B (TMTB) (β= -0.70, 95% CI: -1.34, -0.05; p=0.03] and cognitive processing speed (SDMT) (β= -0.21, 95% CI: -0.40, -0.01, p=0.03). Among the HIV- men only, each 5-marijuana use-years (equivalent to 5-years of daily marijuana use) was significantly associated with a 0.17 annual percentage decline in cognitive processing speed only (TMTA) (β= -0.18, 95% CI: -0.36, -0.01; p=0.04). CONCLUSIONS Our findings suggest that marijuana use, particularly current use, may be associated with worse cognitive processing speed, but the magnitude of the estimates was not clinically meaningful.
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Affiliation(s)
- Chukwuemeka N Okafor
- a Division of Infectious Diseases , David Geffen School of Medicine at University of California, Los Angeles , Los Angeles , California , USA.,b David Geffen School of Medicine , Department of Family Medicine at University of California , Los Angeles , California , USA
| | - Michael W Plankey
- c Department of Medicine, Division of Infectious Diseases , Georgetown University Medical Center , Washington, DC , USA
| | - Michael Li
- b David Geffen School of Medicine , Department of Family Medicine at University of California , Los Angeles , California , USA
| | - Xinguang Chen
- d Department of Epidemiology , College of Public Health and Health Professions, College of Medicine, University of Florida , Gainesville , Florida , USA
| | - Pamela J Surkan
- e Social and Behavioral Interventions Program, Department of International Health , Johns Hopkins Bloomberg School of Public Health , Baltimore , Maryland , USA
| | - Steve Shoptaw
- b David Geffen School of Medicine , Department of Family Medicine at University of California , Los Angeles , California , USA
| | - Eileen Martin
- f Department of Psychiatry , Rush University Medical Center , Chicago , Illinois , USA
| | - Ronald Cohen
- g Center for Cognitive Aging and Memory, Institute on Aging, and the Departments of Neurology, Psychiatry, and Aging and Geriatric Research , University of Florida , Gainesville , Florida , USA
| | - Ned Sacktor
- h Department of Neurology, Johns Hopkins Bayview Medical Center , John Hopkins University , Baltimore , Maryland , USA
| | - Robert L Cook
- d Department of Epidemiology , College of Public Health and Health Professions, College of Medicine, University of Florida , Gainesville , Florida , USA
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20
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Mercuri K, Terrett G, Henry JD, Curran HV, Elliott M, Rendell PG. Episodic foresight deficits in regular, but not recreational, cannabis users. J Psychopharmacol 2018; 32:876-882. [PMID: 29897004 DOI: 10.1177/0269881118776672] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
BACKGROUND Cannabis use is associated with a range of neurocognitive deficits, including impaired episodic memory. However, no study to date has assessed whether these difficulties extend to episodic foresight, a core component of which is the ability to mentally travel into one's personal future. This is a particularly surprising omission given that episodic memory is considered to be critical to engage episodic foresight. AIMS In the present study, we provide the first test of how episodic foresight is affected in the context of differing levels of cannabis use, and the degree to which performance on a measure of this construct is related to episodic memory. RESULTS Fifty-seven regular cannabis users (23 recreational, 34 regular) and 57 controls were assessed using an adapted version of the Autobiographical Interview. The results showed that regular-users exhibited greater impairment of episodic foresight and episodic memory than both recreational-users and cannabis-naïve controls. CONCLUSIONS These data therefore show for the first time that cannabis-related disruption of cognitive functioning extends to the capacity for episodic foresight, and they are discussed in relation to their potential implications for functional outcomes in this group.
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Affiliation(s)
- Kimberly Mercuri
- 1 Cognition and Emotion Research Centre, School of Psychology, Australian Catholic University, Melbourne, VIC, Australia
| | - Gill Terrett
- 1 Cognition and Emotion Research Centre, School of Psychology, Australian Catholic University, Melbourne, VIC, Australia
| | - Julie D Henry
- 2 School of Psychology, University of Queensland, Brisbane, QLD, Australia
| | - H Valerie Curran
- 3 Clinical Psychopharmacology Unit, University College London, UK
| | - Morgan Elliott
- 1 Cognition and Emotion Research Centre, School of Psychology, Australian Catholic University, Melbourne, VIC, Australia
| | - Peter G Rendell
- 1 Cognition and Emotion Research Centre, School of Psychology, Australian Catholic University, Melbourne, VIC, Australia
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21
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Ramones A, Pita A, Keator D, Wu J. Case report: Significant quantitative MRI brain volumetric finding associated with electrical brain injury. BURNS OPEN 2018. [DOI: 10.1016/j.burnso.2018.03.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022] Open
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Memory Impairment in HIV-Infected Individuals with Early and Late Initiation of Regular Marijuana Use. AIDS Behav 2018; 22:1596-1605. [PMID: 28884250 DOI: 10.1007/s10461-017-1898-z] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
Abstract
Marijuana use is disproportionately prevalent among HIV-infected individuals. The strongest neurocognitive effect of marijuana use is impairment in the domain of memory. Memory impairment is also high among HIV-infected persons. The present study examined 69 HIV-infected individuals who were stratified by age of regular marijuana initiation to investigate how marijuana use impacts neurocognitive functioning. A comprehensive battery assessed substance use and neurocognitive functioning. Findings indicated early onset marijuana users (regular use prior to age 18), compared to non-marijuana users and late onset marijuana users (regular use at age 18 or later), were over 8 times more likely to have learning impairment and nearly 4 times more likely to have memory impairment. A similar pattern of early onset marijuana users performing worse in learning emerged when examining domain deficit scores. The potential for early onset of regular marijuana use to exacerbate already high levels of memory impairment among HIV-infected persons has important clinical implications, including increased potential for medication non-adherence and difficulty with independent living.
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23
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Blest-Hopley G, Giampietro V, Bhattacharyya S. Residual effects of cannabis use in adolescent and adult brains - A meta-analysis of fMRI studies. Neurosci Biobehav Rev 2018. [PMID: 29535069 DOI: 10.1016/j.neubiorev.2018.03.008] [Citation(s) in RCA: 58] [Impact Index Per Article: 9.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/24/2023]
Abstract
While numerous studies have investigated the residual effects of cannabis use on human brain function, results of these studies have been inconsistent. Using meta-analytic approaches we summarize the effects of prolonged cannabis exposure on human brain function as measured using task-based functional MRI (fMRI) across studies employing a range of cognitive activation tasks comparing regular cannabis users with non-users. Separate meta-analyses were carried out for studies investigating adult and adolescent cannabis users. Systematic literature search identified 20 manuscripts (13 adult and 7 adolescent studies) meeting study inclusion criteria. Adult analyses compared 530 cannabis users to 580 healthy controls while adolescent analyses compared 219 cannabis users to 224 healthy controls. In adult cannabis users brain activation was increased in the superior and posterior transverse temporal and inferior frontal gyri and decreased in the striate area, insula and middle temporal gyrus. In adolescent cannabis users, activation was increased in the inferior parietal gyrus and putamen compared to healthy controls. Functional alteration in these areas may reflect compensatory neuroadaptive changes in cannabis users.
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Affiliation(s)
- Grace Blest-Hopley
- Department of Psychosis Studies, Institute of Psychiatry, Psychology & Neuroscience, King's College London, UK
| | - Vincent Giampietro
- Department of Neuroimaging, Institute of Psychiatry, Psychology & Neuroscience, King's College London, PO Box 089, UK
| | - Sagnik Bhattacharyya
- Department of Psychosis Studies, Institute of Psychiatry, Psychology & Neuroscience, King's College London, UK; South London and Maudsley NHS Foundation Trust, Denmark Hill, Camberwell, London, UK.
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24
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Lorkiewicz SA, Ventura AS, Heeren TC, Winter MR, Walley AY, Sullivan M, Samet JH, Saitz R. Lifetime marijuana and alcohol use, and cognitive dysfunction in people with human immunodeficiency virus infection. Subst Abus 2017; 39:116-123. [PMID: 29058572 DOI: 10.1080/08897077.2017.1391925] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/01/2023]
Abstract
BACKGROUND Substance use is common among people with human immunodeficiency virus (HIV) infection. Alcohol, marijuana, and HIV can have negative effects on cognition. Associations between current and lifetime marijuana and alcohol use and cognitive dysfunction in people with HIV infection were examined. METHODS Some 215 HIV-infected adults with Diagnostic and Statistical Manual of Mental Disorders Fourth Edition (DSM-IV) substance dependence or ever injection drug use were studied. In adjusted cross-sectional regression analyses associations were assessed between current marijuana use, current heavy alcohol use, lifetime marijuana use, lifetime alcohol use, duration of heavy alcohol use (the independent variables), and 3 measures of cognitive dysfunction (dependent variables): both the (i) memory and (ii) attention domains from the Montreal Cognitive Assessment (MoCA) and the (iii) 4-item cognitive function scale (CF4) from the Medical Outcomes Study HIV Health Survey (MOS-HIV). Analyses were adjusted for demographics, primary language, depressive symptoms, anxiety, comorbidities, antiretroviral therapy, hepatitis C virus (ever), duration of HIV infection (years), HIV-viral load (log copies/mL), CD4 cell count, lifetime and recent cocaine use, and recent illicit and prescribed opioid use. RESULTS Current marijuana use was significantly and negatively associated with the MOS-HIV CF4 score (adjusted mean difference = -0.40, P = .01). Current marijuana use was not significantly associated with either MoCA score. Lifetime marijuana use and current heavy and lifetime alcohol use and duration of heavy alcohol use were not associated with any measure of cognitive dysfunction. CONCLUSION Current marijuana use was associated with one measure of cognitive dysfunction, but there was not a consistent pattern of association with lifetime marijuana use or alcohol use and measures of cognitive dysfunction. Understanding the mechanism by which marijuana, with and without alcohol, are associated with worse cognition warrants larger, longer studies with more precise and diverse measurements of cognitive function.
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Affiliation(s)
- Sara A Lorkiewicz
- a Graduate Medical Sciences, Boston University School of Medicine , Boston , Massachusetts , USA
| | - Alicia S Ventura
- b Department of Community Health Sciences , Boston University School of Public Health , Boston , Massachusetts , USA.,e Clinical Addiction Research and Education (CARE) Unit, Section of General Internal Medicine , Department of Medicine, Boston University School of Medicine and Boston Medical Center , Boston , Massachusetts , USA
| | - Timothy C Heeren
- c Department of Biostatistics , Boston University School of Public Health , Boston , Massachusetts , USA
| | - Michael R Winter
- d Data Coordinating Center , Boston University School of Public Health , Boston , Massachusetts , USA
| | - Alexander Y Walley
- e Clinical Addiction Research and Education (CARE) Unit, Section of General Internal Medicine , Department of Medicine, Boston University School of Medicine and Boston Medical Center , Boston , Massachusetts , USA
| | - Meg Sullivan
- f Section of Infectious Diseases , Department of Medicine, Boston University School of Medicine and Boston Medical Center , Boston , Massachusetts , USA
| | - Jeffrey H Samet
- b Department of Community Health Sciences , Boston University School of Public Health , Boston , Massachusetts , USA.,e Clinical Addiction Research and Education (CARE) Unit, Section of General Internal Medicine , Department of Medicine, Boston University School of Medicine and Boston Medical Center , Boston , Massachusetts , USA
| | - Richard Saitz
- b Department of Community Health Sciences , Boston University School of Public Health , Boston , Massachusetts , USA.,e Clinical Addiction Research and Education (CARE) Unit, Section of General Internal Medicine , Department of Medicine, Boston University School of Medicine and Boston Medical Center , Boston , Massachusetts , USA
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25
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Vidot DC, Lerner B, Gonzalez R. Cannabis Use, Medication Management and Adherence Among Persons Living with HIV. AIDS Behav 2017; 21:2005-2013. [PMID: 28456895 DOI: 10.1007/s10461-017-1782-x] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
Cannabis is used to relieve nausea, trigger weight gain, and reduce pain among adults living with HIV; however, the relationship between its use and medication adherence and management is unclear. Participants (N = 107) were from an ongoing cohort study of community-dwelling HIV+ adults, stratified by cannabis (CB) use: HIV+/CB+ (n = 41) and HIV+/CB- (n = 66). CB+ participants either tested positive in a urine toxicology screen for THC or had a self-reported history of regular and recent use. HIV-status was provided by physician results and/or biomarker assessment. Adherence was measured via the Morisky scale and medication management was assessed via the Medication Management Test-Revised. After adjusting for gender, we found no association between cannabis use group and adherence nor medication management. The amount of cannabis used was also not associated with measures of adherence and management. Preliminary findings suggest that cannabis use may not adversely influence medication adherence/management among adults living with HIV.
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Affiliation(s)
- Denise C Vidot
- School of Nursing and Health Sciences, University of Miami, 5030 Brunson Ave, Coral Gables, FL, 33146, USA.
| | - Brenda Lerner
- Department of Psychology, Center for Children and Families, Florida International University, Miami, FL, USA
| | - Raul Gonzalez
- Department of Psychology, Center for Children and Families, Florida International University, Miami, FL, USA
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26
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Patel VP, Feinstein A. Cannabis and cognitive functioning in multiple sclerosis: The role of gender. Mult Scler J Exp Transl Clin 2017. [PMID: 28634543 PMCID: PMC5468765 DOI: 10.1177/2055217317713027] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
Background Cognitive function in people with multiple sclerosis (PwMS) is associated with gender differences and the use of smoked/ingested cannabis. Objective The objective of this report is to explore a possible gender-cannabis interaction associated with cognitive dysfunction in PwMS. Methods A retrospective analysis was undertaken of cognitive data collected from 140 PwMS. A general linear model was conducted to determine gender and cannabis effects on processing speed (SDMT), verbal (CVLT-II) and visual (BVMT-R) memory, and executive functions (D-KEFS), while controlling for age and years of education. Results Cannabis was smoked at least once a month by 33 (23.6%) participants. Cannabis users were more impaired on the SDMT (p = 0.044). Men, who comprised 30.7% of the entire sample and 42.2% of cannabis users, were more impaired on the CVLT-II (total learning, p = 0.001; delayed recall, p = 0.004). A cannabis-gender interaction was found with the CVLT-II delayed recall (p = 0.049) and BVMT-R total learning (p = 0.014), where male cannabis users performed more poorly than female. Conclusion Males with MS may be particularly vulnerable to the cognitive side effects of smoked cannabis use.
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Affiliation(s)
- Viral P Patel
- Department of Psychiatry, Sunnybrook Health Sciences Center, Canada
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27
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Walsh Z, Gonzalez R, Crosby K, S. Thiessen M, Carroll C, Bonn-Miller MO. Medical cannabis and mental health: A guided systematic review. Clin Psychol Rev 2017; 51:15-29. [DOI: 10.1016/j.cpr.2016.10.002] [Citation(s) in RCA: 105] [Impact Index Per Article: 15.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2016] [Revised: 10/06/2016] [Accepted: 10/10/2016] [Indexed: 12/28/2022]
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Mokrysz C, Freeman TP, Korkki S, Griffiths K, Curran HV. Are adolescents more vulnerable to the harmful effects of cannabis than adults? A placebo-controlled study in human males. Transl Psychiatry 2016; 6:e961. [PMID: 27898071 PMCID: PMC5290352 DOI: 10.1038/tp.2016.225] [Citation(s) in RCA: 64] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/08/2016] [Revised: 09/27/2016] [Accepted: 09/28/2016] [Indexed: 12/18/2022] Open
Abstract
Preclinical research demonstrates that cannabinoids have differing effects in adolescent and adult animals. Whether these findings translate to humans has not yet been investigated. Here we believe we conducted the first study to compare the acute effects of cannabis in human adolescent (n=20; 16-17 years old) and adult (n=20; 24-28 years old) male cannabis users, in a placebo-controlled, double-blind cross-over design. After inhaling vaporized active or placebo cannabis, participants completed tasks assessing spatial working memory, episodic memory and response inhibition, alongside measures of blood pressure and heart rate, psychotomimetic symptoms and subjective drug effects (for example, 'stoned', 'want to have cannabis'). Results showed that on active cannabis, adolescents felt less stoned and reported fewer psychotomimetic symptoms than adults. Further, adults but not adolescents were more anxious and less alert during the active cannabis session (both pre- and post-drug administration). Following cannabis, cognitive impairment (reaction time on spatial working memory and prose recall following a delay) was greater in adults than adolescents. By contrast, cannabis impaired response inhibition accuracy in adolescents but not in adults. Moreover, following drug administration, the adolescents did not show satiety; instead they wanted more cannabis regardless of whether they had taken active or placebo cannabis, while the opposite was seen for adults. These contrasting profiles of adolescent resilience (blunted subjective, memory, physiological and psychotomimetic effects) and vulnerability (lack of satiety, impaired inhibitory processes) show some degree of translation from preclinical findings, and may contribute to escalated cannabis use by human adolescents.
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Affiliation(s)
- C Mokrysz
- Clinical Psychopharmacology Unit, Clinical Educational and Health Psychology, University College London, London, UK
| | - T P Freeman
- Clinical Psychopharmacology Unit, Clinical Educational and Health Psychology, University College London, London, UK
| | - S Korkki
- Behavioural and Clinical Neuroscience Institute, University of Cambridge, Cambridge, UK
| | - K Griffiths
- MRC Cognition and Brain Sciences Unit, University of Cambridge, Cambridge, UK
| | - H V Curran
- Clinical Psychopharmacology Unit, Clinical Educational and Health Psychology, University College London, London, UK
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Hirst RB, Young KR, Sodos LM, Wickham RE, Earleywine M. Trying to remember: Effort mediates the relationship between frequency of cannabis use and memory performance. J Clin Exp Neuropsychol 2016; 39:502-512. [DOI: 10.1080/13803395.2016.1237617] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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Marceau EM, Lunn J, Berry J, Kelly PJ, Solowij N. The Montreal Cognitive Assessment (MoCA) is Sensitive to Head Injury and Cognitive Impairment in a Residential Alcohol and Other Drug Therapeutic Community. J Subst Abuse Treat 2016; 66:30-6. [DOI: 10.1016/j.jsat.2016.03.002] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2015] [Revised: 02/22/2016] [Accepted: 03/18/2016] [Indexed: 10/22/2022]
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Pardini D, White HR, Xiong S, Bechtold J, Chung T, Loeber R, Hipwell A. Unfazed or Dazed and Confused: Does Early Adolescent Marijuana Use Cause Sustained Impairments in Attention and Academic Functioning? JOURNAL OF ABNORMAL CHILD PSYCHOLOGY 2016; 43:1203-17. [PMID: 25862212 DOI: 10.1007/s10802-015-0012-0] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
There is some suggestion that heavy marijuana use during early adolescence (prior to age 17) may cause significant impairments in attention and academic functioning that remain despite sustained periods of abstinence. However, no longitudinal studies have examined whether both male and female adolescents who engage in low (less than once a month) to moderate (at least once a monthly) marijuana use experience increased problems with attention and academic performance, and whether these problems remain following sustained abstinence. The current study used within-individual change models to control for all potential pre-existing and time-stable confounds when examining this potential causal association in two gender-specific longitudinal samples assessed annually from ages 11 to 16 (Pittsburgh Youth Study N = 479; Pittsburgh Girls Study N = 2296). Analyses also controlled for the potential influence of several pertinent time-varying factors (e.g., other substance use, peer delinquency). Prior to controlling for time-varying confounds, analyses indicated that adolescents tended to experience an increase in parent-reported attention and academic problems, relative to their pre-onset levels, during years when they used marijuana. After controlling for several time-varying confounds, only the association between marijuana use and attention problems in the sample of girls remained statistically significant. There was no evidence indicating that adolescents who used marijuana experienced lingering attention and academic problems, relative to their pre-onset levels, after abstaining from use for at least a year. These results suggest that adolescents who engage in low to moderate marijuana use experience an increase in observable attention and academic problems, but these problems appear to be minimal and are eliminated following sustained abstinence.
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Affiliation(s)
- Dustin Pardini
- Department of Psychiatry, University of Pittsburgh Medical Center, Sterling Plaza, Suite 408, 201 North Craig Street, Pittsburgh, PA, 15213, USA,
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Cannabis and tolerance: acute drug impairment as a function of cannabis use history. Sci Rep 2016; 6:26843. [PMID: 27225696 PMCID: PMC4881034 DOI: 10.1038/srep26843] [Citation(s) in RCA: 39] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2016] [Accepted: 05/09/2016] [Indexed: 01/27/2023] Open
Abstract
Cannabis use history as predictor of neurocognitive response to cannabis intoxication remains subject to scientific and policy debates. The present study assessed the influence of cannabis on neurocognition in cannabis users whose cannabis use history ranged from infrequent to daily use. Drug users (N = 122) received acute doses of cannabis (300 μg/kg THC), cocaine HCl (300 mg) and placebo. Cocaine served as active control for demonstrating neurocognitive test sensitivity. Executive function, impulse control, attention, psychomotor function and subjective intoxication were significantly worse after cannabis administration relative to placebo. Cocaine improved psychomotor function and attention, impaired impulse control and increased feelings of intoxication. Acute effects of cannabis and cocaine on neurocognitive performance were similar across cannabis users irrespective of their cannabis use history. Absence of tolerance implies that that frequent cannabis use and intoxication can be expected to interfere with neurocognitive performance in many daily environments such as school, work or traffic.
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Shrivastava A, Johnston M, Terpstra K, Bureau Y. Pathways to psychosis in cannabis abuse. ACTA ACUST UNITED AC 2016; 9:30-5. [PMID: 23491968 DOI: 10.3371/csrp.shjo.030813] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
Cannabis has been implicated as a risk factor for the development of schizophrenia, but the exact biological mechanisms remain unclear. In this review, we attempt to understand the neurobiological pathways that link cannabis use to schizophrenia. This has been an area of great debate; despite similarities between cannabis users and schizophrenia patients, the evidence is not sufficient to establish cause-and-effect. There have been advances in the understanding of the mechanisms of cannabis dependence as well as the role of the cannabinoid system in the development of psychosis and schizophrenia. The neurobiological mechanisms associated with the development of psychosis and effects from cannabis use may be similar but remain elusive. In order to better understand these associations, this paper will show common neurobiological and neuroanatomical changes as well as common cognitive dysfunction in cannabis users and patients of schizophrenia. We conclude that epidemiologic evidence highlights potential causal links; however, neurobiological evidence for causality remains weak.
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Affiliation(s)
- Amresh Shrivastava
- Department of Psychiatry, Elgin Prevention and Early Intervention Program for Psychosis, The University of Western Ontario, and Mental Health Resource Foundation, Ontario, Canada, Mumbai, Maharashtra, India
| | - Megan Johnston
- Department of Psychology, University of Toronto, Toronto, Ontario, Canada
| | - Kristen Terpstra
- Department of Psychology, University of Western Ontario, London, Ontario, Canada
| | - Yves Bureau
- Lawson Health Research Institute, University of Western Ontario, London, Ontario, Canada
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Ganzer F, Bröning S, Kraft S, Sack PM, Thomasius R. Weighing the Evidence: A Systematic Review on Long-Term Neurocognitive Effects of Cannabis Use in Abstinent Adolescents and Adults. Neuropsychol Rev 2016; 26:186-222. [DOI: 10.1007/s11065-016-9316-2] [Citation(s) in RCA: 86] [Impact Index Per Article: 10.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2015] [Accepted: 04/14/2016] [Indexed: 11/29/2022]
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Conroy DA, Kurth ME, Brower KJ, Strong DR, Stein MD. Impact of marijuana use on self-rated cognition in young adult men and women. Am J Addict 2016; 24:160-165. [PMID: 25864605 DOI: 10.1111/ajad.12157] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2013] [Revised: 06/18/2014] [Accepted: 07/02/2014] [Indexed: 01/07/2023] Open
Abstract
BACKGROUND AND OBJECTIVES Marijuana (MJ) is a widely used substance that has been shown to impair cognition in laboratory settings. There is a growing number of medical MJ dispensaries and state policies permitting the use of MJ in the United States. This study is a naturalistic study that explores the association of same day MJ use on self-rated cognition in young adult men and women. METHODS Forty-eight (n = 48) young adults (22 F; mean age = 22.3) participated. After a baseline assessment, participants made daily phone calls to study staff over the next 3 weeks. Cumulative minutes of MJ use in the last 24-hours were assessed. Demographic information collected and self-ratings of cognitive impairment were assessed using six questions about areas of difficulty thinking each day. RESULTS There was a significant relationship between greater number of minutes of MJ use and higher levels of self-rated cognitive difficulties (b = .004; SE = .001; p < .006). There was no main effect of gender (b = 1.0; SE = .81; p < .22). Planned evaluation of the interaction between gender and minutes of MJ use was not significant statistically, suggesting a similar relationship between minutes of MJ use and cognitive difficulties among women compared to men (p < .54). CONCLUSIONS AND SCIENTIFIC SIGNIFICANCE There is an association between current and heavy MJ use and self-perceived cognitive ability in both males and females. These findings reveal important information regarding one consequence of MJ use that has real-world meaning to young adult smokers. (Am J Addict 2015;24:160-165).
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Affiliation(s)
- Deirdre A Conroy
- University of Michigan Addiction Research Center, Ann Arbor, Michigan
| | - Megan E Kurth
- General Medicine Research Unit, Butler Hospital, Providence, Rhode Island
| | - Kirk J Brower
- University of Michigan Addiction Research Center, Ann Arbor, Michigan
| | - David R Strong
- Department of Family and Preventive Medicine, University of California, San Diego, La Jolla, California
| | - Michael D Stein
- General Medicine Research Unit, Butler Hospital, Providence, Rhode Island.,Warren Alpert School of Medicine of Brown University, Providence, Rhode Island
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Mokrysz C, Landy R, Gage SH, Munafò MR, Roiser JP, Curran HV. Are IQ and educational outcomes in teenagers related to their cannabis use? A prospective cohort study. J Psychopharmacol 2016; 30:159-68. [PMID: 26739345 PMCID: PMC4724860 DOI: 10.1177/0269881115622241] [Citation(s) in RCA: 67] [Impact Index Per Article: 8.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/04/2022]
Abstract
There is much debate about the impact of adolescent cannabis use on intellectual and educational outcomes. We investigated associations between adolescent cannabis use and IQ and educational attainment in a sample of 2235 teenagers from the Avon Longitudinal Study of Parents and Children. By the age of 15, 24% reported having tried cannabis at least once. A series of nested linear regressions was employed, adjusted hierarchically by pre-exposure ability and potential confounds (e.g. cigarette and alcohol use, childhood mental-health symptoms and behavioural problems), to test the relationships between cumulative cannabis use and IQ at the age of 15 and educational performance at the age of 16. After full adjustment, those who had used cannabis ⩾ 50 times did not differ from never-users on either IQ or educational performance. Adjusting for group differences in cigarette smoking dramatically attenuated the associations between cannabis use and both outcomes, and further analyses demonstrated robust associations between cigarette use and educational outcomes, even with cannabis users excluded. These findings suggest that adolescent cannabis use is not associated with IQ or educational performance once adjustment is made for potential confounds, in particular adolescent cigarette use. Modest cannabis use in teenagers may have less cognitive impact than epidemiological surveys of older cohorts have previously suggested.
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Affiliation(s)
- C Mokrysz
- Clinical Psychopharmacology Unit, University College London, London, UK
| | - R Landy
- Centre for Cancer Prevention, Wolfson Institute of Preventive Medicine, Queen Mary University of London, London, UK
| | - SH Gage
- MRC Integrative Epidemiology Unit, University of Bristol, Bristol, UK
| | - MR Munafò
- MRC Integrative Epidemiology Unit, University of Bristol, Bristol, UK
| | - JP Roiser
- Institute of Cognitive Neuroscience, University College London, London, UK
| | - HV Curran
- Clinical Psychopharmacology Unit, University College London, London, UK
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Riggs NR, Anthenien AM, Leventhal AM. Separating the Association Between Inhibitory Control and Substance Use Prevalence Versus Quantity During Adolescence: A Hurdle Mixed-Effects Model Approach. Subst Use Misuse 2016; 51:565-73. [PMID: 27010911 PMCID: PMC4861039 DOI: 10.3109/10826084.2015.1126742] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
BACKGROUND Inhibitory control is a critical component to the self-regulation of affect and behavior. Research consistently demonstrates negative associations between inhibitory control and several problem behaviors including substance misuse during early adolescence. However, analytic approaches previously used have often applied ordinary least squares (OLS) regression to non-normal count data with an excessive number of zeros (i.e., never users), violating several model assumptions. Further, OLS regression fails to model effects of the independent variable, separately, for both prevalence and quantity of use. OBJECTIVE The study objective was to simultaneously model associations between inhibitory control and both past 30-day prevalence and amount of cigarette and marijuana use. It was hypothesized that when doing so, inhibitory control would be significantly associated with prevalence, but not quantity of use. METHOD Hurdle Mixed-effects Models (HMM) were used for hypothesis testing on data collected from 3,383, 9th grade adolescents (M(age) = 14.08 years). RESULTS Results confirmed hypotheses, demonstrating that although significant bivariate associations between inhibitory control and quantity of cigarette and marijuana use existed, HMM analyses established that the associations were more precisely specific to past 30-day prevalence, and not quantity of use. CONCLUSION Results from a HMM approach contribute to a more comprehensive and nuanced understanding of which characteristics of cigarette and marijuana use are associated with inhibitory control during early adolescence.
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Affiliation(s)
- Nathaniel R Riggs
- a Department of Human Development and Family Studies , Colorado State University , Fort Collins , Colorado , USA
| | - Amber M Anthenien
- b Department of Psychology , Colorado State University , Fort Collins , Colorado , USA
| | - Adam M Leventhal
- c Keck School of Medicine, University of Southern California , Los Angeles , California , USA
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Skalski LM, Towe SL, Sikkema KJ, Meade CS. The Impact of Marijuana Use on Memory in HIV-Infected Patients: A Comprehensive Review of the HIV and Marijuana Literatures. CURRENT DRUG ABUSE REVIEWS 2016; 9:126-141. [PMID: 27138170 PMCID: PMC5093083 DOI: 10.2174/1874473709666160502124503] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/24/2015] [Revised: 03/11/2016] [Accepted: 04/29/2016] [Indexed: 12/31/2022]
Abstract
BACKGROUND The most robust neurocognitive effect of marijuana use is memory impairment. Memory deficits are also high among persons living with HIV/AIDS, and marijuana is the most commonly used drug in this population. Yet research examining neurocognitive outcomes resulting from co-occurring marijuana and HIV is limited. OBJECTIVE The primary objectives of this comprehensive review are to: (1) examine the literature on memory functioning in HIV-infected individuals; (2) examine the literature on memory functioning in marijuana users; (3) synthesize findings and propose a theoretical framework to guide future research. METHOD PubMed was searched for English publications 2000-2013. Twenty-two studies met inclusion criteria in the HIV literature, and 23 studies in the marijuana literature. RESULTS Among HIV-infected individuals, memory deficits with medium to large effect sizes were observed. Marijuana users also demonstrated memory problems, but results were less consistent due to the diversity of samples. CONCLUSION A compensatory hypothesis, based on the cognitive aging literature, is proposed to provide a framework to explore the interaction between marijuana and HIV. There is some evidence that individuals infected with HIV recruit additional brain regions during memory tasks to compensate for HIV-related declines in neurocognitive functioning. Marijuana is associated with disturbance in similar brain systems, and thus it is hypothesized that the added neural strain of marijuana can exhaust neural resources, resulting in pronounced memory impairment. It will be important to test this hypothesis empirically, and future research priorities are discussed.
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Affiliation(s)
- Linda M. Skalski
- Department of Psychology & Neuroscience, Duke University, Durham, NC, USA
| | - Sheri L. Towe
- Department of Psychiatry & Behavioral Sciences, School of Medicine, Duke University, Durham, NC, USA
- Duke Global Health Institute, Duke University, Durham, NC, USA
| | - Kathleen J. Sikkema
- Department of Psychology & Neuroscience, Duke University, Durham, NC, USA
- Department of Psychiatry & Behavioral Sciences, School of Medicine, Duke University, Durham, NC, USA
- Duke Global Health Institute, Duke University, Durham, NC, USA
| | - Christina S. Meade
- Department of Psychology & Neuroscience, Duke University, Durham, NC, USA
- Department of Psychiatry & Behavioral Sciences, School of Medicine, Duke University, Durham, NC, USA
- Duke Global Health Institute, Duke University, Durham, NC, USA
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Feinstein A, Banwell E, Pavisian B. What to make of cannabis and cognition in MS: In search of clarity amidst the haze. Mult Scler 2015; 21:1755-60. [DOI: 10.1177/1352458515607652] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2015] [Accepted: 08/31/2015] [Indexed: 12/31/2022]
Abstract
Given data showing that cannabis (herbal drug from the Cannabis sativa plant) can impair cognition in healthy subjects, the possibility that it may also do so in people with multiple sclerosis (MS) should be cause for concern. Approximately 20% of people with MS inhale or ingest cannabis for a variety of symptoms, or as a lifestyle choice. In addition, pharmaceutically manufactured cannabis (in capsules or spray) is prescribed most often for pain and spasticity; however, there is a dearth of literature on the cognitive effects of cannabis. Furthermore, methodological limitations introduce a cautionary note when interpreting the data. The evidence, which must therefore be considered preliminary, suggests that smoked cannabis may further compromise information processing speed and memory, with magnetic resonance imaging (fMRI) demonstrating more inefficient patterns of cerebral activation during task performance. The findings related to pharmaceutically manufactured cannabis are equivocal. There is a pressing need for further research to inform clinical opinion, which at present reflects a combination of uncertainty and dogma.
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Affiliation(s)
- Anthony Feinstein
- Sunnybrook Health Sciences Centre, University of Toronto, Toronto, ON, Canada/University of Toronto, Toronto, Ontario, Canada
| | - Emma Banwell
- Sunnybrook Health Sciences Centre, University of Toronto, Toronto, ON, Canada
| | - Bennis Pavisian
- Sunnybrook Health Sciences Centre, University of Toronto, Toronto, ON, Canada
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Gonzalez R, Schuster RM, Mermelstein RM, Diviak KR. The role of decision-making in cannabis-related problems among young adults. Drug Alcohol Depend 2015; 154. [PMID: 26199058 PMCID: PMC4536096 DOI: 10.1016/j.drugalcdep.2015.06.046] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
BACKGROUND Deficits in decision-making and episodic memory are often reported among heavy cannabis users, yet little is known on how they influence negative consequences from cannabis use. Individual differences in decision-making may explain, in part, why some individuals experience significant problems from their cannabis use whereas others do not. We hypothesized that poor decision-making would moderate relationships between amount of cannabis use and problems from cannabis use whereas episodic memory performance would not. METHOD Young adult cannabis users (n=52) with cannabis as their drug of choice and with minimal comorbidities completed semi-structured interviews, self-report questionnaires, and measures of neurocognitive functioning, with decision-making accessed via the Iowa Gambling Task (IGT), episodic memory via the Hopkins Verbal Learning Test - Revised (HVLT) and problems from cannabis use with the Marijuana Problems Scale. RESULTS Strong relationships were observed between amount of cannabis use (lifetime, 12-month, and 30-day) and problems reported from use, but only among participants with low (impaired) decision-making (R(2)=.39 to .51; p<.01). No significant relationships were observed among those with better (low average to high average) decision-making performance (p>.05). In contrast, episodic memory performance was not a significant moderator of the relationship between amount of cannabis use and cannabis problems (p>.05). CONCLUSIONS Cannabis users with poor decision-making may be at greater risk for experiencing significant negative consequences from their cannabis use. Our results lend further support to emerging evidence of decision-making as a risk factor for addiction and extend these findings to cannabis users.
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Affiliation(s)
- Raul Gonzalez
- Department of Psychology, Florida International University, Miami, 11200 SW 8th St, Miami, FL 33199, United States; Center for Children and Families, Florida International University, Miami, 11200 SW 8th St, Miami, FL 33199, United States.
| | - Randi M. Schuster
- Department of Psychiatry, Massachusetts General Hospital, Boston, 55 Fruit Street, Boston, MA 02114
| | - Robin M. Mermelstein
- Department of Psychology, University of Illinois at Chicago, Chicago, 1200 W Harrison St, Chicago, IL 60607,Institute for Health Research and Policy, University of Illinois at Chicago, Chicago, 1747 W Roosevelt Rd, Chicago, IL 60608
| | - Kathleen R. Diviak
- Institute for Health Research and Policy, University of Illinois at Chicago, Chicago, 1747 W Roosevelt Rd, Chicago, IL 60608
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Nicholls C, Bruno R, Matthews A. Chronic cannabis use and ERP correlates of visual selective attention during the performance of a flanker go/nogo task. Biol Psychol 2015; 110:115-25. [PMID: 26232619 DOI: 10.1016/j.biopsycho.2015.07.013] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2014] [Revised: 06/09/2015] [Accepted: 07/23/2015] [Indexed: 11/18/2022]
Abstract
The aim of the study was to investigate the relationship between chronic cannabis use and visual selective attention by examining event-related potentials (ERPs) during the performance of a flanker go/nogo task. Male participants were 15 chronic cannabis users (minimum two years use, at least once per week) and 15 drug naive controls. Cannabis users showed longer reaction times compared to controls with equivalent accuracy. Cannabis users also showed a reduction in the N2 'nogo effect' at frontal sites, particularly for incongruent stimuli, and particularly in the right hemisphere. This suggests differences between chronic cannabis users and controls in terms of inhibitory processing within the executive control network, and may implicate the right inferior frontal cortex. There was also preliminary evidence for differences in early selective attention, with controls but not cannabis users showing modulation of N1 amplitude by flanker congruency. Further investigation is required to examine the potential reversibility of these residual effects after long-term abstinence and to examine the role of early selective attention mechanisms in more detail.
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Affiliation(s)
- Clare Nicholls
- School of Medicine (Psychology), University of Tasmania, Private Bag 30, Hobart, Tasmania 7000, Australia
| | - Raimondo Bruno
- School of Medicine (Psychology), University of Tasmania, Private Bag 30, Hobart, Tasmania 7000, Australia
| | - Allison Matthews
- School of Medicine (Psychology), University of Tasmania, Private Bag 30, Hobart, Tasmania 7000, Australia.
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Fischer B, Murphy Y, Kurdyak P, Goldner E, Rehm J. Medical marijuana programs - Why might they matter for public health and why should we better understand their impacts? Prev Med Rep 2015; 2:53-6. [PMID: 26844050 PMCID: PMC4721313 DOI: 10.1016/j.pmedr.2014.12.006] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022] Open
Abstract
Objective Although cannabis is an illegal drug, ‘medical marijuana programs’ (MMPs) have proliferated (e.g., in Canada and several US states), allowing for legal cannabis use for therapeutic purposes. While both health risks and potential therapeutic benefits for cannabis use have been documented, potential public health impacts of MMPs — also vis-à-vis other psychoactive substance use — remain under-explored. Methods We briefly reviewed the emerging evidence on MMP participants' health status, and specifically other psychoactive substance use behaviors and outcomes. Results While data are limited in amount and quality, MMP participants report improvements in overall health status, and specifically reductions in levels of risky alcohol, prescription drug and — to some extent — tobacco or other illicit drug use; at the same time, increases in cannabis use and risk/problem patterns may occur. Conclusion MMP participation may positively impact — for example, by way of possible ‘substitution effects’ from cannabis use — other psychoactive substance use and risk patterns at a scale relevant for public health, also influenced by the increasing population coverage of MMPs. Yet, net overall MMP-related population health effects need to be more rigorously and comprehensively assessed, including potential increases in cannabis use related risks and harms.
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Affiliation(s)
- Benedikt Fischer
- Centre for Applied Research in Mental Health and Addictions (CARMHA), Faculty of Health Sciences, Simon Fraser University, Vancouver, British Columbia V6B 5K3, Canada; Social & Epidemiological Research, Centre for Addiction & Mental Health (CAMH), Toronto, Ontario M5S 1S1, Canada; Department of Psychiatry, University of Toronto, Toronto, Ontario M5T 1R8, Canada
| | - Yoko Murphy
- Centre for Applied Research in Mental Health and Addictions (CARMHA), Faculty of Health Sciences, Simon Fraser University, Vancouver, British Columbia V6B 5K3, Canada; Social & Epidemiological Research, Centre for Addiction & Mental Health (CAMH), Toronto, Ontario M5S 1S1, Canada
| | - Paul Kurdyak
- Department of Psychiatry, University of Toronto, Toronto, Ontario M5T 1R8, Canada; Mental Health & Addiction Research Program, Institute of Clinical Evaluative Sciences, Toronto, Ontario M4N 3M5, Canada
| | - Elliot Goldner
- Centre for Applied Research in Mental Health and Addictions (CARMHA), Faculty of Health Sciences, Simon Fraser University, Vancouver, British Columbia V6B 5K3, Canada
| | - Jürgen Rehm
- Social & Epidemiological Research, Centre for Addiction & Mental Health (CAMH), Toronto, Ontario M5S 1S1, Canada; Department of Psychiatry, University of Toronto, Toronto, Ontario M5T 1R8, Canada; Dalla Lana School of Public Health, University of Toronto, Ontario M5T 3M7, Canada
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Time perception networks and cognition in schizophrenia: a review and a proposal. Psychiatry Res 2014; 220:737-44. [PMID: 25219610 DOI: 10.1016/j.psychres.2014.07.048] [Citation(s) in RCA: 32] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/14/2013] [Revised: 07/23/2014] [Accepted: 07/24/2014] [Indexed: 11/22/2022]
Abstract
Timing is an essential function for the survival of many living organisms. Despite its significance, it is relatively under-researched, particularly in schizophrenia. We examined neurophysiological, neuropathological, imaging and genetic studies of both healthy subjects and subjects suffering from schizophrenia in relation to time perception as measured by interval timing. We found that the data from studies in healthy populations indicate that time perception may be inter-linked with numerous other cognitive functions and share common brain networks. The same networks are implicated in the pathophysiology of schizophrenia. There is also evidence that several neurotransmitter systems, particularly the dopaminergic D2 system, are involved in interval timing. Patients with schizophrenia have been shown to suffer from a distorted sense of time, which has an impact on their cognitive function and results in both positive and negative symptoms. Therefore, genes involved in interval timing can be considered candidate genes for distorted cognition in schizophrenia. We discuss the hypothesis that time perception dysfunction is a primary cognitive dysfunction in schizophrenia.
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Lubman DI, Cheetham A, Yücel M. Cannabis and adolescent brain development. Pharmacol Ther 2014; 148:1-16. [PMID: 25460036 DOI: 10.1016/j.pharmthera.2014.11.009] [Citation(s) in RCA: 191] [Impact Index Per Article: 19.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2014] [Accepted: 11/03/2014] [Indexed: 12/14/2022]
Abstract
Heavy cannabis use has been frequently associated with increased rates of mental illness and cognitive impairment, particularly amongst adolescent users. However, the neurobiological processes that underlie these associations are still not well understood. In this review, we discuss the findings of studies examining the acute and chronic effects of cannabis use on the brain, with a particular focus on the impact of commencing use during adolescence. Accumulating evidence from both animal and human studies suggests that regular heavy use during this period is associated with more severe and persistent negative outcomes than use during adulthood, suggesting that the adolescent brain may be particularly vulnerable to the effects of cannabis exposure. As the endocannabinoid system plays an important role in brain development, it is plausible that prolonged use during adolescence results in a disruption in the normative neuromaturational processes that occur during this period. We identify synaptic pruning and white matter development as two processes that may be adversely impacted by cannabis exposure during adolescence. Potentially, alterations in these processes may underlie the cognitive and emotional deficits that have been associated with regular use commencing during adolescence.
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Affiliation(s)
- Dan I Lubman
- Turning Point, Eastern Health and Eastern Health Clinical School, Monash University, Victoria, Australia.
| | - Ali Cheetham
- Turning Point, Eastern Health and Eastern Health Clinical School, Monash University, Victoria, Australia
| | - Murat Yücel
- Melbourne Neuropsychiatry Centre, Department of Psychiatry, The University of Melbourne and Melbourne Health, Victoria, Australia; Monash Clinical & Imaging Neuroscience, School of Psychological Sciences, Monash University, Melbourne, Victoria, Australia
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Association between interleukin-6 and neurocognitive performance as a function of self-reported lifetime marijuana use in a community based sample of African American adults. J Int Neuropsychol Soc 2014; 20:773-83. [PMID: 25241622 DOI: 10.1017/s1355617714000691] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
The purpose of the current study was to determine if self-reported lifetime marijuana use moderates the relationship between interleukin-6 (IL-6) and neurocognitive performance. Participants included 161 African American adults (50.3% women), with a mean age of 45.24 (SD=11.34). Serum was drawn upon entry into the study and participants completed a demographic questionnaire, which included drug use history, and a battery of neuropsychological tests. Using multiple regression analyses and adjusting for demographic covariates, the interaction term comprised of IL-6 and self-reported lifetime marijuana use was significantly associated with poorer performance on the Written (β=-.116; SE=.059; p=.049) and Oral trials (β=-.143; SE=.062; p=.022) of the Symbol Digit Modalities Test, as well as the Trail Making Test trial A (β=.157; SE=.071; p=.028). Current findings support previous literature, which presents the inverse relationship between IL-6 and neurocognitive dysfunction. The potential protective properties of marijuana use in African Americans, who are at increased risk for inflammatory diseases, are discussed.
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Stopponi S, Soverchia L, Ubaldi M, Cippitelli A, Serpelloni G, Ciccocioppo R. Chronic THC during adolescence increases the vulnerability to stress-induced relapse to heroin seeking in adult rats. Eur Neuropsychopharmacol 2014; 24:1037-45. [PMID: 24412506 DOI: 10.1016/j.euroneuro.2013.12.012] [Citation(s) in RCA: 47] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/10/2013] [Revised: 12/13/2013] [Accepted: 12/16/2013] [Indexed: 12/13/2022]
Abstract
Cannabis derivatives are among the most widely used illicit substances among young people. The addictive potential of delta-9-tetrahydrocannabinol (THC), the major active ingredient of cannabis is well documented in scientific literature. However, the consequence of THC exposure during adolescence on occurrence of addiction for other drugs of abuse later in life is still controversial. To explore this aspect of THC pharmacology, in the present study, we treated adolescent rats from postnatal day (PND) 35 to PND-46 with increasing daily doses of THC (2.5-10mg/kg). One week after intoxication, the rats were tested for anxiety-like behavior in the elevated plus maze (EPM) test. One month later (starting from PND 75), rats were trained to operantly self-administer heroin intravenously. Finally, following extinction phase, reinstatement of lever pressing elicited by the pharmacological stressor, yohimbine (1.25mg/kg) was evaluated. Data revealed that in comparison to controls, animals treated with chronic THC during adolescence showed a higher level of anxiety-like behavior. When tested for heroin (20μg per infusion) self-administration, no significant differences were observed in both the acquisition of operant responding and heroin intake at baseline. Noteworthy, following the extinction phase, administration of yohimbine elicited a significantly higher level of heroin seeking in rats previously exposed to THC. Altogether these findings demonstrate that chronic exposure to THC during adolescence is responsible for heightened anxiety and increased vulnerability to drug relapse in adulthood.
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Affiliation(s)
- Serena Stopponi
- School of Pharmacy, Pharmacology Unit, University of Camerino, Via Madonna delle Carceri, 62032 Camerino, Italy
| | - Laura Soverchia
- School of Pharmacy, Pharmacology Unit, University of Camerino, Via Madonna delle Carceri, 62032 Camerino, Italy
| | - Massimo Ubaldi
- School of Pharmacy, Pharmacology Unit, University of Camerino, Via Madonna delle Carceri, 62032 Camerino, Italy
| | - Andrea Cippitelli
- School of Pharmacy, Pharmacology Unit, University of Camerino, Via Madonna delle Carceri, 62032 Camerino, Italy
| | - Giovanni Serpelloni
- Dipartimento Politiche Antidroga, Presidenza del Consiglio dei Ministri, Italy
| | - Roberto Ciccocioppo
- School of Pharmacy, Pharmacology Unit, University of Camerino, Via Madonna delle Carceri, 62032 Camerino, Italy.
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Thames AD, Arbid N, Sayegh P. Cannabis use and neurocognitive functioning in a non-clinical sample of users. Addict Behav 2014; 39:994-9. [PMID: 24556155 DOI: 10.1016/j.addbeh.2014.01.019] [Citation(s) in RCA: 65] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2013] [Revised: 01/07/2014] [Accepted: 01/29/2014] [Indexed: 11/25/2022]
Abstract
OBJECTIVE With the recent debates over marijuana legalization and increases in use, it is critical to examine its role in cognition. While many studies generally support the adverse acute effects of cannabis on neurocognition, the non-acute effects remain less clear. The current study used a cross-sectional design to examine relationships between recent and past cannabis use on neurocognitive functioning in a non-clinical adult sample. METHOD One hundred and fifty-eight participants were recruited through fliers distributed around local college campuses and the community. All participants completed the Brief Drug Use History Form, the Structured Clinical Interview for DSM-IV Disorders, and neurocognitive assessment, and underwent urine toxicology screening. Participants consisted of recent users (n=68), past users (n=41), and non-users (n=49). RESULTS Recent users demonstrated significantly (p<.05) worse performance than non-users across cognitive domains of attention/working memory (M=42.4, SD=16.1 vs. M=50.5, SD=10.2), information processing speed (M=44.3, SD=7.3 vs. M=52.1, SD=11.0), and executive functioning (M=43.6, SD=13.4 vs. M=48.6, SD=7.2). There were no statistically significant differences between recent users and past users on neurocognitive performance. Frequency of cannabis use in the last 4 weeks was negatively associated with global neurocognitive performance and all individual cognitive domains. Similarly, amount of daily cannabis use was negatively associated with global neurocognitive performance and individual cognitive domains. CONCLUSIONS Our results support the widespread adverse effects of cannabis use on neurocognitive functioning. Although some of these adverse effects appear to attenuate with abstinence, past users' neurocognitive functioning was consistently lower than non-users.
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Abstract
With the advent of legalization of marijuana for medicinal and recreational purposes, and the increase use of marijuana, healthcare providers will be increasingly confronted with marijuana users as patients in clinical environments. While there is vast literature regarding the societal and mental health harms associated with marijuana use, there is a paucity of reviews of the potential consequences of marijuana use on physical health or medical conditions. We examine the recent literature on the physical harms associated with illicit and legal marijuana administration. We surveyed the peer-reviewed medical literature from 1998 to 2013 of studies assessing the association of marijuana use and physical diseases. We conclude that healthcare providers should be cognizant that the existing literature suggests that marijuana use can cause physical harm. However, evidence is needed, and further research should be considered, to prove causal associations of marijuana with many physical health conditions.
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Affiliation(s)
- Adam J Gordon
- Center for Health Equity Research and Promotion (CHERP), VA Pittsburgh Healthcare System, 151-C, University Drive C, Pittsburgh, PA, 15240-1001, USA,
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van Wel JHP, Kuypers KPC, Theunissen EL, Toennes SW, Spronk DB, Verkes RJ, Ramaekers JG. Single doses of THC and cocaine decrease proficiency of impulse control in heavy cannabis users. Br J Pharmacol 2013; 170:1410-20. [PMID: 24106872 PMCID: PMC3838687 DOI: 10.1111/bph.12425] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2013] [Revised: 08/05/2013] [Accepted: 08/13/2013] [Indexed: 11/26/2022] Open
Abstract
BACKGROUND AND PURPOSE Cannabis is the most popular drug used in the European Union, closely followed by cocaine. Whereas cannabis impairs neurocognitive function in occasional cannabis users, such impairments appear less prominent in heavy users, possibly as a result of tolerance. The present study was designed to assess whether the impairing effects of Δ(9) -tetrahydrocannabinol (THC) in heavy cannabis users would present in a wide range of neuropsychological functions or selectively affect specific performance domains. We also assessed the acute effects of cocaine on neurocognitive functions of heavy cannabis users. EXPERIMENTAL APPROACH Heavy cannabis users, who had a history of cocaine use (n = 61), participated in a double-blind, placebo-controlled, three-way crossover study. Subjects received single doses of cocaine HCl (300 mg), cannabis (THC μg·kg(-1) ) and placebo, and completed a number of tests measuring impulse control and psychomotor function. KEY RESULTS Single doses of cannabis impaired psychomotor function and increased response errors during impulsivity tasks. Single doses of cocaine improved psychomotor function and decreased response time in impulsivity tasks, but increased errors. CONCLUSIONS AND IMPLICATIONS Heavy cannabis users display impairments in a broad range of neuropsychological domains during THC intoxication. Impairments observed in psychomotor tasks, but not in impulsivity tasks, appeared smaller in magnitude as compared with those previously reported in occasional cannabis users. Heavy cannabis users were sensitive to the stimulating and inhibitory effects of cocaine on psychomotor function and impulsivity respectively. The reduction in proficiency in impulse control may put drug users at increased risk of repeated drug use and addiction.
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Affiliation(s)
- J H P van Wel
- Department Neuropsychology and Psychopharmacology, Faculty of Psychology and Neuroscience, Maastricht UniversityMaastricht, The Netherlands
| | - K P C Kuypers
- Department Neuropsychology and Psychopharmacology, Faculty of Psychology and Neuroscience, Maastricht UniversityMaastricht, The Netherlands
| | - E L Theunissen
- Department Neuropsychology and Psychopharmacology, Faculty of Psychology and Neuroscience, Maastricht UniversityMaastricht, The Netherlands
| | - S W Toennes
- Department of Forensic Toxicology, Institute of Legal Medicine, Goethe University of FrankfurtFrankfurt, Germany
| | - D B Spronk
- Department of Psychiatry (966), Radboud University Nijmegen Medical CentreNijmegen, The Netherlands
- Donders Institute for Brain, Cognition and Behaviour, Radboud University NijmegenNijmegen, The Netherlands
| | - R J Verkes
- Department of Psychiatry (966), Radboud University Nijmegen Medical CentreNijmegen, The Netherlands
- Donders Institute for Brain, Cognition and Behaviour, Radboud University NijmegenNijmegen, The Netherlands
| | - J G Ramaekers
- Department Neuropsychology and Psychopharmacology, Faculty of Psychology and Neuroscience, Maastricht UniversityMaastricht, The Netherlands
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