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Bortolato M, Braccagni G, Pederson CA, Floris G, Fite PJ. "Weeding out" violence? Translational perspectives on the neuropsychobiological links between cannabis and aggression. AGGRESSION AND VIOLENT BEHAVIOR 2024; 78:101948. [PMID: 38828012 PMCID: PMC11141739 DOI: 10.1016/j.avb.2024.101948] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/05/2024]
Abstract
Recent shifts in societal attitudes towards cannabis have led to a dramatic increase in consumption rates in many Western countries, particularly among young people. This trend has shed light on a significant link between cannabis use disorder (CUD) and pathological reactive aggression, a condition involving disproportionate aggressive and violent reactions to minor provocations. The discourse on the connection between cannabis use and aggression is frequently enmeshed in political and legal discussions, leading to a polarized understanding of the causative relationship between cannabis use and aggression. However, integrative analyses from both human and animal research indicate a complex, bidirectional interplay between cannabis misuse and pathological aggression. On the one hand, emerging research reveals a shared genetic and environmental predisposition for both cannabis use and aggression, suggesting a common underlying biological mechanism. On the other hand, there is evidence that cannabis consumption can lead to violent behaviors while also being used as a self-medication strategy to mitigate the negative emotions associated with pathological reactive aggression. This suggests that the coexistence of pathological aggression and CUD may result from overlapping vulnerabilities, potentially creating a self-perpetuating cycle where each condition exacerbates the other, escalating into externalizing and violent behaviors. This article aims to synthesize existing research on the intricate connections between these issues and propose a theoretical model to explain the neurobiological mechanisms underpinning this complex relationship.
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Affiliation(s)
- Marco Bortolato
- Department of Pharmacology and Toxicology, College of Pharmacy, University of Utah, Salt Lake City, UT, USA
- Consortium for Translational Research on Aggression and Drug Abuse (ConTRADA), University of Kansas, Lawrence, KS, USA
| | - Giulia Braccagni
- Department of Pharmacology and Toxicology, College of Pharmacy, University of Utah, Salt Lake City, UT, USA
| | - Casey A. Pederson
- Department of Psychiatry, Indiana University School of Medicine, Indianapolis, IN, USA
| | - Gabriele Floris
- Department of Pharmacology and Toxicology, College of Pharmacy, University of Utah, Salt Lake City, UT, USA
- Center for Substance Abuse Research, Temple University, Philadelphia, PA, USA
- Department of Neural Sciences, Temple University, Philadelphia, PA, USA
| | - Paula J. Fite
- Consortium for Translational Research on Aggression and Drug Abuse (ConTRADA), University of Kansas, Lawrence, KS, USA
- Clinical Child Psychology Program, University of Kansas, Lawrence, KS, USA
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Brooks-Russell A, Wrobel J, Brown T, Bidwell LC, Wang GS, Steinhart B, Dooley G, Kosnett MJ. Effects of acute cannabis inhalation on reaction time, decision-making, and memory using a tablet-based application. J Cannabis Res 2024; 6:3. [PMID: 38308382 PMCID: PMC10837858 DOI: 10.1186/s42238-024-00215-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2023] [Accepted: 01/13/2024] [Indexed: 02/04/2024] Open
Abstract
BACKGROUND Acute cannabis use has been demonstrated to slow reaction time and affect decision-making and short-term memory. These effects may have utility in identifying impairment associated with recent use. However, these effects have not been widely investigated among individuals with a pattern of daily use, who may have acquired tolerance. The purpose of this study was to examine the impact of tolerance to cannabis on the acute effects as measured by reaction time, decision-making (gap acceptance), and short-term memory. METHODS Participants (ages 25-45) completed a tablet-based (iPad) test battery before and approximately 60 min after smoking cannabis flower. The change in performance from before to after cannabis use was compared across three groups of cannabis users: (1) occasional use (n = 23); (2) daily use (n = 31); or (3) no current use (n = 32). Participants in the occasional and daily use group self-administered ad libitum, by smoking or vaping, self-supplied cannabis flower with a high concentration of total THC (15-30%). RESULTS The occasional use group exhibited decrements in reaction time (slowed) and short-term memory (replicated fewer shapes) from before to after cannabis use, as compared to the no-use group. In the gap acceptance task, daily use participants took more time to complete the task post-smoking cannabis as compared to those with no use or occasional use; however, the level of accuracy did not significantly change. CONCLUSIONS The findings are consistent with acquired tolerance to certain acute psychomotor effects with daily cannabis use. The finding from the gap acceptance task which showed a decline in speed but not accuracy may indicate a prioritization of accuracy over response time. Cognitive and psychomotor assessments may have utility for identifying impairment associated with recent cannabis use.
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Affiliation(s)
- Ashley Brooks-Russell
- Injury and Violence Prevention Center, Colorado School of Public Health, University of Colorado Anschutz Medical Campus, 13001 E. 17Th Place, Aurora, CO, 80045, USA.
| | - Julia Wrobel
- Department of Biostatistics and Informatics, Colorado School of Public Health, University of Colorado Anschutz Medical Campus, Aurora, CO, USA
- Department of Biostatistics and Bioinformatics, Rollins School of Public Health, Emory University, Atlanta, GA, USA
| | - Tim Brown
- Driving Safety Research Institute, University of Iowa, Iowa City, IA, USA
| | - L Cinnamon Bidwell
- Institute of Cognitive Science, University of Colorado, Boulder, CO, USA
| | - George Sam Wang
- Department of Pediatrics, CU School of Medicine, University of Colorado Anschutz Medical Campus, Aurora, CO, USA
| | - Benjamin Steinhart
- Department of Biostatistics and Informatics, Colorado School of Public Health, University of Colorado Anschutz Medical Campus, Aurora, CO, USA
| | - Gregory Dooley
- Department of Environmental and Radiological Health Sciences, Colorado State University, Fort Collins, CO, USA
| | - Michael J Kosnett
- Department of Medicine, CU School of Medicine, University of Colorado Anschutz Medical Campus, Aurora, CO, USA
- Department of Environmental and Occupational Health, Colorado School of Public Health, University of Colorado Anschutz Medical Campus, Aurora, CO, USA
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Kassim FM, Tod S, Rodger J, Hood SD, Lee JWY, Albrecht MA, Martin-Iverson MT. Nabilone Impairs Spatial and Verbal Working Memory in Healthy Volunteers. Cannabis Cannabinoid Res 2024; 9:199-211. [PMID: 36201240 DOI: 10.1089/can.2022.0099] [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] [Indexed: 11/13/2022] Open
Abstract
Background: Memory impairments and psychosis-like experiences can be adverse effects of cannabis use. However, reports on the cognitive impact of cannabis use are not consistent. There are also limited studies on the psychotomimetic effects of cannabinoid compounds to reveal the association between cannabis and psychosis. Therefore, we investigated the effect of acute cannabinoid intoxication on verbal working memory (VWM) and spatial working memory (SWM) following oral doses of the synthetic cannabinoid agonist, nabilone (1-2 mg, oral). We further investigated the effect of nabilone on psychosis-like experiences (schizotypy scores) and associations of schizotypy with VWM and SWM. Methods: Healthy participants (n=28) completed spatial and digit span tasks across different delay conditions (0, 6, 12, and 18 sec) after receiving nabilone (1-2 mg, PO) or placebo in a randomized, double-blind, counterbalanced, crossover manner. A subset of participants completed a short battery of schizotypy measures (n=25). Results: Nabilone impaired VWM (p=0.03, weak effect size η2=0.02) and SWM (p=0.00016, η2=0.08). Nabilone did not significantly change overall schizotypy scores. Schizotypy scores were negatively correlated with working memory (WM) averaged across all delays and both modalities, under placebo (ρ=-0.41, p=0.04). In addition, there were significant negative correlations between occasions of cannabis use and overall WM averaged scores across drug treatments (ρ=-0.49, p=0.007) and under placebo (ρ=-0.45, p=0.004). The results showed that the drug effect in the less frequent cannabis users was more pronounced on the SWM (p<0.01) and VWM (p<0.01), whereas there appeared to be little drug effect in the frequent cannabis users. Conclusion: Low doses of synthetic cannabinoid impaired SWM and VWM, indicating that exogenous activation of the cannabinoid system influences cognitive performance. Further, the results replicated previous findings that schizotypy is correlated with deficits in WM. Clinical Trial Registry Name: Nabilone and caffeine effects on the perceptions of visually, auditory, tactile and multimodal illusions in healthy volunteers. Clinical Trial Registration Number: CT-2018-CTN-02561 (Therapeutic Goods Administration Clinical Trial Registry) and ACTRN12618001292268 (The Australian New Zealand Clinical Trials Registry).
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Affiliation(s)
- Faiz M Kassim
- Psychopharmacology Research Unit, Discipline of Pharmacology, School of Biomedical Sciences, University of Western Australia, Perth, Western Australia, Australia
| | - Sophie Tod
- Psychopharmacology Research Unit, Discipline of Pharmacology, School of Biomedical Sciences, University of Western Australia, Perth, Western Australia, Australia
| | - Jennifer Rodger
- Experimental and Regenerative Neurosciences, School of Biological Sciences, University of Western Australia, Crawley, Western Australia, Australia
- Brain Plasticity Group, Perron Institute for Neurological and Translational Science, Nedlands, Western Australia, Australia
| | - Sean D Hood
- Division of Psychiatry, Medical School, University of Western Australia, Perth, Western Australia, Australia
| | - Joseph W Y Lee
- Division of Psychiatry, Medical School, University of Western Australia, Perth, Western Australia, Australia
| | - Matthew A Albrecht
- Western Australian Centre for Road Safety Research, School of Psychological Sciences, University of Western Australia, Perth, Western Australia, Australia
| | - Mathew T Martin-Iverson
- Psychopharmacology Research Unit, Discipline of Pharmacology, School of Biomedical Sciences, University of Western Australia, Perth, Western Australia, Australia
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Scott JC. Impact of Adolescent Cannabis Use on Neurocognitive and Brain Development. Psychiatr Clin North Am 2023; 46:655-676. [PMID: 37879830 DOI: 10.1016/j.psc.2023.03.012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/27/2023]
Abstract
Research examining associations between frequent cannabis use in adolescence and brain-behavior outcomes has increased substantially over the past 2 decades. This review attempts to synthesize the state of evidence in this area of research while acknowledging challenges in interpretation. Although there is converging evidence that ongoing, frequent cannabis use in adolescence is associated with small reductions in cognitive functioning, there is still significant debate regarding the persistence of reductions after a period of abstinence. Similarly, there is controversy regarding the replicability of structural and functional neuroimaging findings related to frequent cannabis use in adolescence. Larger studies with informative designs are needed.
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Affiliation(s)
- J Cobb Scott
- Department of Psychiatry, Perelman School of Medicine, University of Pennsylvania, 3700 Hamilton Walk, 5th Floor, Philadelphia, PA 19104, USA; VISN4 Mental Illness Research, Education, and Clinical Center at the Corporal Michael J. Crescenz VA Medical Center, Philadelphia, PA 19104, USA.
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St Pierre M, Daniels S, Sanchez TA, Holtzman S, Russo EB, Walsh Z. The Naturalistic Cannabis Administration Protocol (NCAP): A Proof-of-Concept Study. J Psychoactive Drugs 2023; 55:389-401. [PMID: 36130915 DOI: 10.1080/02791072.2022.2125466] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2022] [Revised: 07/07/2022] [Accepted: 08/02/2022] [Indexed: 10/14/2022]
Abstract
Lab-based studies examining the effects of cannabis administration on human behavior compromise ecological validity due to the influence of set and setting. Contextual factors of clinical settings have long been recognized as producing measurable changes in physiology, emotionality, and cognition. Among people who use drugs, these settings may be associated with higher levels of perceived stigma and stereotype threat which may meaningfully confound the effects of cannabis on outcomes of interest. Recent liberalization of cannabis regulation may allow novel and more ecologically valid approaches to assessing the acute effects of cannabis. The Naturalistic Cannabis Administration Protocol (NCAP) is a novel paradigm for the study of acute cannabis effects in an ecologically valid manner. Two independent studies demonstrated the safety and feasibility of the NCAP. Participants (N= 79; Mage = 25.44, SD = 5.67) self-administered the cannabis of their choice in their home and then (Study 1; n= 47) engaged in a leisure activity or (Study 2; n= 32) underwent cognitive assessment remotely via videoconference following cannabis administration. The NCAP was well tolerated across samples with no reported adverse events. These findings provide a rationale for the adoption of the NCAP to reduce research barriers and develop our research capabilities to fit the landscape of cannabis use today.
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Affiliation(s)
- Michelle St Pierre
- Department of Psychology, the University of British Columbia, Kelowna, BC, Canada
| | - Sarah Daniels
- Department of Psychology, the University of British Columbia, Kelowna, BC, Canada
| | - Tatiana A Sanchez
- Department of Psychology, the University of British Columbia, Kelowna, BC, Canada
| | - Susan Holtzman
- Department of Psychology, the University of British Columbia, Kelowna, BC, Canada
| | | | - Zach Walsh
- Department of Psychology, the University of British Columbia, Kelowna, BC, Canada
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Ansell EB, Bedillion MF, Farris SR, Gilbert JM, Koch MM, Thureen SE. Cannabis use breaks in young adults: The highs and lows of tolerance breaks. Drug Alcohol Depend 2023; 249:109951. [PMID: 37329730 PMCID: PMC10561190 DOI: 10.1016/j.drugalcdep.2023.109951] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/22/2022] [Revised: 05/04/2023] [Accepted: 05/29/2023] [Indexed: 06/19/2023]
Abstract
BACKGROUND/PURPOSE Cannabis tolerance breaks, or T-breaks, are believed to benefit persons who use cannabis (PUCs) by decreasing tolerance levels to cannabis. However, no prior research, to our knowledge, has compared the effects of T-breaks and other use breaks on cannabis use patterns and outcomes. The current study examined whether the occurrence of cannabis use breaks (tolerance and other use breaks), or the duration of these breaks, is associated with changes in hazardous cannabis use (CUDIT-R), CUD severity, cannabis use frequency, and withdrawal symptoms over a 6-month follow-up. METHODS Young adults, who recreationally use cannabis, (N=170, 55.9% female, Mean age=21 yo) completed baseline and on-time 6-month assessments of hazardous cannabis use (CUDIT-R), CUD severity, cannabis use frequency, and withdrawal symptoms. The occurrence of cannabis use breaks and the duration of these breaks during the intervening period was assessed at 6 months. RESULTS Taking a T-break was associated with an increase in hazardous cannabis use and CUD severity at 6 months. When considering cannabis use breaks for other reasons, a longer break was associated with a significant decrease in hazardous cannabis use (CUDIT-R), CUD severity, and cannabis use frequency at 6 months. CONCLUSION Findings from our study suggest recreational PUCs who take a T-break may be at greater risk for problematic cannabis use. In addition, taking a longer cannabis use break for other reasons may have beneficial effects on cannabis-related outcomes. The ability to abstain from cannabis for other reasons may be protective while individuals who take T-breaks may be important targets for intervention and prevention.
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Affiliation(s)
- Emily B Ansell
- Penn State University, Department of Biobehavioral Health, University Park, PA16802, United States.
| | - Margaret F Bedillion
- Penn State University, Department of Biobehavioral Health, University Park, PA16802, United States
| | - Shayna R Farris
- Penn State University, Department of Biobehavioral Health, University Park, PA16802, United States
| | - Jack M Gilbert
- Penn State University, Department of Biobehavioral Health, University Park, PA16802, United States
| | - Mackensie M Koch
- Penn State University, Department of Biobehavioral Health, University Park, PA16802, United States
| | - Sydney E Thureen
- Penn State University, Department of Biobehavioral Health, University Park, PA16802, United States
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Abstract
Research examining associations between frequent cannabis use in adolescence and brain-behavior outcomes has increased substantially over the past 2 decades. This review attempts to synthesize the state of evidence in this area of research while acknowledging challenges in interpretation. Although there is converging evidence that ongoing, frequent cannabis use in adolescence is associated with small reductions in cognitive functioning, there is still significant debate regarding the persistence of reductions after a period of abstinence. Similarly, there is controversy regarding the replicability of structural and functional neuroimaging findings related to frequent cannabis use in adolescence. Larger studies with informative designs are needed.
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Affiliation(s)
- J Cobb Scott
- Department of Psychiatry, Perelman School of Medicine, University of Pennsylvania, 3700 Hamilton Walk, 5th Floor, Philadelphia, PA 19104, USA; VISN4 Mental Illness Research, Education, and Clinical Center at the Corporal Michael J. Crescenz VA Medical Center, Philadelphia, PA 19104, USA.
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8
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Murray CH, Glazer JE, Lee R, Nusslock R, de Wit H. Δ9-THC reduces reward-related brain activity in healthy adults. Psychopharmacology (Berl) 2022; 239:2829-2840. [PMID: 35612654 PMCID: PMC10560585 DOI: 10.1007/s00213-022-06164-y] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/17/2022] [Accepted: 05/12/2022] [Indexed: 10/18/2022]
Abstract
RATIONALE Greater availability of cannabis in the USA has raised concerns about adverse effects of the drug, including possible amotivational states. Lack of motivation may be assessed by examining acute effects of cannabinoids on reward processing. OBJECTIVES This study examined single doses of delta-9-tetrahydrocannabinol (∆9-THC; 7.5, 15 mg oral) in healthy adults using a version of the monetary incentive delay (MID) task adapted for electroencephalography (EEG; e-MID) in a within-subjects, double blind design. METHODS Two phases of reward processing were examined: anticipation, which occurs with presentation of cues that indicate upcoming reward, punishment, or neutral conditions, and outcome, which occurs with feedback indicating hits or misses. During anticipation, we measured two event-related potential (ERP) components: the P300, which measures attention and motivation, and the LPP, which measures affective processing. During outcome processing, we measured P300 and LPP, as well as the RewP, which measures outcome evaluation. RESULTS We found that ∆9-THC modulated outcome processing, but not reward anticipation. Specifically, both doses of ∆9-THC (7.5 and 15 mg) reduced RewP amplitudes after outcome feedback (hits and misses) relative to placebo. ∆9-THC (15 mg) also reduced P300 and LPP amplitudes following hits compared to misses, relative to both placebo and 7.5 mg ∆9-THC. CONCLUSIONS These findings suggest that ∆9-THC dampens responses to both reward and loss feedback, which may reflect an "amotivational" state. Future studies are needed to determine generalizability of this effect, such as its pharmacological specificity and its specificity to monetary vs other types of reward.
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Affiliation(s)
- Conor H Murray
- Department of Psychiatry and Behavioral Neuroscience, University of Chicago, 5841 S Maryland Ave, MC3077, Chicago, IL, 60637, USA
| | - James E Glazer
- Department of Psychology, Northwestern University, 2029 Sheridan Road, Evanston, IL, 60208, USA
| | - Royce Lee
- Department of Psychiatry and Behavioral Neuroscience, University of Chicago, 5841 S Maryland Ave, MC3077, Chicago, IL, 60637, USA
| | - Robin Nusslock
- Department of Psychology, Northwestern University, 2029 Sheridan Road, Evanston, IL, 60208, USA
| | - Harriet de Wit
- Department of Psychiatry and Behavioral Neuroscience, University of Chicago, 5841 S Maryland Ave, MC3077, Chicago, IL, 60637, USA.
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Murray CH, Huang Z, Lee R, de Wit H. Adolescents are more sensitive than adults to acute behavioral and cognitive effects of THC. Neuropsychopharmacology 2022; 47:1331-1338. [PMID: 35110688 PMCID: PMC9117219 DOI: 10.1038/s41386-022-01281-w] [Citation(s) in RCA: 14] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/04/2021] [Revised: 01/16/2022] [Accepted: 01/19/2022] [Indexed: 11/09/2022]
Abstract
Increased cannabis availability has contributed to increased use with concomitant incidence of adverse effects. One risk factor for adverse drug reactions may be age. There is preclinical evidence that acute effects of delta-9-tetrahydrocannabinol (THC), the primary active constituent of cannabis, are greater during adolescence, but this has not been fully studied in humans. The present study sought to determine whether adolescent men and women are more sensitive than adults to acute THC. Adolescents aged 18-20 (N = 12) and adults aged 30-40 (N = 12), with less than 20 total lifetime uses of THC-containing products, received capsules of THC (7.5, 15 mg) and placebo across three study sessions in randomized order under double blind conditions. During each session, subjective, cardiovascular, behavioral, and EEG measures were obtained. Behavioral measures included Simple Reaction Time, Stop Task, Time Production and N-back and EEG measures included P300 amplitudes during an auditory oddball task and eyes-closed resting state. THC affected subjective state and heart rate similarly in both age groups. However, adolescents were more sensitive to performance impairing effects, exhibiting dose-dependent impairments on reaction time, response accuracy, and time perception. On EEG measures, THC dose-dependently decreased P300 amplitude in adolescents but not adults. Adolescents were more sensitive to behavioral and cognitive effects of THC, but not to cardiovascular effects or subjective measures. Thus, at doses that produce comparable ratings of intoxication, adolescents may exhibit greater cognitive impairment and alterations in brain function.
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Affiliation(s)
- Conor H. Murray
- grid.170205.10000 0004 1936 7822Department of Psychiatry and Behavioral Neuroscience, University of Chicago, 5841 S Maryland Ave, Chicago, IL 60637 USA
| | - Zhengyi Huang
- grid.170205.10000 0004 1936 7822Department of Psychiatry and Behavioral Neuroscience, University of Chicago, 5841 S Maryland Ave, Chicago, IL 60637 USA
| | - Royce Lee
- grid.170205.10000 0004 1936 7822Department of Psychiatry and Behavioral Neuroscience, University of Chicago, 5841 S Maryland Ave, Chicago, IL 60637 USA
| | - Harriet de Wit
- Department of Psychiatry and Behavioral Neuroscience, University of Chicago, 5841 S Maryland Ave, Chicago, IL, 60637, USA.
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Morais PR, Nema Areco KC, Fidalgo TM, Xavier da Silveira D. Mental health and quality of life in a population of recreative cannabis users in Brazil. J Psychiatr Res 2022; 146:11-20. [PMID: 34936933 DOI: 10.1016/j.jpsychires.2021.12.010] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/25/2021] [Revised: 12/03/2021] [Accepted: 12/10/2021] [Indexed: 11/19/2022]
Abstract
Cannabis is the third most used recreational drug worldwide. Despite the popularity of cannabis use among Brazilians, information about frequent cannabis users outside clinical contexts remains scarce. This is a cross-sectional study of a non-probabilistic sample of 7405 Brazilian adults (6620 [89.4%] cannabis users and 785 [10.6%] non-users) who answered an online survey that collected demographic data, cannabis and other substance use information (initial substance use, lifetime and past-month use), and standardized scales to assess quality of life, subjective well-being, anxiety, and depression scores. Among cannabis users, 17.1% of the participants self-classified themselves as occasional users, 64.6% as habitual users, and 7.7% as dysfunctional users. Participants were mostly young male adults, with at least high-school education, employed, without children. The highest scores for quality of life were observed among habitual cannabis users, followed by occasional users, while both non-users and dysfunctional users presented less favorable scores. Subjective measures of well-being were higher among habitual and occasional users than among non-users, whereas dysfunctional users were the most affected. Poor quality of life, depression or anxiety were more prevalent among dysfunctional users, but non-users of cannabis reported more depression or anxiety symptoms and less quality of life than both occasional and habitual users. The results obtained in this study are particularly relevant because they refer to a sample predominantly composed of habitual cannabis users from the general population, a rarely represented group in other surveys. The fact that cannabis use is generally associated with increased risk of adverse health outcomes was not observed in this study.
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Affiliation(s)
- Paulo Rogério Morais
- Department of Psychiatry, Universidade Federal de São Paulo, Rua Major Maragliano 241, São Paulo, SP, 04017-030, Brazil; Department of Psychology, Universidade Federal de Rondônia, BR 364, Km 9,5, Porto Velho, RO, 76801-059, Brazil; Observatory of Violence, Health and Work (OBSAT), Av. Presidente Dutra, 2965, Porto Velho, RO, 76801-974, Brazil.
| | - Kelsy Catherina Nema Areco
- Department of Health Informatics, Universidade Federal de São Paulo, Rua Botucatu, 862 - Vila Clementino, São Paulo, SP, 4023-062, Brazil.
| | - Thiago Marques Fidalgo
- Department of Psychiatry, Universidade Federal de São Paulo, Rua Major Maragliano 241, São Paulo, SP, 04017-030, Brazil.
| | - Dartiu Xavier da Silveira
- Department of Psychiatry, Universidade Federal de São Paulo, Rua Major Maragliano 241, São Paulo, SP, 04017-030, Brazil.
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Richard CD, Poole JR, McConnell M, Meghdadi AH, Stevanovic-Karic M, Rupp G, Fink A, Schmitt R, Brown TL, Berka C. Alterations in Electroencephalography Theta as Candidate Biomarkers of Acute Cannabis Intoxication. Front Neurosci 2021; 15:744762. [PMID: 34671242 PMCID: PMC8520987 DOI: 10.3389/fnins.2021.744762] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2021] [Accepted: 09/15/2021] [Indexed: 01/25/2023] Open
Abstract
The trend toward cannabis legalization in the United States over the past two decades has unsurprisingly been accompanied by an increase in the number of cannabis users and use patterns that potentially pose wider risks to the public like driving under the influence. As such, it is becoming increasingly important to develop methods to accurately quantify cannabis intoxication and its associated impairments on cognitive and motor function. Electroencephalography (EEG) offers a non-invasive method for quantitatively assessing neurophysiological biomarkers of intoxication and impairment with a high degree of temporal resolution. Twelve healthy, young recreational cannabis users completed a series of neurocognitive tasks with concurrent EEG acquisition using the ABM STAT X24 EEG headset in a within-subject counterbalanced design. The 1-h testbed consisted of resting state tasks and tests of attention and memory. Spectral densities were computed for resting state tasks, and event-related potentials (ERPs) were obtained for the attention and memory tasks. Theta band power (3–5 Hz) was decreased during cannabis intoxication compared to placebo during resting state tasks, as were average P400 and late positive potential (LPP) amplitudes during attention and memory tasks. Cannabis intoxication was also associated with elevated frontal coherence and diminished anterior–posterior coherence in the Theta frequency band. This work highlights the utility of EEG to identify and quantify neurophysiological biomarkers from recordings obtained during a short neurocognitive testbed as a method for profiling cannabis intoxication. These biomarkers may prove efficacious in distinguishing intoxicated from non-intoxicated individuals in lab and real-world settings.
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Affiliation(s)
| | - Jared R Poole
- Advanced Brain Monitoring, Carlsbad, CA, United States
| | | | | | | | - Greg Rupp
- Advanced Brain Monitoring, Carlsbad, CA, United States
| | - Abigail Fink
- Advanced Brain Monitoring, Carlsbad, CA, United States
| | - Rose Schmitt
- National Advanced Driving Simulator, The University of Iowa, Iowa City, IA, United States
| | - Timothy L Brown
- National Advanced Driving Simulator, The University of Iowa, Iowa City, IA, United States
| | - Chris Berka
- Advanced Brain Monitoring, Carlsbad, CA, United States
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12
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Acute effects of high-potency cannabis flower and cannabis concentrates on everyday life memory and decision making. Sci Rep 2021; 11:13784. [PMID: 34215784 PMCID: PMC8253757 DOI: 10.1038/s41598-021-93198-5] [Citation(s) in RCA: 17] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2021] [Accepted: 06/22/2021] [Indexed: 11/15/2022] Open
Abstract
Statewide legislation has increased public access to high-potency cannabis flower and concentrates, yet federal restrictions limit researchers’ access to relatively low-potency whole-plant cannabis. The goal of this study was to examine the acute effects of high-potency cannabis on cognition using a novel methodology. We further sought to compare cognitive effects of high-potency cannabis flower with and without cannabidiol (CBD), as well as cannabis concentrates to cannabis flower. 80 cannabis users were randomly assigned to stay sober or use their funds to purchase one of three high-potency cannabis products: (1) high-potency flower (≥ 20% THC) without CBD, (2) high-potency flower with CBD, (3) high-potency concentrates (≥ 60% THC) with CBD. Participants were observed over Zoom videoconferencing while inhaling their product or remaining sober and then were administered tests of everyday life memory (prospective, source, temporal order, and false memory) and decision making (risky choice framing, consistency in risk perception, resistance to sunk cost, and over/under confidence) over Zoom. High-potency cannabis flower with CBD impaired free recall, high-potency flower without CBD and concentrates had detrimental effects on source memory, and all three products increased susceptibility to false memories. CBD did not offset impairments and concentrates were self-titrated producing comparable intoxication and impairment as flower.
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Hájková M, Knížková K, Siroňová A, Keřková B, Jonáš J, Šustová P, Dorazilová A, Rodriguez M. Cognitive performance and lifetime cannabis use in patients with first-episode schizophrenia spectrum disorder. Cogn Neuropsychiatry 2021; 26:257-272. [PMID: 33973827 DOI: 10.1080/13546805.2021.1924649] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Abstract
INTRODUCTION Cognitive impairment is among the core features of schizophrenia. In a healthy population, the cognitive deficit is often linked with cannabis abuse, and although the same would be expected in patients with schizophrenia, research has presented contradictory results. METHODS Participants were patients with first-episode schizophrenia (FES) spectrum disorder who had been lifetime cannabis users (N = 30), FES non-users (N = 53) as well as healthy controls (HC) also divided into cannabis users (N = 20) and non-users (N = 49). All participants underwent an extensive neurocognitive assessment and filled in a cannabis questionnaire, which allowed for a comparison of the four groups on cognitive functioning. RESULTS FES patients using cannabis showed less impaired cognitive functioning with the most prominent difference in visual memory compared to FES non-users. However, they differed neither in the clinical assessment of general psychopathology, positive and negative symptoms, nor in medication from the patient's non-users. A comparison of the HC who used cannabis, and those who did not, revealed no sizeable differences in cognitive performance between the groups. CONCLUSIONS The results delivered supporting evidence for the trend of superior neurocognitive performance in FES patients with a lifetime history of cannabis use compared to non-using patients.
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Affiliation(s)
- M Hájková
- Institut of Neuropsychiatric Care, Prague, Czech Republic.,Military University Hospital Prague, Prague, Czech Republic
| | - K Knížková
- National Institute of Mental Health, Klecany, Czech Republic.,Department of Psychiatry, First Faculty of Medicine, Charles University and General University Hospital in Prague, Prague, Czech Republic
| | - A Siroňová
- National Institute of Mental Health, Klecany, Czech Republic.,Department of Psychology, Faculty of Social Studies, Masaryk University, Brno, Czech Republic
| | - B Keřková
- National Institute of Mental Health, Klecany, Czech Republic
| | - J Jonáš
- National Institute of Mental Health, Klecany, Czech Republic.,Department of Psychology, Faculty of Arts, Charles University in Prague, Prague, Czech Republic
| | - P Šustová
- National Institute of Mental Health, Klecany, Czech Republic.,Department of Psychology, Faculty of Arts, Charles University in Prague, Prague, Czech Republic
| | - A Dorazilová
- National Institute of Mental Health, Klecany, Czech Republic
| | - M Rodriguez
- National Institute of Mental Health, Klecany, Czech Republic.,Department of Psychology, Faculty of Arts, Charles University in Prague, Prague, Czech Republic
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An Observational, Longitudinal Study of Cognition in Medical Cannabis Patients over the Course of 12 Months of Treatment: Preliminary Results. J Int Neuropsychol Soc 2021; 27:648-660. [PMID: 34261553 DOI: 10.1017/s1355617721000114] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
Abstract
OBJECTIVE Cannabis use has increased dramatically across the country; however, few studies have assessed the long-term impact of medical cannabis (MC) use on cognition. Studies examining recreational cannabis users generally report cognitive decrements, particularly in those with adolescent onset. As MC patients differ from recreational consumers in motives for use, product selection, and age of onset, we assessed cognitive and clinical measures in well-characterized MC patients over 1 year. Based on previous findings, we hypothesized MC patients would not show decrements and might instead demonstrate improvements in executive function over time. METHOD As part of an ongoing study, MC patients completed a baseline visit prior to initiating MC and evaluations following 3, 6, and 12 months of treatment. At each visit, patients completed a neurocognitive battery assessing executive function, verbal learning/memory, and clinical scales assessing mood, anxiety, and sleep. Exposure to delta-9-tetrahydrocannabinol (THC) and cannabidiol (CBD) was also quantified. RESULTS Relative to baseline, MC patients demonstrated significant improvements on measures of executive function and clinical state over the course of 12 months; verbal learning/memory performance generally remained stable. Improved cognitive performance was not correlated with MC use; however, clinical improvement was associated with higher CBD use. Analyses suggest cognitive improvements were associated with clinical improvement. CONCLUSIONS Study results extend previous pilot findings, indicating that MC patients may exhibit enhanced rather than impaired executive function over time. Future studies should examine distinctions between recreational and MC use to identify potential mechanisms related to cognitive changes and the role of clinical improvement.
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Ciccarelli TM, Leatherdale ST, Perlman C, Thompson K, Ferro MA. Steering clear: Traffic violations among emerging adults who engage in habitual or casual cannabis use. ACCIDENT; ANALYSIS AND PREVENTION 2021; 153:106059. [PMID: 33662695 DOI: 10.1016/j.aap.2021.106059] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/12/2020] [Revised: 02/17/2021] [Accepted: 02/18/2021] [Indexed: 06/12/2023]
Abstract
While some research has shown that cannabis use can impair driving ability, evidence to the degree and impact of impairment are lacking. This study examined the association between habitual or casual cannabis use and past-year traffic violations among emerging adults (EAs). Data come from the 2012 Canadian Community Health Survey-Mental Health. Respondents (n = 5630) were categorized as: early (15-19 y), middle (20-24 y), and late (25-29 y) EAs. Traffic violations were measured using self-report and cannabis use was measured using the WHO Composite International Diagnostic Interview. The prevalence of traffic violations was higher for males (19.2 %) vs females (9.9 %) and middle (16.2 %) and late (19.4 %) EAs vs early (8.8 %) EAs. The odds of reporting traffic violations were higher for EAs who engaged in habitual [OR = 1.77 (1.17-2.67)] or casual [OR = 1.79 (1.27-2.51)] cannabis use when compared to non-users. Age moderated the association such that higher odds of traffic violations were reported in early EAs who were casual cannabis users and middle EAs who were habitual or casual cannabis users when compared to non-users. Use of other drugs was also a moderator-in the absence vs. presence of other drug use, odds of traffic violations were higher in those who engaged in either habitual or casual use of cannabis. When accounting for the moderating effects of age and drug use, habitual and casual cannabis use resulted in increased odds of a traffic violation. Future research is warranted to explore the robustness of our findings.
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Affiliation(s)
- Tiana M Ciccarelli
- School of Public Health and Health Systems, University of Waterloo, Waterloo, Canada
| | - Scott T Leatherdale
- School of Public Health and Health Systems, University of Waterloo, Waterloo, Canada
| | - Chris Perlman
- School of Public Health and Health Systems, University of Waterloo, Waterloo, Canada
| | - Kara Thompson
- Department of Psychology, St. Francis Xavier University, Antigonish, Canada
| | - Mark A Ferro
- School of Public Health and Health Systems, University of Waterloo, Waterloo, Canada.
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Kloft L, Monds LA, Blokland A, Ramaekers JG, Otgaar H. Hazy memories in the courtroom: A review of alcohol and other drug effects on false memory and suggestibility. Neurosci Biobehav Rev 2021; 124:291-307. [PMID: 33587958 DOI: 10.1016/j.neubiorev.2021.02.012] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2020] [Revised: 01/26/2021] [Accepted: 02/04/2021] [Indexed: 12/25/2022]
Abstract
Alcohol and other psychoactive drugs are oftentimes implicated in legal cases. A pertinent question herein is whether such substances might adversely affect testimonies of victims, eyewitnesses, or suspects by propelling the formation of false memory and increasing susceptibility to suggestion. In the current review, we amassed all available evidence on the effects of intoxication on false memory formation and suggestibility, including the substances alcohol, benzodiazepines, cannabis, stimulants, hallucinogens, and antipsychotics. Our review indicated that alcohol and cannabis under certain conditions increased the susceptibility to false memories and/or suggestion with effect sizes ranging from medium to large. When intoxicated during an event, alcohol is most likely to increase this susceptibility at high intoxication levels or after a delay, whereas cannabis exerts detrimental effects during acute intoxication but not necessarily once sober. For other substances, ecologically valid research separating different memory phases is needed. Overall, differences between substances regarding false memory effects exist, suggesting that a nuanced approach is needed when dealing with intoxicated individuals in a legal context.
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Affiliation(s)
- Lilian Kloft
- Faculty of Psychology and Neuroscience, Maastricht University, the Netherlands.
| | - Lauren A Monds
- Faculty of Medicine and Health, The University of Sydney, Australia
| | - Arjan Blokland
- Faculty of Psychology and Neuroscience, Maastricht University, the Netherlands
| | | | - Henry Otgaar
- Faculty of Psychology and Neuroscience, Maastricht University, the Netherlands; Faculty of Law, Catholic University of Leuven, Belgium
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Zhornitsky S, Pelletier J, Assaf R, Giroux S, Li CSR, Potvin S. Acute effects of partial CB 1 receptor agonists on cognition - A meta-analysis of human studies. Prog Neuropsychopharmacol Biol Psychiatry 2021; 104:110063. [PMID: 32791166 DOI: 10.1016/j.pnpbp.2020.110063] [Citation(s) in RCA: 20] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/20/2020] [Revised: 07/05/2020] [Accepted: 08/05/2020] [Indexed: 10/23/2022]
Abstract
BACKGROUND Impairment in cognition is frequently associated with acute cannabis consumption. However, some questions remain unanswered as to which deficits are most prominent and which demographic groups are most vulnerable. METHODS A literature search yielded 52 experimental studies of acute administration of partial CB1 receptor agonists (i.e. cannabis, THC, and nabilone) that assessed cognitive dysfunction in 1580 healthy volunteers. Effect size estimates were calculated using the Comprehensive Meta-Analysis for the following six cognitive domains: attention, executive functions, impulsivity, speed of processing, verbal learning/memory, and working memory. RESULTS There were small-to-moderate impairments across all cognitive domains. Deficits in verbal learning/memory and working memory were more prominent, whereas attention and impulsivity were the least affected. Meta-regression analysis revealed that the greater the male ratio is in a sample, the greater the negative effect of cannabinoids on speed of processing and impulsivity. Analysis of route of administration showed that the deficits in speed of processing were smaller in the oral, relative to smoking, vaping, and intravenous administration studies. A publication bias was observed. DISCUSSION Verbal learning/memory and working memory are most prominently affected by acute administration of partial CB1 receptor agonists. The results are consistent with the residual cognitive effects that have been documented among chronic cannabis users.
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Affiliation(s)
- Simon Zhornitsky
- Department of Psychiatry, Yale University School of Medicine, New Haven, CT 06519, United States of America
| | - Julie Pelletier
- Department of Psychiatry, Faculty of Medicine, Université de Montréal, Montréal, QC, Canada
| | - Roxane Assaf
- Department of Psychiatry, Faculty of Medicine, Université de Montréal, Montréal, QC, Canada; Centre de recherche de l'Institut Universitaire en Santé Mentale de Montréal, Montreal, QC, Canada
| | - Sarah Giroux
- Department of Psychology, Université de Montréal, Montréal, QC, Canada
| | - Chiang-Shan R Li
- Department of Psychiatry, Yale University School of Medicine, New Haven, CT 06519, United States of America; Department of Neuroscience, Yale University School of Medicine, New Haven, CT 06520, United States of America; Interdepartmental Neuroscience Program, Yale University School of Medicine, New Haven, CT 06520, United States of America
| | - Stephane Potvin
- Department of Psychiatry, Faculty of Medicine, Université de Montréal, Montréal, QC, Canada; Centre de recherche de l'Institut Universitaire en Santé Mentale de Montréal, Montreal, QC, Canada.
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Cancio R. Structural Pathways Between Race/Ethnicity, Substance Use, Military Service, and Male-Perpetrated Intimate Partner Violence in Pre-9/11 Military Families. JOURNAL OF INTERPERSONAL VIOLENCE 2020; 35:5624-5651. [PMID: 29294857 DOI: 10.1177/0886260517723142] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/07/2023]
Abstract
Along with service members, military families bear the brute consequences of global U.S. military intervention. Various studies have concluded that these deployments put military families at high risk for intimate partner violence (IPV). Using structural equation modeling (SEM) as a novel approach to examine IPV among pre-9/11 military families, this study considers variations of self-reported IPV from the point of the abused partner to test the impact of several life events and demographic factors on the type of IPV most prevalent among perpetrators. The study sample contains information about 599 male perpetrators from the Nature and Scope of Violence Against Women in San Diego, California (1996-1998), a survey about domestic violence from clients admitted to women's shelters. Perpetrators race/ethnicity, age, military experience, previous exposure to abuse, income, and education were modeled using SEM procedures to determine the frequency of IPV perpetrated under the influence of certain substances and etiologic characteristics. Particular attention focused on the differences among the military's racial and ethnic groups and on the overall differences between IPV perpetrations among military families to nonmilitary families. Study findings indicate that (a) irrespective of race, pre-9/11 veteran perpetrators commit verbal/mental abuse more often than other forms of IPV, (b) when taking race/ethnicity into account, for veterans, there are differences with IPV perpetration trends and substance use, and (c) IPV perpetration trends are different between veteran and nonveteran groups, irrespective of race.
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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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20
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Scherer M, Romano E, Voas R, Taylor E. Latent Classes of Polydrug Users as a Predictor of Crash Involvement and Alcohol Consumption. J Stud Alcohol Drugs 2019; 79:481-489. [PMID: 29885157 DOI: 10.15288/jsad.2018.79.481] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
OBJECTIVE Polydrug users have been shown to be at higher risk for alcohol consumption and crash involvement. However, research has shown that polydrug groups differ in some important ways. It is currently unknown how polydrug-using groups differ in terms of crash involvement and alcohol consumption. METHOD The current study used latent class analysis to examine subgroups of polydrug users (n = 384) among a sample of drivers in Virginia Beach, Virginia (N = 10,512). A series of logistic regression analyses were conducted to determine the relationship between polydrug use categories and crash involvement and alcohol consumption. RESULTS Four distinct subclasses of users were identified among polydrug-using drivers: Class 1 is the "marijuana-amphetamines class" and accounts for 21.6% of polydrug users. Class 2 is the "benzo-antidepressant class" and accounts for 39.0% of polydrug users. Class 3 is the "opioid-benzo class" and accounts for 32.7% of polydrug users. Finally, Class 4 is the "marijuana-cocaine class" and accounts for 6.7% of the study sample. Drivers in the opioid-benzo class were significantly more likely than those in any other class as well as non-drug users and single-drug users to be involved in a crash and were more likely than those in most other conditions to consume alcohol. No significant difference was found between marijuana-amphetamine users or benzo-antidepressant users and non-drug users on crash risk. CONCLUSIONS Some polydrug users are indeed at greater risk for crash involvement and alcohol consumption; however, not all polydrug users are significantly worse than single-drug users and/or non-drug users, and the practice of lumping polydrug users together when predicting crash risk runs the risk of inaccurately attributing crash involvement to certain drivers.
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Affiliation(s)
- Michael Scherer
- Pacific Institute for Research and Evaluation, Calverton, Maryland
| | - Eduardo Romano
- Pacific Institute for Research and Evaluation, Calverton, Maryland
| | - Robert Voas
- Pacific Institute for Research and Evaluation, Calverton, Maryland
| | - Eileen Taylor
- Pacific Institute for Research and Evaluation, Calverton, Maryland
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21
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Ginsburg BC. Strengths and limitations of two cannabis-impaired driving detection methods: a review of the literature. THE AMERICAN JOURNAL OF DRUG AND ALCOHOL ABUSE 2019; 45:610-622. [DOI: 10.1080/00952990.2019.1655568] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Affiliation(s)
- Brett C. Ginsburg
- Department of Psychiatry and Behavioral Sciences, The University of Texas Health Science Center at San Antonio, San Antonio, TX, USA
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22
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Cannabis-associated impairments in the fading affect bias and autobiographical memory specificity. Conscious Cogn 2019; 74:102792. [PMID: 31349209 DOI: 10.1016/j.concog.2019.102792] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2019] [Revised: 07/10/2019] [Accepted: 07/10/2019] [Indexed: 11/22/2022]
Abstract
We investigated potential relationships between cannabis use and 2 phenomena associated with autobiographical remembering: the fading affect bias (FAB) and memory specificity. The FAB is an emotional affect regulation mechanism that is observed when the intensity of affect associated with experiencing negative memories fades faster than the intensity of affect associated with experiencing positive memories. Memory specificity refers to the level of detail with which events are recalled. No studies have examined the relationships between cannabis use, the FAB, and memory specificity simultaneously. Chronic cannabis users (N = 47) and non-users (N = 52) recalled and described positive and negative autobiographical events and rated the affective intensity for the events at the time of occurrence and at time of test. Participants retrieved additional memories using a sentence-completion recall task, which were coded for specificity. Cannabis users showed reduced fading affect for unpleasant events and reduced memory specificity compared to non-users.
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Chow RM, Marascalchi B, Abrams WB, Peiris NA, Odonkor CA, Cohen SP. Driving Under the Influence of Cannabis: A Framework for Future Policy. Anesth Analg 2019; 128:1300-1308. [PMID: 31094805 DOI: 10.1213/ane.0000000000003575] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
Marijuana is the most widely consumed illicit substance in the United States, and an increasing number of states have legalized it for both medicinal and recreational purposes. As it becomes more readily available, there will be a concurrent rise in the number of users and, consequently, the number of motor vehicle operators driving under the influence. This article examines the cognitive and psychomotor effects of cannabis, as well as current policy concerning driving under the influence of drugs. The authors performed a MEDLINE search on the epidemiology of cannabis use, its cognitive and psychomotor effects, and policies regarding driving under the influence of drugs. Twenty-eight epidemiological studies, 16 acute cognitive and psychomotor studies, 8 chronic cognitive and psychomotor studies, and pertinent state and federal laws and policies were reviewed. These search results revealed that marijuana use is associated with significant cognitive and psychomotor effects. In addition, the legalization of marijuana varies from state to state, as do the laws pertaining to driving under the influence of drugs. Marijuana is a commonly found illicit substance in motor vehicle operators driving under the influence of drugs. Current evidence shows that blood levels of tetrahydrocannabinol do not correlate well with the level of impairment. In addition, although acute infrequent use of cannabis typically leads to cognitive and psychomotor impairment, this is not consistently the case for chronic heavy use. To establish the framework for driving under the influence of cannabis policy, we must review the current published evidence and examine existing policy at state and federal levels.
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Affiliation(s)
- Robert M Chow
- From the Department of Anesthesiology, Yale School of Medicine, New Haven, Connecticut
| | | | - Winfred B Abrams
- Physical Medicine & Rehabilitation, Johns Hopkins School of Medicine, Baltimore, Maryland
| | - Nathalie A Peiris
- Department of Anesthesiology, University of Maryland School of Medicine, Baltimore, Maryland
| | - Charles A Odonkor
- Physical Medicine & Rehabilitation, Johns Hopkins School of Medicine, Baltimore, Maryland
| | - Steven P Cohen
- Department of Anesthesiology, Neurology and Physical Medicine and Rehabilitation, Johns Hopkins School of Medicine, Baltimore, Maryland
- Department of Anesthesiology and Physical Medicine & Rehabilitation, Walter Reed National Military Medical Center, Uniformed Services University of the Health Sciences, Bethesda, Maryland
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Jones J, Jones KN. Commentary on Jones J, Jones KN and Peil J (2018) The impact of the legalization of recreational marijuana on college students. Addictive Behaviors 77: 255-259, https://doi.org/10.1016/j.addbeh.2017.08.015. SUBSTANCE ABUSE-RESEARCH AND TREATMENT 2019; 13:1178221819827603. [PMID: 30799928 PMCID: PMC6378431 DOI: 10.1177/1178221819827603] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 01/02/2019] [Accepted: 01/07/2019] [Indexed: 11/17/2022]
Abstract
With the broadening legislative changes surrounding legalized recreational marijuana in the United States, tracking the impact of such changes is imperative. As such, in a recent article published in Addictive Behaviors, we identified several emerging trends in the first state to legalize recreational marijuana, Colorado. Since our publication, similar research from other states that have legalized recreational marijuana (Oregon and Washington) has emerged. Here, we attempt to expand on our findings and identify patterns across the research, by comparing and contrasting our results to research in other states with legalized recreational marijuana. We identified several trends including, but not limited to, the rates of marijuana use rising after decriminalization, but not the retail sale of recreational marijuana; recreational marijuana legalization leading to a decrease in the relationship between marijuana and alcohol use; and the identification of binge drinkers as a high-risk population for marijuana use after recreational legalization. We also explore the complicated relationship between marijuana use and academic performance, and point out areas where future research is needed.
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Affiliation(s)
- Jacob Jones
- Social and Behavioral Sciences, Colorado Mesa University, Grand Junction, CO, USA
| | - K Nicole Jones
- Social and Behavioral Sciences, Colorado Mesa University, Grand Junction, CO, USA
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25
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Kloft L, Otgaar H, Blokland A, Garbaciak A, Monds LA, Ramaekers JG. False memory formation in cannabis users: a field study. Psychopharmacology (Berl) 2019; 236:3439-3450. [PMID: 31250074 PMCID: PMC6892757 DOI: 10.1007/s00213-019-05309-w] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/26/2019] [Accepted: 06/18/2019] [Indexed: 12/20/2022]
Abstract
RATIONALE Cannabis use is widespread and has previously been associated with memory impairments. However, the role of cannabis in relation to false memory production, i.e., memories of events that were not experienced, is less well-understood. OBJECTIVE The aim of the current field study was to examine the impact of cannabis use on false memory production. METHODS The Deese/Roediger-McDermott (DRM) paradigm was used to induce false memories. In this paradigm, participants study word lists that are associatively related to a non-presented word, termed the critical lure. In a later memory test, true recognition rates and false alarm rates toward critical lures and unrelated items are assessed. Memory performance was compared between three groups: regular cannabis consumers who were acutely intoxicated (n = 53), regular cannabis consumers who were sober (n = 50), and cannabis-naïve controls (n = 53). The participants were approached in Dutch coffee shops (cannabis outlets) and cafes and asked to participate in our study. After collecting general information on their cannabis use, they were subjected to the DRM procedure. RESULTS Although false memory rates for critical lures did not statistically differ between groups, both intoxicated and sober cannabis consumers falsely recognized more unrelated items than control participants. Also, individuals without a history of cannabis use demonstrated higher memory accuracy compared with the intoxicated group. CONCLUSION It is concluded that cannabis intoxication and history of cannabis use induce a liberal response criterion for newly presented words for which the level of association with previously learned words is low and uncertainty is high.
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Affiliation(s)
- Lilian Kloft
- Faculty of Psychology and Neuroscience, Maastricht University, Maastricht, The Netherlands.
| | - Henry Otgaar
- Faculty of Psychology and Neuroscience, Maastricht University, Maastricht, The Netherlands ,Faculty of Law, Catholic University of Leuven, Leuven, Belgium
| | - Arjan Blokland
- Faculty of Psychology and Neuroscience, Maastricht University, Maastricht, The Netherlands
| | - Alicja Garbaciak
- Faculty of Psychology and Neuroscience, Maastricht University, Maastricht, The Netherlands
| | - Lauren A. Monds
- Faculty of Medicine and Health, The University of Sydney, Sydney, Australia
| | - Johannes G. Ramaekers
- Faculty of Psychology and Neuroscience, Maastricht University, Maastricht, The Netherlands
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26
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Testa M, Wang W, Derrick JL, Leonard KE. Marijuana Use Episodes and Partner Intimacy Experiences: A Daily Report Study. CANNABIS (RESEARCH SOCIETY ON MARIJUANA) 2019; 2:19-28. [PMID: 30923794 PMCID: PMC6433396 DOI: 10.26828/cannabis.2019.01.002] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/14/2023]
Abstract
Although marijuana use has been linked to negative consequences for intimate relationships, an emerging literature suggests that under some circumstances it may have positive consequences. Couples who use substances together report better relationship functioning over time and may experience positive short-term outcomes. Using a sample of 183 heterosexual, frequent marijuana-using couples from the community, reporting over 30 consecutive days, we examined whether marijuana use episodes were associated temporally with reports of couple intimacy experiences within the next two hours. We used multilevel modeling, within an Actor Partner Interdependence Model (APIM) framework, modeling male and female outcomes simultaneously. Consistent with hypotheses, simultaneous marijuana use (male and female partners reported use at the same hour) increased the likelihood of an intimate experience for both men and women. However, we also found positive effects for Actor and Partner solo marijuana use on male and female reports of intimacy events. When analyses were limited to marijuana use episodes in which the respondent reported on presence of partner, we found that positive effects on intimate experiences were limited to marijuana use episodes in which partner was present; use without partner did not influence likelihood of intimacy. The robust positive effects of using marijuana with one's partner on intimacy events may serve to reinforce continued couple use and explain the positive effects of concordant substance use on relationship functioning over time.
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Doss MK, Weafer J, Gallo DA, de Wit H. Δ 9-Tetrahydrocannabinol at Retrieval Drives False Recollection of Neutral and Emotional Memories. Biol Psychiatry 2018; 84:743-750. [PMID: 29884456 DOI: 10.1016/j.biopsych.2018.04.020] [Citation(s) in RCA: 20] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/08/2018] [Revised: 04/05/2018] [Accepted: 04/26/2018] [Indexed: 11/16/2022]
Abstract
BACKGROUND It is well established that the main psychoactive constituent of cannabis, Δ9-tetrahydrocannabinol (THC), impairs episodic memory encoding and modulates emotional processing, but little is known about the impact of THC during the retrieval of emotional episodic memories. With the rise of cannabis to treat medical conditions, including those characterized by emotional and episodic memory disturbances, there is an urgent need to determine the effects of THC on memory accuracy and distortion. Here, we report the first study investigating the effects of THC during retrieval of neutral and emotional episodic memories. METHODS Using a double-blind, placebo-controlled, within-subjects design, healthy volunteers (N = 23) viewed negative, neutral, and positive pictures (emotional memory task) and lists of semantically related words (false memory task). Forty-eight hours later, participants ingested a capsule containing either THC (15 mg) or placebo and completed tasks to test their memories for the previously studied pictures and words. RESULTS THC during retrieval did not reduce the number of correct responses to studied items. Instead, it robustly increased false recollection on both the emotional memory and false memory tasks. This effect was found for both neutral and emotional items. CONCLUSIONS These findings show that THC has adverse effects during memory retrieval, distorting both neutral and emotional memories. Coupled with THC's known effects during encoding, these new retrieval findings are important in light of the spreading acceptance of cannabis.
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Affiliation(s)
- Manoj K Doss
- Department of Psychology, the University of Chicago, Chicago, Illinois.
| | - Jessica Weafer
- Department of Psychiatry and Behavioral Neuroscience, the University of Chicago, Chicago, Illinois
| | - David A Gallo
- Department of Psychology, the University of Chicago, Chicago, Illinois
| | - Harriet de Wit
- Department of Psychiatry and Behavioral Neuroscience, the University of Chicago, Chicago, Illinois
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Colizzi M, Bhattacharyya S. Cannabis use and the development of tolerance: a systematic review of human evidence. Neurosci Biobehav Rev 2018; 93:1-25. [DOI: 10.1016/j.neubiorev.2018.07.014] [Citation(s) in RCA: 68] [Impact Index Per Article: 11.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2018] [Revised: 07/21/2018] [Accepted: 07/24/2018] [Indexed: 01/15/2023]
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Hirst RB, Watson J, S Rosen A, Quittner Z. Perceptions of the cognitive effects of cannabis use: A survey of neuropsychologists' beliefs. J Clin Exp Neuropsychol 2018; 41:133-146. [PMID: 30124369 DOI: 10.1080/13803395.2018.1503644] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
Introduction: Research evaluating the neuropsychological effects of cannabis has yielded mixed findings, with some studies finding cognitive deficits in cannabis users (primarily in learning and memory) and others finding no significant effects. It is important to understand how clinicians perceive this discrepancy in the empirical literature. However, no studies have assessed neuropsychologists' beliefs regarding the effects of cannabis on cognitive functioning. Thus, this study sought to evaluate how patient and cannabis-use factors influence neuropsychologists' perceptions of cannabis's cognitive effects. Method: Neuropsychologists (N = 261) read eight vignettes, each depicting cannabis users varying in age, gender, and cannabis-use history (frequency, duration, and recreational/medicinal use). Respondents rated the anticipated effects of cannabis in each vignette on nine cognitive domains. Mixed effects linear regression modeled the ratings of cognitive abilities as a function of neuropsychologist, neuropsychologists' training, vignette, patient age, gender, and frequency/duration/type of cannabis use, and treated neuropsychologist and vignette as random effects. Results: Duration of use had the most notable effect on neuropsychologists' ratings, with a small (0.1 to 0.2 SDs) yet statistically significant (p < .001) negative effect on each cognitive domain. Male gender and medicinal use also predicted lower cognitive ratings. Differences in ratings between neuropsychologists accounted for 73% of the total variability in each domain, whereas variability due to vignette alone was negligible (<1%). Conclusions: Results suggest that neuropsychologists believe that cannabis use results in broad but mild cognitive deficits, consistent with meta-analytic findings of active chronic cannabis users, particularly for males and for individuals using cannabis for medicinal purposes. Interestingly, neuropsychologists expected fewer cognitive effects in recreational cannabis users. Further, duration of use (rather than frequency) was believed to be the primary factor contributing to cognitive deficits.
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Affiliation(s)
- Rayna B Hirst
- a Department of Psychology , Palo Alto University , Palo Alto , CA , USA
| | - Jessica Watson
- a Department of Psychology , Palo Alto University , Palo Alto , CA , USA
| | - Alexis S Rosen
- a Department of Psychology , Palo Alto University , Palo Alto , CA , USA
| | - Zoe Quittner
- a Department of Psychology , Palo Alto University , Palo Alto , CA , USA
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Vredeveldt A, Charman SD, den Blanken A, Hooydonk M. Effects of cannabis on eyewitness memory: A field study. APPLIED COGNITIVE PSYCHOLOGY 2018; 32:420-428. [PMID: 30069079 PMCID: PMC6055797 DOI: 10.1002/acp.3414] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2017] [Revised: 03/14/2018] [Accepted: 03/22/2018] [Indexed: 11/06/2022]
Abstract
Eyewitnesses to crimes are regularly under the influence of drugs, such as cannabis. Yet there is very little research on how the use of cannabis affects eyewitness memory. In the present study, we assessed the effects of cannabis on eyewitness recall and lineup identification performance in a field setting. One hundred twenty visitors of coffee shops in Amsterdam viewed a videotaped criminal event, were interviewed about the event, and viewed a target-present or target-absent lineup. Witnesses under the influence of cannabis remembered significantly fewer correct details about the witnessed event than did sober witnesses, with no difference in incorrect recall. Cannabis use was not significantly associated with lineup identification performance, but intoxicated witnesses were significantly better at judging whether their lineup identification was accurate. Theoretical and practical implications of the findings are discussed.
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Affiliation(s)
- Annelies Vredeveldt
- Department of Criminal Law and Criminology, Faculty of LawVrije Universiteit AmsterdamAmsterdamThe Netherlands
| | - Steve D. Charman
- Department of PsychologyFlorida International UniversityMiamiUSA
| | - Aukje den Blanken
- Department of Criminal Law and Criminology, Faculty of LawVrije Universiteit AmsterdamAmsterdamThe Netherlands
| | - Maren Hooydonk
- Department of Criminal Law and Criminology, Faculty of LawVrije Universiteit AmsterdamAmsterdamThe Netherlands
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Colizzi M, Bhattacharyya S. Neurocognitive effects of cannabis: Lessons learned from human experimental studies. PROGRESS IN BRAIN RESEARCH 2018; 242:179-216. [DOI: 10.1016/bs.pbr.2018.08.010] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/21/2023]
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John WS, Martin TJ, Solingapuram Sai KK, Nader SH, Gage HD, Mintz A, Nader MA. Chronic Δ 9-THC in Rhesus Monkeys: Effects on Cognitive Performance and Dopamine D2/D3 Receptor Availability. J Pharmacol Exp Ther 2017; 364:300-310. [PMID: 29203575 DOI: 10.1124/jpet.117.244194] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/24/2017] [Accepted: 11/30/2017] [Indexed: 01/24/2023] Open
Abstract
Cannabis-related impairments to cognitive function may represent novel therapeutic targets for cannabis-use disorder, although the nature, persistence, and reversibility of such deficits remain unclear. Adult male rhesus monkeys (N = 6) responded in the morning on tasks designed to assess different cognitive domains using the Cambridge Neuropsychological Test Automated Battery (CANTAB) touchscreens followed by responding maintained under a fixed-ratio (FR) 10 schedule of food presentation in different operant chambers. First, the acute effects of Δ9-tetrahydrocannabinol (THC; 0.01-0.56 mg/kg, i.v.) on cognitive performance, FR responding, and body temperature were determined. Next, THC (1.0-2.0 mg/kg, s.c.) was administered daily after FR 10 sessions for 12 weeks, during which the residual effects of THC (i.e., 22 hours after administration) on cognition were examined and the acute effects of THC were redetermined. In a subgroup of monkeys, dopamine D2/D3 receptor availability was assessed after 4 weeks of chronic THC exposure and compared with drug-naive controls using positron emission tomography and [11C]-raclopride (N = 4/group). Acute THC pretreatments dose-dependently decreased FR responding and body temperature, and impairment to cognitive performance was task specific. During chronic treatment, THC produced persistent residual impairment only to working memory; tolerance differentially developed to acute cognitive impairments. There was recovery from residual cognitive impairments to working memory within 2 weeks of abstinence. Compared with controls, D2/D3 receptor availability was not altered during chronic THC treatment. In conclusion, THC-induced disruptions in cognition were task-specific, as was tolerance development, and not related to changes in D2/D3 receptor availability. Intervention strategies for cannabis-use disorder that enhance working memory performance may facilitate positive treatment outcomes.
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Affiliation(s)
- William S John
- Departments of Physiology and Pharmacology (W.S.J., S.H.N., M.A.N.), Anesthesiology (T.J.M.), and Radiology (K.K.S.S., H.D.G., A.M., M.A.N.), Wake Forest School of Medicine, Winston-Salem, North Carolina
| | - Thomas J Martin
- Departments of Physiology and Pharmacology (W.S.J., S.H.N., M.A.N.), Anesthesiology (T.J.M.), and Radiology (K.K.S.S., H.D.G., A.M., M.A.N.), Wake Forest School of Medicine, Winston-Salem, North Carolina
| | - Kiran Kumar Solingapuram Sai
- Departments of Physiology and Pharmacology (W.S.J., S.H.N., M.A.N.), Anesthesiology (T.J.M.), and Radiology (K.K.S.S., H.D.G., A.M., M.A.N.), Wake Forest School of Medicine, Winston-Salem, North Carolina
| | - Susan H Nader
- Departments of Physiology and Pharmacology (W.S.J., S.H.N., M.A.N.), Anesthesiology (T.J.M.), and Radiology (K.K.S.S., H.D.G., A.M., M.A.N.), Wake Forest School of Medicine, Winston-Salem, North Carolina
| | - H Donald Gage
- Departments of Physiology and Pharmacology (W.S.J., S.H.N., M.A.N.), Anesthesiology (T.J.M.), and Radiology (K.K.S.S., H.D.G., A.M., M.A.N.), Wake Forest School of Medicine, Winston-Salem, North Carolina
| | - Akiva Mintz
- Departments of Physiology and Pharmacology (W.S.J., S.H.N., M.A.N.), Anesthesiology (T.J.M.), and Radiology (K.K.S.S., H.D.G., A.M., M.A.N.), Wake Forest School of Medicine, Winston-Salem, North Carolina
| | - Michael A Nader
- Departments of Physiology and Pharmacology (W.S.J., S.H.N., M.A.N.), Anesthesiology (T.J.M.), and Radiology (K.K.S.S., H.D.G., A.M., M.A.N.), Wake Forest School of Medicine, Winston-Salem, North Carolina
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Hindocha C, Freeman TP, Xia JX, Shaban NDC, Curran HV. Acute memory and psychotomimetic effects of cannabis and tobacco both 'joint' and individually: a placebo-controlled trial. Psychol Med 2017; 47:2708-2719. [PMID: 28558859 PMCID: PMC5647681 DOI: 10.1017/s0033291717001222] [Citation(s) in RCA: 64] [Impact Index Per Article: 9.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/13/2017] [Revised: 04/07/2017] [Accepted: 04/07/2017] [Indexed: 12/28/2022]
Abstract
BACKGROUND Cannabis and tobacco have contrasting cognitive effects. Smoking cannabis with tobacco is prevalent in many countries and although this may well influence cognitive and mental health outcomes, the possibility has rarely been investigated in human experimental psychopharmacological research. METHOD The individual and interactive effects of cannabis and tobacco were evaluated in 24 non-dependent cannabis and tobacco smokers in a randomized, placebo-controlled, double-blind, 2 (cannabis, placebo) × 2 (tobacco, placebo) crossover design. Verbal memory (prose recall), working memory (WM) performance including maintenance, manipulation and attention (N-back), psychotomimetic, subjective and cardiovascular measures were recorded on each of four sessions. RESULTS Cannabis alone impaired verbal memory. A priori contrasts indicated that tobacco offset the effects of cannabis on delayed recall. However, this was not supported by linear mixed model analysis. Cannabis load-dependently impaired WM. By contrast, tobacco improved WM across all load levels. The acute psychotomimetic effects and ratings of 'stoned' and 'dizzy' induced by cannabis were not altered by tobacco. Cannabis and tobacco had independent effects on increasing heart rate and interacting effects on increasing diastolic blood pressure. CONCLUSIONS Relative to placebo, acute cannabis impaired verbal memory and WM. Tobacco enhanced performance on WM, independently of cannabis. Moreover, we found some preliminary evidence that tobacco may offset the effects of cannabis on delayed, but not immediate, verbal recall. In contrast, the psychotomimetic and subjective effects of cannabis were unaffected by tobacco co-administration. By reducing the cognitive impairment from cannabis, tobacco co-administration may perpetuate use despite adverse health consequences.
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Affiliation(s)
- C. Hindocha
- Clincial Psychopharmacology Unit,
University College London, Gower St,
London, UK
| | - T. P. Freeman
- Clincial Psychopharmacology Unit,
University College London, Gower St,
London, UK
| | - J. X. Xia
- The Sophie Davis School of Biomedical Education,
The City College of New York, NY,
USA
| | - N. D. C. Shaban
- Clincial Psychopharmacology Unit,
University College London, Gower St,
London, UK
| | - H. V. Curran
- Clincial Psychopharmacology Unit,
University College London, Gower St,
London, UK
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Ranganathan M, Radhakrishnan R, Addy PH, Schnakenberg-Martin AM, Williams AH, Carbuto M, Elander J, Pittman B, Andrew Sewell R, Skosnik PD, D'Souza DC. Tetrahydrocannabinol (THC) impairs encoding but not retrieval of verbal information. Prog Neuropsychopharmacol Biol Psychiatry 2017. [PMID: 28642081 DOI: 10.1016/j.pnpbp.2017.06.019] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
Abstract
INTRODUCTION Cannabis and agonists of the brain cannabinoid receptor (CB1R) produce acute memory impairments in humans. However, the extent to which cannabinoids impair the component processes of encoding and retrieval has not been established in humans. The objective of this analysis was to determine whether the administration of Δ9-Tetrahydrocannabinol (THC), the principal psychoactive constituent of cannabis, impairs encoding and/or retrieval of verbal information. MATERIALS AND METHODS Healthy subjects were recruited from the community. Subjects were administered the Rey-Auditory Verbal Learning Test (RAVLT) either before administration of THC (experiment #1) (n=38) or while under the influence of THC (experiment #2) (n=57). Immediate and delayed recall on the RAVLT was compared. Subjects received intravenous THC, in a placebo-controlled, double-blind, randomized manner at doses known to produce behavioral and subjective effects consistent with cannabis intoxication. RESULTS Total immediate recall, short delayed recall, and long delayed recall were reduced in a statistically significant manner only when the RAVLT was administered to subjects while they were under the influence of THC (experiment #2) and not when the RAVLT was administered prior. CONCLUSIONS THC acutely interferes with encoding of verbal memory without interfering with retrieval. These data suggest that learning information prior to the use of cannabis or cannabinoids is not likely to disrupt recall of that information. Future studies will be necessary to determine whether THC impairs encoding of non-verbal information, to what extent THC impairs memory consolidation, and the role of other cannabinoids in the memory-impairing effects of cannabis. CLINICAL TRIAL INFORMATION Cannabinoids, Neural Synchrony, and Information Processing (THC-Gamma) http://clinicaltrials.gov/ct2/show/study/NCT00708994 NCT00708994 Pharmacogenetics of Cannabinoid Response http://clinicaltrials.gov/ct2/show/NCT00678730 NCT00678730.
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Affiliation(s)
- Mohini Ranganathan
- Department of Psychiatry, Yale University School of Medicine, New Haven, CT, USA; Psychiatry Service, VA Connecticut Healthcare System, West Haven, CT, USA; Abraham Ribicoff Research Facilities, Connecticut Mental Health Center, New Haven, CT, USA.
| | - Rajiv Radhakrishnan
- Department of Psychiatry, Yale University School of Medicine, New Haven, CT, USA; Psychiatry Service, VA Connecticut Healthcare System, West Haven, CT, USA; Abraham Ribicoff Research Facilities, Connecticut Mental Health Center, New Haven, CT, USA
| | - Peter H Addy
- Department of Psychiatry, Yale University School of Medicine, New Haven, CT, USA; Medical Informatics, VA Connecticut Healthcare System, West Haven, CT, USA; Substance Abuse Treatment Unit, Connecticut Mental Health Center, New Haven, CT, USA
| | - Ashley M Schnakenberg-Martin
- Department of Psychiatry, Yale University School of Medicine, New Haven, CT, USA; Psychiatry Service, VA Connecticut Healthcare System, West Haven, CT, USA; Abraham Ribicoff Research Facilities, Connecticut Mental Health Center, New Haven, CT, USA
| | - Ashley H Williams
- Department of Psychiatry, Yale University School of Medicine, New Haven, CT, USA; Psychiatry Service, VA Connecticut Healthcare System, West Haven, CT, USA; Abraham Ribicoff Research Facilities, Connecticut Mental Health Center, New Haven, CT, USA
| | - Michelle Carbuto
- Department of Psychiatry, Yale University School of Medicine, New Haven, CT, USA; Psychiatry Service, VA Connecticut Healthcare System, West Haven, CT, USA; Abraham Ribicoff Research Facilities, Connecticut Mental Health Center, New Haven, CT, USA
| | - Jacqueline Elander
- Department of Psychiatry, Yale University School of Medicine, New Haven, CT, USA; Psychiatry Service, VA Connecticut Healthcare System, West Haven, CT, USA; Abraham Ribicoff Research Facilities, Connecticut Mental Health Center, New Haven, CT, USA
| | - Brian Pittman
- Department of Psychiatry, Yale University School of Medicine, New Haven, CT, USA; Abraham Ribicoff Research Facilities, Connecticut Mental Health Center, New Haven, CT, USA
| | - R Andrew Sewell
- Department of Psychiatry, Yale University School of Medicine, New Haven, CT, USA; Psychiatry Service, VA Connecticut Healthcare System, West Haven, CT, USA; Abraham Ribicoff Research Facilities, Connecticut Mental Health Center, New Haven, CT, USA
| | - Patrick D Skosnik
- Department of Psychiatry, Yale University School of Medicine, New Haven, CT, USA; Psychiatry Service, VA Connecticut Healthcare System, West Haven, CT, USA; Abraham Ribicoff Research Facilities, Connecticut Mental Health Center, New Haven, CT, USA
| | - Deepak Cyril D'Souza
- Department of Psychiatry, Yale University School of Medicine, New Haven, CT, USA; Psychiatry Service, VA Connecticut Healthcare System, West Haven, CT, USA; Abraham Ribicoff Research Facilities, Connecticut Mental Health Center, New Haven, CT, USA
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Keith DR, Gunderson EW, Haney M, Foltin RW, Hart CL. Smoked marijuana attenuates performance and mood disruptions during simulated night shift work. Drug Alcohol Depend 2017; 178:534-543. [PMID: 28728115 PMCID: PMC5578830 DOI: 10.1016/j.drugalcdep.2017.04.036] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/17/2013] [Revised: 04/09/2017] [Accepted: 04/10/2017] [Indexed: 11/16/2022]
Abstract
Individuals who work nonstandard schedules, such as rotating or night shifts, are more susceptible to workplace injuries, performance decrements, and reduced productivity. This population is also almost twice as likely to use illicit drugs as individuals working a standard day shift. The purpose of this study was to examine the effects of smoked marijuana on performance, mood, and sleep during simulated shift work. Ten experienced marijuana smokers completed this 23-day, within-participant residential study. They smoked a single marijuana cigarette (0, 1.9, 3.56% Δ9-THC) one hour after waking for three consecutive days under two shift conditions: day shift and night shift. Shifts alternated three times during the study, and shift conditions were separated by an 'off' day. When participants smoked placebo cigarettes, psychomotor performance and subjective-effect ratings were altered during the night shift compared to the day shift: performance (e.g., vigilance) and a few subjective ratings were decreased (e.g., "Self-Confident"), whereas other ratings were increased (e.g., "Tired"). Objective and subjective measures of sleep were also disrupted, but to a lesser extent. Marijuana attenuated some performance, mood, and sleep disruptions: participants performed better on vigilance tasks, reported being less miserable and tired and sleep a greater number of minutes. Limited negative effects of marijuana were noted. These data demonstrate that abrupt shift changes produce performance, mood, and sleep decrements during night shift work and that smoked marijuana containing low to moderate Δ9-THC concentrations can offset some of these effects in frequent marijuana smokers.
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Affiliation(s)
| | - Erik W. Gunderson
- Division on Substance Abuse, New York State Psychiatric Institute and Department of Psychiatry, College of Physicians and Surgeons of Columbia University
| | - Margaret Haney
- Division on Substance Abuse, New York State Psychiatric Institute and Department of Psychiatry, College of Physicians and Surgeons of Columbia University
| | - Richard W. Foltin
- Division on Substance Abuse, New York State Psychiatric Institute and Department of Psychiatry, College of Physicians and Surgeons of Columbia University
| | - Carl L. Hart
- Department of Psychology, Columbia University,Division on Substance Abuse, New York State Psychiatric Institute and Department of Psychiatry, College of Physicians and Surgeons of Columbia University,Institute for Research in African-American Studies, Columbia University
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Blank MD, Breland AB, Cobb CO, Spindle T, Ramôa C, Eissenberg T. Clinical Laboratory Evaluation of Electronic Cigarettes/Electronic Nicotine Delivery Systems: Methodological Challenges. TOB REGUL SCI 2016; 2:426-439. [PMID: 28819633 PMCID: PMC5555604 DOI: 10.18001/trs.2.4.12] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
Abstract
OBJECTIVE Evaluating electronic cigarettes (ECIGs) in the clinical laboratory is critical to understanding their effects. However, laboratory evaluation of ECIGs can be challenging, as they are a novel, varied, and evolving class of products. The objective of this paper is to describe some methodological challenges to the clinical laboratory evaluation of ECIGs. METHODS The authors gathered information about challenges involved in the laboratory evaluation of ECIGs. Challenges were categorized and solutions provided when possible. RESULTS Methods used to study combustible cigarettes may need to be adapted to account for ECIG novelty and differences within the class. Challenges to ECIG evaluation can include issues related to 1) identification of ECIG devices and liquids, 2) determination of short -term ECIG abstinence, 3) measurement of use behavior, and 4) assessment of dependence. These challenges are discussed, and some suggestions to inform ECIG evaluation using clinical laboratory methods are provided. CONCLUSIONS Awareness of challenges and developing, validating, and reporting methods used to address them aids interpretation of results and replication efforts, thus enhancing the rigor of science used to protect public health through appropriate, empirically-based, ECIG regulation.
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Affiliation(s)
- Melissa D Blank
- Assistant Professor, West Virginia University, Morgantown, WV
| | - Alison B Breland
- Assistant Professor, Virginia Commonwealth University, Center for the Study of Tobacco Products, Richmond, VA
| | - Caroline O Cobb
- Assistant Professor, Virginia Commonwealth University, Center for the Study of Tobacco Products, Richmond, VA
| | - Tory Spindle
- Virginia Commonwealth University, Center for the Study of Tobacco Products, Richmond, VA
| | - Carolina Ramôa
- Post-Doctoral Fellow, Virginia Commonwealth University, Center for the Study of Tobacco Products, Richmond, VA
| | - Thomas Eissenberg
- Thomas Eissenberg, Professor, Virginia Commonwealth University, Center for the Study of Tobacco Products, Richmond, VA
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Murray RM, Quigley H, Quattrone D, Englund A, Di Forti M. Traditional marijuana, high-potency cannabis and synthetic cannabinoids: increasing risk for psychosis. World Psychiatry 2016; 15:195-204. [PMID: 27717258 PMCID: PMC5032490 DOI: 10.1002/wps.20341] [Citation(s) in RCA: 148] [Impact Index Per Article: 18.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/11/2022] Open
Abstract
Epidemiological evidence demonstrates that cannabis use is associated with an increased risk of psychotic outcomes, and confirms a dose-response relationship between the level of use and the risk of later psychosis. High-potency cannabis and synthetic cannabinoids carry the greatest risk. Experimental administration of tetrahydrocannabinol, the active ingredient of cannabis, induces transient psychosis in normal subjects, but this effect can be ameliorated by co-administration of cannabidiol. This latter is a constituent of traditional hashish, but is largely absent from modern high-potency forms of cannabis. Argument continues over the extent to which genetic predisposition is correlated to, or interacts with, cannabis use, and what proportion of psychosis could be prevented by minimizing heavy use. As yet, there is not convincing evidence that cannabis use increases risk of other psychiatric disorders, but there are no such doubts concerning its detrimental effect on cognitive function. All of the negative aspects are magnified if use starts in early adolescence. Irrespective of whether use of cannabis is decriminalized or legalized, the evidence that it is a component cause of psychosis is now sufficient for public health messages outlining the risk, especially of regular use of high-potency cannabis and synthetic cannabinoids.
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Affiliation(s)
- Robin M. Murray
- Institute of Psychiatry, Psychology and Neuroscience, King's CollegeDe Crespigny ParkLondonSE5 8AFUK
| | - Harriet Quigley
- Institute of Psychiatry, Psychology and Neuroscience, King's CollegeDe Crespigny ParkLondonSE5 8AFUK
| | - Diego Quattrone
- Institute of Psychiatry, Psychology and Neuroscience, King's CollegeDe Crespigny ParkLondonSE5 8AFUK
| | - Amir Englund
- Institute of Psychiatry, Psychology and Neuroscience, King's CollegeDe Crespigny ParkLondonSE5 8AFUK
| | - Marta Di Forti
- Institute of Psychiatry, Psychology and Neuroscience, King's CollegeDe Crespigny ParkLondonSE5 8AFUK
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Abstract
Cannabis has been widely used as a medicinal agent in Eastern medicine with earliest evidence in ancient Chinese practice dating back to 2700 BC. Over time, the use of medical cannabis has been increasingly adopted by Western medicine and is thus a rapidly emerging field that all pain physicians need to be aware of. Several randomized controlled trials have shown a significant and dose-dependent relationship between neuropathic pain relief and tetrahydrocannabinol – the principal psychoactive component of cannabis. Despite this, barriers exist to use from both the patient perspective (cost, addiction, social stigma, lack of understanding regarding safe administration) and the physician perspective (credibility, criminality, clinical evidence, patient addiction, and policy from the governing medical colleges). This review addresses these barriers and draws attention to key concerns in the Canadian medical system, providing updated treatment approaches to help clinicians work with their patients in achieving adequate pain control, reduced narcotic medication use, and enhanced quality of life. This review also includes case studies demonstrating the use of medical marijuana by patients with neuropathic low-back pain, neuropathic pain in fibromyalgia, and neuropathic pain in multiple sclerosis. While significant preclinical data have demonstrated the potential therapeutic benefits of cannabis for treating pain in osteoarthritis, rheumatoid arthritis, fibromyalgia, and cancer, further studies are needed with randomized controlled trials and larger study populations to identify the specific strains and concentrations that will work best with selected cohorts.
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Affiliation(s)
- Gordon D Ko
- Apollo Applied Research Inc.; Department of Medicine, Sunnybrook Health Sciences Centre, University of Toronto, Toronto
| | | | - Sean Mindra
- University of Ottawa Medical School, Ottawa, ON, Canada
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Wilsey B, Marcotte TD, Deutsch R, Zhao H, Prasad H, Phan A. An Exploratory Human Laboratory Experiment Evaluating Vaporized Cannabis in the Treatment of Neuropathic Pain From Spinal Cord Injury and Disease. THE JOURNAL OF PAIN 2016; 17:982-1000. [PMID: 27286745 PMCID: PMC5007175 DOI: 10.1016/j.jpain.2016.05.010] [Citation(s) in RCA: 57] [Impact Index Per Article: 7.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/27/2016] [Revised: 04/18/2016] [Accepted: 05/20/2016] [Indexed: 12/14/2022]
Abstract
UNLABELLED Using 8-hour human laboratory experiments, we evaluated the analgesic efficacy of vaporized cannabis in patients with neuropathic pain related to injury or disease of the spinal cord, most of whom were experiencing pain despite traditional treatment. After obtaining baseline data, 42 participants underwent a standardized procedure for inhaling 4 puffs of vaporized cannabis containing either placebo, 2.9%, or 6.7% delta 9-THC on 3 separate occasions. A second dosing occurred 3 hours later; participants chose to inhale 4 to 8 puffs. This flexible dosing was used to attempt to reduce the placebo effect. Using an 11-point numerical pain intensity rating scale as the primary outcome, a mixed effects linear regression model showed a significant analgesic response for vaporized cannabis. When subjective and psychoactive side effects (eg, good drug effect, feeling high, etc) were added as covariates to the model, the reduction in pain intensity remained significant above and beyond any effect of these measures (all P < .0004). Psychoactive and subjective effects were dose-dependent. Measurement of neuropsychological performance proved challenging because of various disabilities in the population studied. Because the 2 active doses did not significantly differ from each other in terms of analgesic potency, the lower dose appears to offer the best risk-benefit ratio in patients with neuropathic pain associated with injury or disease of the spinal cord. PERSPECTIVE A crossover, randomized, placebo-controlled human laboratory experiment involving administration of vaporized cannabis was performed in patients with neuropathic pain related to spinal cord injury and disease. This study supports consideration of future research that would include longer duration studies over weeks to months to evaluate the efficacy of medicinal cannabis in patients with central neuropathic pain.
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Affiliation(s)
- Barth Wilsey
- VA Northern California Health Care System Sacramento VA Medical Center, 10535 Hospital Way, Mather, CA 95655 USA, 916-843-7000 | 800-382-8387
- Department of Physical Medicine and Rehabilitation, University of California, Davis Medical Center, Lawrence J. Ellison Ambulatory Care Center, 4860 Y Street, Sacramento, CA 95817 USA
| | - Thomas D. Marcotte
- Department of Psychiatry, University of California, San Diego, 220 Dickinson Street, Suite B, MC8231, San Diego, CA 92103-8231 USA
| | - Reena Deutsch
- Department of Psychiatry, University of California, San Diego, 220 Dickinson Street, Suite B, MC8231, San Diego, CA 92103-8231 USA
| | - Holly Zhao
- VA Northern California Health Care System Sacramento VA Medical Center, 10535 Hospital Way, Mather, CA 95655 USA, 916-843-7000 | 800-382-8387
- Department of Physical Medicine and Rehabilitation, University of California, Davis Medical Center, Lawrence J. Ellison Ambulatory Care Center, 4860 Y Street, Sacramento, CA 95817 USA
| | - Hannah Prasad
- VA Northern California Health Care System Sacramento VA Medical Center, 10535 Hospital Way, Mather, CA 95655 USA, 916-843-7000 | 800-382-8387
- Department of Physical Medicine and Rehabilitation, University of California, Davis Medical Center, Lawrence J. Ellison Ambulatory Care Center, 4860 Y Street, Sacramento, CA 95817 USA
| | - Amy Phan
- VA Northern California Health Care System Sacramento VA Medical Center, 10535 Hospital Way, Mather, CA 95655 USA, 916-843-7000 | 800-382-8387
- Department of Physical Medicine and Rehabilitation, University of California, Davis Medical Center, Lawrence J. Ellison Ambulatory Care Center, 4860 Y Street, Sacramento, CA 95817 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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Wang GY, Kydd R, Russell BR. Resting EEG and ERPs findings in methadone-substituted opiate users: a review. Acta Neurol Belg 2015; 115:539-46. [PMID: 25894352 DOI: 10.1007/s13760-015-0476-2] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/19/2015] [Accepted: 04/06/2015] [Indexed: 11/30/2022]
Abstract
Methadone has been used to treat opiate dependence since the mid-1960s. Despite its clinical effectiveness there is evidence from neuropsychological studies demonstrating that its long-term use might have negative effects on cognition. Nevertheless, it remains uncertain whether the observed cognitive impairments in patients undertaking methadone maintenance treatment (MMT) are solely attributable to the pharmacological effects of methadone, as suggested by some researchers. Determining the effects of MMT on neuropsychological function using electroencephalography (EEG) combined with event-related potentials (ERP) has been used infrequently. However EEG and ERP provide a means of closely examining information processing to determine whether MMT induces any deficits. The purpose of this review was to investigate whether psychophysiological evidence supports cognitive impairment in association with MMT by focusing on research using EEG and ERPs. The findings of EEG studies to date appear not support the notion that cognitive impairments are attributable to the specific pharmacological effects of methadone suggested by some neuropsychological studies. However, due to the methodological deficits and limited number of the studies, any conclusion based on the findings of the existing EEG studies should be avoided.
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Affiliation(s)
- Grace Y Wang
- Department of Psychology, Auckland University of Technology, Auckland, New Zealand.
| | - Robert Kydd
- Centre for Brain Research, University of Auckland, Auckland, New Zealand
- Department of Psychological Medicine, University of Auckland, Auckland, New Zealand
| | - Bruce R Russell
- Centre for Brain Research, University of Auckland, Auckland, New Zealand
- School of Pharmacy, University of Auckland, Auckland, New Zealand
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Dose-dependent effects of cannabis on the neural correlates of error monitoring in frequent cannabis users. Eur Neuropsychopharmacol 2015; 25:1943-53. [PMID: 26298832 DOI: 10.1016/j.euroneuro.2015.08.001] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/22/2015] [Revised: 06/18/2015] [Accepted: 08/03/2015] [Indexed: 01/10/2023]
Abstract
Cannabis has been suggested to impair the capacity to recognize discrepancies between expected and executed actions. However, there is a lack of conclusive evidence regarding the acute impact of cannabis on the neural correlates of error monitoring. In order to contribute to the available knowledge, we used a randomized, double-blind, between-groups design to investigate the impact of administration of a low (5.5 mg THC) or high (22 mg THC) dose of vaporized cannabis vs. placebo on the amplitudes of the error-related negativity (ERN) and error positivity (Pe) in the context of the Flanker task, in a group of frequent cannabis users (required to use cannabis minimally 4 times a week, for at least 2 years). Subjects in the high dose group (n=18) demonstrated a significantly diminished ERN in comparison to the placebo condition (n=19), whereas a reduced Pe amplitude was observed in both the high and low dose (n=18) conditions, as compared to placebo. The results suggest that a high dose of cannabis may affect the neural correlates of both the conscious (late), as well as the initial automatic processes involved in error monitoring, while a low dose of cannabis might impact only the conscious (late) processing of errors.
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Dede E, Zalonis I, Gatzonis S, Sakas D. Integration of computers in cognitive assessment and level of comprehensiveness of frequently used computerized batteries. ACTA ACUST UNITED AC 2015. [DOI: 10.1016/j.npbr.2015.07.003] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
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Garg S, Sharma R, Mittal S, Thapar S. Alterations in brain-stem auditory evoked potentials among drug addicts. A cross-sectional study. ACTA ACUST UNITED AC 2015; 20:253-8. [PMID: 26166594 PMCID: PMC4710344 DOI: 10.17712/nsj.2015.3.20150105] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
Objective: To compare the absolute latencies, the interpeak latencies, and amplitudes of different waveforms of brainstem auditory evoked potentials (BAEP) in different drug abusers and controls, and to identify early neurological damage in persons who abuse different drugs so that proper counseling and timely intervention can be undertaken. Methods: In this cross-sectional study, BAEP’s were assessed by a data acquisition and analysis system in 58 male drug abusers in the age group of 15-45 years as well as in 30 age matched healthy controls. The absolute peak latencies and the interpeak latencies of BAEP were analyzed by applying one way ANOVA and student t-test. The study was carried out at the GGS Medical College, Faridkot, Punjab, India between July 2012 and May 2013. Results: The difference in the absolute peak latencies and interpeak latencies of BAEP in the 2 groups was found to be statistically significant in both the ears (p<0.05). However, the difference in the amplitude ratio in both the ears was found to be statistically insignificant. Conclusion: Chronic intoxication by different drugs has been extensively associated with prolonged absolute peak latencies and interpeak latencies of BAEP in drug abusers reflecting an adverse effect of drug dependence on neural transmission in central auditory nerve pathways.
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Affiliation(s)
- Sonia Garg
- Department of Physiology, GGS Medical College, Faridkot, Punjab, India. E-mail:
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46
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Shrier LA, Ross CS, Blood EA. Momentary positive and negative affect preceding marijuana use events in youth. J Stud Alcohol Drugs 2015; 75:781-9. [PMID: 25208196 DOI: 10.15288/jsad.2014.75.781] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/03/2023] Open
Abstract
UNLABELLED ABSTRACT. among young people. This study examined how positive and negative affect differ before marijuana use compared with other times. METHOD Forty medical outpatients ages 15-24 years who used marijuana recreationally at least twice a week (M = 18.7 years; 58% female) reported momentary positive affect, negative affect, companionship, perceived ease of obtaining marijuana, and marijuana use several times a day for 2 weeks on a handheld computer. Mean momentary positive affect and negative affect scores in the 24 hours leading up to a marijuana use event (n = 294) were compared with affect scores in times further from subsequent use. Generalized estimating equation models considered as potential moderators perceived ease of obtaining marijuana and being with friends. RESULTS Positive affect did not differ in the 24 hours before marijuana use compared with times further before use. Negative affect was significantly higher before marijuana use compared with other times. Being with friends and perceived easy marijuana availability did not moderate the associations. The association between negative affect and subsequent marijuana use was attenuated when negative affect was examined only for the moment just before use, suggesting that use may follow a period of increased negative affect. CONCLUSIONS The findings support an affect regulation model for marijuana use among frequently using youth. Specifically, these youth may use marijuana to manage increased negative affect.
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Affiliation(s)
- Lydia A Shrier
- Division of Adolescent/Young Adult Medicine, Boston Children's Hospital, Boston, Massachusetts
| | - Craig S Ross
- Department of Epidemiology, Boston University School of Public Health, Boston, Massachusetts
| | - Emily A Blood
- Clinical Research Center, Boston Children's Hospital, Boston, Massachusetts
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Baron EP. Comprehensive Review of Medicinal Marijuana, Cannabinoids, and Therapeutic Implications in Medicine and Headache: What a Long Strange Trip It's Been …. Headache 2015; 55:885-916. [PMID: 26015168 DOI: 10.1111/head.12570] [Citation(s) in RCA: 120] [Impact Index Per Article: 13.3] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/07/2015] [Indexed: 02/06/2023]
Abstract
BACKGROUND The use of cannabis, or marijuana, for medicinal purposes is deeply rooted though history, dating back to ancient times. It once held a prominent position in the history of medicine, recommended by many eminent physicians for numerous diseases, particularly headache and migraine. Through the decades, this plant has taken a fascinating journey from a legal and frequently prescribed status to illegal, driven by political and social factors rather than by science. However, with an abundance of growing support for its multitude of medicinal uses, the misguided stigma of cannabis is fading, and there has been a dramatic push for legalizing medicinal cannabis and research. Almost half of the United States has now legalized medicinal cannabis, several states have legalized recreational use, and others have legalized cannabidiol-only use, which is one of many therapeutic cannabinoids extracted from cannabis. Physicians need to be educated on the history, pharmacology, clinical indications, and proper clinical use of cannabis, as patients will inevitably inquire about it for many diseases, including chronic pain and headache disorders for which there is some intriguing supportive evidence. OBJECTIVE To review the history of medicinal cannabis use, discuss the pharmacology and physiology of the endocannabinoid system and cannabis-derived cannabinoids, perform a comprehensive literature review of the clinical uses of medicinal cannabis and cannabinoids with a focus on migraine and other headache disorders, and outline general clinical practice guidelines. CONCLUSION The literature suggests that the medicinal use of cannabis may have a therapeutic role for a multitude of diseases, particularly chronic pain disorders including headache. Supporting literature suggests a role for medicinal cannabis and cannabinoids in several types of headache disorders including migraine and cluster headache, although it is primarily limited to case based, anecdotal, or laboratory-based scientific research. Cannabis contains an extensive number of pharmacological and biochemical compounds, of which only a minority are understood, so many potential therapeutic uses likely remain undiscovered. Cannabinoids appear to modulate and interact at many pathways inherent to migraine, triptan mechanisms ofaction, and opiate pathways, suggesting potential synergistic or similar benefits. Modulation of the endocannabinoid system through agonism or antagonism of its receptors, targeting its metabolic pathways, or combining cannabinoids with other analgesics for synergistic effects, may provide the foundation for many new classes of medications. Despite the limited evidence and research suggesting a role for cannabis and cannabinoids in some headache disorders, randomized clinical trials are lacking and necessary for confirmation and further evaluation.
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Affiliation(s)
- Eric P Baron
- Department of Neurology, Headache Center, Cleveland Clinic Neurological Institute, Cleveland, OH, USA
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48
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Turetsky BI, Dress EM, Braff DL, Calkins ME, Green MF, Greenwood TA, Gur RE, Gur RC, Lazzeroni LC, Nuechterlein KH, Radant AD, Seidman LJ, Siever LJ, Silverman JM, Sprock J, Stone WS, Sugar CA, Swerdlow NR, Tsuang DW, Tsuang MT, Light G. The utility of P300 as a schizophrenia endophenotype and predictive biomarker: clinical and socio-demographic modulators in COGS-2. Schizophr Res 2015; 163:53-62. [PMID: 25306203 PMCID: PMC4382423 DOI: 10.1016/j.schres.2014.09.024] [Citation(s) in RCA: 69] [Impact Index Per Article: 7.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/20/2014] [Revised: 09/09/2014] [Accepted: 09/11/2014] [Indexed: 10/24/2022]
Abstract
Reduced auditory P300 amplitude is a robust schizophrenia deficit exhibiting the qualities of a viable genetic endophenotype. These include heritability, test-retest reliability, and trait-like stability. Recent evidence suggests that P300 may also serve as a predictive biomarker for transition to psychosis during the schizophrenia prodrome. Historically, the utility of the P300 has been limited by its clinical nonspecificity, cross-site measurement variability, and required EEG expertise. The Consortium on the Genetics of Schizophrenia (COGS-2) study provided an opportunity to examine the consistency of the measure across multiple sites with varying degrees of EEG experience, and to identify important modulating factors that contribute to measurement variability. Auditory P300 was acquired from 649 controls and 587 patients at 5 sites. An overall patient deficit was observed with effect size 0.62. Each site independently observed a significant patient deficit, but site differences also existed. In patients, site differences reflected clinical differences in positive symptomatology and functional capacity. In controls, site differences reflected differences in racial stratification, smoking and substance use history. These factors differentially suppressed the P300 response, but only in control subjects. This led to an attenuated patient-control difference among smokers and among African Americans with history of substance use. These findings indicate that the P300 can be adequately assessed quantitatively, across sites, without substantial EEG expertise. Measurements are suitable for both genetic endophenotype analyses and studies of psychosis risk and conversion. However, careful attention must be given to selection of appropriate comparison samples to avoid misleading false negative results.
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Affiliation(s)
- Bruce I. Turetsky
- Department of Psychiatry, University of Pennsylvania, Philadelphia,
PA
| | - Erich M. Dress
- Department of Psychiatry, University of Pennsylvania, Philadelphia,
PA
| | - David L. Braff
- Department of Psychiatry, University of California San Diego, La
Jolla, CA,VISN-22 Mental Illness, Research, Education and Clinical Center
(MIRECC), VA San Diego Healthcare System
| | - Monica E. Calkins
- Department of Psychiatry, University of Pennsylvania, Philadelphia,
PA
| | - Michael F. Green
- Department of Psychiatry and Biobehavioral Sciences, Geffen School
of Medicine, University of California Los Angeles, Los Angeles, CA,VA Greater Los Angeles Healthcare System, Los Angeles, CA
| | | | - Raquel E. Gur
- Department of Psychiatry, University of Pennsylvania, Philadelphia,
PA
| | - Ruben C. Gur
- Department of Psychiatry, University of Pennsylvania, Philadelphia,
PA
| | - Laura C. Lazzeroni
- Department of Psychiatry and Behavioral Sciences, Stanford
University, Palo Alto, CA
| | - Keith H. Nuechterlein
- Department of Psychiatry and Biobehavioral Sciences, Geffen School
of Medicine, University of California Los Angeles, Los Angeles, CA
| | - Allen D. Radant
- Department of Psychiatry and Behavioral Sciences, University of
Washington, Seattle, WA,VA Puget Sound Health Care System, Seattle, WA
| | - Larry J. Seidman
- Department of Psychiatry, Harvard Medical School, Boston, MA,Massachusetts Mental Health Center Public Psychiatry Division of the
Beth Israel Deaconess Medical Center, Boston, MA
| | - Larry J. Siever
- Department of Psychiatry, The Mount Sinai School of Medicine, New
York, NY,James J. Peters VA Medical Center, New York, NY
| | - Jeremy M. Silverman
- Department of Psychiatry, The Mount Sinai School of Medicine, New
York, NY,James J. Peters VA Medical Center, New York, NY
| | - Joyce Sprock
- Department of Psychiatry, University of California San Diego, La
Jolla, CA
| | - William S. Stone
- Department of Psychiatry, Harvard Medical School, Boston, MA,Massachusetts Mental Health Center Public Psychiatry Division of the
Beth Israel Deaconess Medical Center, Boston, MA
| | - Catherine A. Sugar
- Department of Biostatistics, University of California Los Angeles
School of Public Health, Los Angeles, CA
| | - Neal R. Swerdlow
- Department of Psychiatry, University of California San Diego, La
Jolla, CA
| | - Debby W. Tsuang
- Department of Psychiatry and Behavioral Sciences, University of
Washington, Seattle, WA,VA Puget Sound Health Care System, Seattle, WA
| | - Ming T. Tsuang
- Department of Psychiatry, University of California San Diego, La
Jolla, CA,Center for Behavioral Genomics, and Institute for Genomic Medicine,
University of California SanDiego, La Jolla, CA,Harvard Institute of Psychiatric Epidemiology and Genetics, Boston,
MA
| | - Gregory Light
- Department of Psychiatry, University of California San Diego, La
Jolla, CA,VISN-22 Mental Illness, Research, Education and Clinical Center
(MIRECC), VA San Diego Healthcare System
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49
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Desrosiers NA, Ramaekers JG, Chauchard E, Gorelick DA, Huestis MA. Smoked cannabis' psychomotor and neurocognitive effects in occasional and frequent smokers. J Anal Toxicol 2015; 39:251-61. [PMID: 25745105 DOI: 10.1093/jat/bkv012] [Citation(s) in RCA: 92] [Impact Index Per Article: 10.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Δ9-Tetrahydrocannabinol (THC), the primary psychoactive constituent in cannabis, impairs psychomotor performance, cognition and driving ability; thus, driving under the influence of cannabis is a public safety concern. We documented cannabis' psychomotor, neurocognitive, subjective and physiological effects in occasional and frequent smokers to investigate potential differences between these smokers. Fourteen frequent (≥4x/week) and 11 occasional (<2x/week) cannabis smokers entered a secure research unit ∼19 h prior to smoking one 6.8% THC cigarette. Cognitive and psychomotor performance was evaluated with the critical tracking (CTT), divided attention (DAT), n-back (working memory) and Balloon Analog Risk (BART) (risk-taking) tasks at -1.75, 1.5, 3.5, 5.5 and 22.5 h after starting smoking. GLM (General Linear Model) repeated measures ANOVA was utilized to compare scores. Occasional smokers had significantly more difficulty compensating for CTT tracking error compared with frequent smokers 1.5 h after smoking. Divided attention performance declined significantly especially in occasional smokers, with session × group effects for tracking error, hits, false alarms and reaction time. Cannabis smoking did not elicit session × group effects on the n-back or BART. Controlled cannabis smoking impaired psychomotor function, more so in occasional smokers, suggesting some tolerance to psychomotor impairment in frequent users. These data have implications for cannabis-associated impairment in driving under the influence of cannabis cases.
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Affiliation(s)
- Nathalie A Desrosiers
- Chemistry and Drug Metabolism Section, Clinical Pharmacology and Therapeutic Research Branch, NIDA IRP, 251 Bayview Boulevard, Suite 200 Room 05A-721, Baltimore, MD 21224, USA Program in Toxicology, University of Maryland Baltimore, Baltimore, MD, USA
| | - Johannes G Ramaekers
- Department of Neuropsychology and Psychopharmacology, Faculty of Psychology and Neuroscience, Maastricht University, Maastricht, The Netherlands
| | - Emeline Chauchard
- Chemistry and Drug Metabolism Section, Clinical Pharmacology and Therapeutic Research Branch, NIDA IRP, 251 Bayview Boulevard, Suite 200 Room 05A-721, Baltimore, MD 21224, USA Present address: Laboratoire de Psychologie des Pays de la Loire, Faculté de Psychologie, Université de Nantes, Nantes, France
| | - David A Gorelick
- Chemistry and Drug Metabolism Section, Clinical Pharmacology and Therapeutic Research Branch, NIDA IRP, 251 Bayview Boulevard, Suite 200 Room 05A-721, Baltimore, MD 21224, USA Present address: Department of Psychiatry, University of Maryland School of Medicine, Baltimore, MD, USA
| | - Marilyn A Huestis
- Chemistry and Drug Metabolism Section, Clinical Pharmacology and Therapeutic Research Branch, NIDA IRP, 251 Bayview Boulevard, Suite 200 Room 05A-721, Baltimore, MD 21224, USA
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50
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Cannabis and creativity: highly potent cannabis impairs divergent thinking in regular cannabis users. Psychopharmacology (Berl) 2015; 232:1123-34. [PMID: 25288512 PMCID: PMC4336648 DOI: 10.1007/s00213-014-3749-1] [Citation(s) in RCA: 36] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/09/2014] [Accepted: 09/15/2014] [Indexed: 01/10/2023]
Abstract
RATIONALE Cannabis users often claim that cannabis has the potential to enhance their creativity. Research suggests that aspects of creative performance might be improved when intoxicated with cannabis; however, the evidence is not conclusive. OBJECTIVE The aim of this study was to investigate the acute effects of cannabis on creativity. METHODS We examined the effects of administering a low (5.5 mg delta-9-tetrahydrocannabinol [THC]) or high (22 mg THC) dose of vaporized cannabis vs. placebo on creativity tasks tapping into divergent (Alternate Uses Task) and convergent (Remote Associates Task) thinking, in a population of regular cannabis users. The study used a randomized, double-blind, between-groups design. RESULTS Participants in the high-dose group (n = 18) displayed significantly worse performance on the divergent thinking task, compared to individuals in both the low-dose (n = 18) and placebo (n = 18) groups. CONCLUSIONS The findings suggest that cannabis with low potency does not have any impact on creativity, while highly potent cannabis actually impairs divergent thinking.
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