Advertisement

Marijuana's Effects on Brain Structure and Function: What Do We Know and What Should We Do? A Brief Review and Commentary

Published:September 18, 2018DOI:https://doi.org/10.1016/j.amjmed.2018.09.006

      Abstract

      The recent US Food and Drug Administration approval of the marijuana constituent cannabidiol as safe and effective for treatment of 2 rare forms of epilepsy has raised hopes that others of the 500 chemicals in marijuana will be found to be therapeutic. However, the long-term consequences of street marijuana use are unclear, and recent studies raise red flags about its effects. Changes in brain maturation and intellectual function, including decreases in intelligence quotient, have been noted in chronic users and appear permanent in early users in most but not all studies. These studies suggest that at a minimum, regular marijuana use should be discouraged in individuals under the age of 21.

      Keywords

      To read this article in full you will need to make a payment

      Purchase one-time access:

      Academic & Personal: 24 hour online accessCorporate R&D Professionals: 24 hour online access
      One-time access price info
      • For academic or personal research use, select 'Academic and Personal'
      • For corporate R&D use, select 'Corporate R&D Professionals'

      Subscribe:

      Subscribe to The American Journal of Medicine
      Already a print subscriber? Claim online access
      Already an online subscriber? Sign in
      Institutional Access: Sign in to ScienceDirect

      References

        • Volkow ND
        • Baler RD
        • Compton WM
        • Weiss SR
        Adverse health effects of marijuana use.
        N Engl J Med. 2014; 370: 2219-2227
        • Grant I
        • Gonzalez R
        • Carey CL
        • Natarajan L
        • Wolfson T
        Non-acute (residual) neurocognitive effects of cannabis use: a meta-analytic study.
        J Int Neuropsychol Soc. 2003; 9: 679-689
        • Shreiner AM
        • Dunn ME
        Residual effects of cannabis use on neurocognitive performance after prolonged abstinence: a meta-analysis.
        Exp Clin Psychopharmacol. 2012; 20: 420-429
        • United Nations’ Office on Drugs and Crime, World Drug Report, Vienna 2016
        (Available at:)
        Date: 2018
        • Center for Behavioral Health Statistics and Quality (2015)
        Behavioral health trends in the United States: results of the 2014 National Survey on Drug Use and Health.
        (Available at:)
      1. National Institute on Drug Abuse: Advancing Addiction Science. Monitoring the Future survey: high school and youth trends. Available at: www.drugabuse.gov/publications/drugfacts/high-school-youth-trends. Accessed September 5, 2018.

      2. Substance Abuse and Mental Health Administration. Center for Behavioral Health Statistics and Quality, National Survey on Drug Use and Health, 2015 and 2016. Available at: https://www.samhsa.gov/data/sites/default/files/NSDUH-FFR1-2016/NSDUH-FFR1-2016.htm. Accessed September 5, 2018.

        • Weir K
        Marijuana and the developing brain.
        Am Psychol. 2015; 46: 48
        • Harrison G
        • Pope Jr, HG
        • Yurgelun-Todd D
        The residual cognitive effects of heavy marijuana use in college students.
        JAMA. 1996; 275: 521-527
        • American Psychiatric Association
        Diagnostic and statistical manual of mental disorders.
        5th ed. American Psychiatric Publishing, Arlington, VA2013
        • Jensen FE
        • Nutt AE
        The Teenage Brain: A Neuroscientist's Survival Guide to Raising Adolescents and Young Adults. Chapter 9,.
        HarperCollins Publishers, New York, NY2015: 141-158
        • Leirer VO
        • Yesavage JA
        • Morrow DG
        Marijuana carry-over effects on air craft pilot performance.
        Aviat Space Environ Med. 1991; 62: 221-227
        • Leggett T
        United Nations Office on Drugs and Crime. A review of the world cannabis situation.
        Bull Narc. 2006; 58: 1-155
        • Rogeberg O
        • Elvik R
        The effects of cannabis intoxication on motor vehicle collision revisited and revised.
        Addiction. 2016; 111: 1348-1359
        • Murray RM
        • Morrison PD
        • Henquet C
        • Di Forti M
        Cannabis, the mind and society: the harsh realities.
        Nat Rev Neurosci. 2007; 8: 885-895
      3. Pope HG Jr, Gruber AJ, Hudson JI, et al. Early-onset cannabis use and cognitive defects: what is the nature of the association? Drug Alcohol Depend. 2003;69:303–310.

        • Gruber SA
        • Sagar KA
        • Dahlgren MK
        Age of onset of marijuana use and executive function.
        Psychol Addict Behav. 2012; 26: 496-506
        • Winters KC
        • Arria AM
        Adolescent brain development and drugs.
        Prev Res. 2011; 18: 21-24
        • Meier MH
        • Caspi A
        • Ambler A
        • et al.
        Persistent cannabis users show neuropsychological decline from childhood to midlife.
        Proc Natl Acad Sci U S A. 2012; 109: E2657-E2664
        • Giedd JN
        Structural magnetic resonance imaging of the adolescent brain.
        Ann NY Acad Sci. 2004; 1021: 77-85
        • Gogtay N
        • Giedd JN
        • Lusk L
        • et al.
        Dynamic mapping of human cortical development during childhood through early adulthood.
        Proc Natl Acad Sci U S A. 2004; 101: 8174-8179
        • Squeglia LM
        • Jacobus J
        • Tapert SF
        The influence of substance use on adolescent brain development.
        Clin EEG Neurosci. 2009; 40: 31-38
        • Ladouceur CD
        • Peper JS
        • Crone EA
        • Dahl RE
        White matter development in adolescence: the influence of puberty and implications for affective disorders.
        Dev Cogn Neurosci. 2012; 2: 36-54
        • Meruelo AD
        • Castro N
        • Cota CI
        • et al.
        Cannabis and alcohol use, and the developing brain.
        Behav Brain Res. 2017; 325: 44-50
        • Jager G
        • Ramsey NF
        Long-term consequences of adolescent cannabis exposure on the development of cognition, brain structure and function: an overview of animal and human research.
        Curr Drug Abuse Rev. 2008; 1: 114-123
        • ElSohly HN
        • ElSohly MA
        Marijuana smoke condensate: chemistry and pharmacology.
        in: ElSohly MA Marijuana and Cannabinoids. Humana Press, New York, NY2007: 67-97
        • Atakan Z.
        Cannabis, a complex plant: different compounds and different effect on individuals.
        Ther Adv Psychopharmacol. 2012; 2: 241-254
        • Elsohly MA
        • Mehmedic Z
        • Foster S
        • et al.
        Changes in cannabis potency over the last 2 decades (1995-2014): analysis of current data in the United States.
        Biol Psychiatry. 2016; 79: 613-619
      4. National Institute on Drug Abuse. Marijuana. Available at:https://www.drugabuse.gov/publications/research-reports/marijuana/what-are-effects-secondhand-exposure-to-marijuana-smoke. Accessed September 5, 2018.

        • Herkenham M
        • Lynn AB
        • Little MD
        • et al.
        Cannabinoid receptor location in the brain.
        Proc Natl Acad Sci U S A. 1990; 87: 1932-1936
        • Hall W
        • Degenhardt L
        Adverse effects of non-medical cannabis use.
        Lancet. 2009; 372: 1383-1391
        • Manzaneres J
        • Julian MD
        • Carrascosa A
        Role of the cannabinoid system in pain control and therapeutic implications for the management of acute and chronic pain episodes.
        Curr Neuropharmacol. 2006; 4: 239-257
        • Schweinsburg AD
        • Brown SA
        • Tapert SF
        The influence of marijuana use on neurocongnitive functioning in adolescents.
        Curr Drug Abuse Rev. 2008; 1: 99-111
        • Pope Jr HG
        • Yurgelun-Todd D
        The residual cognitive effects of heavy marijuana use in college students.
        JAMA. 1996; 275: 521-527
        • Solowij N
        • Stephens RS
        • Roffman RA
        • et al.
        Cognitive functioning of long-term heavy cannabis users seeking treatment.
        JAMA. 2002; 287: 1123-1131
        • Camchong J
        • Lim KO
        • Kumra S
        Adverse effects of cannabis on adolescent brain development: a longitudinal study.
        Cerebral Cortex. 2017; 27: 1922-1930
        • Mizrahi R
        • Watts JJ
        • Tseng KY
        Mechanisms contributing to cognitive deficits in cannabis users.
        Neuropharmacology. 2017; 124: 84-88
        • Lawston J
        • Borella A
        • Robinson JK
        • Whitaker-Azmitia PM
        Changes in hippocampal morphology following chronic treatment with the synthetic cannabinoid WIN 55,212-2. 2000.
        Brain Res. 2000; 877: 407-410
        • Lyons MJ
        • Bar JL
        • Panizzon MS
        • et al.
        Neuropsychological consequences of regular marijuana use: A twin study.
        Psychol Med. 2004; 34: 1239-1250
        • Jackson NJ
        • Isen JD
        • Khoddam R
        • et al.
        Impact of adolescent marijuana use on intelligence: results from two longitudinal twin studies.
        Proc Natl Acad Sci U S A. 2016; 113: E500-E508
        • Kuepper R
        • van Os J
        • Lieb R
        • Wittchen HU
        • Höfler M
        • Henquet C
        Continued cannabis use and risk of incidence and persistence of psychotic symptoms: 10 year follow-up cohort study.
        BMJ. 2016; 342: d738
      5. Collaborative Research on Addiction at NIH. Adolescent Brain Cognitive Development Study. Available at: https://addictionresearch.nih.gov/abcd-study. Accessed September 5, 2018.

      6. Adolescent Brain Cognitive Development. Teen brains. Today's Science. Brighter Future. Available at: https://abcdstudy.org/about.html. Accessed September 5, 2018.

        • Broyd SJ
        • Van Hell HH
        • Beale C
        • Yücel M
        • Solowij N
        Acute and chronic effects of cannabinoids on human cognition-a systematic review.
        Biol Psychiatry. 2016; 79: 557-567
        • Nader DA
        • Sanchez ZM
        Effects of regular cannabis use on neurocognition, brain structure and function: a systematic review of findings in adults.
        Am J Drug Alcohol Abuse. 2017; 12: 1-15
      7. Substance Abuse and Mental Health Services Administration. Screening, Brief Intervention, and Referral to Treatment (SBIRT). Available at: https://www.samhsa.gov/sbirt. Accessed September 5, 2018.

        • Bostwick JM
        Blurred boundaries: the therapeutics and politics of medical marijuana.
        Mayo Clinic Proc. 2012; 87: 172-186