Neuropsychological Performance in Long-term Cannabis Users | Adolescent Medicine | JAMA Psychiatry | JAMA Network
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Pope  HG  JrGruber  AJYurgelun-Todd  D The residual neuropsychological effects of cannabis.  Drug Alcohol Depend. 1995;3825- 34Google ScholarCrossref
Pope  HG  JrYurgelun-Todd  D The residual cognitive effects of heavy marijuana use in college students.  JAMA. 1996;275521- 527Google ScholarCrossref
Fletcher  JMPage  JBFrancis  DJCopeland  KNaus  MJDavis  CMMorris  RKrauskopf  DSatz  P Cognitive correlates of long-term cannabis use in Costa Rican men.  Arch Gen Psychiatry. 1996;531051- 1057Google ScholarCrossref
Struve  FAStraumanis  JJPatrick  GLeavitt  JManno  JEManno  BR Topographic quantitative EEG sequelae of chronic marihuana use.  Drug Alcohol Depend. 1999;56167- 179Google ScholarCrossref
Patrick  GStruve  FA Reduction of auditory P50 gating response in marihuana users: further supporting data.  Clin Electroencephalogr. 2000;3188- 93Google Scholar
Patrick  GStraumanis  JJStruve  FAFitz-Gerald  MJManno  JE Early and middle latency evoked potentials in medically and psychiatrically normal daily marihuana users.  Clin Electroencephalogr. 1997;2826- 31Google ScholarCrossref
Solowij  N Cannabis and Cognitive Functioning.  Cambridge, England Cambridge University Press1998;
Lyketsos  CGGarrett  ELiang  KYAnthony  JC Cannabis use and cognitive decline in persons under 65 years of age.  Am J Epidemiol. 1999;149794- 800Google ScholarCrossref
Struve  FAPatrick  GStraumanis  JJFitz-Gerald  MJManno  J Possible EEG sequelae of very long duration marihuana use.  Clin Electroencephalogr. 1998;2931- 36Google ScholarCrossref
First  MBSpitzer  RLGibbon  MWilliams  JBW Structured Clinical Interview for DSM-IV Axis I Disorders.  New York Biometrics Research Dept, New York State Psychiatric Institute1996;
Ward  MFWender  PHReimherr  FW The Wender Utah Rating Scale.  Am J Psychiatry. 1993;150885- 890Google Scholar
DuPaul  GJ Parent and teacher ratings of ADHD symptoms: psychometric properties in a community-based sample.  J Clin Child Psychol. 1991;20245- 253Google ScholarCrossref
Findling  RLSchwartz  MAFlannery  DJManos  MJ Venlafaxine in adults with attention-deficit/hyperactivity disorder.  J Clin Psychiatry. 1996;57184- 189Google Scholar
Hudson  JIPope  HG  JrJonas  JMYurgelun-Todd  DFrankenburg  FR A controlled family history study of bulimia.  Psychol Med. 1987;17883- 890Google ScholarCrossref
Huestis  MACone  EJ Differentiating new marijuana use from residual drug excretion in occasional marijuana users.  J Anal Toxicol. 1998;22445- 454Google ScholarCrossref
Wechsler  D Wechsler Adult Intelligence Scale–Revised Manual.  Cleveland, Ohio Psychological Corp1981;
Luria  A Higher Cortical Functions in Man.  New York, NY Basic Books1966;
Conners  CKMulti-Health Systems Staff, Conners' Continuous Performance Tests.  North Tonawanda, NY Multi-Health Systems Inc1995;
Weintraub  SMesulam  M-M Mental state assessment of young and elderly adults in behavioral neurology. Mesulam  M-Med. Principles of Behavioral Neurology. Philadelphia, Pa FA Davis Co1985;71- 123Google Scholar
Buschke  H Selective reminding for analyses of memory and learning.  J Verbal Learning Verbal Behav. 1973;12543- 550Google ScholarCrossref
Benton  AL The Revised Visual Retention Test. 4th ed. New York, NY Psychological Corp1974;
Heaton  R Wisconsin Card Sorting Test Manual.  Odessa, Fla Psychological Assessment Resources1981;
Wechsler  D A standardized memory scale for clinical use.  J Clin Psychol. 1945;1987- 95Google Scholar
Lezak  MD Neuropsychological Assessment. 3rd ed. New York, NY Oxford University Press1995;
MacLeod  CM Half a century of research on the Stroop effect: an integrative review.  Psychol Bull. 1991;109163- 203Google ScholarCrossref
Burke  HR Raven Progressive Matrices (1938): more on norms, reliability, and validity.  J Clin Psychol. 1985;41231- 235Google ScholarCrossref
Diggle  PJLiang  KYZeger  SL Analysis of Longitudinal Data.  Oxford, England Oxford University Press1994;
Not Available, Stata Statistical Software. Release 6.0. College Station, Tex StataCorp1999;
Pennington  BEOzonoff  S Executive functions and developmental psychopathology.  J Child Psychol Psychiatry. 1996;3751- 87Google ScholarCrossref
Barkley  RA Behavioral inhibition, sustained attention, and executive functions: constructing a unifying theory of ADHD.  Psychol Bull. 1997;12165- 94Google ScholarCrossref
Aronowitz  BLiebowitz  MHollander  EFazzini  EDurlach-Misteli  CFrenkel  MMosovich  SGarfinkel  RSaoud  JDelBene  D Neuropsychiatric and neuropsychological findings in conduct disorder and attention-deficit hyperactivity disorder.  J Neuropsychiatry Clin Neurosci. 1994;6245- 249Google Scholar
Lueger  RJGill  KJ Frontal-lobe cognitive dysfunction in conduct disorder adolescents.  J Clin Psychol. 1990;46696- 706Google Scholar
Gorenstein  EE Cognitive-perceptual deficit in an alcoholism spectrum disorder.  J Stud Alcohol. 1987;48310- 318Google Scholar
Morgan  ABLilienfeld  SO A meta-analytic review of the relation between antisocial behavior and neuropsychological measures of executive function.  Clin Psychol Rev. 2000;20113- 136Google ScholarCrossref
Kouri  EMPope  HG  JrLukas  SE Changes in aggressive behavior during withdrawal from long-term marijuana use.  Psychopharmacology. 1999;143302- 308Google ScholarCrossref
Haney  MWard  ASComer  SDFoltin  RWFischman  MW Abstinence symptoms following smoked marijuana in humans.  Psychopharmacology. 1999;141395- 404Google ScholarCrossref
Kouri  EMPope  HG  Jr Abstinence symptoms during withdrawal from chronic marijuana use.  Exp Clin Psychopharmacol. 2000;8483- 492Google ScholarCrossref
Levin  EDRezvani  AH Development of nicotinic drug therapy for cognitive disorders.  Eur J Pharmacol. 2000;393141- 146Google ScholarCrossref
Harrison  ERHaaga  JRichards  T Self-reported drug use data: what do they reveal?  Am J Drug Alcohol Abuse. 1993;19423- 441Google ScholarCrossref
Brown  JKranzler  HRDel Boca  FK Self-reports by alcohol and drug abuse inpatients: factors affecting reliability and validity.  Br J Addict. 1992;871013- 1024Google ScholarCrossref
Rouse  BAKozel  NJRichards  LG Self-Report Methods of Estimating Drug Use: Meeting Current Challenges to Validity.  Washington, DC Government Printing Office1985;National Institute on Drug Abuse Research Monograph 57
Original Article
October 2001

Neuropsychological Performance in Long-term Cannabis Users

Author Affiliations

From the Biological Psychiatry Laboratory, McLean Hospital, and the Department of Psychiatry, Harvard Medical School, Belmont, Mass (Drs Pope, Gruber, Hudson, and Yurgelun-Todd); and the Intramural Research Program, National Institute on Drug Abuse, Baltimore, Md (Dr Huestis).

Arch Gen Psychiatry. 2001;58(10):909-915. doi:10.1001/archpsyc.58.10.909

Background  Although cannabis is the most widely used illicit drug in the United States, its long-term cognitive effects remain inadequately studied.

Methods  We recruited individuals aged 30 to 55 years in 3 groups: (1) 63 current heavy users who had smoked cannabis at least 5000 times in their lives and who were smoking daily at study entry; (2) 45 former heavy users who had also smoked at least 5000 times but fewer than 12 times in the last 3 months; and (3) 72 control subjects who had smoked no more than 50 times in their lives. Subjects underwent a 28-day washout from cannabis use, monitored by observed urine samples. On days 0, 1, 7, and 28, we administered a neuropsychological test battery to assess general intellectual function, abstraction ability, sustained attention, verbal fluency, and ability to learn and recall new verbal and visuospatial information. Test results were analyzed by repeated-measures regression analysis, adjusting for potentially confounding variables.

Results  At days 0, 1, and 7, current heavy users scored significantly below control subjects on recall of word lists, and this deficit was associated with users' urinary 11-nor-9-carboxy-Δ9-tetrahydrocannabinol concentrations at study entry. By day 28, however, there were virtually no significant differences among the groups on any of the test results, and no significant associations between cumulative lifetime cannabis use and test scores.

Conclusion  Some cognitive deficits appear detectable at least 7 days after heavy cannabis use but appear reversible and related to recent cannabis exposure rather than irreversible and related to cumulative lifetime use.