Effects of Chronic, Heavy Cannabis Use on Executive Functions

The Scripps Research Institute
Journal of Addiction Medicine (Impact Factor: 1.76). 03/2011; 5(1):9-15. DOI: 10.1097/ADM.0b013e31820cdd57
Source: PubMed


This case describes the clinical course of a cannabis-dependent individual entering a 12-week abstinence-based research program. The case illustrates the effects of chronic, heavy cannabis use on executive functions at three time points: 1) 24 hours of abstinence; 2) 4 weeks of abstinence; and 3) 12 weeks of abstinence. It is followed by discussions by two clinical psychologists and a psychiatrist. The findings described here have important clinical implications, as executive functions have a vital role in treatment participation and in sustaining recovery. It should be of particular interest to clinicians who work with people with cannabis use disorders.

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Available from: Natania A Crane
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    • "The chronic use of cannabis has been associated with a range of cognitive impairments, including impairments in learning, memory , and executive functions (Crean et al., 2011; Ranganathan and D'Souza, 2006), with a dose–response relationship between chronicity of cannabis consumption and deterioration in these cognitive domains (Messinis et al., 2006). While there remains equivocation regarding the specific nature of the executive function impairments in the cannabis-using population (Grant et al., 2002) – likely due to diverse methodologies and measures employed (Verdejo-García et al., 2004) – there is more consistent evidence of impairments in learning (see Solowij and Battisti, 2008 for a review). "
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    ABSTRACT: The chronic use of cannabis has been associated with error processing dysfunction, in particular, hypoactivity in the dorsal anterior cingulate cortex (dACC) during the processing of cognitive errors. Given the role of such activity in influencing post-error adaptive behaviour, we hypothesised that chronic cannabis users would have significantly poorer learning from errors. Fifteen chronic cannabis users (four females, mean age=22.40 years, SD=4.29) and 15 control participants (two females, mean age=23.27 years, SD=3.67) were administered a paired associate learning task that enabled participants to learn from their errors, during fMRI data collection. Compared with controls, chronic cannabis users showed (i) a lower recall error-correction rate and (ii) hypoactivity in the dACC and left hippocampus during the processing of error-related feedback and re-encoding of the correct response. The difference in error-related dACC activation between cannabis users and healthy controls varied as a function of error type, with the control group showing a significantly greater difference between corrected and repeated errors than the cannabis group. The present results suggest that chronic cannabis users have poorer learning from errors, with the failure to adapt performance associated with hypoactivity in error-related dACC and hippocampal regions. The findings highlight a consequence of performance monitoring dysfunction in drug abuse and the potential consequence this cognitive impairment has for the symptom of failing to learn from negative feedback seen in cannabis and other forms of dependence. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.
    Full-text · Article · Jul 2015 · Drug and alcohol dependence
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    • "This is of particular concern given the vulnerability of the adolescent brain to neurotoxic exposures such as alcohol and drugs (Hurd et al., 2014). Although the perception of the addictiveness and risk is low, there is clear evidence to support a relationship between cannabis use and poor medical, neurocognitive, functional, and psychosocial problems (Crean et al., 2011). Cannabis use during adolescence has been associated with an elevated risk of later problematic use of illicit drugs, impaired mental health and neurocognitive functioning, lower intelligence quotient, risky behavior, and criminal offenses (Copeland and Swift, 2009; Ehlers et al., 2010; Meier et al., 2012; National Institute on Drug Abuse, 2012). "
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    ABSTRACT: Background: Withdrawal, a diagnostic indicator of cannabis use disorder, is often minimized or ignored as a consequence of cannabis use, particularly among adolescents. This study aims to characterize cannabis withdrawal among adolescents in outpatient treatment for substance use disorder and evaluate the clinical significance of withdrawal as a predictor of substance-related outcomes. Methods: Adolescent outpatients (N = 127) reporting cannabis as their drug of choice (n = 90) were stratified by the presence of withdrawal and compared on demographic and clinical variables at treatment intake. Hierarchical linear models compared the effect of withdrawal on percentage days abstinent (PDA) and related outcomes over a 1-year follow-up period. Results: Adolescents reporting withdrawal (40%) were more likely to meet criteria for cannabis dependence, have higher levels of substance use severity, report more substance-related consequences, and have a mood disorder. Withdrawal was not associated with PDA over the follow-up period; however, this relationship was moderated by problem recognition such that adolescents reporting withdrawal and a drug problem improved at a greater rate with respect to PDA than those who did not recognize a problem with drugs and did not report withdrawal. Discussion: Withdrawal is common among adolescent outpatients and is associated with a more clinically severe profile. In this sample, all adolescents reporting withdrawal met criteria for cannabis dependence, suggesting that withdrawal is a highly specific indicator of cannabis use disorder. Although withdrawal does not seem to be independently associated with substance use outcomes posttreatment, moderating factors such as drug problem recognition should be taken into account when formulating treatment and continuing care plans.
    Full-text · Article · Aug 2014 · Journal of Addiction Medicine
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    ABSTRACT: Rationale: The error-related negativity (ERN) is a negative event-related potential that occurs immediately after an erroneous response and is thought to reflect human performance monitoring. Delta-9-Tetrahydrocannabinol (THC) administration in healthy volunteers has been linked to impaired performance monitoring in behavioral studies, but to date no studies have examined the effects of cannabinoids on the ERN. Methods: EEG data from 10 healthy volunteers was recorded during execution of a speeded choice-reaction-time task (Flankers task) after administration of THC or placebo vapor in a double-blind randomized crossover design. Results: The findings of this study show that the ERN was significantly reduced after administration of THC. The behavioral outcomes on the Flankers task showed no indications of drug-induced impairments. Discussion: The diminished ERN reflects impairments in the process of performance monitoring. The task design was not optimized to find behavioral effects. The study shows that cannabinoids impair performance monitoring.
    Full-text · Article · Sep 2011 · Frontiers in Behavioral Neuroscience
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