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Cannabis Use, Age of Initiation, and Neurocognitive Performance: Findings from a Large Sample of Heavy Drinking Emerging Adults

Published online by Cambridge University Press:  15 July 2021

Melissa Parlar ,
Emily MacKillop ,
Tashia Petker ,
James Murphy  and
James MacKillop Open the ORCID record for James MacKillop [Opens in a new window]
Melissa Parlar
Affiliation:
Clinical Neuropsychology Service, St. Joseph’s Healthcare, Hamilton, Ontario, L8N 3K7, Canada Peter Boris Centre for Addictions Research, St. Joseph’s Healthcare, Hamilton, Ontario, L8N 3K7, Canada Department of Psychology, York University, Toronto, Ontario, M3J 1P3, Canada
Emily MacKillop
Affiliation:
Clinical Neuropsychology Service, St. Joseph’s Healthcare, Hamilton, Ontario, L8N 3K7, Canada Department of Psychiatry and Behavioral Neurosciences, McMaster University, Hamilton, Ontario, L8S 4L8, Canada
Tashia Petker
Affiliation:
Peter Boris Centre for Addictions Research, St. Joseph’s Healthcare, Hamilton, Ontario, L8N 3K7, Canada Department of Psychiatry and Behavioral Neurosciences, McMaster University, Hamilton, Ontario, L8S 4L8, Canada
James Murphy
Affiliation:
Department of Psychology, University of Memphis, Memphis, Tennessee, 38152, USA
James MacKillop*
Affiliation:
Peter Boris Centre for Addictions Research, St. Joseph’s Healthcare, Hamilton, Ontario, L8N 3K7, Canada Department of Psychiatry and Behavioral Neurosciences, McMaster University, Hamilton, Ontario, L8S 4L8, Canada Michael G. DeGroote Centre for Medicinal Cannabis Research, St. Joseph’s Healthcare Hamilton and McMaster University, Hamilton, Ontario, L8N 3K7, Canada Homewood Research Institute, Guelph, Ontario, N1E 6K9, Canada
*
*Correspondence and reprint requests to: Dr. James MacKillop, Peter Boris Centre for Addictions Research, St. Joseph’s Healthcare, 100 West 5th Street, Hamilton, Ontario, Canada. Fax: +1 905-575-6085x39492. E-mail: [email protected]
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Abstract

Objective:

To evaluate the associations between cannabis use and neurocognitive functioning, including self-reported attention deficit hyperactivity disorder (ADHD) symptoms, in a large sample of emerging adults (ages 21–25) using a cross-sectional design. A secondary objective was to examine age of cannabis initiation as a moderator.

Methods:

Participants were high-risk drinking emerging adults (n = 598) reporting past-month cannabis use in the following categories: 1) non-users (i.e., never or not in the past month; n = 276), 2) occasional users (i.e., monthly or weekly users; n = 201), and 3) daily users (n = 121). Categorical comparisons were conducted on working memory, attention, behavioral inhibition, delay and probability discounting, verbal intelligence, and ADHD symptoms. Complementary dimensional analyses examined cannabis severity in relation to neurocognition using regressions. Covariates were age, race, sex, income, years of education, tobacco use, and alcohol use.

Results:

Frequency of cannabis use was significantly associated with poorer working memory performance, more impulsive delay discounting, and greater endorsement of ADHD symptoms, but not other domains. Effect sizes were small and poorer performance was selectively present among daily, not occasional, cannabis users. Earlier age of initiation was not independently or interactively associated with neurocognitive performance.

Conclusions:

Daily cannabis use was selectively adversely associated with aspects of memory, impulsivity, and subjective attentional functioning, but most cognitive indicators were not implicated, and evidence of amplification by earlier age of initiation was not observed. Ascertaining causal versus consequential roles of cannabis in neurocognitive functioning is an important priority.

Keywords

CannabisMarijuanaMemoryCognitionImpulsivityAttention deficit/hyperactivityDisorderAge of first use
Type
Regular Research
Information
Journal of the International Neuropsychological Society , Volume 27 , Special Issue 6: Clarifying the Complexities of Cannabis and Cognition , July 2021 , pp. 533 - 545
Copyright
Copyright © INS. Published by Cambridge University Press, 2021

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References

REFERENCES

Adamson, S.J., Kay-Lambkin, F.J., Baker, A.L., Lewin, T.J., Thornton, L., Kelly, B.J., & Sellman, J.D. (2010). An improved brief measure of cannabis misuse: The Cannabis Use Disorders Identification Test-Revised (CUDIT-R). Drug and Alcohol Dependence, 110(1–2), 137–143. https://doi.org/10.1016/j.drugalcdep.2010.02.017 CrossRefGoogle Scholar
Amlung, M., Vedelago, L., Acker, J., Balodis, I., & MacKillop, J. (2017). Steep delay discounting and addictive behavior: a meta-analysis of continuous associations. Addiction, 112(1), 51–61. https://doi.org/10.1111/add.13535 CrossRefGoogle ScholarPubMed
Artigas, M.S., Sanchez-Mora, C., Rovira, P., Richarte, V., Garcia-Martinez, I., Pagerols, M., & Ribases, M. (2020). Attention-deficit/hyperactivity disorder and lifetime cannabis use: genetic overlap and causality. Molecular Psychiatry, 25, 2493–2503. doi: 10.1038/s41380-018-0339-3 CrossRefGoogle Scholar
Batalla, A., Lorenzetti, V., Chye, Y., Yücel, M., Soriano-Mas, C., Bhattacharyya, S., … Martín-Santos, R. (2018). The Influence of DAT1, COMT, and BDNF Genetic Polymorphisms on Total and Subregional Hippocampal Volumes in Early Onset Heavy Cannabis Users. Cannabis and Cannabinoid Research, 3(1), 1–10. https://doi.org/10.1089/can.2017.0021 CrossRefGoogle ScholarPubMed
Brière, F.N., Fallu, J.S., Descheneaux, A., & Janosz, M. (2011). Predictors and consequences of simultaneous alcohol and cannabis use in adolescents. Addictive Behaviors, 36(7), 785–788. https://doi.org/10.1016/j.addbeh.2011.02.012 CrossRefGoogle ScholarPubMed
Broyd, S.J., Van Hell, H.H., Beale, C., Yücel, M., & Solowij, N. (2016). Acute and chronic effects of cannabinoids on human cognition - A systematic review. Biological Psychiatry, 79(7), 557–567. https://doi.org/10.1016/j.biopsych.2015.12.002 CrossRefGoogle ScholarPubMed
Collins, R. L., Parks, G. A., & Marlatt, G. A. (1985). Social determinants of alcohol consumption: the effects of social interaction and model status on the self-administration of alcohol. Journal of Consulting and Clinical Psychology, 53(2), 189–200. doi: 10.1037//0022-006x.53.2.189.CrossRefGoogle ScholarPubMed
Ganzer, F., Bröning, S., Kraft, S., Sack, P.M., & Thomasius, R. (2016). Weighing the evidence: A systematic review on long-term neurocognitive effects of cannabis use in abstinent adolescents and adults. Neuropsychology Review, 26(2), 186–222. https://doi.org/10.1007/s11065-016-9316-2 CrossRefGoogle ScholarPubMed
Greiffenstein, M.F., Baker, W.J., & Gola, T. (1994). Validation of malingered amnesia measures with a large clinical sample. Psychological Assessment, 6(3), 218–224. https://doi.org/10.1037/1040-3590.6.3.218 CrossRefGoogle Scholar
Gruber, S.A., Dahlgren, M.K., Sagar, K.A., Gönenç, A., & Lukas, S.E. (2014). Worth the wait: Effects of age of onset of marijuana use on white matter and impulsivity. Psychopharmacology, 231(8), 1455–1465. https://doi.org/10.1007/s00213-013-3326-z CrossRefGoogle ScholarPubMed
Gruber, S.A., Sagar, K.A., Dahlgren, M.K., Racine, M., & Lukas, S.E. (2012). Age of onset of marijuana use and executive function. Psychology of Addictive Behaviors, 26(3), 496–506. https://doi.org/10.1037/a0026269 CrossRefGoogle ScholarPubMed
Harvey, M.A, Sellman, J.D., Porter, R.J., & Frampton, C.M. (2009). The relationship between non-acute adolescent cannabis use and cognition. Drug and Alcohol Review, 26(3), 309–319. doi: 10.1080/09595230701247772 CrossRefGoogle Scholar
Kessler, R.C., Adler, L., Ames, M., Demler, O., Faraone, S., Hiripi, E., … Walters, E.E. (2005). The World Health Organization adult ADHD self-report scale (ASRS): A short screening scale for use in the general population. Psychological Medicine, 35(2), 245–256. https://doi.org/10.1017/S0033291704002892 CrossRefGoogle Scholar
Koffarnus, M.N., & Bickel, W.K. (2014). A 5-trial adjusting delay discounting task: Accurate discount rates in less than one minute. Experimental and Clinical Psychopharmacology, 22(3), 222–228. https://doi.org/10.1037/a0035973 CrossRefGoogle ScholarPubMed
Liddle, P.F., Kiehl, K.A., & Smith, A.M. (2001). Event-related fMRI study of response inhibition. Human Brain Mapping, 12(2), 100–109. https://doi.org/10.1002/1097-0193(200102)12:2<100:AID-HBM1007>3.0.CO;2-6 3.0.CO;2-6>CrossRefGoogle ScholarPubMed
Loflin, M., Earleywine, M., De Leo, J., & Hobkirk, A. (2014). Subtypes of attention deficit-hyperactivity disorder (ADHD) and cannabis use. Substance Use and Misuse, 49(4), 427–434. https://doi.org/10.3109/10826084.2013.841251 CrossRefGoogle ScholarPubMed
MacKillop, J., Amlung, M.T., Few, L.R., Ray, L.A., Sweet, L.H., & Munafo, M.R. (2011). Delayed reward discounting and addictive behaviour: A meta-analysis. Psychopharmacology (Berl), 216, 305–321.CrossRefGoogle ScholarPubMed
Meier, M.H., Caspi, A., Danese, A., Fisher, H.L., Houts, R., Arseneault, L., & Moffitt, T.E. (2018). Associations between adolescent cannabis use and neuropsychological decline: a longitudinal co-twin control study. Addiction, 113, 257–265. doi: 10.1111/add.13946 CrossRefGoogle ScholarPubMed
Notzon, D.P., Pavlicova, M., Glass, A., Mariani, J.J., Mahony, A.L., Brooks, D.J., & Levin, F.R. (2016). ADHD is highly prevalent in patients seeking treatment for cannabis use disorders. Journal of Attention Disorders, 24(11), 1487–1492. https://doi.org/10.1177/1087054716640109 CrossRefGoogle ScholarPubMed
Owens, M. M., McNally, S., Petker, T., Amlung, M. T., Balodis, I. M., Sweet, L. H., & Mackillop, J. (2019). Urinary tetrahydrocannabinol is associated with poorer working memory performance and alterations in associated brain activity. Neuropsychopharmacology, 44(3), 613–619. doi: 10.1038/s41386-018-0240-4 CrossRefGoogle ScholarPubMed
Pape, H., Rossow, I., & Storvoll, E.E. (2009). Under double influence: Assessment of simultaneous alcohol and cannabis use in general youth populations. Drug and Alcohol Dependence, 101(1–2), 69–73. https://doi.org/10.1016/j.drugalcdep.2008.11.002 CrossRefGoogle ScholarPubMed
Petker, T., DeJesus, J., Lee, A., Gillard, J., Owens, M.M., Balodis, I., & Mackillop, J. (2020). Cannabis use, cognitive performance, and symptoms of attention deficit/hyperactivity disorder in community adults. Experimental and Clinical Psychopharmacology. doi: 10.1037/pha0000354 CrossRefGoogle ScholarPubMed
Petker, T., Owens, M. M., Amlung, M. T., Oshri, A., Sweet, L. H., & MacKillop, J. (2019). Cannabis involvement and neuropsychological performance: findings from the Human Connectome Project. Journal of Psychiatry & Neuroscience, 44(6), 414–422. doi: 10.1503/jpn.180115 CrossRefGoogle ScholarPubMed
Pope, H.G., Gruber, A.J., Hudson, J.I., Cohane, G., Huestis, M.A., & Yurgelun-Todd, D. (2003). Early-onset cannabis use and cognitive deficits: What is the nature of the association? Drug and Alcohol Dependence, 69(3), 303–310. https://doi.org/10.1016/S0376-8716(02)00334-4 CrossRefGoogle ScholarPubMed
Power, E., Sabherwal, S., Healy, C., O’ Neill, A., Cotter, D., & Cannon, M. (2021). Intelligence quotient decline following frequent or dependent cannabis use in youth: a systematic review and meta-analysis of longitudinal studies. Psychological Medicine, 27, 1–7. doi: 10.1017/S0033291720005036 Google Scholar
Ramaekers, J.G., Kauert, G., Theunissen, E.L., Toennes, S.W., & Moeller, M.R. (2009). Neurocognitive performance during acute THC intoxication in heavy and occasional cannabis users. Journal of Psychopharmacology, 23(3), 266–277. https://doi.org/10.1177/0269881108092393 CrossRefGoogle ScholarPubMed
Ramesh, D., Haney, M., & Cooper, Z.D. (2013). Marijuana’s dose-dependent effects in daily marijuana smokers. Experimental and Clinical Psychopharmacology, 21(4), 287–293. https://doi.org/10.1037/a0033661 CrossRefGoogle ScholarPubMed
Ross, J.M., Ellingson, J.M., Rhee, S.H., Hewitt, J.K., Corley, R.P., Lessem, J.M., & Friedman, N.P. (2020). Investigating the causal effect of cannabis use on cognitive function with a quasi-experimental co-twin design. Drug Alcohol Dependence, 206, 107712. doi: 10.1016/j.drugalcdep.2019.107712 CrossRefGoogle ScholarPubMed
Sagar, K.A., Dahlgren, M.K., Gönenç, A., Racine, M.T., Dreman, M.W., & Gruber, S.A. (2015). The impact of initiation: Early onset marijuana smokers demonstrate altered Stroop performance and brain activation. Developmental Cognitive Neuroscience, 16, 84–92. https://doi.org/10.1016/j.dcn.2015.03.003 CrossRefGoogle ScholarPubMed
Schuster, R.M., Gilman, J., Schoenfeld, D., Evenden, J., Hareli, M., Ulysse, C., … Evins, A.E. (2018). One month of cannabis abstinence in adolescents and young adults is associated with improved memory. Journal of Clinical Psychiatry, 79(6). https://doi.org/10.4088/JCP.17m11977 Google Scholar
Schwope, D.M., Bosker, W.M., Ramaekers, J.G., Gorelick, D.A., & Huestis, M.A. (2012). Psychomotor performance, subjective and physiological effects and whole blood Δ9-tetrahydrocannabinol concentrations in heavy, chronic cannabis smokers following acute smoked cannabis. Journal of Analytical Toxicology, 36(6), 405–412. https://doi.org/10.1093/jat/bks044 CrossRefGoogle ScholarPubMed
Scott, J.C., Slomiak, S.T., Jones, J.D., Rosen, A.F.G., Moore, T.M., & Gur, R.C. (2018). Association of cannabis with cognitive functioning in adolescents and young adults. JAMA Psychiatry, 75(6), 585–595. https://doi.org/10.1001/jamapsychiatry.2018.0335 CrossRefGoogle ScholarPubMed
Shipley, W.C. (2009). Shipley-2: Manual. Western Psychological Services, Torrance, CA.Google Scholar
Sofis, M.J., Budney, A.J., Stanger, C., Knapp, A.A., & Borodovsky, J.T. (2020). Greater delay discounting and cannabis coping motives are associated with more frequent cannabis use in a large sample of adult cannabis users. Drug and Alcohol Dependence, 207, 107820. https://doi.org/10.1016/j.drugalcdep.2019.107820 CrossRefGoogle Scholar
Squeglia, L.M., & Gray, K.M. (2016). Alcohol and drug use and the developing brain. Current Psychiatry Reports, 18(5), 46. doi: 10.1007/s11920-016-0689-y CrossRefGoogle ScholarPubMed
Strickland, J.C., Lee, D.C., Vandrey, R., & Johnson, M.W. (2020). A systematic review and meta-analysis of delay discounting and cannabis use. Experimental and Clinical Psychopharmacology. https://doi.org/10.1037/pha0000378 CrossRefGoogle ScholarPubMed
Subbaraman, M.S., & Kerr, W.C. (2015). Simultaneous versus concurrent use of alcohol and cannabis in the national alcohol survey. Alcoholism: Clinical and Experimental Research, 39(5), 872–879. https://doi.org/10.1111/acer.12698 CrossRefGoogle ScholarPubMed
Tabachnick, B.G., & Fidell, L.S. (2001). Using Multivariate Statistics (4th ed). Using Multivariate Statistics. New York: Pearson.Google Scholar
Terry-McElrath, Y.M., O’Malley, P.M., & Johnston, L.D. (2014). Alcohol and marijuana use patterns associated with unsafe driving among U.S. high school seniors: High use frequency, concurrent use, and simultaneous use. Journal of Studies on Alcohol and Drugs, 75(3), 378–389. https://doi.org/10.15288/jsad.2014.75.378 CrossRefGoogle ScholarPubMed
Terry-McElrath, Y.M., O’Malley, P.M., Johnston, L.D., Bray, B.C., Patrick, M.E., & Schulenberg, J.E. (2017). Longitudinal patterns of marijuana use across ages 18–50 in a US national sample: A descriptive examination of predictors and health correlates of repeated measures latent class membership. Drug and Alcohol Dependence, 171, 70–83. https://doi.org/10.1016/j.drugalcdep.2016.11.021 CrossRefGoogle Scholar
Thames, A.D., Arbid, N., & Sayegh, P. (2014). Cannabis use and neurocognitive functioning in a non-clinical sample of users. Addictive Behaviors, 39(5), 994–999. https://doi.org/10.1016/j.addbeh.2014.01.019 CrossRefGoogle Scholar
United Nations Office on Drug and Crime (2017). Annual Prevalence of Drug Use. https://dataunodc.un.org/drugs/prevalence_table-2017 Google Scholar
Van de Glind, G., Van Emmerik-van Oortmerssen, K., Carpentier, P.J., Levin, F.R., Koeter, M.W.J., Barta, C., … van den Brink, W. (2013). The International ADHD in Substance Use Disorders Prevalence (IASP) study: Background, methods and study population. International Journal of Methods in Psychiatric Research, 22(3), 232–244. https://doi.org/10.1002/mpr.1397 CrossRefGoogle ScholarPubMed
World Health Organization (2016). Cannabis. https://www.who.int/teams/mental-health-and-substance-use/alcohol-drugs-and-addictive-behaviours/drugs-psychoactive/cannabis Google Scholar
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