Intellectual, neurocognitive, and academic achievement in abstinent adolescents with cannabis use disorder

Abstract

Rationale The active component of cannabis, delta-9 tetrahydrocannabinol (THC), has a long half-life and widespread neurocognitive effects. There are inconsistent reports of neurocognitive deficits in adults and adolescents with cannabis use disorders (CUD), particularly after a period of abstinence. Objectives To examine neurocognitive measures (IQ, academic achievement, attention, memory, executive functions) in abstinent adolescents with CUD, while controlling for demographic, psychopathology, and poly-substance confounders. Methods We investigated neurocognitive performance in three groups: adolescents with CUD after successful first treatment and in full remission (n=33); controls with psychiatric disorders without substance use disorder history (n=37); and healthy adolescents (n=43). Results Adolescents with psychiatric disorders, regardless of CUD status, performed significantly worse than the healthy adolescents in academic achievement. No group differences were seen in IQ, attention, memory, or executive functions. Lower academic achievement was positively associated with younger age of CUD onset, regular cannabis use, and maximum daily use. In the CUD group, lifetime nicotine use episodes were negatively associated with IQ. Lower overall neurocognitive function was associated with younger age of onset of regular cannabis use and relapse within the one year follow-up. Conclusions Verifiably abstinent adolescents with CUD history did not differ from the two comparison groups, suggesting that previously reported neurocognitive deficits may be related to other factors, including residual drug effects, pre-existing cognitive deficits, concurrent use of other substances (e.g., nicotine), or psychopathology. Adolescents with CUD may not be vulnerable to THC neuropsychological deficits once they achieve remission from all drugs for at least 30 days.

Acute and Chronic Effects of Cannabinoids on Human Cognition—A Systematic Review

“…Numerous studies report impairment in adolescent and adult cannabis users with a wide range of exposure as well as former users abstinent for several weeks on measures of sustained and divided attention, processing speed, rapid visual information processing, visual search, tracking, trail making, and paced serial addition (46,54,55,57,61,(91)(92)(93)(94). Users abstinent for 23 days remained impaired relative to control subjects despite improvements in sustained and divided attention with increasing abstinence (91) with poor attentional performance associated with younger age of onset in this study (91) and another study of adolescents abstinent for 30 days (95). However, no difference between abstinent former users and control subjects on broader measures of attention was also reported (57,63,64,79,95).…”

“…Users abstinent for 23 days remained impaired relative to control subjects despite improvements in sustained and divided attention with increasing abstinence (91) with poor attentional performance associated with younger age of onset in this study (91) and another study of adolescents abstinent for 30 days (95). However, no difference between abstinent former users and control subjects on broader measures of attention was also reported (57,63,64,79,95). Therefore, cannabis-related attentional impairment may reflect residual effects that dissipate gradually as cannabinoids are cleared from the body (Supplement 1).…”

Incorporating Cognitive Retraining for Management of Individuals Having Cannabis Dependence Currently Abstinent

“…6 Amount of use of cannabinoids was also found to be a significant factor determining level of deficits. 1,8 A longitudinal study of cognitive functions from birth to adulthood, reported participants Hooper 8 with history of cannabis dependence prior to age of 18 showed neuropsychological decline over time. 9 Early use of cannabis is likely to negatively influence neurodevelopmental process occurring in adolescence.…”

Pediatric Concerns Due to Expanded Cannabis Use: Unintended Consequences of Legalization

“…In several cohort studies, adolescents who reported marijuana use were more likely to have impaired cognitive and academic abilities despite 28 days of abstinence [59][60][61][62].…”