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Persistent cannabis users show neuropsychological decline from childhood to midlife
Open accessAbstract
Recent reports show that fewer adolescents believe that regular cannabis use is harmful to health. Concomitantly, adolescents are initiating cannabis use at younger ages, and more adolescents are using cannabis on a daily basis. The purpose of the present study was to test the association between persistent cannabis use and neuropsychological decline and determine whether decline is concentrated among adolescent-onset cannabis users. Participants were members of the Dunedin Study, a prospective study of a birth cohort of 1,037 individuals followed from birth (1972/1973) to age 38 y. Cannabis use was ascertained in interviews at ages 18, 21, 26, 32, and 38 y. Neuropsychological testing was conducted at age 13 y, before initiation of cannabis use, and again at age 38 y, after a pattern of persistent cannabis use had developed. Persistent cannabis use was associated with neuropsychological decline broadly across domains of functioning, even after controlling for years of education. Informants also reported noticing more cognitive problems for persistent cannabis users. Impairment was concentrated among adolescent-onset cannabis users, with more persistent use associated with greater decline. Further, cessation of cannabis use did not fully restore neuropsychological functioning among adolescent-onset cannabis users. Findings are suggestive of a neurotoxic effect of cannabis on the adolescent brain and highlight the importance of prevention and policy efforts targeting adolescents.
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“In humans, studies have reported effects of ACE on academic achievement [144], IQ [145], and performance on specific cognitive tasks [146, 147] (but see also [148]).”
From Consequences of adolescent drug use (2023) · cites this paper as [145]
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“In humans, studies have reported effects of ACE on academic achievement [144], IQ [145], and performance on”
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“Whilst cognitive deficits have also been shown to be associated with cannabis use (63) these studies suffer from the same issues as discussed above regarding establishing whether association from observational studies are causal or not.”
From Association Between Cannabis and Psychosis: Epidemiologic Evidence (2016) · cites this paper as [63]
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“(23) found greater IQ decline with increased occasions of a marijuana use disorder diagnosis, but this type of categorization captures more than simply the hypothesized neurotoxic effects.”
BackgroundInfluentialA Big Fish in a Small Pond: Ability Rank and Human Capital Investment
Elsner, B., & Isphording, I. E. (2016) · Journal of Labor Economics · doi:10.1086/690714 · Cited by 171
“Marie and Zölitz (2015) find that access to marijuana impedes performance at university;Meier et al. (2012) show that regular marijuana use can lead to cognitive decline, although their results have been challenged by Rogeberg (2013), who shows that the effect is not causal and is most likely zero.”
BackgroundParent education and biologic factors influence on cognition in sickle cell anemia
King, A. A., Strouse, J. J., Rodeghier, M., Compas, B. E., Casella, J. F., McKinstry, R. C., Noetzel, M. J., Quinn, C. T., Ichord, R., Dowling, M. M., et al. (2013) · American Journal of Hematology · doi:10.1002/ajh.23604 · Cited by 177
“[39] Further, a five-point loss in IQ is comparable with the effects of chronic cannabis use during adolescence on adult IQ[40] and is greater than the effect of prenatal and perinatal lead exposure on childhood IQ.”
BackgroundAssociation Between Electronic Cigarette Use and Marijuana Use Among Adolescents and Young Adults
Chadi, N., Schroeder, R. E., Jensen, J. W., & Levy, S. (2019) · Archives of Pediatrics and Adolescent Medicine · doi:10.1001/jamapediatrics.2019.2574 · Cited by 174
Adolescent cannabis use, cognition, brain health and educational outcomes: A review of the evidence
Lorenzetti, V., Hoch, E., & Hall, W. (2020) · European Neuropsychopharmacology · doi:10.1016/j.euroneuro.2020.03.012 · Cited by 166
Haug, N. A., Padula, C. B., Sottile, J. E., Vandrey, R. G., Heinz, A. J., & Bonn‐Miller, M. O. (2017) · Addictive Behaviors · doi:10.1016/j.addbeh.2017.03.006 · Cited by 167
Morin, J.-F. G., Afzali, M. H., Bourque, J., Stewart, S. H., Séguin, J. R., O’Leary-Barrett, M., & Conrod, P. (2018) · American Journal of Psychiatry · doi:10.1176/appi.ajp.2018.18020202 · Cited by 179
Lisdahl, K. M., Wright, N. E., Medina-Kirchner, C., Maple, K. E., & Shollenbarger, S. (2014) · Current Addiction Reports · doi:10.1007/s40429-014-0019-6 · Cited by 160
Considering Marijuana Legalization: Insights for Vermont and Other Jurisdictions
Caulkins, J. P., Kilmer, B., R.Kleiman, M. A., MacCoun, R. J., Midgette, G., Oglesby, P., Pacula, R. L., & Reuter, P. (2015) · RAND Corporation eBooks · doi:10.7249/rr864 · Cited by 154
“Perhaps the most rigorous and ambitious study of chronic effects is the 38-year Dunedin Multidisciplinary Health and Development Study analysis of 1,038 New Zealand residents born in 1972 and 1973 (Meier et al., 2012).”
BackgroundHippocampal harms, protection and recovery following regular cannabis use
Yücel, M., Lorenzetti, V., Suo, C., Zalesky, A., Fornito, A., Takagi, M., Lubman, D. I., & Solowij, N. (2016) · Translational Psychiatry · doi:10.1038/tp.2015.201 · Cited by 161
Medical Cannabinoids in Children and Adolescents: A Systematic Review
Wong, S. S., & Wilens, T. E. (2017) · PEDIATRICS · doi:10.1542/peds.2017-1818 · Cited by 159
UPPS-P model impulsivity and marijuana use behaviors in adolescents: A meta-analysis
VanderVeen, J. D., Hershberger, A. R., & Cyders, M. A. (2016) · Drug and Alcohol Dependence · doi:10.1016/j.drugalcdep.2016.09.016 · Cited by 163
Englund, A., Freeman, T. P., Murray, R. M., & McGuire, P. K. (2017) · The Lancet Psychiatry · doi:10.1016/s2215-0366(17)30075-5 · Cited by 156
Onaemo, V. N., Fawehinmi, T. O., & D'Arcy, C. (2021) · Journal of Affective Disorders · doi:10.1016/j.jad.2020.12.043 · Cited by 152
Burggren, A. C., Shirazi, A., Ginder, N., & London, E. D. (2019) · The American Journal of Drug and Alcohol Abuse · doi:10.1080/00952990.2019.1634086 · Cited by 144
“ing years of regular cannabis use (135,140,149,150).”
BackgroundAssociation Between Lifetime Marijuana Use and Cognitive Function in Middle Age
Auer, R., Vittinghoff, E., Yaffe, K. S., Künzi, A., Kertesz, S. G., Levine, D. A., Albanese, E., Whitmer, R. A., Jacobs, D. R., Sidney, S. S., et al. (2016) · JAMA Internal Medicine · doi:10.1001/jamainternmed.2015.7841 · Cited by 149
“e 2 (0-12) 5 (1-13) 9 (2-17) 9 (3-18) 10 (3-21) <.”
Schulte, M. H. J., Cousijn, J., den Uyl, T. E., Goudriaan, A. E., van den Brink, W., Veltman, D. J., Schilt, T., & Wiers, R. W. H. J. (2014) · Clinical Psychology Review · doi:10.1016/j.cpr.2014.08.002 · Cited by 162
Long-term consequences of adolescent cannabinoid exposure in adult psychopathology
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Neurocognitive consequences of chronic cannabis use: a systematic review and meta-analysis
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Prenatal cannabis exposure - The “first hit” to the endocannabinoid system
Richardson, K. A., Hester, A. K., & McLemore, G. L. (2016) · Neurotoxicology and Teratology · doi:10.1016/j.ntt.2016.08.003 · Cited by 145
“Meier and colleagues investigated the effects of PCE and marijuana use during adolescence, contending that young people who use marijuana heavily during adolescence lose a significant number of IQ points, which may not be recovered after cessation of drug use in adulthood (Meier et al., 2012).”
BackgroundDaily Marijuana Use Is Not Associated with Brain Morphometric Measures in Adolescents or Adults
Weiland, B. J., Thayer, R. E., Depue, B. E., Sabbineni, A., Bryan, A. D., & Hutchison, K. E. (2015) · Journal of Neuroscience · doi:10.1523/jneurosci.2946-14.2015 · Cited by 141
The long-term cognitive consequences of adolescent exposure to recreational drugs of abuse
Mooney-Leber, S. M., & Gould, T. J. (2018) · Learning & Memory · doi:10.1101/lm.046672.117 · Cited by 140
Adolescent Substance Use and the Brain: Behavioral, Cognitive and Neuroimaging Correlates
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Colizzi, M., & Bhattacharyya, S. (2017) · Current Addiction Reports · doi:10.1007/s40429-017-0142-2 · Cited by 138
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Meier, M. H., Caspi, A., Danese, A., Fisher, H. L., Houts, R., Arseneault, L., & Moffitt, T. E. (2018) · Addiction · doi:10.1111/add.13946 · Cited by 129
“In general, studies with the longest follow-up [8,9] and greatest cannabis exposure [8,9,11] tended to show the strongest evidence of cannabisrelated neuropsychological decline, and studies with the shortest follow-up period and least cannabis exposure [14–17] (i.”
Self-citationRisks Associated With the Non-Medicinal Use of Cannabis
Hoch, E., Bonnet, U., Thomasius, R., Ganzer, F., Havemann‐Reinecke, U., & Preuss, U. W. (2015) · Deutsches Ärzteblatt international · doi:10.3238/arztebl.2015.0271 · Cited by 142
“One of the highest-quality studies is by Meier and colleagues (4).”
BackgroundResultGenome-wide association study implicates CHRNA2 in cannabis use disorder
Demontis, D., Rajagopal, V. M., Thorgeirsson, T. E., Als, T. D., Grove, J., Leppälä, K., Gudbjartsson, D. F., Pallesen, J., Hjorthøj, C. R., Reginsson, G. W., et al. (2019) · Nature Neuroscience · doi:10.1038/s41593-019-0416-1 · Cited by 137
Heavy cannabis use, dependence and the brain: a clinical perspective
Kroon, E., Kuhns, L., Hoch, E., & Cousijn, J. (2019) · Addiction · doi:10.1111/add.14776 · Cited by 133
Impact of Cannabis Use on the Development of Psychotic Disorders
Wilkinson, S. T., Radhakrishnan, R., & D’Souza, D. C. (2014) · Current Addiction Reports · doi:10.1007/s40429-014-0018-7 · Cited by 139
Safety and Toxicology of Cannabinoids
Sachs, J., McGlade, E., & Yurgelun-Todd, D. A. (2015) · Neurotherapeutics · doi:10.1007/s13311-015-0380-8 · Cited by 134
“[46] found that cessation of cannabis did not fully restore cognitive deficits among adolescent-onset cannabis users, and may result in a greater loss of IQ in adolescence [46, 57].”
BackgroundGanzer, F., Bröning, S., Kraft, S., Sack, P., & Thomasius, R. (2016) · Neuropsychology Review · doi:10.1007/s11065-016-9316-2 · Cited by 133
Implications of Marijuana Legalization for Adolescent Substance Use
Hopfer, C. (2014) · Substance Abuse · doi:10.1080/08897077.2014.943386 · Cited by 131
“Weekly marijuana use under age 18 years has been associated with an 8-point drop in intelligence among those who develop persistent dependence, whereas those with adult onset of comparable levels of use are less affected; importantly, the loss of cognitive capacity may not recover completely after desisting from marij…”
BackgroundSugden, K., Moffitt, T. E., Pinto, L., Poulton, R., Williams, B. S., & Caspi, A. (2016) · PLoS ONE · doi:10.1371/journal.pone.0148435 · Cited by 129
“Moreover, we have previously published positive findings in this cohort using these same brain and behavior phenotypes [27, 28, 37, 38].”
BackgroundSelf-citationRoditis, M. L., Delucchi, K., Chang, A. O., & Halpern‐Felsher, B. L. (2016) · Preventive Medicine · doi:10.1016/j.ypmed.2016.10.013 · Cited by 125
“Long-term use of marijuana can lead to addiction, with initiation in adolescence associated with higher rates of addiction, negative impacts on brain development, and lower levels of school and lifetime achievement (Bray et al., 2000; Brook et al., 2013; Hall & Degenhardt, 2009; Meier et al., 2012; Volkow et al., 2014…”
BackgroundCannabinoids: Medical implications
Schrot, R. J., & Hubbard, J. R. (2016) · Annals of Medicine · doi:10.3109/07853890.2016.1145794 · Cited by 135
“The maturing adolescent brain, which may not achieve complete anatomic development until the early 20’s (65), appears to be more vulnerable to the long-term effects of marijuana use (47).”
BackgroundInfluentialDellazizzo, L., Potvin, S., Giguère, S., & Dumais, A. (2022) · Addiction · doi:10.1111/add.15764 · Cited by 120
Metadata
- Authors
- Meier, M. H., Caspi, A., Ambler, A., Harrington, H., Houts, R., Keefe, R. S. E., McDonald, K., Ward, A., Poulton, R., & Moffitt, T. E.
- Affiliations
- Duke University (US)
- King's College London (GB)
- University of Otago (NZ)
- ORCID
- Venue
- Proceedings of the National Academy of Sciences
- Publisher
- National Academy of Sciences
- Published
- 2012-08-27
- Volume
- 109
- Issue
- 40
- Pages
- E2657-64
- ISSN
- 0027-8424 (ISSN-L)
- 1091-6490
- PMC
- PMC3479587
- OpenAlex
- W2153739923
- Cited by
- 1,523
- References
- 59
- Citations by year
- 2026: 48 · 2025: 69 · 2024: 57 · 2023: 103 · 2022: 86 · 2021: 112 · 2020: 144 · 2019: 139 · 2018: 119 · 2017: 149 · 2016: 152 · 2015: 130 · 2014: 114 · 2013: 83 · 2012: 15
- FWCI
- 80.45
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Locations
- Proceedings of the National Academy of Sciences (publishedVersion)
- Europe PMC (PubMed Central) (publishedVersion)
- PubMed Central (publishedVersion)
- PubMed (publishedVersion)
- Research Portal (King's College London) (submittedVersion)
- Funders
- Jacobs Foundation (AG032282)
- Medical Research Council (MR/K00381X, MR/K00381X/1, AG032282, G0100527)
- National Institute on Aging (AG-032282, R01AG032282)
- National Institute of Mental Health (MH-077874, R01MH077874)
- National Institute on Drug Abuse (P30DA023026)
- Eunice Kennedy Shriver National Institute of Child Health and Human Development (P2CHD065563, R24HD065563)
- Topics
- Health Sciences › Medicine › Pharmacology (medical) › Cannabis and Cannabinoid Research
- Health Sciences › Medicine › Epidemiology › Substance Abuse Treatment and Outcomes
- Health Sciences › Medicine › Pediatrics, Perinatology and Child Health › Prenatal Substance Exposure Effects
- Keywords
- cannabis use, neuropsychological decline, cognitive impairment, adolescent brain development, neurotoxicity, cannabis cessation, Dunedin Study, birth cohort
- MeSH terms
- Adolescent, Adult, Age Factors, Humans, Longitudinal Studies, Marijuana Smoking, Mental Processes, Neuropsychological Tests, Prospective Studies, Regression Analysis, Cohort Studies, Least-Squares Analysis
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