Cited by 1,523Cannabis and Cannabinoid ResearchSubstance Abuse Treatment and OutcomesPrenatal Substance Exposure Effects

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Persistent cannabis users show neuropsychological decline from childhood to midlife

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Meier, Madeline H., Caspi, Avshalom, Ambler, Antony, Harrington, HonaLee, Houts, Renate, Keefe, Richard S. E., McDonald, Kay, Ward, Aimee, Poulton, Richie, Moffitt, Terrie E.·2012·Proceedings of the National Academy of Sciences

DOI 10.1073/pnas.1206820109PMC PMC3479587

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Abstract

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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Colizzi, M., Tosato, S., & Ruggeri, M. (2020) · Brain Sciences · doi:10.3390/brainsci10030133 · Cited by 9
“, daily [13], being associated with more pronounced cognitive impairments, thus supporting a cumulative adverse effect of ∆9-THC.”
Background
Alcohol substitution during one month of cannabis abstinence among non-treatment seeking youth
Schuster, R. M., Potter, K. W., Lamberth, E., Rychik, N., Hareli, M., Allen, S. E., Broos, H. C., Mustoe, A. K., Gilman, J. M., Pachas, G. N., et al. (2020) · Progress in Neuro-Psychopharmacology and Biological Psychiatry · doi:10.1016/j.pnpbp.2020.110205 · Cited by 10
Impact of Cannabis Legalization on Adolescent Cannabis Use
Ladegard, K. M., & Bhatia, D. (2023) · Psychiatric Clinics of North America · doi:10.1016/j.psc.2023.03.008 · Cited by 9
Role of Cannabis in the Management of Chronic Non-Cancer Pain: A Narrative Review
Al-Husinat, L., Obeidat, S., Azzam, S., Al-Gwairy, Y., Obeidat, F., Sharie, S. A., Haddad, D., Haddad, F. F., Rekatsina, M., Leoni, M. L. G., et al. (2025) · Clinics and Practice · doi:10.3390/clinpract15010016 · Cited by 9
Cognitive presentation at psychosis onset through premorbid deterioration and exposure to environmental risk factors
Ferraro, L., Forti, M. D., Barbera, D. L., Cascia, C. L., Morgan, C., Tripoli, G., Jongsma, H. E., Seminerio, F., Sartorio, C., Sideli, L., et al. (2025) · Psychological Medicine · doi:10.1017/s0033291724003507 · Cited by 10
“This type of cannabis has a higher addictive, dissociative (Ricci et al., 2021, 2023), psychotic-leading (Di Forti et al., 2019; Quattrone et al., 2020, 2021) and detrimental potential on cognition and premorbid adjustment than low-potency varieties (Meier et al., 2012; Mokrysz et al., 2016).”
Primary Care Screening, Brief Intervention, and Referral to Treatment for Adolescent Substance Use in Lebanon: A National Cross-sectional Study
Alayan, N., Naal, H., Makhoul, M., Avedissian, T., Assaf, G. N., Talih, F. R., & Hamadeh, R. S. (2021) · Substance Abuse Research and Treatment · doi:10.1177/1178221821994608 · Cited by 10
“survey measures attitudes, perceptions, and practices of SBIRT among healthcare providers, and it is based on the 8-component model of SBIRT assessing: (1) substance use, (2) quantity and frequency of substance use, (3) the use of standardized screening tools, (4) provision of positive feedback, (5) explanation of sub…”
Method
Neurocognitive moderation of repetitive transcranial magnetic stimulation (rTMS) effects on cannabis use in schizophrenia: a preliminary analysis
Johnstone, S., Lowe, D. J. E., Kozak, K., Sanches, M., Castle, D. J., Rabin, J. S., Rabin, R. A., & George, T. P. (2022) · Schizophrenia · doi:10.1038/s41537-022-00303-2 · Cited by 8
Organic and Synthetic Cannabinoid Use in Adolescents
Bhatty, S., & Wu, W. (2013) · Pediatric Annals · doi:10.3928/00904481-20121221-16 · Cited by 8
L’impact du cannabis à l’adolescence sur la transition psychotique de l’adulte
Krebs, M., Gut, A., Plaze, M., & Dervaux, A. (2013) · Neuropsychiatrie de l Enfance et de l Adolescence · doi:10.1016/j.neurenf.2013.03.001 · Cited by 8
Cannabis Use Disorders and Altered Brain Morphology: Where Is the Evidence?
Lorenzetti, V., Batalla, A., & Cousijn, J. (2016) · Current Addiction Reports · doi:10.1007/s40429-016-0102-2 · Cited by 8
“Nevertheless, CUDs are linked to significant harms to executive functions such as planning, organizing, problem solving, decision-making, memory, and emotional control [7, 8], and mental health, with high comorbidity with depression, anxiety, and psychotic disorders [9 (cid:129)(cid:129) ].”
The legalization of dangerous consumption: a comparison of cannabis and gambling policies in three US states
Nikkinen, J. (2017) · Addiction Research & Theory · doi:10.1080/16066359.2017.1366455 · Cited by 8
“Although close to 60 percent of 12th-graders in the US think that cannabis is harmless (NIDA 2013), its long-term use from childhood to midlife has proved to have a negative impact on neuropsychological functioning (Meier et al. 2012).”
Background
Pathologie duelle, actualités et perspectives
Benyamina, A. (2018) · Annales Médico-psychologiques revue psychiatrique · doi:10.1016/j.amp.2018.08.016 · Cited by 8
Neuropsychological performance in patients with substance use disorder with and without mood disorders
Höijer, I., Ilonen, T., Löyttyniemi, E., & Salokangas, R. K. R. (2020) · Nordic Journal of Psychiatry · doi:10.1080/08039488.2020.1734079 · Cited by 9
“Findings from prospective research provide evidence that earlier onset cannabis abuse would be associated with worse cognitive deficits [44].”
Background
Cannabis use, subsequent other illicit drug use and drug use disorders: A 16-year follow-up study among Swedish adults
Rabiee, R. H. S., Lundin, A., Agardh, E. E., Forsell, Y., Allebeck, P., & Danielsson, A. (2020) · Addictive Behaviors · doi:10.1016/j.addbeh.2020.106390 · Cited by 9
Economic Effects of Adolescent to Adult Patterns of Cannabis Use: Full-Time Employment and Employment Stability
Augustyn, M. B., Loughran, T., Larroulet, P., & Henry, K. L. (2020) · Journal of Drug Issues · doi:10.1177/0022042620943538 · Cited by 9
“After all, the documented short- and long-term consequences of cannabis use, including impaired judgment, reduced motor coordination, reduced cognitive functioning, and health issues (Crean et al., 2011; Meier et al., 2012; Owen et al., 2014; Tashkin, 2013; Thomas et al., 2014), are likely to affect job performance an…”
Background
Patterns of Medical Cannabis Use among Patients Diagnosed with Multiple Sclerosis
Guarnaccia, J. B., Khan, A., Ayettey, R. G., Treu, J. A., Comerford, B., & Njike, V. Y. (2021) · Multiple Sclerosis and Related Disorders · doi:10.1016/j.msard.2021.102830 · Cited by 8
Residual effects of cannabis-use on neuropsychological functioning
Wendel, L. K., Daedelow, L. S., Kaminski, J. A., Banaschewski, T., Millenet, S., Bokde, A. L. W., Quinlan, E. B., Desrivières, S., Flor, H., Grigis, A., et al. (2021) · Cognitive Development · doi:10.1016/j.cogdev.2021.101072 · Cited by 10
Cannabis use outcomes by past-month binge drinking status in the general United States population
Vijapur, S. M., Levy, N. S., & Martins, S. S. (2021) · Drug and Alcohol Dependence · doi:10.1016/j.drugalcdep.2021.108997 · Cited by 8
Disrupted Resting State Attentional Network Connectivity in Adolescent and Young Adult Cannabis Users following Two-Weeks of Monitored Abstinence
Harris, J. C., Wallace, A. L., Thomas, A. M., Wirtz, H. G., Kaiver, C. M., & Lisdahl, K. M. (2022) · Brain Sciences · doi:10.3390/brainsci12020287 · Cited by 9
“These findings also build upon previous work demonstrating differences in behavioral measures of attention in chronic cannabis users compared to controls [28,32,33,93].”
Result
Pathways to substance use: Examining conduct problems and parenting behaviors from preschool to adolescence
Hare, M. M., Trucco, E. M., Hawes, S. W., Villar, M. G., & Zucker, R. A. (2023) · Development and Psychopathology · doi:10.1017/s0954579422001328 · Cited by 9
“Adolescent substance use (SU) can lead to a cascade of maladaptive outcomes, including academic failure, delinquency, suicidality, and SU disorders (Meier et al., 2012; Miotto et al., 2013; Schulte & Hser, 2013).”
Background
Early Birds and Night Owls: Distinguishing Profiles of Cannabis Use Habits by Use Times with Latent Class Analysis
Hetelekides, E. M., Joseph, V. W., Pearson, M. R., Bravo, A. J., Prince, M. A., & Conner, B. T. (2023) · Cannabis · doi:10.26828/cannabis/2023.01.007 · Cited by 8
“…suicidality (Kimbrel et al., 2018; Roberts, 2019), impacts on cognitive function and educational achievement (Arria et al., 2015; Homel et al., 2014; Meier et al., 2012), motor vehicle accidents (National Academies of Sciences, Engineering, and Medicine, 2017), and increased Corresponding Author:…”
Background
Visions of Cannabis Control
Heidt, J., & Wheeldon, J. (2023) · doi:10.1093/oso/9780198875215.001.0001 · Cited by 9
Klinische Prognose schizophrener Patienten mit Cannabisabhängigkeit
Schnell, T. G. (2013) · Der Nervenarzt · doi:10.1007/s00115-013-3926-1 · Cited by 8
Adolescent cannabinoid treatment negatively affects reproductive behavior in female rats
Minney, S. M., & López, H. H. (2013) · Pharmacology Biochemistry and Behavior · doi:10.1016/j.pbb.2013.09.015 · Cited by 8
Illness versus substance use effects on the frontal white matter in early phase schizophrenia: A 4 Tesla 1 H-MRS study
Bernier, D. C., Bartha, R., McAllindon, D. P., Hanstock, C. C., Marchand, Y., Dillen, K. N. H., Gallant, M., Good, K. P., & Tibbo, P. G. (2016) · Schizophrenia Research · doi:10.1016/j.schres.2016.04.022 · Cited by 8
“, 2001) and incremental cognitive decline with long-lasting use (Meier et al., 2012).”
Background
Diferencias de género entre autocultivadores de cannabis en España
Amado, B. G., Villanueva‐Blasco, V. J., Vidal‐Infer, A., & Folgar, M. I. (2019) · Adicciones · doi:10.20882/adicciones.1142 · Cited by 8
“Cannabis use has been clearly associated with neuropsychological problems (Meier et al., 2012), psychosis (Murray, Quigley, Quattrone, Englund & Di Forti, 2016), and, although with less empirical support, with affective disorders (Marconi, Di Forti, Lewis, Murray & Vassos, 2016).”
Background
Cannabis points to the synaptic pathology of mental disorders: how aberrant synaptic components disrupt the highest psychological functions
Morrison, P. D., & Murray, R. M. (2020) · Dialogues in Clinical Neuroscience · doi:10.31887/dcns.2020.22.3/pmorrison · Cited by 8
Padrões de Uso de Drogas e Problemas Associados em Adolescentes Judicializados
Komatsu, A. V., Bono, E. L., & Bazon, M. R. (2021) · Psico-USF · doi:10.1590/1413-82712021260203 · Cited by 8
Efficacy of the “Sé tú Mismo” (Be Yourself) Program in Prevention of Cannabis Use in Adolescents
Villanueva‐Blasco, V. J., Puig‐Pérez, S., & Becoña, E. (2020) · International Journal of Mental Health and Addiction · doi:10.1007/s11469-019-00219-6 · Cited by 8
“In addition, unlike the effects in adults, these deficits can persist and reappear later in adolescence after long periods of abstinence (Fried et al. 2005), and can even prevent the adequate recovery of cognitive function (Meier et al. 2012).”
Background
Investigating sex differences and age of onset in emotion regulation, executive functioning, and cannabis use in adolescents and young adults
Wade, N. E., Courtney, K. E., Wallace, A. L., Hatz, L. E., & Jacobus, J. (2024) · Journal of Cannabis Research · doi:10.1186/s42238-024-00225-z · Cited by 10
“Age of Onset was defined as the first age at which an individual engaged in regular (> weekly for at least a year) cannabis use [35].”
BackgroundMethod
The impact of nutritional, environmental, and lifestyle factors on neurological disorders: therapeutic implications and mechanistic insights
Chakif, D., & Furrer, J. (2026) · Frontiers in Pharmacology · doi:10.3389/fphar.2026.1765786 · Cited by 9
“Moreover, highly potent synthetic drugs carry additional neuropsychiatric risks (Meier et al., 2012).”
Medical cannabis and cannabis-based medicine show both potential efficacy and potential harms: Cross-sectional comparison with controls on self-rated and interviewer-rated outcomes within the Danish pilot program on medical cannabis
Kudahl, B., Berg, M. E., Posselt, C. M., Nordentoft, M., & Hjorthøj, C. R. (2021) · Complementary Therapies in Clinical Practice · doi:10.1016/j.ctcp.2021.101476 · Cited by 7
Genetic support of a causal relationship between cannabis use and educational attainment: a two‐sample Mendelian randomization study of European ancestry
Chen, D., Wang, X., Huang, T., & Jia, J. (2022) · Addiction · doi:10.1111/add.16090 · Cited by 7
Effect of recreational cannabis use on bone mineral density: a systematic review
Magno, L. A. V., Tameirão, D. R., Alves, L. F., & Guimarães, N. S. (2023) · Osteoporosis International · doi:10.1007/s00198-023-06992-4 · Cited by 9
E-cigarette, tobacco, and cannabis vaping among diverse sexual and gender identities in U.S. high school students
Azagba, S., Ebling, T., & de Silva, G. S. R. (2025) · Public Health · doi:10.1016/j.puhe.2024.12.034 · Cited by 7
Substance use in young people 2 Why young people's substance use matters for global health
Hall, W., Patton, G. C., Stockings, E., Weier, M., Lynskey, M. T., Morley, K. I., & Degenhardt, L. J. (2016) · Cited by 7
Psychometric properties of the Spanish version of the Cannabis Use Problems Identification Test among Chilean university students: A validation study
Cantillano, V., Villar, P. D., Contreras, L., Martínez, D. M., Zuzulich, M. S., Ramírez, C., Pons, C., & Bashford, J. (2016) · Drug and Alcohol Dependence · doi:10.1016/j.drugalcdep.2016.10.032 · Cited by 7

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: Meier, Madeline H.
Caspi, Avshalom
Ambler, Antony
Houts, Renate
Keefe, Richard S. E.
Ward, Aimee
Poulton, Richie
Moffitt, Terrie E.
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
DOI: 10.1073/pnas.1206820109
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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Persistent cannabis users show neuropsychological decline from childhood to midlife

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