The why behind the high: determinants of neurocognition during acute cannabis exposure

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Abstract

Acute cannabis intoxication may induce neurocognitive impairment and is a possible cause of human error, injury and psychological distress. One of the major concerns raised about increasing cannabis legalization and the therapeutic use of cannabis is that it will increase cannabis-related harm. However, the impairing effect of cannabis during intoxication varies among individuals and may not occur in all users. There is evidence that the neurocognitive response to acute cannabis exposure is driven by changes in the activity of the mesocorticolimbic and salience networks, can be exacerbated or mitigated by biological and pharmacological factors, varies with product formulations and frequency of use and can differ between recreational and therapeutic use. It is argued that these determinants of the cannabis-induced neurocognitive state should be taken into account when defining and evaluating levels of cannabis impairment in the legal arena, when prescribing cannabis in therapeutic settings and when informing society about the safe and responsible use of cannabis.

Acute cannabis exposure modulates numerous aspects of neurocognitive function; however, the effects experienced by individuals are highly variable. Ramaekers and colleagues here review the neural basis of cannabis-induced neurocognitive changes and response variability, and consider the legal, therapeutic and societal implications.

Original languageEnglish
Pages (from-to)439-454
Number of pages16
JournalNature Reviews Neuroscience
Volume22
Issue number7
Early online date27 May 2021
DOIs
Publication statusPublished - Jul 2021

Keywords

  • CATECHOL-O-METHYLTRANSFERASE
  • 69 MG DELTA-9-TETRAHYDROCANNABINOL
  • STRIATAL DOPAMINE RELEASE
  • PUBLIC-HEALTH IMPACTS
  • FUNCTIONAL CONNECTIVITY
  • ORAL CANNABIS
  • DRIVING ABILITY
  • MEMORY FUNCTION
  • SMOKED COCAINE
  • BRAIN NETWORKS

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