US Surgeon Generals Advisory Marijuana Use and the Developing Brain

U.S. Surgeon General’s Advisory: Marijuana Use and the Developing Brain

Professor DeBacco


Marijuana Use during Pregnancy
Marijuana use during pregnancy can affect the developing fetus.
THC can enter the fetal brain from the mother’s bloodstream.
It may disrupt the endocannabinoid system, which is important for a healthy pregnancy and fetal brain development
Brents L. K. (2016). Marijuana, the Endocannabinoid System and the Female Reproductive System. The Yale journal of biology and medicine, 89(2), 175–191.
Studies have shown that marijuana use in pregnancy is associated with adverse outcomes, including lower birth weight.
National Academies of Sciences, Engineering, and Medicine. 2017. The health effects of cannabis and cannabinoids: Current state of evidence and recommendations for research. Washington, DC: The National Academies Press.
The Colorado Pregnancy Risk Assessment Monitoring System reported that maternal marijuana use was associated with a 50% increased risk of low birth weight regardless of maternal age, race, ethnicity, education, and tobacco use.
Crume et al: Cannabis use during the perinatal period in a state with legalized recreational and medical marijuana: the association between maternal characteristics, breastfeeding patterns, and neonatal outcomes. J Pediatr. 2018;197:90-96.

Marijuana Use during Adolescence
The human brain continues to develop from before birth into the mid-20s and is vulnerable to the effects of addictive substances.
Pujol, J., Vendrell, P., Junqué, C., Martí-Vilalta, J. L., & Capdevila, A. (1993). When does human brain development end? Evidence of corpus callosum growth up to adulthood. Annals of Neurology, 34(1), 71-75. doi:10.1002/ana.410340113.
Levine, A., Clemenza, K., Rynn, M., & Lieberman, J. (2017). Evidence for the Risks and Consequences of Adolescent Cannabis Exposure. Journal of the American Academy of Child & Adolescent Psychiatry, 56(3), 214-225. doi:10.1016/j.jaac.2016.12.014.



Marijuana Use during Adolescence
Frequent marijuana use during adolescence is associated with:
Changes in the areas of the brain involved in attention, memory, decision-making, and motivation. Deficits in attention and memory have been detected in marijuana-using teens even after a month of abstinence.
Meruelo AD, Castro N, Cota CI, Tapert SF. Cannabis and alcohol use, and the developing brain. Behav Brain Res. 2017;325(Pt A):44–50. doi:10.1016/j.bbr.2017.02.025.
Impaired learning in adolescents. Chronic use is linked to declines in IQ, school performance that jeopardizes professional and social achievements, and life satisfaction.
Meier M.H., Caspi A., Ambler A., et. al. Persistent cannabis users show neuropsychological decline from childhood to midlife. Proc Natl Acad Sci USA., 2012. Oct 2; 109(40) E2657-64 doi 10.1073/pnas. 1206820109. Epub 2012 Aug 27
Increased rates of school absence and drop-out, as well as suicide attempts.
Silins, E., Horwood, L. J., & Patton, G. C. (2014). Young adult sequelae of adolescent cannabis use: An integrative analysis. The Lancet Psychiatry, 1(4), 286-293. doi:10.1016/s2215-0366(14)70307-4.

Psychotic Disorders
Risk for and early onset of psychotic disorders, such as schizophrenia.
The risk for psychotic disorders increases with frequency of use, potency of the marijuana product, and as the age at first use decreases.
Di Forti, M., Quattrone, D., & Freeman, T. (2019). The contribution of cannabis use to variation in the incidence of psychotic disorder across Europe (EU-GEI): A multicenter case-control study. The Lancet Psychiatry, 6(5), 427-436. doi:10.1016/S2215-0366(19)30048-3.
Other substance use.
Lopez-Quintero C., Perez de los Cabos J., Hasin D.S. (2011). Probability and predictors of transition from first use to dependence on nicotine, alcohol, cannabis, and cocaine: results of the National Epidemiologic Survey on Alcohol and Related Conditions (NESARC). Drug Alcohol Dependence. 115(1-2):120-130.
Jones, C. M., & McCance-Katz, E.F. (2019). Relationship Between Recency and Frequency of Youth Cannabis Use on Other Substance Use. Journal of Adolescent Health, 64(3), 411-413. doi:10.1016/j.jadohealth.2018.09.017.



Teens
In 2017, teens 12-17 reporting frequent use of marijuana showed a 130% greater likelihood of misusing opioids.

Substance Abuse and Mental Health Services Administration. (2018). Key Substance Use and Mental Health Indicators in the United States: Results from the 2017 National Survey on Drug Use and Health (HHS Publication No. SMA 18-5068, NSDUH Series H-53). Rockville, MD: Center for Behavioral Health Statistics and Quality, Substance Abuse and Mental Health Services Administration




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