Neurodevelopmental Effects of Cannabis Use in Adolescents and Emerging Adults with ADHD: A Systematic Review

Overview

Journal Harv Rev Psychiatry

Specialty Psychiatry

Date 2021 Jun 17

PMID 34138796

Citations 3

Authors

Philip B Cawkwell

David S Hong

John E Leikauf

Affiliations

Soon will be listed here.

Abstract

Objective: Systematically review the scientific literature to characterize the effects of cannabis use on brain structure, function, and neurodevelopmental outcomes in adolescents and young adults with ADHD.

Method: Systematic review following PRISMA guidelines utilizing PubMed, Embase, PsycINFO, and Cochrane CENTRAL trials register from inception until 1 January 2020. Articles that examined the impact of cannabis use on youth with ADHD were included.

Results: Eleven studies were identified that compared outcomes for individuals with ADHD who used cannabis or synthetic cannabinoids against those with ADHD who did not. Seven of these studies used neuroimaging techniques, including fMRI, structural MRI, and SPECT. Differential regions of activation were identified, including the right hippocampus and cerebellar vermis, and bilateral temporal lobes. Morphological differences were identified in the right precentral and postcentral gyri, left nucleus accumbens, right superior frontal and postcentral gyri. No study identified any additive or ADHD × cannabis use interaction on neuropsychological tasks of executive function. Two studies found adverse differential impacts of early-onset cannabis use in this population.

Conclusion: A dearth of evidence is available on the impact of cannabis use on the developing brain and functioning for individuals with ADHD, despite the elevated risk for substance use in this population. The limited, potentially underpowered evidence does not support the hypothesis that cannabis use has a deleterious impact on neuropsychological tasks in transitional age youth with ADHD. Larger and longer-term studies are needed, however, to better inform clinicians and patients as to the impacts of cannabis use in youth with ADHD.

Citing Articles

Adolescent Substance Use Disorders.

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Evaluation of Efficacy of Cannabis Use in Patients With Attention Deficit Hyperactivity Disorder: A Systematic Review.

Dhamija D, Bello A, Khan A, Gutlapalli S, Sohail M, Patel P Cureus. 2023; 15(6):e40969.

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Challenges of Treating ADHD with Comorbid Substance Use Disorder: Considerations for the Clinician.

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References

Mitchell J, Weisner T, Jensen P, Murray D, Molina B, Eugene Arnold L . How Substance Users With ADHD Perceive the Relationship Between Substance Use and Emotional Functioning. J Atten Disord. 2017; 22(9_suppl):49S-60S. PMC: 5538943. DOI: 10.1177/1087054716685842. View

Jepsen J, Fagerlund B, Mortensen E . Do attention deficits influence IQ assessment in children and adolescents with ADHD?. J Atten Disord. 2008; 12(6):551-62. DOI: 10.1177/1087054708322996. View

Harstad E, Wisk L, Ziemnik R, Huang Q, Salimian P, Weitzman E . Substance Use Among Adolescents with Attention-Deficit/Hyperactivity Disorder: Reasons for Use, Knowledge of Risks, and Provider Messaging/Education. J Dev Behav Pediatr. 2017; 38(6):417-423. PMC: 5505316. DOI: 10.1097/DBP.0000000000000461. View

Rasmussen J, Casey B, van Erp T, Tamm L, Epstein J, Buss C . ADHD and cannabis use in young adults examined using fMRI of a Go/NoGo task. Brain Imaging Behav. 2015; 10(3):761-71. PMC: 4840078. DOI: 10.1007/s11682-015-9438-9. View

Biederman J, Faraone S . The effects of attention-deficit/hyperactivity disorder on employment and household income. MedGenMed. 2007; 8(3):12. PMC: 1781280. View

Solowij N, Jones K, Rozman M, Davis S, Ciarrochi J, Heaven P . Verbal learning and memory in adolescent cannabis users, alcohol users and non-users. Psychopharmacology (Berl). 2011; 216(1):131-44. DOI: 10.1007/s00213-011-2203-x. View

Osuch E, Manning K, Hegele R, Theberge J, Neufeld R, Mitchell D . Depression, marijuana use and early-onset marijuana use conferred unique effects on neural connectivity and cognition. Acta Psychiatr Scand. 2016; 134(5):399-409. DOI: 10.1111/acps.12629. View

Volkow N, Koob G, Croyle R, Bianchi D, Gordon J, Koroshetz W . The conception of the ABCD study: From substance use to a broad NIH collaboration. Dev Cogn Neurosci. 2017; 32:4-7. PMC: 5893417. DOI: 10.1016/j.dcn.2017.10.002. View

Katusic S, Barbaresi W, Colligan R, Weaver A, Leibson C, Jacobsen S . Psychostimulant treatment and risk for substance abuse among young adults with a history of attention-deficit/hyperactivity disorder: a population-based, birth cohort study. J Child Adolesc Psychopharmacol. 2005; 15(5):764-76. DOI: 10.1089/cap.2005.15.764. View

10.

Jacobus J, Goldenberg D, Wierenga C, Tolentino N, Liu T, Tapert S . Altered cerebral blood flow and neurocognitive correlates in adolescent cannabis users. Psychopharmacology (Berl). 2012; 222(4):675-84. PMC: 3510003. DOI: 10.1007/s00213-012-2674-4. View

11.

Polanczyk G, Silva de Lima M, Horta B, Biederman J, Rohde L . The worldwide prevalence of ADHD: a systematic review and metaregression analysis. Am J Psychiatry. 2007; 164(6):942-8. DOI: 10.1176/ajp.2007.164.6.942. View

12.

Tapert S, Granholm E, Leedy N, Brown S . Substance use and withdrawal: neuropsychological functioning over 8 years in youth. J Int Neuropsychol Soc. 2002; 8(7):873-83. DOI: 10.1017/s1355617702870011. View

13.

Vitulano M, Fite P, Hopko D, Lochman J, Wells K, Asif I . Evaluation of underlying mechanisms in the link between childhood ADHD symptoms and risk for early initiation of substance use. Psychol Addict Behav. 2014; 28(3):816-27. DOI: 10.1037/a0037504. View

14.

Merrill B, Molina B, Coxe S, Gnagy E, Altszuler A, Macphee F . Functional Outcomes of Young Adults with Childhood ADHD: A Latent Profile Analysis. J Clin Child Adolesc Psychol. 2019; 49(2):215-228. PMC: 6661228. DOI: 10.1080/15374416.2018.1547968. View

15.

Wisk L, Levy S, Weitzman E . Parental views on state cannabis laws and marijuana use for their medically vulnerable children. Drug Alcohol Depend. 2019; 199:59-67. DOI: 10.1016/j.drugalcdep.2018.12.027. View

16.

Umemoto A, Lukie C, Kerns K, Muller U, Holroyd C . Impaired reward processing by anterior cingulate cortex in children with attention deficit hyperactivity disorder. Cogn Affect Behav Neurosci. 2014; 14(2):698-714. DOI: 10.3758/s13415-014-0298-3. View

17.

Wilens T, Martelon M, Joshi G, Bateman C, Fried R, Petty C . Does ADHD predict substance-use disorders? A 10-year follow-up study of young adults with ADHD. J Am Acad Child Adolesc Psychiatry. 2011; 50(6):543-53. PMC: 3104208. DOI: 10.1016/j.jaac.2011.01.021. View

18.

Artigas M, Sanchez-Mora C, Rovira P, Richarte V, Garcia-Martinez I, Pagerols M . Attention-deficit/hyperactivity disorder and lifetime cannabis use: genetic overlap and causality. Mol Psychiatry. 2019; 25(10):2493-2503. PMC: 8025199. DOI: 10.1038/s41380-018-0339-3. View

19.

Hoogman M, Muetzel R, Guimaraes J, Shumskaya E, Mennes M, Zwiers M . Brain Imaging of the Cortex in ADHD: A Coordinated Analysis of Large-Scale Clinical and Population-Based Samples. Am J Psychiatry. 2019; 176(7):531-542. PMC: 6879185. DOI: 10.1176/appi.ajp.2019.18091033. View

20.

Lorenzetti V, Alonso-Lana S, Youssef G, Verdejo-Garcia A, Suo C, Cousijn J . Adolescent Cannabis Use: What is the Evidence for Functional Brain Alteration?. Curr Pharm Des. 2016; 22(42):6353-6365. DOI: 10.2174/1381612822666160805155922. View