There is a lot of uncertainty in the medical community about the health effects of marijuana. This scientific statement is intended to guide healthcare professionals in a balanced and intentional discussion with patients about the known and unknown potential effects of marijuana on brain health.
Fernando D. Testai, MD, Ph.D., FAHA, Editorial Group Chair, Professor of Neurology and Rehabilitation, University of Illinois at Chicago The United States Drug Enforcement Agency (DEA) and Food and Drug Administration (FDA) classifies cannabis as a Schedule I Controlled Substance, on par with heroin and LSD, for having “high potential for abuse and little or no medical benefit.” In contrast, CBD is legal when derived from hemp, which is the same species of plant as cannabis and contains less than 0.3% THC.
The most studied chemicals in cannabis are THC and CBD. THC is the compound in marijuana that makes you feel high. CBD (cannabidiol) has antioxidant and anti-inflammatory properties but does not have psychoactive effects. The potential therapeutic benefits of CBD continue to be studied in clinical trials. To fully understand the potential impact of marijuana, it is important to know that the human body naturally produces compounds called endocannabinoids that are similar to those in marijuana. Endocannabinoids are involved in the regulation of many bodily processes throughout life (including learning, memory, pain control, and sleep), and the action of endocannabinoids is essential for prenatal brain development. and brain maturation during adolescence.
This is the Association’s first scientific statement on cannabis and brain health, following a statement on marijuana and heart health, released in August 2020. Both statements are important because the use of marijuana in the States United States is increasing, particularly among teens and young adults, with about one-third of 12th graders and nearly half of college students reporting marijuana use in 2018. Additionally, the use of marijuana for medical purposes medical and/or recreational drugs has been legalized or decriminalized in many states in the United States over the past 2 decades, and the concentration of tetrahydrocannabinol (THC, the psychoactive component of marijuana) in cannabis products has dramatically increased. increased from around 4% in 1995 to 15% in 2018.
According to the statement, previous animal studies (in rodents) indicate that prolonged exposure to THC impairs memory and learning, and impacts brain development and maturation in specific ways if it is exposed at certain stages of life: endocannabinoids, as well as THC, can attach themselves to neurons in the brain via molecules called cannabinoid receptors. When THC activates cannabinoid receptors in the brain, it can disrupt the normal actions of endocannabinoids. “These receptors are highly concentrated in areas of the brain related to cognition,” Testai said.
“The data obtained in these animal studies demonstrate that disruption of endocannabinoid pathways leads to behavioral and cognitive abnormalities, such as poorer memory and learning ability and increased sensitivity to stress. Additionally, there may be vital periods of life – gestation and adolescence – where the brain may be particularly vulnerable to the impact of THC,” Testai said. While the exact timing and amount of marijuana exposure is more easily controlled in animal studies, as well as control of animals’ social and environmental conditions, human research studies cannot reproduce similar strict parameters. Thus, the results of existing studies in humans have been mixed, but raise similar concerns about the impact of marijuana exposure on brain health. Among the human studies summarized in the scientific statement, the results included:
During prenatal life, an important period for brain development, THC disrupts normal signaling pathways in the endocannabinoid system and can alter thinking, emotional behavior and stress response in offspring.
During adolescence, an important period for brain maturation, THC alters the structure and function of brain circuits, particularly in areas involved in cognition, emotional regulation and social behavior (such as the prefrontal cortex and hippocampus ).
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