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

Acute cannabis intoxication can impair neurocognitive function, potentially leading to human error, injury, and psychological distress. However, the impairing effect varies among individuals and may not occur in all users. The neurocognitive response is driven by changes in mesocorticolimbic and salience network activity and can be exacerbated or mitigated by biological and pharmacological factors, product formulations, and frequency of use, and it can differ between recreational and therapeutic use. These determinants should be considered when defining cannabis impairment in legal contexts, prescribing cannabis therapeutically, and informing the public about safe and responsible use.

Study at a glance

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.