Cognitive consequences of cannabis use: Comparison with abuse of stimulants and heroin with regard to attention, memory and executive functions

Lundqvist, Thomas · 2005 · OpenAlex-citations

DOI: 10.1016/j.pbb.2005.02.017

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Summary

This review by Thomas Lundqvist (2005) examines and compares the cognitive consequences of cannabis use against those of stimulants (amphetamine, methamphetamine, MDMA, cocaine) and heroin, specifically regarding attention, memory, and executive functions. The study addresses the question of whether cognitive impairment is a general impact of psychoactive substance abuse or specific to certain drugs. It synthesizes findings from brain imaging techniques and neuropsychological tests to determine the nature, severity, and reversibility of these deficits. The analysis draws on existing literature, including neuroimaging studies (PET, SPECT, fMRI) and neuropsychological assessments. For cannabis, the review highlights that acute use causes immediate cognitive impairment, particularly in attention and memory, due to decreased activity in relevant brain areas. Chronic heavy use is associated with reduced function of the attentional/executive system, manifested as decreased mental flexibility, increased perseveration, and reduced learning. Brain imaging reveals that chronic cannabis users exhibit hypoactivity in the prefrontal cortex and cerebellum, even after periods of abstinence, suggesting persistent metabolic alterations. Neuropsychological tests confirm subtle but significant impairments in working memory and attention that may endure beyond intoxication and worsen with the duration of use. In comparison, stimulants show distinct patterns of impairment. Amphetamine and methamphetamine abuse is linked to deficits in learning, delayed recall, processing speed, and working memory, alongside neurotoxic effects on dopaminergic neurons. MDMA use is associated with difficulties in coding information into long-term memory, impaired verbal learning, and reduced cognitive flexibility, particularly in male users. Chronic cocaine use results in impaired attention, learning, memory, and cognitive flexibility, with deficits correlating with the lifetime amount of cocaine used. Heroin addiction appears to have a more selective impact, primarily affecting impulse control and selective processing of drug-related cues, while leaving attention and abstract reasoning relatively intact compared to stimulants. The significance of these findings lies in the identification of drug-specific cognitive profiles. While all substances cause acute disharmony in neuropsychological networks, chronic effects vary. Cannabis and stimulants broadly impair executive functions and memory, whereas heroin primarily disrupts impulse control. The review suggests that cannabis users may recruit alternative neural networks to compensate for deficits, indicating potential reversibility or adaptation. The study underscores the need for more sensitive neuropsychological tools and further research into the long-term reversibility of these cognitive impairments, noting that current evidence suggests some deficits may persist for weeks to months or longer, depending on the substance and severity of use.

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• illicit drugs