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By CARLA K. JOHNSON

With more Americans using ever-stronger marijuana, a federal advisory panel is calling for a public health approach that’s a big departure from “Just Say No.”

Thursday’s report proposes a health-focused strategy with the Centers for Disease Control and Prevention taking a larger role in cannabis policy than ever before.

Read the rest of this story on BostonHerald.com.

In recent years, the debate surrounding cannabis effect on brain function has intensified, especially as more states and countries move toward legalizing the drug for both medical and recreational use. Historically, marijuana has been associated with cognitive impairments, particularly in areas such as memory, attention, and executive function. However, a new study published by the American Medical Association (AMA) challenges this long-standing view, suggesting that moderate cannabis use does not significantly impair certain cognitive processes such as working memory, reward processing, and inhibitory control. This groundbreaking research shifts the conversation about cannabis, particularly in its medical applications, and prompts a re-evaluation of prior assumptions.

Background: Changing Perceptions of Cannabis

For decades, cannabis was largely viewed as a recreational substance that carried risks of addiction, cognitive decline, and other negative health outcomes, particularly in adolescents and heavy users. Early studies indicated that cannabis use, especially when initiated during adolescence, could impair brain development and lead to long-term cognitive deficits. This perspective influenced policy and public opinion, leading to its classification as a Schedule I substance in the United States, alongside drugs like heroin and LSD.

However, as cannabis legalization has gained momentum, the need for a more nuanced understanding of its effects has become increasingly important. Medical cannabis, in particular, is used to manage conditions such as chronic pain, anxiety, and depression. These evolving applications prompted researchers to take a closer look at how cannabis affects brain function, especially in moderate, controlled doses for medical use.

The AMA Study: Key Findings

The AMA-funded study, published in JAMA Network Open, investigated the long-term effects of marijuana use on cognitive functions. The research focused on adults who were using medical cannabis to manage symptoms like chronic pain, anxiety, and depression. Researchers utilized functional magnetic resonance imaging (fMRI) to assess brain activity related to working memory, reward processing, and inhibitory control tasks at baseline and after one year of moderate cannabis use.

The results were surprising. Contrary to previous assumptions, the study found no significant differences in brain activation between the two time points, even after a year of consistent marijuana use. Specifically, the researchers reported that “working memory, reward, and inhibitory control tasks did not differ statistically from baseline to one year and were not associated with changes in cannabis use frequency.” This suggests that moderate cannabis use for medical purposes does not impair these key areas of cognitive function.

Furthermore, the study noted that prior research on marijuana’s cognitive impacts often focused on adolescents or heavy, recreational users, which could explain the previously observed deficits. The current study’s focus on adults using cannabis for medical purposes, and typically in moderate amounts, paints a different picture, indicating that the cognitive risks associated with cannabis may not apply equally to all users.

Implications for Medical Marijuana Patients

The AMA study offers promising news for medical marijuana patients. Many individuals who use cannabis to manage chronic health conditions often worry about the potential cognitive side effects of long-term use. This research provides some reassurance that moderate use, particularly in adults, may not carry the same risks as previously thought.

For patients dealing with chronic pain, anxiety, or depression, medical marijuana has often been viewed as a trade-off: potential relief from debilitating symptoms in exchange for possible cognitive decline. The findings of this study suggest that for those using cannabis in controlled, moderate amounts, the cognitive risks may be minimal. This is especially important for patients who rely on cannabis to manage their symptoms without the use of more addictive medications, such as opioids.

The Importance of Context: Adolescents vs. Adults

One key takeaway from the AMA study is the distinction between the effects of cannabis on adolescents and adults. Prior studies have shown that cannabis use, particularly when started in adolescence, can lead to long-term cognitive impairments. The adolescent brain is still in a critical stage of development, and cannabis use during this period has been linked to changes in brain structure and function.

However, the AMA study focused on adult users, who have fully developed brains, and the results suggest that moderate cannabis use in this population does not have the same deleterious effects. This highlights the importance of considering age and developmental stage when discussing the risks associated with marijuana use. While cannabis may still pose risks for younger users, adults who use it for medical purposes may experience fewer cognitive side effects than previously believed.

Long-Term Cognitive Effects: What We Still Don’t Know

While the AMA study provides valuable insights, it also underscores the need for further research. The study focused on light to moderate cannabis use for medical purposes, and it’s unclear whether the findings would hold true for heavier use or for recreational users. Additionally, the study’s participants were adults with chronic health conditions, a group that may respond differently to cannabis than the general population.

Further studies are needed to explore the effects of higher doses of cannabis, different consumption methods (such as smoking vs. edibles), and the long-term cognitive effects across a broader range of populations. As more states legalize cannabis, the number of users is likely to increase, making it even more important to understand the full scope of marijuana’s impact on brain function.

Potential Policy Implications

The AMA’s findings could have significant implications for cannabis policy. As more evidence emerges suggesting that moderate cannabis use does not impair cognitive function, there may be increased pressure to reclassify cannabis under federal law. Currently, its Schedule I classification denotes that it has “no accepted medical use and a high potential for abuse,” a categorization that is increasingly at odds with scientific research and public opinion.

If further research continues to support the AMA’s findings, policymakers may be more inclined to reconsider cannabis’s legal status. Additionally, this research could influence the guidelines and recommendations for medical marijuana use, helping to establish safe, evidence-based dosing protocols for patients.

Conclusion

The AMA study offers new insights into the effects of marijuana on brain function, challenging long-held assumptions about its cognitive risks. For adults using cannabis moderately to manage medical symptoms, the findings are reassuring, suggesting that key cognitive processes like working memory and reward processing are not significantly impacted by long-term use. However, more research is needed to fully understand the broader implications of these findings, particularly in younger populations and heavier users. As the legal landscape around cannabis continues to evolve, studies like this one will be critical in shaping our understanding of marijuana’s role in both medical and recreational contexts.

AMA research is here.

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