Neuroscience of Addiction Lab, Department of Psychology, University of Amsterdam, Amsterdam, the Netherlands.
The Amsterdam Brain and Cognition Center (ABC), University of Amsterdam, Amsterdam, the Netherlands.
Addiction. 2020 Mar;115(3):559-572. doi: 10.1111/add.14776. Epub 2019 Sep 4.
To summarize and evaluate our knowledge of the relationship between heavy cannabis use, cannabis use disorder (CUD) and the brain.
Narrative review of relevant literature identified through existing systematic reviews, meta-analyses and a PubMed search. Epidemiology, clinical representations, potential causal mechanisms, assessments, treatment and prognosis are discussed.
Although causality is unclear, heavy and dependent cannabis use is consistently associated with a high prevalence of comorbid psychiatric disorders and learning and memory impairments that seem to recover after a period of abstinence. Evidence regarding other cognitive domains and neurological consequences, including cerebrovascular events, is limited and inconsistent. Abstinence after treatment is only achieved in a minority of cases; treatment targeted at reduction in use appears have some success. Potential moderators of the impact of CUD on the brain include age of onset, heaviness of use, CUD severity, the ratio of ∆9-tetrahydrocannabinol to cannabidiol and severity of comorbid disorders.
Current evidence of long-term effects of daily cannabis use and cannabis use disorder on brain-related outcomes is suggestive rather than conclusive, but use is associated with psychiatric morbidity and with cognitive impairments that recover after a period of abstinence.
总结和评估我们对大量吸食大麻、大麻使用障碍（CUD）与大脑之间关系的认识。
通过现有的系统评价、荟萃分析和 PubMed 搜索，对相关文献进行综述。讨论了流行病学、临床表现、潜在的因果机制、评估、治疗和预后。
尽管因果关系尚不清楚，但大量和依赖大麻的使用与共患精神障碍和学习记忆障碍的高患病率密切相关，这些障碍似乎在一段时间的戒断后会恢复。关于其他认知领域和神经后果的证据，包括脑血管事件，有限且不一致。治疗后仅少数患者能戒除；针对减少使用的治疗似乎有一定的效果。CUD 对大脑影响的潜在调节因素包括发病年龄、使用量、CUD 严重程度、∆9-四氢大麻酚与大麻二酚的比值以及共患疾病的严重程度。
目前关于每日吸食大麻和大麻使用障碍对与大脑相关结果的长期影响的证据只是提示性的而非结论性的，但使用大麻与精神疾病发病率以及与戒断后一段时间内恢复的认知障碍有关。
