San Diego State University/University of California San Diego Joint Doctoral Program in Clinical Psychology, San Diego, CA, USA.
Department of Psychiatry, University of California San Diego, San Diego, CA, USA.
J Int Neuropsychol Soc. 2024 Jan;30(1):84-93. doi: 10.1017/S1355617723000292. Epub 2023 Aug 9.
Methamphetamine and cannabis are two widely used, and frequently co-used, substances with possibly opposing effects on the central nervous system. Evidence of neurocognitive deficits related to use is robust for methamphetamine and mixed for cannabis. Findings regarding their combined use are inconclusive. We aimed to compare neurocognitive performance in people with lifetime cannabis or methamphetamine use disorder diagnoses, or both, relative to people without substance use disorders.
423 (71.9% male, aged 44.6 ± 14.2 years) participants, stratified by presence or absence of lifetime methamphetamine (M-/M+) and/or cannabis (C-/C+) DSM-IV abuse/dependence, completed a comprehensive neuropsychological, substance use, and psychiatric assessment. Neurocognitive domain T-scores and impairment rates were examined using multiple linear and binomial regression, respectively, controlling for covariates that may impact cognition.
Globally, M+C+ performed worse than M-C- but better than M+C-. M+C+ outperformed M+C- on measures of verbal fluency, information processing speed, learning, memory, and working memory. M-C+ did not display lower performance than M-C- globally or on any domain measures, and M-C+ even performed better than M-C- on measures of learning, memory, and working memory.
Our findings are consistent with prior work showing that methamphetamine use confers risk for worse neurocognitive outcomes, and that cannabis use does not appear to exacerbate and may even reduce this risk. People with a history of cannabis use disorders performed similarly to our nonsubstance using comparison group and outperformed them in some domains. These findings warrant further investigation as to whether cannabis use may ameliorate methamphetamine neurotoxicity.
甲基苯丙胺和大麻是两种广泛使用且经常同时使用的物质,它们可能对中枢神经系统产生相反的影响。与使用相关的神经认知缺陷的证据在甲基苯丙胺方面是确凿的,而在大麻方面则混合不一。关于它们联合使用的结果尚无定论。我们旨在比较有或无终生大麻或甲基苯丙胺使用障碍诊断的人(或两者兼有)的神经认知表现,与无物质使用障碍的人进行比较。
423 名参与者(71.9%为男性,年龄 44.6±14.2 岁),根据是否存在终生甲基苯丙胺(M-/M+)和/或大麻(C-/C+)DSM-IV 滥用/依赖进行分层,完成了全面的神经心理学、物质使用和精神科评估。使用多元线性和二项式回归分别检查神经认知域 T 分数和损伤率,控制可能影响认知的协变量。
总的来说,M+C+的表现比 M-C-差,但比 M+C-好。M+C+在言语流畅性、信息处理速度、学习、记忆和工作记忆方面的表现优于 M+C-。M-C+在全球范围内或任何领域的测量上都没有表现出比 M-C-更差的表现,而且在学习、记忆和工作记忆方面的测量上,M-C+的表现甚至优于 M-C-。
我们的发现与先前的研究一致,即甲基苯丙胺的使用会增加神经认知结果恶化的风险,而大麻的使用似乎不会加剧,甚至可能降低这种风险。有大麻使用障碍史的人表现与我们的非物质使用对照组相似,在某些领域甚至优于他们。这些发现值得进一步研究,以确定大麻的使用是否可以减轻甲基苯丙胺的神经毒性。