By Paul Armentano, Truthout Published March 20, 2019
Claims that cannabis use is associated with lower cognitive functioning are largely based upon the findings of a single longitudinal study. The paper, published by Madeline Meier and a team of Duke University researchers in 2012, reported that the onset of cannabis use in early adolescence was associated with an average decline of eight IQ points by middle-age.
However, a critique of Meier’s study, published in the Proceedings of the National Academy of Sciences, opined that the reported differences in IQ were consistent with socioeconomic differences among the study’s participants and likely were not attributable to marijuana use. (This criticism is hardly surprising as data has historically shown that those of greater economic means tend to test higher on IQ tests than those who are poorer, and critics have also raised questions as to whether the test itself may possess inherent racial biases.) It countered that the Duke team likely “overestimate[d]” the impact of marijuana on IQ and opined that the “true effect [of cannabis exposure] could be zero.”
This criticism is given additional merit by the fact that several later and better controlled studies have failed to replicate Meier’s initial findings. For example, a British study of more than 2,000 teens reported that cannabis exposure prior to the age of 15 “did not predict either lower teenage IQ scores or poorer educational performance … once adjustment is made for potential confounds.”
Researchers at the University of Southern California, Los Angeles, and at the University of Minnesota similarly assessed the potential relationship between cannabis and IQ in two longitudinal investigations of adolescent twins. They reported: “We find little evidence to suggest that adolescent marijuana use has a direct effect on intellectual decline…. The lack of a dose–response relationship, and an absence of meaningful differences between discordant siblings lead us to conclude that the deficits observed in marijuana users are attributable to confounding factors that influence both substance initiation and IQ rather than a neurotoxic effect of marijuana.”
In fact, even Meier appears to concede this point in her later work. Writing in the journal Addiction in 2018, she and her colleagues acknowledged: “Short-term cannabis use in adolescence does not appear to cause IQ decline or impair executive functions, even when cannabis use reaches the level of dependence. Family background factors explain why adolescent cannabis users perform worse on IQ and executive function tests.”
Most recently, a new study published in The Lancet being widely publicized this week claims that an estimated 30 to 50 percent of psychosis cases in Europe are due to cannabis exposure. However, this study does not establish causation, nor could it because of the observational nature of its design. In fact, the authors clearly state in the abstract that they are “assuming causality.” Given the fact that such a cause-and-effect relationship is yet unproven and there is no consensus among experts that such causation exists, this would appear to be a troubling leap for the authors to take and it should not go unnoticed. Moreover, it is well established that those with psychiatric illness typically use all intoxicants at greater rates than the general public, so the fact that those admitted to institutions for first-episode psychosis are more likely to consume cannabis than are those in the general population is hardly surprising. But it is not evidence that marijuana in any way causes the condition. Finally, the fact that cannabis has been used by various populations for decades at disparate rates, yet rates of psychosis and other psychiatric disorders have generally remained static over this same period of time, strongly argues against a direct causal relationship.
The Developing Brain
While the use of alcohol has been unequivocally associated with deleterious effects on brain morphology in both adults and adolescents, claims that cannabis exposure significantly damages the developing brain are far less persuasive.
Specifically, a team of University of Colorado investigators in 2017 assessed the impact of marijuana exposure and alcohol ingestion on brain structure in groups of adults and adolescents. They reported that, “Alcohol use severity is associated with widespread lower grey matter volume and white matter integrity in adults, and with lower grey matter volume in adolescents.” (Changes in white matter are associated with the onset of certain neurodegenerative diseases while grey matter contains most of the brain’s neurons.) By contrast, “no associations were observed between structural measures and past 30-day cannabis use in adults or adolescents.”
In 2018, researchers from the University of Pennsylvania, Perlman School of Medicine performed a systematic review of 69 studies (published between the years 1973 and 2017) assessing the relationship between adolescent cannabis use and cognition. Researchers reported no significant long-term deficits in memory, attention or other aspects of cognitive functioning that could be independently attributed to cannabis use, regardless of subjects’ age of initiation.
They concluded that, “Associations between cannabis use and cognitive functioning in cross-sectional studies of adolescents and young adults are small and may be of questionable clinical importance for most individuals…. [R]esults indicate that previous studies of cannabis in youth may have overstated the magnitude and persistence of cognitive deficits associated with [marijuana] use.”
Most recently, University of Pennsylvania researchers compared brain scans of adolescents who used cannabis occasionally (one to two times per week) and frequently (more than three times per week) versus matched controls (similarly aged teens who abstained from the plant). They concluded, “There were no significant differences by cannabis group in global or regional brain volumes, cortical thickness, or gray matter density, and no significant group by age interactions were found…. In sum, structural brain metrics were largely similar among adolescent and young adult cannabis users and non-users.”
While some have theorized that marijuana exposure over the long term may be associated with an adverse impact on the brain, clinical assessments of frequent cannabis consumers challenge concerns. For instance, cumulative lifetime cannabis exposure is not associated with deficits in cognitive performance following drug abstinence.
Long-term exposure is also not associated with changes in working memory. In a 2015 Canadian clinical trial assessing the safety of daily cannabis consumption, users demonstrated no identifiable differences in neurocognitive skills compared to non-using controls. These findings were similar to those of a U.S. trial assessing the health of four Compassionate IND patients (federally authorized medical marijuana consumers) who had smoked cannabis daily for a period of up to 27 years. Authors concluded that, “No consistent or attributable neuropsychological or neurological deterioration has been observed.”
Most recently, University of Colorado scientists compared magnetic resonance imaging scans in 28 cannabis users over the age of 60 versus matched controls. Cannabis-consuming participants in the study, on average, had used marijuana weekly for 24 years. The authors reported that long-term cannabis exposure “does not have a widespread impact on overall cortical volumes while controlling for age” despite over two decades of regular cannabis use on average. This is in contrast to the large, widespread effects of alcohol on cortical volumes that might be expected to negatively impact cognitive performance.
Facts, Not Fears, Should Guide Marijuana Policy
An estimated one out of five Americans now resides in a jurisdiction where the adult use of cannabis is legally regulated, while more than 30 states have enacted statutes authorizing its medical access. Public support for marijuana policy reform has also steadily increased over the past decade, and now two out of three Americans endorse cannabis legalization. It is time for politicians to reject the unsubstantiated “reefer rhetoric” and fear-mongering of the past and move forward to amend U.S. cannabis laws in response to the emerging science, public opinion and the plant’s rapidly changing cultural status.
Editor’s note: This article was updated on March 20, 2019, to address a study that estimates 30-50 percent of psychosis cases in Europe are due to cannabis exposure.
Sixteen days ago I made a decision to participate in Lent. I have given up things for Lent before, but this year I wanted what I chose to “give up” for 44 days to make a difference in my life. As I began to consider what would be difficult, coffee came to mind. I am a daily coffee drinker, actually an hourly coffee drinker, an every day, all the time coffee drinker . Wow! How did this happen? As I analyzed my daily routine, I was shocked to discover how addicted I had become to coffee.
Actually, drinking coffee was really easy for me. I have a fancy coffee maker that crushes the beans and makes a single cup of coffee on demand. Nice! And about five years ago, my dad upgraded the one pound coffee roaster at work to a six pound coffee roaster, making sure we always have fresh roasted coffee there as well. And since I work for our family businesses, I am guaranteed fresh roasted coffee! And, if I am desperate, there’s always the handy quick coffee maker with coffee pods as well as the local coffee stores for the quick fix. This dang coffee is everywhere!
Without any further hesitation, the decision was made–I’m not just “giving up” coffee for just this designated period; I am quitting cold turkey right now! However, I had no idea how severe the withdrawal symptoms would be four to five days later, but I was determined to kick this caffeine habit to the curb. I really did not realize how adversely the excessive caffeine was affecting my body. I began to consider that perhaps many of the things I was dealing with like anxiety, stress were related to my caffeine consumption.
Today, at Day 15, my body is quiet. For as long as I can remember, during those coffee days, my body always seemed to be humming at what seemed like a low vibration, but I had become so used to that feeling that it had become my normal. Because I knew that my decision required discipline and would be difficult, I started a small daily diary of what was going on with my body. The following are the thirteen days of withdrawal and sleeplessness on this journey to better health.
Day 1: Everything was fine. I just wasn’t sure what to drink instead of coffee. I liked water, but coffee tasted better…and drinking water was not nearly as much fun. Maybe I just liked hot beverages in the morning…maybe?
Day 2: Getting used to having substitutes for coffee was rough…juice was good, but too much sugar. I started drinking Zevia (a soda substitute), using stevia as a sweetener, no sugar, no caffeine…. tried to eat healthier.
Day 3: Still looking for things to do when not drinking coffee. Sauna helped me feel better and get my mind off things.
Days 4, 5: I awoke abruptly at 3 a.m., slightly trembling. ( In Chinese medicine this is known as “liver time,” a state where your liver is “angry.”) After dealing with the sleeplessness, I awoke again to feel as if I were still trembling and began having random, sporadic thoughts like hearing the same thing over and over in my head. I felt anxious and depressed and had difficulty concentrating. Thanks to my brother, I learned that Zevia Colas (not the other Zevia drinks),actually contained caffeine, Whoops! It pays to read the labels!
Days 6, 7, 8: Struggling…I was not prepared for this…I was dizzy, couldn’t focus, didn’t want to eat. I was irritable, just not myself (I love my wife for helping me). Water was getting harder and harder to drink. My anxiety kicked into high gear. My cycling thoughts got worse. I started thinking about death and felt I was in the future. The worst part was that I didn’t get tired. I couldn’t get comfortable. I was shaking constantly. I kept sighing and taking deep breaths. I couldn’t sleep. When I did fall asleep, I woke up at 3 a.m. in a full panic attack, shaking uncontrollably with those crazy thoughts. I thought I was dying. On Day 7 I started to do Tummo breathing to help calm me–huge help, by the way. I stopped taking all supplements because I didn’t want anything to affect my mental state. Those three days were some of the worst I have ever experienced.
Day 9: I’m starting to rely on my routine–wake up, drink lots of water (8 to 16 oz.), wait fifteen minutes, then drink a magnesium supplement (Standard Process MG supplement) with 8 oz. of water. This routine is what kept me going in a straight line. I didn’t have time to think about what to do next; the routine just moved me along. After consuming my water, I ate whole foods. Breakfast has been two eggs sunny side or hardboiled with some butter and toast. Many times I had to force this down because I did not want to eat.
The water helped flush my system as best it could. Caffeine stays in your body for a long time after consumption. I had been taking in so much caffeine that my system was overloaded. The half life of caffeine is 5-7 hours, which means that half of the caffeine is gone within 5-7 hours; therefore, with 100mg of caffeine, 50mg is digested within 5-7 hours. Then the next 5-7 hours you will digest 25mg, then 12.5mg, then 6.25mg, then 3.125, and 1.5 until it is gone. This process with 100mg takes approximately 36 hours to complete. I can only assume my caffeine levels were in the thousands.
My biggest source of joy these last few days has been my family, the sauna, and working out. Sweating has been a big answer for me. I am now back on my supplements, including CBD, Magnesium, Turmeric Forte, and Catalyn. (The last three supplements are produced by Standard Process.)
Days 10, 11, 12: Slowly, day by day, I felt my brain and body coming back under my control. I began to feel hungry. I began to sleep a bit, even relax a bit. When I felt those waves of anxiety, Tummo breathing helped immensely. I kept busy during the days eating as healthy as possible and drinking water. I actually began to fall back in love with water! Guided evening meditations using Headspace helped diminish my anxiety before bedtime. Sleep at this point reminded me of panic attacks causing me to be afraid to relax or sleep. Learning how to control those sporadic thoughts through Headspace allowed me to breath through the waves of emotions and process them correctly.
Days 13, 14: I am feeling like a normal person! Water is the best, and I started drinking Kombucha to get some flavor. I am starting to enjoy my breakfast and morning routines. I actually slept comfortably for 6+ hours. My cycling thoughts have diminished and are being replaced with rational thoughts of plans for my future. I am discovering what I am passionate about again. I feel happy and rejuvenated; and from all the Tummo breathing, my lungs feel amazing and strong.
Day 15: I can concentrate, and I am able to write this post to share with others and, perhaps, be able to inspire change. I woke up early, feeling fully awake and motivated. I did my daily routine of water, magnesium, breakfast. And I cannot stand the thought of drinking coffee! I am about 90% today and am getting closer and closer to my goal of feeling good on a regular basis. I am proud of myself, and I want to share my knowledge and experience with others.
Day 16: I feel great! My body is calm for the first time in a very long time. I was able to go to my Jiu Jitsu class for the first time since starting this detox. I don’t think I am ever going back to caffeine!
In conclusion, caffeine is a horrible drug with some wicked withdrawal symptoms that need to be addressed in a serious manner. Throughout this journey, my family was a tremendous source of encouragement and support, as was my friend Dr. Kendall Gregory, who helped me with my supplements and answered my questions. If it weren’t for him, I may have gone to the emergency room during days 6, 7, and 8. I advise each of you to stop the caffeine now and have a healthier life.
I have included below some articles about anxiety and caffeine. Caffeine triggers anxiety. The processing of caffeine affects your liver when this anxiety kicks in. The stress kicks in, hitting your body hard, overloading the systems and causing the fight or flight mode. For me, any added stress was breaking me. My family’s history of slow liver function was made worse by caffeine, resulting in unnecessary anxiety. I am going to do all I can to improve my inherent slow liver function through good health choices. Caffeine is done for good, and alcohol will be kept at an absolute minimum.
Anyone wants to chat about it, leave me a comment or email me anytime firstname.lastname@example.org
More info that relates to this article.