10-Year Study Shows Adolescent Cannabis Use Linked to Different Brain Changes Than Young Adult Use
In a 10-year prospective study of 704 participants, cannabis initiation during adolescence was associated with cortical thinning in the prefrontal cortex that persisted into adulthood, while initiation in young adulthood affected temporal and midline areas and was linked to psychotic symptoms.
Quick Facts
What This Study Found
Adolescent cannabis initiation (14-19) was associated with cortical thinning in dorsolateral and ventrolateral prefrontal cortex that persisted into young adulthood and partially mediated associations with later cocaine, ecstasy, and cannabis use at age 22. Young adult initiation (19-22) was associated with thickness changes in temporal and midline areas that mediated the link to psychotic symptoms at age 22.
Key Numbers
704 participants; ~10 years of follow-up; 8 European sites; adolescent initiation linked to prefrontal thinning and later drug use; young adult initiation linked to temporal changes and psychotic symptoms at age 22
How They Did This
Prospective longitudinal study of 704 participants from the IMAGEN study across 8 European sites. Participants were cannabis-naive at baseline with MRI data at baseline, 5-year, and 9-year follow-up. Cannabis use assessed with ESPAD. T1-weighted MRI processed through CIVET pipeline. Mediation analyses tested brain changes as intermediaries between cannabis use and behavioral outcomes.
Why This Research Matters
This is one of the largest and longest prospective neuroimaging studies on cannabis, with a cannabis-naive baseline eliminating reverse causation concerns. The finding that adolescent and young adult initiation affect different brain regions with different behavioral consequences has major implications for prevention messaging.
The Bigger Picture
This study provides some of the strongest evidence yet that when you start using cannabis matters for how it affects the brain. The adolescent brain appears vulnerable in its decision-making regions (prefrontal cortex), while the young adult brain is more vulnerable in areas linked to psychosis.
What This Study Doesn't Tell Us
Observational design cannot definitively establish causation despite prospective baseline. Cannabis use measured by self-report. MRI measures brain structure, not function. Genetic predisposition to both cannabis use and brain changes cannot be fully ruled out.
Questions This Raises
- ?Is there a safe age to begin cannabis use based on brain development?
- ?Could the prefrontal thinning from adolescent use be reversed with abstinence?
- ?Do these brain changes differ by THC potency or frequency of use?
Trust & Context
- Key Stat:
- 704 participants over ~10 years
- Evidence Grade:
- Large prospective longitudinal study with cannabis-naive baseline, MRI data at three time points, and multi-site design
- Study Age:
- 2023 study
- Original Title:
- Differential associations of adolescent versus young adult cannabis initiation with longitudinal brain change and behavior.
- Published In:
- Molecular psychiatry, 28(12), 5173-5182 (2023)
- Authors:
- Albaugh, Matthew D(5), Owens, Max M(5), Juliano, Anthony(4), Ottino-Gonzalez, Jonatan, Cupertino, Renata, Cao, Zhipeng, Mackey, Scott, Lepage, Claude, Rioux, Pierre, Evans, Alan, Banaschewski, Tobias, Bokde, Arun L W, Conrod, Patricia, Desrivières, Sylvane, Flor, Herta, Grigis, Antoine, Gowland, Penny, Heinz, Andreas, Ittermann, Bernd, Martinot, Jean-Luc, Martinot, Marie-Laure Paillère, Artiges, Eric, Nees, Frauke, Orfanos, Dimitri Papadopoulos, Paus, Tomáš, Poustka, Luise, Millenet, Sabina, Fröhner, Juliane H, Smolka, Michael N, Walter, Henrik, Whelan, Robert, Schumann, Gunter, Potter, Alexandra, Garavan, Hugh
- Database ID:
- RTHC-04355
Evidence Hierarchy
Follows a group of people over time to track how outcomes develop.
What do these levels mean? →Frequently Asked Questions
Does starting cannabis as a teenager affect the brain differently than starting in your 20s?
Yes, according to this study. Teenage initiation was associated with thinning in the prefrontal cortex (involved in decision-making) and later drug use, while starting in early adulthood affected temporal brain areas and was linked to psychotic symptoms.
Do the brain changes from teenage cannabis use go away?
In this study, the prefrontal cortex thinning associated with adolescent cannabis initiation persisted into young adulthood (age 22). Whether these changes eventually reverse was not examined.
Read More on RethinkTHC
Cite This Study
https://rethinkthc.com/research/RTHC-04355APA
Albaugh, Matthew D; Owens, Max M; Juliano, Anthony; Ottino-Gonzalez, Jonatan; Cupertino, Renata; Cao, Zhipeng; Mackey, Scott; Lepage, Claude; Rioux, Pierre; Evans, Alan; Banaschewski, Tobias; Bokde, Arun L W; Conrod, Patricia; Desrivières, Sylvane; Flor, Herta; Grigis, Antoine; Gowland, Penny; Heinz, Andreas; Ittermann, Bernd; Martinot, Jean-Luc; Martinot, Marie-Laure Paillère; Artiges, Eric; Nees, Frauke; Orfanos, Dimitri Papadopoulos; Paus, Tomáš; Poustka, Luise; Millenet, Sabina; Fröhner, Juliane H; Smolka, Michael N; Walter, Henrik; Whelan, Robert; Schumann, Gunter; Potter, Alexandra; Garavan, Hugh. (2023). Differential associations of adolescent versus young adult cannabis initiation with longitudinal brain change and behavior.. Molecular psychiatry, 28(12), 5173-5182. https://doi.org/10.1038/s41380-023-02148-2
MLA
Albaugh, Matthew D, et al. "Differential associations of adolescent versus young adult cannabis initiation with longitudinal brain change and behavior.." Molecular psychiatry, 2023. https://doi.org/10.1038/s41380-023-02148-2
RethinkTHC
RethinkTHC Research Database. "Differential associations of adolescent versus young adult c..." RTHC-04355. Retrieved from https://rethinkthc.com/research/albaugh-2023-differential-associations-of-adolescent
Access the Original Study
Study data sourced from PubMed, a service of the U.S. National Library of Medicine, National Institutes of Health.
This study breakdown was produced by the RethinkTHC research team. We analyze and report published research findings without making health recommendations. All interpretations are based solely on the published abstract and study data.