Women Cannabis Users Show Different Brain Responses to Cannabis Cues Than Men

Women who use cannabis regularly showed blunted brain responses to cannabis cues in reward regions compared to men, with unique brain-craving associations found only in women.

Kaag, A M et al.·Progress in neuro-psychopharmacology & biological psychiatry·2025·Moderate Evidenceneuroimaging study
RTHC-06780Neuroimaging studyModerate Evidence2025RETHINKTHC RESEARCH DATABASErethinkthc.com/research

Quick Facts

Study Type
neuroimaging study
Evidence
Moderate Evidence
Sample
N=27

What This Study Found

Women cannabis users showed blunted neural cue-reactivity in the right insula and putamen compared to male users, a pattern opposite to controls. Among women only, session-induced craving correlated with cue-reactivity in the right superior frontal gyrus, cerebellum, and precentral gyrus. Cannabis use severity was linked to precentral gyrus cue-reactivity exclusively in women.

Key Numbers

66 cannabis users (27 women), 71 controls (31 women). Cannabis users used 2-7 days/week. Women showed blunted insula and putamen cue-reactivity vs men. Brain-craving correlations in frontal gyrus, cerebellum, and precentral gyrus found only in women.

How They Did This

fMRI cue-reactivity study with 66 regular cannabis users (27 women, using 2-7 days/week) and 71 controls (31 women). Cannabis-related and neutral images presented during scanning. Craving measured twice with the Marijuana Craving Questionnaire.

Why This Research Matters

Women transition more rapidly from initial cannabis use to cannabis use disorder. Understanding the distinct neural mechanisms in women could explain this accelerated progression and inform sex-specific treatments.

The Bigger Picture

The sex reversal pattern (blunted in women users but enhanced in women controls, opposite in men) suggests that regular cannabis use may fundamentally reorganize reward circuitry differently by sex, potentially contributing to the faster CUD progression seen in women.

What This Study Doesn't Tell Us

Moderate sample size limits statistical power for sex-stratified analyses. Cross-sectional design cannot determine if neural differences preceded or resulted from cannabis use. Craving measures are self-reported. Participants were non-treatment-seeking.

Questions This Raises

  • ?Does the blunted cue-reactivity in women reflect tolerance or a distinct neurobiological vulnerability?
  • ?Would sex-specific treatment approaches improve CUD outcomes for women?

Trust & Context

Key Stat:
Women cannabis users showed blunted insula and putamen cue-reactivity compared to men, opposite to the pattern in non-using controls
Evidence Grade:
Well-designed fMRI study with sex-stratified analysis, but moderate sample and cross-sectional design limit causal conclusions.
Study Age:
2025 publication.
Original Title:
Unravelling gender differences in cannabis cue-reactivity in individuals who use cannabis.
Published In:
Progress in neuro-psychopharmacology & biological psychiatry, 142, 111515 (2025)
Authors:
Kaag, A M(2), Cousijn, J(5), Kroon, E(2)
Database ID:
RTHC-06780

Evidence Hierarchy

Meta-Analysis / Systematic Review
Randomized Controlled Trial
Cohort / Case-Control
Cross-Sectional / ObservationalSnapshot without intervening
This study
Case Report / Animal Study
What do these levels mean? →

Read More on RethinkTHC

Cite This Study

RTHC-06780·https://rethinkthc.com/research/RTHC-06780

APA

Kaag, A M; Cousijn, J; Kroon, E. (2025). Unravelling gender differences in cannabis cue-reactivity in individuals who use cannabis.. Progress in neuro-psychopharmacology & biological psychiatry, 142, 111515. https://doi.org/10.1016/j.pnpbp.2025.111515

MLA

Kaag, A M, et al. "Unravelling gender differences in cannabis cue-reactivity in individuals who use cannabis.." Progress in neuro-psychopharmacology & biological psychiatry, 2025. https://doi.org/10.1016/j.pnpbp.2025.111515

RethinkTHC

RethinkTHC Research Database. "Unravelling gender differences in cannabis cue-reactivity in..." RTHC-06780. Retrieved from https://rethinkthc.com/research/kaag-2025-unravelling-gender-differences-in

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.