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Study breakdown

Adolescents and adults showed different brain reward responses to cannabis in a controlled fMRI experiment

Randomized Controlled TrialModerate evidence
The takeaway

In a placebo-controlled crossover trial, acute THC blunted reward-related brain activity in adults but not adolescents, and adding CBD partially offset that effect.

Neuroscience researchers, policymakers focused on youth cannabis use, clinicians working with adolescents, and parents seeking evidence on age-related cannabis effects.

THC blunted reward brain activity in adults but not in 16-17 year olds

What the researchers found

Adults showed reduced ventral striatum activation during reward anticipation after THC, while adolescents did not. The THC+CBD condition partially attenuated this blunting in adults, suggesting CBD may modulate THC effects on reward circuitry.

Why it matters

The developing adolescent brain may process cannabis differently than the adult brain. Understanding these age-dependent effects on reward circuits is critical for assessing the unique risks cannabis poses to younger users.

The numbers in context

47 participants (24 adolescents, 23 adults). THC dose: 0.107 mg/kg (about 8 mg for 75 kg person). CBD dose: 0.320 mg/kg. Three conditions: THC only, THC+CBD, placebo. Adults showed reduced ventral striatum activation under THC; adolescents did not.

How the study worked

Double-blind, placebo-controlled, randomized crossover design. 47 participants (24 adolescents ages 16-17, 23 adults ages 26-29) matched on cannabis use frequency completed the Monetary Incentive Delay task during fMRI after inhaling THC alone, THC+CBD, or placebo.

What this study cannot tell us

Moderate sample size (47 total). Participants were existing cannabis users (0.5-3 days/week), so findings may not generalize to naive users. Single-session design cannot address repeated exposure effects. THC dose was relatively low.

How to read the evidence

Randomized, placebo-controlled crossover design with neuroimaging is rigorous. Moderate sample size and single-session design are limitations.

When this study was published

Published 2022.

The bigger picture

Reward system development is a key feature of adolescence. If THC affects reward processing differently in teens versus adults, age-specific risk communication and policy approaches may be warranted rather than one-size-fits-all messaging.

Questions still open

  • Does the lack of reward blunting in adolescents reflect resilience or a different vulnerability pattern? Would higher or repeated doses produce different age-dependent effects?

Common questions

Does this mean cannabis is safer for teens than adults?
Not at all. The absence of acute reward blunting in adolescents does not mean cannabis is safe for teens. It may reflect different neural mechanisms that could carry their own risks, including altered reward development. The adolescent brain is still maturing, and other studies link teen cannabis use to long-term cognitive and mental health outcomes.
What does reward anticipation mean in brain imaging?
The Monetary Incentive Delay task shows participants cues signaling they can win or lose money. Brain regions involved in motivation and reward, especially the ventral striatum, activate in anticipation of the reward. Reduced activation can indicate blunted reward processing.

Read the original research

The Effects of Acute Cannabis With and Without Cannabidiol on Neural Reward Anticipation in Adults and Adolescents.

Biological psychiatry. Cognitive neuroscience and neuroimaging, 8(2), 219-229

Citation

Skumlien, Martine; Freeman, Tom P; Hall, Daniel; Mokrysz, Claire; Wall, Matthew B; Ofori, Shelan; Petrilli, Kat; Trinci, Katie; Borissova, Anna; Fernandez-Vinson, Natalia; Langley, Christelle; Sahakian, Barbara J; Curran, H Valerie; Lawn, Will. (2023). The Effects of Acute Cannabis With and Without Cannabidiol on Neural Reward Anticipation in Adults and Adolescents.. Biological psychiatry. Cognitive neuroscience and neuroimaging, 8(2), 219-229. https://doi.org/10.1016/j.bpsc.2022.10.004

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