Table 2.
Cannabis and other substance use information
| Acute administration studies | Cannabis, nicotine, alcohol, and other drug use/criteria | Length of time since last cannabis use |
| Battistella et al. (2013)40 |
Cannabis: Occasional cannabis smokers (1 joint/month to <1 per week) Alcohol: 1–10 drinks/week (mean = 5) Nicotine: Not exclusionary, participants estimated amount of tobacco in self-made joints using diagram (mean % of cannabis in mixture was 48%) Other drugs: Exclusionary |
>12 h |
| Bhattacharyya et al. (2009)54, (2010)55 |
Cannabis: 15 or fewer lifetime uses and no use in the past month Alcohol: No alcohol abuse or dependence history for subject or subject’s family, no alcohol within 24 h of study Nicotine: 7 of 15 subjects current tobacco smokers (2.92 mean cig./day), participants requested to avoid smoking on morning of study Other drugs: <3 occasions of exposure to other illicit drugs |
N/A |
| Bossong, Jager et al. (2012)38; Bossong, Jansma et al., (2012)39 |
Cannabis: Incidental cannabis smokers (4–7 days/week in the past year) Alcohol: Average use of 16.7 units/week (range: 2–30) Nicotine: 5 cigarettes/day max (2.7 average) Other drugs: Lifetime use 5× (and not in past 6 months) |
2 weeks |
| Borgwardt et al. (2008)50 |
Cannabis: 15 or fewer lifetime uses and no use in the past month Alcohol: < 21 units of alcohol/week Nicotine: Not reported Other drugs: No illicit, psychotropic drug use |
N/A |
| Fusar-Poli et al. (2009)57 |
Cannabis: Used cannabis <15 times Alcohol: No alcohol within 24 h of study session Nicotine: Not reported Other drugs: Drug abuse exclusionary as evaluated by addiction severity index (ASI); no recreational or medical drugs for duration of study, exclusionary urine drug screen analyses |
N/A |
| Winton-Brown et al. (2011)56 |
Cannabis: Used cannabis 1–15 times in their lives, but not use in past month Alcohol: No alcohol within 24 h of study session Nicotine: Not reported Other drugs: Minimal previous exposure to illicit substances |
>1 month |
| Chronic/residual use studies | Cannabis, nicotine, alcohol, and other drug use/criteria | Length of time since last use |
| Abdullaev et al. (2010)70 |
Cannabis: Heavy cannabis users Alcohol: No significant alcohol use Nicotine: Not reported Other drugs: No significant drug use |
>48 h |
| Ames et al. (2013)81 |
Cannabis: Heavy users who reported using cannabis >500 times in the past 3 years and current, daily use Alcohol Users and non-using controls were matched on past 3-year alcohol use (light alcohol or non-drinkers) Nicotine: Users and non-using controls were matched for tobacco use Other drugs: Minimal lifetime use of drugs other than cannabis (no significant differences in methamphetamine, tranquilizer, opiate or hallucinogen use, but slightly more cocaine use in cannabis group) |
Assessed via a 12-item rating scale, ranging from “1= never used” to “12=within the last 24 h”; average rating was 11.46 ± 0.52 |
| Becker et al. (2010)78 |
Cannabis: While most participants were current cannabis users, 8 (19.0%) reported no cannabis use in the month before the study. Average cannabis use: 14.2 days per month, 2.4 joints/day, 51.3-month duration, and 612.2 grams of cannabis in their lifetimes. Alcohol: Excluded participants with a history of alcohol abuse Nicotine: Authors acknowledge limitation that acute nicotine use may have been related to differences in parahippocampal blood oxygenation level–dependent response Other drugs: Excluded for >5 uses of any illicit substance aside from cannabis |
Average self-reported time since last use was 86.52 days. |
| Behan et al. (2014)69 |
Cannabis: Tested positive for cannabis (average amount of use in past week = 42.9 joints) Alcohol: Groups matched for occasions of use in last week and month (cannabis-using group 1.4× in last week, 4.8× in last month; HC 1× in last week, 2.5× in last month) Nicotine: The cannabis-using group contained more smokers and these had smoked more cigarettes in the week and month prior to participation Other drugs: Cannabis-using group exhibited significantly greater use of nicotine and illicit drugs in general; all cannabis-using participants provided urine samples that tested positive for cannabinoid metabolites but not for any other drugs |
The night before the scan |
| Carey et al. (2015)87 |
Cannabis: Regularly consumed cannabis (5–7 days/week) for the previous two years and to have smoked a minimum of 500 joints in their lifetime Alcohol: Excluded current or past alcohol dependence Nicotine: Nicotine smokers = 40% of HC, 47% of cannabis users; no reported current or past dependence on tobacco Other drugs: Excluded for positive drug test (except for cannabis in cannabis group); no reported concurrent or past dependence on other drugs |
>12 h |
| Chang et al. (2006)71 |
Cannabis: Cannabis use at least 5 days per week for at least 2 years Alcohol: In the cannabis and control groups, most subjects used alcohol recreationally, but did not meet criteria for alcohol dependence Nicotine: 3/19 controls, 5/12 abstinent cannabis users and 5/12 active cannabis subjects smoked nicotine cigarettes daily; all were asked to abstain from nicotine use for at least 2 h before the fMRI Other drugs: Negative urine toxicology screen for other drugs (also other drugs used recreationally reported as <10 times in life) |
4–24 h before scan |
| Cousijn et al. (2013)92 |
Cannabis: Heavy cannabis users who used cannabis >10 days/ month for at least 2 years (not seeking treatment or having a treatment history for cannabis use) Alcohol: Excluded participants with an AUDIT score >10 Nicotine: Excluded participants who smoked >20 cigarettes daily Other drugs: Excluded participants with a positive urine screen for other drugs |
>24 h |
| Cousijn et al. (2014)79 |
Cannabis: Heavy cannabis users who used cannabis >10 days/ month for at least 1.5 at baseline Alcohol: Excluded participants with an AUDIT score >10 or positive urine screen for alcohol Nicotine: Excluded participants who smoked >20 cigarettes daily Other drugs: Excluded participants with more 100 lifetime uses of other drugs; positive urine screen for amphetamines, benzodiazepines, opioids, or cocaine |
>24 h |
| De Bellis et al. (2013)94 |
Cannabis: Among the 15 adolescents receiving outpatient treatment for cannabis use disorder (full remission), 6 individuals met criteria for past cannabis abuse and 9 met criteria for past cannabis dependence Alcohol and Nicotine: 6 participants in the cannabis use disorder group met DSM-IV criteria for past history of alcohol abuse (without regular drinking) or for nicotine dependence (n = 2 alcohol and nicotine, n = 2 alcohol abuse, n = 2 nicotine dependence) Other drugs: Full remission of any substance use disorder prior to study enrollment. |
Abstinent adolescents with cannabis use disorder |
| Gruber and Yurgelun-Todd (2005)60 |
Cannabis: Heavy cannabis users (smoked cannabis at least 4000 times in their lives, tested positive for urinary cannabinoids) Alcohol: Excluded for DSM-IV alcohol abuse/dependence Nicotine: Not reported Other drugs: Maximum of 10 lifetime episodes of illicit drug use in any category (including sedative-hypnotics, stimulants, cocaine, opioids, hallucinogens, and MDMA); excluded for any substance use disorders based on DSM-IV criteria (other than cannabis dependence for the cannabis smokers) |
> 12 h |
| Gruber et al. (2009)96 |
Cannabis: >3000 joints in their lifetime, and smoked at least 4 of the last 7 days Alcohol: Did not meet criteria for current or previous alcohol abuse or dependence. Cannabis smokers reported more days of alcohol use per month (9.6 days) than control subjects (4.0 days), but no significant differences between groups for number of days intoxicated in the past month; Nicotine: Subjects did not meet criteria for tobacco abuse or dependence Other drugs: Excluded if >5 lifetime uses or tested positive for any category of illicit drugs |
Night before (~ 12 h or more) |
| Gruber et al. (2012)66 |
Cannabis: Chronic, heavy cannabis users (minimum of 2500 times in their lives, used cannabis at least five out of the last seven days, tested positive for urinary cannabinoids, and met DSM-IV criteria for cannabis abuse or dependence; not regular cigarette smokers overall) Alcohol: Routinely <15 drinks per week; excluded for current or previous alcohol dependence based on SCID-P Nicotine: Not reported Other drugs: <15 lifetime uses of any category of illicit drug; Current or previous drug dependence based on SCID-P (with exception of cannabis for smokers) |
> 12 h |
| Harding et al. (2012)67 |
Cannabis: Daily/near daily cannabis use Alcohol: Cannabis group consumed less alcohol than the HC group Nicotine: 5 on average in cannabis group, 0 in control group Other drugs: No regular consumption (>1×/month for any period of time) of any substance other than cannabis within the past 2 years; median lifetime episodes for amphetamines, benzodiazepines, cocaine, ecstasy, hallucinogens, inhalants, or opiates ranged from 0–6.5 uses |
> 12 h |
| Hatchard 2014 (33)63 |
Cannabis: Heavy adolescent onset cannabis use (>1 joint/week for 3 years; average of 11.48 joints/week) Alcohol: Excluded individuals with substance abuse disorders as determined by DSM-IV criteria, Nicotine: 7/10 cannabis users reported regular use of nicotine (but controlled for in analyses) Other drugs: No regular illicit drug use, or within a month of fMRI testing (including amphetamines, crack, cocaine, heroin, mushrooms, hashish, lysergic acid, steroids, solvents, and tranquilizers); no substance abuse disorders as determined by DSM-IV criteria; no reported substance abuse disorders in parents |
>2 h |
| Heitzeg et al. (2015)95 |
Cannabis: >100 lifetime occasions Alcohol: As all cannabis users reported >100 lifetime drinks, only healthy controls with >100 drinks were included in order to ensure subjects were matched Nicotine: Cannabis and healthy control groups were matched based on nicotine use Other drugs: All participants were required to abstain from other drug use for >48 h, excluded for positive drug screen (other than cannabis) |
>48 h |
| Hester et al. (2009)88 |
Cannabis: Regularly consumed cannabis (5–7 days/week) for the previous 2 years and smoked a minimum of 500 joints in their lifetime Alcohol: Excluded if concurrent or past dependence on alcohol; no group differences Nicotine: Excluded if concurrent or past dependence on nicotine; no group differences Other drugs: Excluded if concurrent or past dependence on other drugs; no group differences |
Average 38 h (+/− 47.7) |
| Jager et al. (2006)72 |
Cannabis: Median current use = 7 (range 2–17) joints per week; median past year use = 350 joints (range 75–900); median lifetime cannabis use = 1300 joints (range 675–5400) Alcohol: Cannabis users reported greater (but not statistically significant) alcohol consumption than the control subjects (median drinks per week: 17 versus 7); no alcohol within 1 week of testing Nicotine: Consumption of tobacco was significantly higher in cannabis users than in controls (8 versus 0 cigarettes per week) Other drugs: Limited other drug use, excluded for intravenous drug use and/or positive urine drug screen on day of testing |
1 week prior to testing and negative urine screen |
| Jager et al. (2007)82 |
Cannabis: >500 lifetime joints (median lifetime use: 1900 joints; median past year use: 332.5 joints) Alcohol: Included as covariates in all analyses Nicotine: Included as covariates in all analyses Other drugs: <5 occasions of other substance use |
>7 days |
| Jager et al. (2013)89 |
Cannabis: Abstinent, but frequent cannabis use; average lifetime joints in cannabis group = 4006 (range: 224–32,850), and control group = 1.8 (4.0, 0–15) Alcohol: 13.3 drinks/week in cannabis group versus 3.4 drinks/week in HC Nicotine: 63.8 cigarettes/week in the cannabis group versus 6.1 cigarettes/week in the control group; smoking cigarettes was allowed until 2 h before the scanning session (to avoid nicotine withdrawal). Other drugs: Regular use of illegal drugs other than cannabis (>10 episodes lifetime) |
>1 week required; average abstinence was 5.1 weeks (range 1–16 weeks). |
| Kanayama et al. (2004)73 |
Cannabis: Smoked cannabis at least 5000 times and at least 7 times per week at the time of study entry Alcohol: No history of abuse or dependence Nicotine: Not indicated Other drugs: No history of abuse or dependence |
6–36 h |
| King et al. (2011)84 |
Cannabis: Using cannabis 6–7 days/week for at least one year, and tested positive for urinary cannabinoids on each day of testing (only 4 of 29 assessed subjects met DSM-IV criteria for cannabis dependence) Alcohol: Alcohol consumption (lifetime grams), duration and frequency of use, and amount per use showed no difference between groups Nicotine: No difference between groups in pack years of nicotine use. Other drugs: Negative urine toxicology screen for cocaine, amphetamine, methamphetamine, THC (except for cannabis users), opiates, and benzodiazepines |
The night before (approximately 12 h) |
| Kober et al. (2014)62 |
Cannabis: Cannabis dependent (used cannabis in the previous 28 days; baseline days of cannabis use in in past 28 days = 17.55) Alcohol: Healthy controls excluded DSM alcohol abuse or dependence; exclusion criteria for cannabis group not reported Nicotine: 55% daily cigarette smokers Other drugs: Healthy controls excluded for DSM substance abuse or dependence (except nicotine); no mention of exclusion for cannabis group |
Not reported |
| Lopez-Larson et al. (2012)86 |
Cannabis: Heavy cannabis use with >100 smokes in the previous year (average frequency of use: 10.3 times/week; average total lifetime use: 1500.6) Alcohol: Excluded for any alcohol dependence (during 2 months prior to scan or total past history of dependence ≥12 months); 4 cannabis participants met criteria for current alcohol abuse, and 2 cannabis participants for past alcohol dependence (over 1.5 years prior) Nicotine: 4 cannabis users reported current nicotine use (average duration: 1.31 ± 3.07 months) and 4 endorsed having a history of nicotine use (average duration: 1.47 ± 4.69 months). Other drugs: Use of any illicit substance <15 times |
20/24 cannabis participants used cannabis <24 h prior to study; 3/24 reported using cannabis within 24–48 h of study; 1/24 reported using cannabis >48h prior to study |
| Nestor et al. (2008)83 (Experiment 2) |
Cannabis: Consumed cannabis 5–7 days/week for the past 2 years and >500 joints in their lifetime. Alcohol: No differences between control group and cannabis group; no participants reported concurrent or past alcohol misuse Nicotine: Not nicotine users Other drugs: 0 days of use in the past month for: nicotine, amphetamine, cocaine, MDMA, and hallucinogens; no participants reported concurrent or past misuse of any other substances |
Average abstinence = 80.8 h |
| Nestor et al. (2010)90 |
Cannabis: Regularly consumed cannabis (5–7 days/week) for the previous 2 years and >500 lifetime joints. On average, 6.1 years (range = 2.5–17) of lifetime cannabis use, consumption of 7258 lifetime joints (range = 700–34,403), 20 days of use in the last 30 days (range = 6–30), and 64 joints in the last 30 days (range = 15–140) Alcohol: No past or concurrent abuse of alcohol; no significant difference in past month of alcohol use between groups, but significantly higher years of alcohol use in cannabis group (6.9 versus 5.2) Nicotine: No nicotine use Other drugs: No past or concurrent dependence of any substances (other than cannabis for the cannabis group) |
Average abstinence period = 108 h (range=12–504). |
| Padula et al. (2007)75 |
Cannabis: Average of 477 episodes of lifetime cannabis use Alcohol: Cannabis users reported higher rates of alcohol than controls Nicotine: Both groups had low rates of tobacco use Other drugs: Although cannabis users reported more use of other drugs than controls, lifetime use of other drugs was <27 times across all substance types |
After 28 days of monitored abstinence |
| Pillay et al. (2004)85 |
Cannabis: >5000 lifetime uses (mean = 16,711.5 ± 4695.35) Alcohol: Lifetime drinks (with one drink defined as a can of beer, a 4 oz glass of wine or 1.5 shots of spirits) = 4777.50 ± 3327.03; excluded for any history of alcohol abuse or dependence Nicotine: Lifetime packs of tobacco: 2138.5 ± 2249.78 (SD); no history of tobacco use disorder Other drugs: No current or past substance abuse or dependence (with exception of cannabis use for cannabis users); mean number of lifetime uses ± SD: stimulant = 5.25 ± 7.36; cocaine = 24.75 ± 32.48; hallucinogen = 19.63 ± 17.99; inhalant = 2.88 ± 3.69; opiate = 0.13 ± 0.33; PCP = 0.88 ± 1.05; sedative–hypnotic = 1.75 ± 1.92 |
4–36 h |
| Sagar et al. (2015)61 |
Cannabis: Heavy cannabis users (minimum of 2500 lifetime uses, used cannabis at least 5 of the last 7 days, tested positive for urinary cannabinoids, and met DSM-IV criteria for cannabis abuse/dependence) Alcohol: Excluded for alcohol use disorder based on DSM-IV criteria Nicotine: No significant differences between cannabis users and controls on the Fagerström test for nicotine dependence (FTND) Other drugs: No more than 15 lifetime uses of any illicit drugs (other than cannabis), no recreational use of Rx or OTC medications |
> 12 h |
| Schweinsburg et al. (2008)76 |
Cannabis: While most cannabis teens were current users, five reported no use in the past month before abstinence Alcohol: Those in the cannabis group who met DSM-IV criteria for alcohol use disorder (abuse: n = 2, dependence: n = 2) were included due to high comorbidity with cannabis use disorder Nicotine: Average of 1.3 (cannabis group) and 0.8 (control group) cigarettes/day Other drugs: Excluded for drug use disorders based on youth or parent report |
After 28 days of monitored abstinence |
| Schweinsburg et al. (2010)77 |
Cannabis: Lifetime use episodes 342.31 ± 260.49 in recent cannabis users, 515.38 ± 275.67 in abstinent cannabis users, and 1.50±4.68 in healthy controls Alcohol: Cannabis groups had greater lifetime alcohol use than the healthy group (recent cannabis users: 140.92 ± 234.82; abstinent cannabis users: 184.85 ± 164.39; healthy controls: 7.11 ± 13.85); cannabis groups reported greater drinks/month than the healthy control group (recent cannabis users: 39.00 ± 47.34; abstinent cannabis users: 54.77 ± 50.96; healthy controls: 1.78 ± 4.68); alcohol use was controlled for in fMRI analyses Nicotine: No between-group differences on the Fagerström test for nicotine dependence (FTND) scores Other drugs: Abstinent users had significantly greater lifetime other drug user than healthy controls (recent cannabis users: 4.77 ± 7.90; abstinent cannabis users: 9.15 ± 12.24; healthy controls: 0.78 ± 3.30) |
Recent cannabis (2–7 days of abstinence required, average: 3.33); abstinent cannabis (27–60 days of abstinence, average: 38.08) |
| Smith et al. (2010)74 |
Cannabis: >1 joint/week minimum; average of 11.48 cannabis joints/week (range of 2–37.5 joints/week), average duration of use of 4.55 years. Alcohol: Controlled for alcohol use in analyses Nicotine: 7/10 cannabis used nicotine (no healthy controls), but controlled for in analyses Other drugs: No use of illicit drugs on a regular basis or within the month prior to testing. |
Not required to abstain |
| Sneider et al. (2013)80 |
Cannabis: Minimum of 2500 lifetime uses, used cannabis at least 5 of the last 7 days, tested positive for urinary cannabinoids, and met DSM-IV criteria for cannabis abuse on the day of scanning Alcohol: 4.4 ± 4.3 and 1.8 ± 2.5 alcoholic beverages per week in cannabis users and non-using comparison subjects, respectively; no alcohol use disorders based on DSM-IV criteria Nicotine: Four cannabis users reported recent nicotine use (1 pack per day; 1 pack every 2 weeks; 1 pack per month; occasional/social use) Other drugs: No substance use disorders based on DSM-IV criteria (except cannabis abuse in cannabis group) |
>12 h |
| Tapert et al. (2007)68 |
Cannabis: >60 lifetime uses of cannabis (475 lifetime uses and 14 past month days on average) Alcohol: On average, cannabis users consumed 35 drinks per month and approximately 200 lifetime drinks; healthy controls consumed 2.7 drinks on average and 15 lifetime uses Nicotine: Cannabis users smoked of 1.4 cigarettes/day (FTND average score = 0.3; healthy controls smoked 0.2 cigarettes/day on average (FTND average score = 0.1) Other drugs: Limited histories of other drug use—average of about 7 uses in cannabis group and 0 in control group |
28 days of abstinence |
| Van Hell et al. (2010)91 |
Cannabis: Average lifetime cannabis use: 3841 uses. Average past year cannabis use: 614 uses; 3 cannabis users tested positive via urinalysis—analyses were done with and without these subjects and no significant differences were found Alcohol: No alcohol use within one week of study, no history or alcohol use disorder, and all groups matched for alcohol use Nicotine: Cannabis group 6.9 cigarettes, nicotine group 13.2 cigarettes, control group = non-users/no nicotine use listed; no nicotine use within 2 h of testing (upon arrival at hospital) Other drugs: <7 lifetime uses of hard drugs and excluded for positive urine sample for any drug other than cannabis |
1 week |
| Wesley et al. (2011)93 |
Cannabis: 4 of 16 cannabis users met criteria for dependence, all tested positive for THC the day of scanning; cannabis users reported using cannabis 2.1 ± 1.5 times/day, 29.4 ± 1.0 days/month; control group <50 lifetime uses occurring more than 2 years prior to study Alcohol: Excluded individuals with alcohol abuse Nicotine: Did not exclude individuals who met criteria for nicotine abuse Other drugs: Test negative for illicit drugs |
Abstinent since the night before the scan |
| Zimmermann et al. (2017)97 |
Cannabis: >3 days per week during the previous 12 months, and use on >200 lifetime occasions Alcohol: No significant differences between healthy controls and cannabis users for number of drinks per week (13.09 versus 9.24) Nicotine: <20 cigarettes/day Other drugs: Cannabis users excluded for >50 lifetime uses of illicit substances or any use during the 28 days prior to the experiment; healthy controls excluded for illicit substance use >10 lifetime uses or any use within 28 days of experiment) |
48 h |