Skip to main content Accessibility help

Impact of 2 Weeks of Monitored Abstinence on Cognition in Adolescent and Young Adult Cannabis Users

  • Alexander L. Wallace (a1), Natasha E. Wade (a2) and Krista M. Lisdahl (a1)



Previous research suggests recovery from cannabis-related deficits in verbal learning and memory functioning after periods of cannabis abstinence in adolescents. Here, we examine how cannabis cessation affects cognitive performance over 2 weeks of monitored abstinence compared to controls in adolescents and young adults.


Seventy-four participants (35 cannabis users) aged 16–26 ceased all cannabis, alcohol, and other illicit substance consumption for a 2-week period; abstinence was monitored via weekly urinalysis, breath, and sweat patch testing. Starting at baseline, participants completed weekly abbreviated neuropsychological batteries. Measures included tests of attention, inhibition, verbal working memory, and learning. Repeated measures assessed within and between subject effects for time and group status, while controlling for past year alcohol and nicotine use.


Cannabis users showed increased performance compared to controls on sustained attention tasks after 2 weeks of cannabis use.


Deficits in attention, but not verbal learning and memory, recovered after 2 weeks of monitored abstinence. This differs from previous literature, suggesting that other cognitive domains may show signs of recovery after periods of cannabis cessation in adolescents and young adults.


Corresponding author

*Correspondence and reprint requests to: Krista M. Lisdahl, 2441 East Hartford Ave, Milwaukee, WI53211, USA. E-mail:


Hide All
Ashare, R.L., Falcone, M., & Lerman, C. (2014). Cognitive function during nicotine withdrawal: Implications for nicotine dependence treatment. Neuropharmacology, 76, 581591.
Bolla, K.I., Brown, K., Eldreth, D., Tate, K., & Cadet, J. (2002). Dose-related neurocognitive effects of marijuana use. Neurology, 59(9), 13371343.
Brandt, J. & Benedict, R. (1991). Hopkins Verbal Learning Test-Revised (HVLT-R). Lutz, FL: Psychological Assessment Resources, Inc.
Brown, S.A., Myers, M.G., Lippke, L., Tapert, S.F., Stewart, D.G., & Vik, P.W. (1998). Psychometric evaluation of the Customary Drinking and Drug Use Record (CDDR): A measure of adolescent alcohol and drug involvement. Journal of Studies on Alcohol, 59(4), 427438.
Budney, A.J., Roffman, R., Stephens, R.S., & Walker, D. (2007). Marijuana dependence and its treatment. Addiction Science & Clinical Practice, 4(1), 4.
Casey, B.J., Getz, S., & Galvan, A. (2008). The adolescent brain. Developmental Review, 28(1), 6277. doi: 10.1016/j.dr.2007.08.003
De Fonseca, F.R., Gorriti, M., Fernandez-Ruiz, J., Palomo, T., & Ramos, J. (1994). Downregulation of rat brain cannabinoid binding sites after chronic Δ9-tetrahydrocannabinol treatment. Pharmacology Biochemistry and Behavior, 47(1), 3340.
Diamond, G., Godley, S.H., Liddle, H.A., Sampl, S., Webb, C., Tims, F.M., & Meyers, R. (2002). Five outpatient treatment models for adolescent marijuana use: A description of the Cannabis Youth Treatment Interventions. Addiction, 97, 7083.
Ehrenreich, H., Rinn, T., Kunert, H.J., Moeller, M.R., Poser, W., Schilling, L., & Hoehe, M.R. (1999). Specific attentional dysfunction in adults following early start of cannabis use. Psychopharmacology, 142(3), 295301.
Fontes, M.A., Bolla, K.I., Cunha, P.J., Almeida, P.P., Jungerman, F., Laranjeira, R.R., & Lacerda, A.L. (2011). Cannabis use before age 15 and subsequent executive functioning. The British Journal of Psychiatry, 198(6), 442447.
Ganzer, F., Bröning, S., Kraft, S., Sack, P.-M., & Thomasius, R. (2016). Weighing the evidence: A systematic review on long-term neurocognitive effects of cannabis use in abstinent adolescents and adults. Neuropsychology Review, 26(2), 186222.
Gentili, S., Mortali, C., Mastrobattista, L., Berretta, P., & Zaami, S. (2016). Determination of different recreational drugs in sweat by headspace solid-phase microextraction gas chromatography mass spectrometry (HS-SPME GC/MS): Application to drugged drivers. Journal of Pharmaceutical and Biomedical Analysis, 129, 282287.
Giedd, J.N., Blumenthal, J., Jeffries, N.O., Castellanos, F.X., Liu, H., Zijdenbos, A., & Rapoport, J.L. (1999). Brain development during childhood and adolescence: A longitudinal MRI study. Nature Neuroscience, 2(10), 861.
Golden, C.J. & Freshwater, S.M. (2002). The Stroop color and word test: A manual for clinical and experimental uses. Chicago: Stoelting Co.
Gonzalez, R., Schuster, R.M., Mermelstein, R.J., Vassileva, J., Martin, E.M., & Diviak, K.R. (2012). Performance of young adult cannabis users on neurocognitive measures of impulsive behavior and their relationship to symptoms of cannabis use disorders. Journal of Clinical Experimental Neuropsychology, 34(9), 962976. doi: 10.1080/13803395.2012.703642
Grotenhermen, F. (2003). Pharmacokinetics and pharmacodynamics of cannabinoids. Clinical Pharmacokinetics, 42(4), 327360.
Gruber, S.A., Dahlgren, M.K., Sagar, K.A., Gönenc, A., & Killgore, W.D. (2012). Age of onset of marijuana use impacts inhibitory processing. Neuroscience Letters, 511(2), 8994.
Gruber, S.A., Sagar, K.A., Dahlgren, M.K., Racine, M., & Lukas, S.E. (2012). Age of onset of marijuana use and executive function. Psychology of Addictive Behaviors, 26(3), 496.
Hanson, K.L., Winward, J.L., Schweinsburg, A.D., Medina, K.L., Brown, S.A., & Tapert, S.F. (2010). Longitudinal study of cognition among adolescent marijuana users over three weeks of abstinence. Addictive Behaviors, 35(11), 970976. doi: 10.1016/j.addbeh.2010.06.012
Hirst, R.B., Watson, J., Rosen, A.S., & Quittner, Z. (2019). Perceptions of the cognitive effects of cannabis use: A survey of neuropsychologists’ beliefs. Journal of Clinical and Experimental Neuropsychology, 41(2), 133146.
Hirvonen, J., Goodwin, R., Li, C.-T., Terry, G., Zoghbi, S., Morse, C., & Innis, R. (2012). Reversible and regionally selective downregulation of brain cannabinoid CB 1 receptors in chronic daily cannabis smokers. Molecular Psychiatry, 17(6), 642.
Howlett, A.C., Breivogel, C.S., Childers, S.R., Deadwyler, S.A., Hampson, R.E., & Porrino, L.J. (2004). Cannabinoid physiology and pharmacology: 30 years of progress. Neuropharmacology, 47, 345358.
Huestis, M.A., Scheidweiler, K.B., Saito, T., Fortner, N., Abraham, T., Gustafson, R.A., & Smith, M.L. (2008). Excretion of Δ9-tetrahydrocannabinol in sweat. Forensic Science International, 174(2–3), 173177.
Jacobus, J., Goldenberg, D., Wierenga, C.E., Tolentino, N.J., Liu, T.T., & Tapert, S.F. (2012). Altered cerebral blood flow and neurocognitive correlates in adolescent cannabis users. Psychopharmacology, 222(4), 675684.
Jacobus, J., Squeglia, L.M., Sorg, S.F., Nguyen-Louie, T.T., & Tapert, S.F. (2014). Cortical thickness and neurocognition in adolescent marijuana and alcohol users following 28 days of monitored abstinence. Journal of Studies on Alcohol and Drugs, 75(5), 729743.
Jernigan, T.L., Trauner, D.A., Hesselink, J.R., & Tallal, P.A. (1991). Maturation of human cerebrum observed in vivo during adolescence. Brain, 114(5), 20372049.
Johnston, L.D., Miech, R.A., O’Malley, P.M., Bachman, J.G., Scheulenberg, J.E., & Patrick, M.E. (2019). Monitoring the future national survey results on drug use, 1975–2018: Overview, key findings on adolescent drug use. Ann Arbor: Institute for Social Research.
Lisdahl, K.M., Gilbart, E.R., Wright, N.E., & Shollenbarger, S. (2013). Dare to delay? The impacts of adolescent alcohol and marijuana use onset on cognition, brain structure, and function. Frontiers in Psychiatry, 4, 53.
Lisdahl, K.M. & Price, J.S. (2012). Increased marijuana use and gender predict poorer cognitive functioning in adolescents and emerging adults. Journal of the International Neuropsychological Society, 18(4), 678688.
Lisdahl, K.M., Wright, N.E., Medina-Kirchner, C., Maple, K.E., & Shollenbarger, S. (2014). Considering cannabis: The effects of regular cannabis use on neurocognition in adolescents and young adults. Current Addiction Reports, 1(2), 144156.
Maple, K.E., Thomas, A.M., Kangiser, M.M., & Lisdahl, K.M. (2019). Anterior cingulate volume reductions in abstinent adolescent and young adult cannabis users: Association with affective processing deficits. Psychiatry Research: Neuroimaging, 288, 5159.
Mathias, C.W., Blumenthal, T.D., Dawes, M.A., Liguori, A., Richard, D.M., Bray, B., & Dougherty, D.M. (2011). Failure to sustain prepulse inhibition in adolescent marijuana users. Drug and Alcohol Dependence, 116(1–3), 110116.
McQueeny, T., Padula, C.B., Price, J., Medina, K.L., Logan, P., & Tapert, S.F. (2011). Gender effects on amygdala morphometry in adolescent marijuana users. Behavioural Brain Research, 224(1), 128134.
Medina, K.L., Hanson, K.L., Schweinsburg, A.D., Cohen-Zion, M., Nagel, B.J., & Tapert, S.F. (2007). Neuropsychological functioning in adolescent marijuana users: Subtle deficits detectable after a month of abstinence. Journal of the International Neuropsychological Society, 13(5), 807820.
Medina, K.L., McQueeny, T., Nagel, B.J., Hanson, K.L., Yang, T.T., & Tapert, S.F. (2009). Prefrontal cortex morphometry in abstinent adolescent marijuana users: Subtle gender effects. Addiction Biology, 14(4), 457468.
Medina, K.L., Nagel, B.J., & Tapert, S.F. (2010). Abnormal cerebellar morphometry in abstinent adolescent marijuana users. Psychiatry Research: Neuroimaging, 182(2), 152159.
Medina, K.L., Schweinsburg, A.D., Cohen-Zion, M., Nagel, B.J., & Tapert, S.F. (2007). Effects of alcohol and combined marijuana and alcohol use during adolescence on hippocampal volume and asymmetry. Neurotoxicology and Teratology, 29(1), 141152.
Padula, C.B., Schweinsburg, A.D., & Tapert, S.F. (2007). Spatial working memory performance and fMRI activation interaction in abstinent adolescent marijuana users. Psychology of Addictive Behaviors, 21(4), 478.
Pope, H.G. & Yurgelun-Todd, D. (1996). The residual cognitive effects of heavy marijuana use in college students. JAMA, 275(7), 521527.
Price, J.S., McQueeny, T., Shollenbarger, S., Browning, E.L., Wieser, J., & Lisdahl, K.M. (2015). Effects of marijuana use on prefrontal and parietal volumes and cognition in emerging adults. Psychopharmacology, 232(16), 29392950.
Ramaekers, J.G., Theunissen, E.L., De Brouwer, M., Toennes, S.W., Moeller, M.R., & Kauert, G. (2011). Tolerance and cross-tolerance to neurocognitive effects of THC and alcohol in heavy cannabis users. Psychopharmacology, 214(2), 391401.
Roten, A., Baker, N.L., & Gray, K.M. (2015). Cognitive performance in a placebo-controlled pharmacotherapy trial for youth with marijuana dependence. Addictive Behaviors, 45, 119123.
Ruff, R.M. & Allen, C.C. (1996). Ruff 2 & 7 selective attention test: Professional manual. Odessa, Fl: Psychological Assessment Resources, Inc.
Saito, T., Wtsadik, A., Scheidweiler, K.B., Fortner, N., Takeichi, S., & Huestis, M.A. (2004). Validated gas chromatographic–negative ion chemical ionization mass spectrometric method for δ9-tetrahydrocannabinol in sweat patches. Clinical Chemistry, 50(11), 20832090.
Schreiner, A.M. & Dunn, M.E. (2012). Residual effects of cannabis use on neurocognitive performance after prolonged abstinence: A meta-analysis. Experimental and Clinical Psychopharmacology, 20(5), 420.
Schuster, R.M., Gilman, J., Schoenfeld, D., Evenden, J., Hareli, M., Ulysse, C., & Evins, A.E. (2018). One month of cannabis abstinence in adolescents and young adults is associated with improved memory. The Journal of Clinical Psychiatry, 79(6), 17m11977.
Schweinsburg, A.D., Schweinsburg, B.C., Medina, K.L., McQueeny, T., Brown, S.A., & Tapert, S.F. (2010). The influence of recency of use on fMRI response during spatial working memory in adolescent marijuana users. Journal of Psychoactive Drugs, 42(3), 401412.
Scott, J.C., Slomiak, S.T., Jones, J.D., Rosen, A.F., Moore, T.M., & Gur, R.C. (2018). Association of cannabis with cognitive functioning in adolescents and young adults: A systematic review and meta-analysis. JAMA Psychiatry, 75(6), 585595.
Sheehan, D.V., Lecrubier, Y., Sheehan, K.H., Amorim, P., Janavs, J., Weiller, E., … Dunbar, G.C. (1998). The Mini-International Neuropsychiatric Interview (MINI): The development and validation of a structured diagnostic psychiatric interview for DSM-IV and ICD-10. The Journal of Clinical Psychiatry, 59, 2233.
Sheehan, D.V., Sheehan, K.H., Shytle, R.D., Janavs, J., Bannon, Y., Rogers, J.E., … Wilkinson, B. (2010). Reliability and validity of the mini international neuropsychiatric interview for children and adolescents (MINI-KID). The Journal of Clinical Psychiatry, 71, 313326.
Shollenbarger, S.G., Price, J., Wieser, J., & Lisdahl, K. (2015). Poorer frontolimbic white matter integrity is associated with chronic cannabis use, FAAH genotype, and increased depressive and apathy symptoms in adolescents and young adults. NeuroImage: Clinical, 8, 117125.
Sim-Selley, L.J., Schechter, N.S., Rorrer, W.K., Dalton, G.D., Hernandez, J., Martin, B.R., & Selley, D.E. (2006). Prolonged recovery rate of CB1 receptor adaptation after cessation of long-term cannabinoid administration. Molecular Pharmacology, 70(3), 986996.
Sneider, J.T., Pope, Jr, H.G., Silveri, M.M., Simpson, N.S., Gruber, S.A., & Yurgelun-Todd, D.A. (2008). Differences in regional blood volume during a 28-day period of abstinence in chronic cannabis smokers. European Neuropsychopharmacology, 18(8), 612619.
Sobell, L.C. & Sobell, M.B. (1992). Timeline follow-back, In Litten, R.Z. & Allen, J.P. (Eds.), Measuring alcohol consumption, (pp. 4172). Totowa, NJ: Humana Press.
Solowij, N., Jones, K.A., Rozman, M.E., Davis, S.M., Ciarrochi, J., Heaven, P.C., & Yücel, M. (2011). Verbal learning and memory in adolescent cannabis users, alcohol users and non-users. Psychopharmacology, 216(1), 131144.
Solowij, N., Michie, P.T., & Fox, A.M. (1995). Differential impairments of selective attention due to frequency and duration of cannabis use. Biological Psychiatry, 37(10), 731739.
Tait, R.J., Mackinnon, A., & Christensen, H. (2011). Cannabis use and cognitive function: 8-year trajectory in a young adult cohort. Addiction, 106(12), 21952203.
Tapert, S.F., Schweinsburg, A.D., Drummond, S.P., Paulus, M.P., Brown, S.A., Yang, T.T., & Frank, L.R. (2007). Functional MRI of inhibitory processing in abstinent adolescent marijuana users. Psychopharmacology, 194(2), 173183. doi: 10.1007/s00213-007-0823-y
Thoma, R.J., Monnig, M.A., Lysne, P.A., Ruhl, D.A., Pommy, J.A., Bogenschutz, M., & Yeo, R.A. (2011). Adolescent substance abuse: The effects of alcohol and marijuana on neuropsychological performance. Alcoholism: Clinical and Experimental Research, 35(1), 3946.
Turner, S.D., Spithoff, S., & Kahan, M. (2014). Approach to cannabis use disorder in primary care: Focus on youth and other high-risk users. Canadian Family Physician, 60(9), 801808.
Wade, N.E., Thomas, A.M., Gruber, S.A., Tapert, S.F., Filbey, F.M., & Lisdahl, K.M. (2020). Binge and cannabis co-use episodes in relation to white matter integrity in emerging adults. Cannabis and Cannabinoid Research, 5(1), 6272.
Wade, N.E., Wallace, A.L., Swartz, A.M., & Lisdahl, K.M. (2019). Aerobic fitness level moderates the association between cannabis use and executive functioning and psychomotor speed following abstinence in adolescents and young adults. Journal of the International Neuropsychological Society, 25(2), 134145.
Wallace, A.L., Wade, N.E., Hatcher, K.F., & Lisdahl, K.M. (2019). Effects of cannabis use and subclinical ADHD symptomology on attention based tasks in adolescents and young adults. Archives of Clinical Neuropsychology, 34(5), 700705.
Wechsler, D., Coalson, D., & Raiford, III, S. (1997). WAIS-III: Wechsler adult intelligence scale. San Antonio, TX: Psychological Corporation.
Winward, J.L., Hanson, K.L., Tapert, S.F., & Brown, S.A. (2014). Heavy alcohol use, marijuana use, and concomitant use by adolescents are associated with unique and shared cognitive decrements. Journal of the International Neuropsychological Society, 20(8), 784795.


Impact of 2 Weeks of Monitored Abstinence on Cognition in Adolescent and Young Adult Cannabis Users

  • Alexander L. Wallace (a1), Natasha E. Wade (a2) and Krista M. Lisdahl (a1)


Altmetric attention score

Full text views

Total number of HTML views: 0
Total number of PDF views: 0 *
Loading metrics...

Abstract views

Total abstract views: 0 *
Loading metrics...

* Views captured on Cambridge Core between <date>. This data will be updated every 24 hours.

Usage data cannot currently be displayed.