Journal of the International Neuropsychological Society

Non-acute (residual) neurocognitive effects of cannabis use: A meta-analytic study

IGOR  GRANT  a1 a2 a3 a5 c1, RAUL  GONZALEZ  a4 a5, CATHERINE L.  CAREY  a4 a5, LOKI  NATARAJAN  a5 a6 and TANYA  WOLFSON  a5
a1 Department of Psychiatry, University of California, San Diego
a2 Center for Medicinal Cannabis Research, University of California, San Diego
a3 Veterans Affairs Healthcare System, San Diego, CA
a4 SDSU/UCSD Joint Doctoral Program in Clinical Psychology
a5 HIV Neurobehavioral Research Center, University of California, San Diego
a6 Department of Family and Preventive Medicine, University of California, San Diego


The possible medicinal use of cannabinoids for chronic diseases emphasizes the need to understand the long-term effects of these compounds on the central nervous system. We provide a quantitative synthesis of empirical research pertaining to the non-acute (residual) effects of cannabis on the neurocognitive performance of adult human subjects. Out of 1,014 studies retrieved using a thorough search strategy, only 11 studies met essential a priori inclusion criteria, providing data for a total of 623 cannabis users and 409 non- or minimal users. Neuropsychological results were grouped into 8 ability domains, and effect sizes were calculated by domain for each study individually, and combined for the full set of studies. Using slightly liberalized criteria, an additional four studies were included in a second analysis, bringing the total number of subjects to 1,188 (i.e., 704 cannabis users and 484 non-users). With the exception of both the learning and forgetting domains, effect size confidence intervals for the remaining 6 domains included zero, suggesting a lack of effect. Few studies on the non-acute neurocognitive effects of cannabis meet current research standards; nevertheless, our results indicate that there might be decrements in the ability to learn and remember new information in chronic users, whereas other cognitive abilities are unaffected. However, from a neurocognitive standpoint, the small magnitude of these effect sizes suggests that if cannabis compounds are found to have therapeutic value, they may have an acceptable margin of safety under the more limited conditions of exposure that would likely obtain in a medical setting. (JINS, 2003, 9, 679–689.)

(Received September 12 2002)
(Revised December 4 2002)
(Accepted December 23 2002)

Key Words: Cannabis; Cannabinoids; Marijuana; THC; Cognitive effects; Neuropsychology; Meta-analysis.

c1 Reprint requests to: Igor Grant, M.D., University of California, Center for Medicinal Cannabis Research, 150 West Washington Street, Second Floor, San Diego, CA 92103. E-mail: