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Cognitive and psychomotor effects in males after smoking a combination of tobacco and cannabis containing up to 69 mg delta-9-tetrahydrocannabinol (THC)

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Abstract

Rationale

Δ9-Tetrahydrocannabinol (THC) is the main active constituent of cannabis. In recent years, the average THC content of some cannabis cigarettes has increased up to approximately 60 mg per cigarette (20% THC cigarettes). Acute cognitive and psychomotor effects of THC among recreational users after smoking cannabis cigarettes containing such high doses are unknown.

Objectives

The objective of this study was to study the dose–effect relationship between the THC dose contained in cannabis cigarettes and cognitive and psychomotor effects for THC doses up to 69.4 mg (23%).

Materials and methods

This double-blind, placebo-controlled, randomised, four-way cross-over study included 24 non-daily male cannabis users (two to nine cannabis cigarettes per month). Participants smoked four cannabis cigarettes containing 0, 29.3, 49.1 and 69.4 mg THC on four exposure days.

Results

The THC dose in smoked cannabis was linearly associated with a slower response time in all tasks (simple reaction time, visuo-spatial selective attention, sustained attention, divided attention and short-term memory tasks) and motor control impairment in the motor control task. The number of errors increased significantly with increasing doses in the short-term memory and the sustained attention tasks. Some participants showed no impairment in motor control even at THC serum concentrations higher than 40 ng/mL. High feeling and drowsiness differed significantly between treatments.

Conclusions

Response time slowed down and motor control worsened, both linearly, with increasing THC doses. Consequently, cannabis with high THC concentrations may be a concern for public health and safety if cannabis smokers are unable to titrate to a high feeling corresponding to a desired plasma THC level.

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Acknowledgements

This study was funded by the Dutch Ministry of Health, Welfare and Sport which had no further role in study design, data collection, analysis and interpretation of data and writing the reports. The authors declare that the study complies with the current Dutch laws, i.e. the country in which the study was performed. The authors wish to express their gratitude to Andrew Clark for his linguistic advice. The authors also acknowledge the anonymous reviewers of Psychopharmacology whose suggestions greatly improved this article.

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Author notes

  1. Tjeert T. Mensinga

    Present address: Clinic for Treatment of Drug Addiction in Northern, Vondellaan 71-73, 9721 LB, Groningen, The Netherlands

Authors and Affiliations

  1. National Poisons Information Center, National Institute for Public Health and the Environment, Bilthoven, The Netherlands

    Claudine C. Hunault, Tjeert T. Mensinga, Maaike Kruidenier, Marianne E. C. Leenders, Irma de Vries & Jan Meulenbelt

  2. Department of Psychopharmacology, Utrecht Institute of Pharmaceutical Studies, Rudolf Magnus Institute of Neuroscience & Helmholz Institute, Utrecht University, Utrecht, The Netherlands

    Koen B. E. Böcker

  3. Expertise Centre for Methodology and Information Services, National Institute for Public Health and the Environment, Bilthoven, The Netherlands

    C. Maarten A. Schipper

  4. Division of Perioperative and Emergency Care, University Medical Center Utrecht, Utrecht, 3584 CX, The Netherlands

    Marianne E. C. Leenders

  5. Division of Intensive Care Center, University Medical Center Utrecht, Utrecht, 3584 CX, The Netherlands

    Jan Meulenbelt

  6. Institute for Risk Assessment Sciences, University Utrecht, Utrecht, The Netherlands

    Jan Meulenbelt

  7. National Institute for Public Health and the Environment, P.O. Box 1, 3720 BA, Bilthoven, The Netherlands

    Claudine C. Hunault

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  1. Claudine C. Hunault
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Corresponding author

Correspondence to Claudine C. Hunault.

Additional information

Trial registration: ClinicalTrials.gov identifier, NCT00225407.

Appendix 1

Appendix 1

Table 4 Multilevel models used for the different tasks: the PROC MIXED was used to fit mixed effects models (SAS v9.1)
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Hunault, C.C., Mensinga, T.T., Böcker, K.B.E. et al. Cognitive and psychomotor effects in males after smoking a combination of tobacco and cannabis containing up to 69 mg delta-9-tetrahydrocannabinol (THC). Psychopharmacology 204, 85–94 (2009). https://doi.org/10.1007/s00213-008-1440-0

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  • DOI: https://doi.org/10.1007/s00213-008-1440-0

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