# Medical Marijuana, Neurocognition, and Subsequent Substance Use

> **NIH NIH R01** · MASSACHUSETTS GENERAL HOSPITAL · 2021 · $636,868

## Abstract

Medical marijuana (MM) policies are changing rapidly, and the consequences of MM use for individuals who
seek access to it are unknown. At the time of this submission, 25 states as well as the District of Columbia
have legalized MM, and following this policy change, it is likely that individuals who either have not used
marijuana in the past, or who have used marijuana occasionally for recreational purposes, will start to use
marijuana medicinally for the first time. Once these individuals receive MM cards, they will have increased
access to marijuana as well as societal permission because of perceived medical benefit. Increased access to
marijuana may lead to escalation of use and possible marijuana-related harms; as recreational marijuana use
has been associated with adverse heath outcomes such as cannabis use disorders (CUD), neurocognitive
impairments, and brain-based changes, it is critical to study whether MM patients will experience similar effects.
To address these timely and clinically important questions, we propose to conduct a randomized, longitudinal
study of MM that will: (1) characterize the impact of MM on indices of addiction, such as CUD, escalation of
use, tolerance, and withdrawal among those who stop using, (2) assess, via dosing diaries, the effect of MM
use patterns on use of other medications, and perception of underlying disease symptomatology, (3)
characterize the impact of MM on neurocognitive performance, including executive function, memory, attention,
and decision-making and (4) examine evidence for impact of MM on brain structure and function. We propose
to enroll 200 adults with no current CUD or heavy marijuana use (e.g. weekly or less frequent), who express
interest in obtaining MM cards to use MM to treat pain, insomnia, anxiety, and/or depression, the most
common conditions for which MM is used. Participants will be randomly assigned to either an active MM arm (n
= 100) in which they can obtain MM cards without delay, or to a waitlist control arm (WLC) (n = 100), in which
they are asked to wait 3 months before obtaining a card. Participants will be assessed at baseline, regularly for
3 months, and at a 6-month and 1-year follow-up for MM use behaviors, development of CUD, perception of
disease symptomatology, and neurocognitive performance. Participants will be incentivized to keep detailed
dosing diaries, via smartphone apps, to record how much MM was used each day, other medications used,
and daily ratings of pain, sleep quality, and mood. Urine collected at each visit will be assessed with
quantitative assays for cannabis metabolites. In the MM group, MRI scans will be collected at baseline and at 1
year, to longitudinally investigate possible brain changes associated with MM use. The proposed project will fill
a critical gap in our knowledge, at a significant time when cannabis is being legalized for ‘medical’ use with little
known about effects of MM on disease symptoms, addictions, neurocognition or brain...

## Key facts

- **NIH application ID:** 10087508
- **Project number:** 5R01DA042043-05
- **Recipient organization:** MASSACHUSETTS GENERAL HOSPITAL
- **Principal Investigator:** Jodi Gilman
- **Activity code:** R01 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2021
- **Award amount:** $636,868
- **Award type:** 5
- **Project period:** 2017-04-01 → 2024-01-31

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10087508

## Citation

> US National Institutes of Health, RePORTER application 10087508, Medical Marijuana, Neurocognition, and Subsequent Substance Use (5R01DA042043-05). Retrieved via AI Analytics 2026-05-22 from https://api.ai-analytics.org/grant/nih/10087508. Licensed CC0.

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