Examining Neuropsychological Sex Differences in Young Adult Cannabis Users

Cannabis is the most widely used illicit substance worldwide, and its use is especially prevalent among adolescents and young adults. This is concerning, given that cannabis use is associated with deficits in neuropsychological functioning. A burgeoning area of research indicates there may be important sex differences in cannabis use and the effects of cannabis on neurocognition, perhaps due to sex-specific vulnerabilities to the neuropharmacological effects of cannabis and differences in age of initiated use. The goal of the present study was to examine potential neurocognitive sex differences among a sample of young adult cannabis users and non-users, and to examine how important factors, such as amount of use and age of initiation of use, may differentially affect neurocognition in male and female cannabis users. We found that young adult cannabis users showed deficits in immediate and delayed recall, but not decision-making, compared to non-users and there were no sex differences in these relationships. However, among cannabis users, more lifetime cannabis use was associated with poorer episodic memory, especially for females. In contrast, more lifetime and past month cannabis use predicted worse decision-making only for males. Further, we found that, surprisingly, an earlier age of first use and an earlier age of regular initiated use was associated with better decision-making for both males and females, but poorer episodic memory for only females, not males. These findings indicate there may be important, sex-specific differences in how amount of cannabis use and age of initiated use related to neurocognition in male and female cannabis users.