Impact of Acute and Chronic Cannabis Use on Stress Response Regulation: Challenging the Belief That Cannabis Is an Effective Method for Coping

Mustafa Al'Absi,Alicia M Allen

doi:10.3389/fpsyg.2021.687106

Mustafa Al'Absi, Alicia M Allen

Open Access

https://doi.org/10.3389/fpsyg.2021.687106

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Abstract

Although research has only recently started to examine the impact of cannabis use on stress response, there is some evidence that indicates acute and chronic impacts of cannabis on these processes. In this paper, we review processes involved in regulating the stress response and we review the influence of acute and chronic exposure to cannabis on patterns and regulation of the stress response. We also highlight the role of stress as a risk factor for initiation and maintenance of cannabis use. In this context, we examine moderating variables, including sex and life adversity. In light of recent observations indicating increasing prevalence of cannabis use during pregnancy, we provide additional focus on cannabis use in this vulnerable population, including how acute and chronic stress may predispose some individuals to use cannabis during pregnancy. While this line of research is in its infancy, we review available articles that focus on the perinatal period and that examined the association between cannabis use and various life stressors, including partner violence, job loss, and lack of housing. We also review psychiatric co-morbidities (e.g., post-traumatic stress disorder, anxiety). A better understanding of the way stress and cannabis use relate within the general population, as well as within certain subgroups that may be at a greater risk of using and/or at greater risk for adverse outcomes of use, may lead to the development of novel prevention and intervention approaches.

Highlights

Cannabis is the most widely used psychoactive substance in the world (UNODC, 2020)
We reviewed titles and abstracts to identify relevant articles that matched searches in Pubmed, Embase, Scopus, and PsychINFo using multiple combinations of the following terms: “stress response,” “cortisol,” “cardiovascular reactivity,” or “hypothalamic pituitary adrenal (HPA) axis” and each of the following terms: “endocannabinoids,” “tetrahydrocannabinol (THC)”, “cannabis,” or “marijuana,” as well as “pregnancy,” “prenatal,” “post-partum,” and “perinatal.” Overall, this review will highlight how cannabis use is linked to stress response dysregulation, and it will challenge the belief that cannabis is an effective coping method when dealing with stress
Ellis and colleagues (Ellis et al, 2019) did not observe a link between psychological distress and cannabis use during pregnancy among justice-involved women. These three studies (Ashford et al, 2019; Ellis et al, 2019; Sanjuan et al, 2019) suggest that the relationship between subjective stress and cannabis use may be complicated with daily fluctuation that may not be detectable via onetime assessments

Summary

INTRODUCTION

Cannabis is the most widely used psychoactive substance in the world (UNODC, 2020). Changes in the legal and regulatory status of the substance have contributed to escalation of use in recent years, with a growing number of countries and regions legalizing and decriminalizing cannabis for medical and recreational purposes (Leweke and Koethe, 2008; Office, 2012; Peters et al, 2012; Administration SAaMHS, 2013; Lev-Ran et al, 2013; Hurd et al, 2014; Ahrnsbrak et al, 2016; Carliner et al, 2017; Steigerwald et al, 2018). Findings from human and animal studies suggest the importance of additional research to disentangle potential sex-specific effects on the relationship between cannabis use and stress, as well as determining sex differences in long-term impacts of cannabis use. Ellis and colleagues (Ellis et al, 2019) did not observe a link between psychological distress and cannabis use during pregnancy among justice-involved women Together, these three studies (Ashford et al, 2019; Ellis et al, 2019; Sanjuan et al, 2019) suggest that the relationship between subjective stress and cannabis use may be complicated with daily fluctuation that may not be detectable via onetime assessments. This is important missing information, given numerous known changes to physiological stress responses during pregnancy (La Marca-Ghaemmaghami et al, 2015)

Findings

DISCUSSION

CONCLUSIONS