Longitudinal neurocognitive trajectories in a large cohort of youth who use cannabis: combining self-report and toxicology

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Abstract

Adolescents experience extensive neurocognitive development, with cannabis use potentially impacting developmental trajectories. Here, we comprehensively assess the influence of adolescent cannabis use onset on neurocognitive trajectories and consider how recent delta-9-tetrahydrocannabinol (THC) and cannabidiol (CBD) may influence neurocognition. We use the large, diverse longitudinal Adolescent Brain Cognitive Development (ABCD) Study dataset, combining self-reported substance use with objective toxicological tests (hair, urine, breath, oral fluid). Longitudinal mixed methods of the full cohort (n = 11,036, ages 9-17; 47% Female/53% Male) investigate time-varying cannabis onset on neurocognitive performance. Primary model covariates include sociodemographics, family history of substance use disorder, prenatal substance exposure, early psychopathology, other substance use, and nesting for participant ID, study site, and family ID. Secondarily, in participants with repeat toxicological hair testing (n = 645; 38% Female/62% Male) at ages 12-16, we consider the influence of THC v. CBD v. Controls. Primary models included false discovery rate corrections (FDR-p

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Wade, N. E., Sullivan, R. M., Wallace, A. L., Visontay, R., Szpak, V., Lisdahl, K. M., … Tapert, S. F. (2026). Longitudinal neurocognitive trajectories in a large cohort of youth who use cannabis: combining self-report and toxicology. Neuropsychopharmacology. https://doi.org/10.1038/s41386-026-02395-1

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