In weekly cannabis users, cannabis suppresses the brain's anticipatory reward response to money, and cannabidiol (CBD) does not moderate this effect. The adolescent reward circuitry is not differentially sensitive to the acute effects of cannabis on reward anticipation. This double-blind, placebo-controlled, crossover study with 23 adults (26-29 years) and 24 adolescents (16-17 years) used functional magnetic resonance imaging (fMRI) to measure brain activity during a monetary reward anticipation task after inhaling cannabis with tetrahydrocannabinol (THC), THC plus CBD, or placebo. THC acutely reduced reward anticipation activity in the ventral striatum and right insula compared with placebo. THC plus CBD also reduced activity in these regions. The effects were the same in adolescents and adults.
A meta-analysis of 41 double-blind, placebo-controlled experiments involving 1,020 infrequent cannabis users found that acute THC administration increases feelings of high, anxiety, and tiredness, while decreasing alertness and contentedness, with no effect on calmness. Inhaled THC dose-dependently increased high and contentedness but decreased calmness, with greater consistency in high and contentedness at higher doses. On a 100-point scale, inhaling 5 mg THC increased high by 34.3 points, anxiety by 14.4, tiredness by 26.3, and calmness by 4.5, while decreasing alertness by 40.2 and contentedness by 71.0. Oral THC showed no significant subjective effects, though higher oral doses produced more consistent alertness. These findings can inform public health guidance on expected THC effects.