Mechanisms Underlying Sex Differences in Cannabis Use

Abstract

Purpose of the Review Cannabis is the most commonly used illicit substance worldwide. In recent decades, highly concentrated products have flooded the market, and prevalence rates have increased. Gender differences exist in cannabis use, as men have higher prevalence of both cannabis use and cannabis use disorder (CUD), while women progress more rapidly from first use to CUD. This paper reviews findings from preclinical and human studies examining the sex-specific neurobiological underpinnings of cannabis use and CUD, and associations with psychiatric symptoms. Recent Findings Sex differences exist in the endocannabinoid system, in cannabis exposure effects on brain structure and function, and in the co-occurrence of cannabis use with symptoms of anxiety, depression and schizophrenia. In female cannabis users, anxiety symptoms correlate with larger amygdala volume and social anxiety disorder symptoms correlate with CUD symptoms. Female cannabis users are reported to be especially vulnerable to earlier onset of schizophrenia, and mixed trends emerge in the correlation of depressive symptoms with cannabis exposure in females and males. Summary As prevalence of cannabis use may continue to increase given the shifting policy landscape regarding marijuana laws, understanding the neurobiological mechanisms of cannabis exposure in females and males is key. Examining these mechanisms may help inform future research on sex-specific pharmacological and behavioral interventions for women and men with high-risk cannabis use, comorbid psychiatric disease, and CUD.

Effects of cannabis on visual function and self-perceived visual quality

“…So we believe future research is needed in order to explore the effects of cannabis on visual performance, but also to examine the relationship between (objectively evaluated) visual effects and the subjective perception of such effects. Finally, although previous findings suggest that cannabis may have a different effect on males and females 60 , 61 , we did not observe such a difference. This could be because of the sample size and different distribution of males and females.…”

An Investigation of Neurochemical Changes in Chronic Cannabis Users

“…Differential effects of CB use as a function of sex have been reported previously in humans as well as in animal models (Calakos et al, 2017). For example, male CB users exhibit higher circulating levels of delta9-tetrahydrocannabinol (THC), the psychoactive component of CB (Jones et al, 2013); show larger cardiovascular and subjective effects than female users (Leatherdale et al, 2007); display more withdrawal symptoms and are less likely to be CB-only users (Hasin et al, 2008).…”

History of Lifetime Cannabis Use Is Associated with Better Cognition and Worse Real-World Functioning in Schizophrenia Spectrum Disorders

“…In relation to cognitive findings, it is necessary to bear in mind the lack of accuracy and subjectivity of the CGI-C measure. More than half of our patients reported to have used cannabis at least 1 day of each month in a year, and this was associated with younger age and male sex as reported in previous studies [21,22]. Furthermore, while this type of cannabis use was associated with a greater number of hospital admissions and younger age at first admission, it was irrelevant for the severity of positive, negative or depressive symptomatology at the time of evaluation.…”