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Jack M. Fletcher, PhD; J. Bryan Page, PhD; David J. Francis, PhD; Kimberly Copeland, MA; Mary J. Naus, PhD; Chester M. Davis, PhD; Robin Morris, PhD; Dina Krauskopf, MA; Paul Satz, PhD

Arch Gen Psychiatry. 1996;53(11):1051-1057.

Abstract
Background
Cognitive correlates of long-term cannabis use have been elusive. We tested the hypothesis that long-term cannabis use is associated with deficits in shortterm memory, working memory, and attention in a literate, westernized culture (Costa Rica) in which the effects of cannabis use can be isolated.

Methods
Two cohorts of long-term cannabis users and nonusers were studied. Within each cohort, users and nonusers were comparable in age and socioeconomic status. Polydrug users and users who tested positive for the use of cannabis at the time of cognitive assessment after a 72-hour abstention period were excluded. The older cohort (whose age was ~45 years) had consumed cannabis for an average of 34 years, and comprised 17 users and 30 nonusers, who had been recruited in San José, Costa Rica, and had been observed since 1973. The younger cohort (whose age was ~28 years) had consumed cannabis for an average of 8 years, and comprised 37 users and 49 nonusers. Short-term memory, working memory, and attentional skills were measured in each subject.

Results
Older long-term users performed worse than older nonusers on 2 short-term memory tests involving learning lists of words. In addition, older long-term users performed worse than older nonusers on selective and divided attention tasks associated with working memory. No notable differences were apparent between younger users and nonusers.

Conclusion
Long-term cannabis use was associated with disruption of short-term memory, working memory, and attentional skills in older long-term cannabis users.

Author Affiliations
From the Departments of Pediatrics (Dr Fletcher) and Psychiatry and Behavioral Sciences (Drs Fletcher and Davis), University of Texas-Houston Medical School; Department of Psychiatry, University of Miami (Fla) School of Medicine (Dr Page); Department of Psychology, University of Houston (Drs Francis and Naus and Ms Copeland); Department of Psychology, Georgia State University, Atlanta (Dr Morris); Department of Psychology, University of Costa Rica, San José (Dr Krauskopf); and the Neuropsychiatrie Institute, University of California, Los Angeles (Dr Satz).

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