Acute and chronic effects of cannabinoids on effort-related decision-making and reward learning: an evaluation of the cannabis ‘amotivational’ hypotheses

• Published in: Psychopharmacology Vol. 233; no. 19-20; pp. 3537 - 3552
• Main Authors: Lawn, Will, Freeman, Tom P, Pope, Rebecca A, Joye, Alyssa, Harvey, Lisa, Hindocha, Chandni, Mokrysz, Claire, Moss, Abigail, Wall, Matthew B, Bloomfield, Michael AP, Das, Ravi K, Morgan, Celia JA, Nutt, David J, Curran, H Valerie
• Format: Journal Article
• Language: English
• Published: Berlin/Heidelberg Springer Berlin Heidelberg 01.10.2016; Springer; Springer Nature B.V
• Subjects: Administration, Inhalation; Adult; Biomedical and Life Sciences; Biomedicine; Cannabidiol - pharmacology; Cannabinoid Receptor Agonists - pharmacology; Cannabinoids; Cannabis; Choice Behavior - drug effects; Decision making; Decision Making - drug effects; Depression; Double-Blind Method; Dronabinol - pharmacology; Female; Humans; Learning - drug effects; Male; Marijuana; Marijuana Abuse - psychology; Marijuana Smoking; Motivation; Motivation - drug effects; Neurosciences; Original Investigation; Pharmacology/Toxicology; Physiological aspects; Psychiatry; Psychological aspects; Psychopharmacology; Reward; Rewards (Psychology); Young Adult; Cannabis; Cannabinoids; Motivation; Addiction; Effort-related decision-making; Reinforcement learning; Cannabidiol; Reward; THC
• ISSN: 0033-3158; 1432-2072
• DOI: 10.1007/s00213-016-4383-x

Rationale Anecdotally, both acute and chronic cannabis use have been associated with apathy, amotivation, and other reward processing deficits. To date, empirical support for these effects is limited, and no previous studies have assessed both acute effects of Δ-9-tetrahydrocannabinol (THC) and cannabidiol (CBD), as well as associations with cannabis dependence. Objectives The objectives of this study were (1) to examine acute effects of cannabis with CBD (Cann + CBD) and without CBD (Cann-CBD) on effort-related decision-making and (2) to examine associations between cannabis dependence, effort-related decision-making and reward learning. Methods In study 1, 17 participants each received three acute vaporized treatments, namely Cann-CBD (8 mg THC), Cann + CBD (8 mg THC + 10 mg CBD) and matched placebo, followed by a 50 % dose top-up 1.5 h later, and completed the Effort Expenditure for Rewards Task (EEfRT). In study 2, 20 cannabis-dependent participants were compared with 20 non-dependent, drug-using control participants on the EEfRT and the Probabilistic Reward Task (PRT) in a non-intoxicated state. Results Cann-CBD reduced the likelihood of high-effort choices relative to placebo ( p  = 0.042) and increased sensitivity to expected value compared to both placebo ( p  = 0.014) and Cann + CBD ( p  = 0.006). The cannabis-dependent and control groups did not differ on the EEfRT. However, the cannabis-dependent group exhibited a weaker response bias than the control group on the PRT ( p  = 0.007). Conclusions Cannabis acutely induced a transient amotivational state and CBD influenced the effects of THC on expected value. In contrast, cannabis dependence was associated with preserved motivation alongside impaired reward learning, although confounding factors, including depression, cannot be disregarded. This is the first well powered, fully controlled study to objectively demonstrate the acute amotivational effects of THC.