Blunted stress reactivity in chronic cannabis users

Psychopharmacology (Berl). 2017 Aug;234(15):2299-2309. doi: 10.1007/s00213-017-4648-z. Epub 2017 May 31.


Rationale: One of the most commonly cited reasons for chronic cannabis use is to cope with stress. Consistent with this, cannabis users have shown reduced emotional arousal and dampened stress reactivity in response to negative imagery.

Objectives: To our knowledge, the present study represents the first to examine the effects of an acute stress manipulation on subjective stress and salivary cortisol in chronic cannabis users compared to non-users.

Methods: Forty cannabis users and 42 non-users were randomly assigned to complete either the stress or no stress conditions of the Maastricht Acute Stress Test (MAST). The stress condition of the MAST manipulates both physiological (placing hand in ice bath) and psychosocial stress (performing math under conditions of social evaluation). Participants gave baseline subjective stress ratings before, during, and after the stress manipulation. Cortisol was measured from saliva samples obtained before and after the stress manipulation. Further, cannabis cravings and symptoms of withdrawal were measured.

Results: Subjective stress ratings and cortisol levels were significantly higher in non-users in the stress condition relative to non-users in the no stress condition. In contrast, cannabis users demonstrated blunted stress reactivity; specifically, they showed no increase in cortisol and a significantly smaller increase in subjective stress ratings. The stress manipulation had no impact on cannabis users' self-reported cravings or withdrawal symptoms.

Conclusion: Chronic cannabis use is associated with blunted stress reactivity. Future research is needed to determine whether this helps to confer resiliency or vulnerability to stress-related psychopathology as well as the mechanisms underlying this effect.

Keywords: Cannabis; Cortisol; Craving; Marijuana; Stress; Withdrawal.

Publication types

  • Randomized Controlled Trial

MeSH terms

  • Adaptation, Psychological / physiology
  • Adult
  • Cannabis
  • Emotions / physiology
  • Female
  • Humans
  • Hydrocortisone / analysis
  • Hydrocortisone / metabolism*
  • Male
  • Marijuana Smoking / metabolism*
  • Marijuana Smoking / psychology*
  • Middle Aged
  • Saliva / chemistry
  • Saliva / metabolism*
  • Self Report
  • Stress, Psychological / metabolism*
  • Stress, Psychological / psychology*
  • Substance Withdrawal Syndrome / metabolism
  • Substance Withdrawal Syndrome / psychology


  • Hydrocortisone