Cannabis Addiction and the Brain: a Review

J Neuroimmune Pharmacol. 2018 Dec;13(4):438-452. doi: 10.1007/s11481-018-9782-9. Epub 2018 Mar 19.


Cannabis is the most commonly used substance of abuse in the United States after alcohol and tobacco. With a recent increase in the rates of cannabis use disorder (CUD) and a decrease in the perceived risk of cannabis use, it is imperative to assess the addictive potential of cannabis. Here we evaluate cannabis use through the neurobiological model of addiction proposed by Koob and Volkow. The model proposes that repeated substance abuse drives neurobiological changes in the brain that can be separated into three distinct stages, each of which perpetuates the cycle of addiction. Here we review previous research on the acute and long-term effects of cannabis use on the brain and behavior, and find that the three-stage framework of addiction applies to CUD in a manner similar to other drugs of abuse, albeit with some slight differences. These findings highlight the urgent need to conduct research that elucidates specific neurobiological changes associated with CUD in humans.

Keywords: Dopamine; Marijuana; Substance use disorders; THC.

Publication types

  • Research Support, N.I.H., Intramural
  • Review

MeSH terms

  • Animals
  • Behavior, Addictive / diagnostic imaging
  • Behavior, Addictive / psychology
  • Brain / diagnostic imaging*
  • Brain / drug effects
  • Cannabis / adverse effects
  • Humans
  • Magnetic Resonance Imaging / trends
  • Marijuana Abuse / diagnostic imaging*
  • Marijuana Abuse / psychology*
  • Marijuana Smoking / psychology*
  • Marijuana Smoking / trends
  • Nerve Net / diagnostic imaging*
  • Nerve Net / drug effects
  • Receptor, Cannabinoid, CB1 / agonists
  • Receptor, Cannabinoid, CB1 / metabolism
  • Reinforcement, Psychology


  • Receptor, Cannabinoid, CB1