Does acute cannabidiol (CBD) use impair performance? A meta-analysis and comparison with placebo and delta-9-tetrahydrocannabinol (THC)

• Published in: Neuropsychopharmacology (New York, N.Y.) N.Y.), 2024-08, Vol.49 (9), p.1425-1436
• Main Authors: Lo, Lindsay A, Christiansen, April L, Strickland, Justin C, Pistawka, Carly A, Eadie, Lauren, Vandrey, Ryan, MacCallum, Caroline A
• Format: Article
• Language: English
• Subjects: Cannabidiol; Cannabidiol - administration & dosage; Cannabidiol - pharmacology; Cannabinoids; Clinical trials; Cognition - drug effects; Dronabinol - administration & dosage; Dronabinol - pharmacology; Humans; Meta-analysis; Placebos; Psychomotor Performance - drug effects; Statistical analysis; Tetrahydrocannabinol; THC
• ISSN: 0893-133X; 1740-634X; 1740-634X
• DOI: 10.1038/s41386-024-01847-w

Cannabidiol (CBD) is widely used and believed to be non-intoxicating, lacking acute performance effects (e.g., non-impairing). However, a synthesis of data has not evaluated this. This meta-analysis synthesized data from controlled human laboratory studies that evaluated if acute CBD use impairs performance. Performance on objective and subjective measures of cognitive and psychomotor function were used as markers for potential performance changes and impairment. Studies were identified through systematic database searches. Adult clinical trials measuring acute CBD effects (within 0-8 h of administration) were included. The primary outcome was the peak mean difference in performance measures between CBD and placebo. A secondary analysis utilizing delta-9-tetrahydrocannabinol (Δ9-THC) as a positive control for comparison to CBD was completed. Pooled Hedges' g estimates were calculated using robust variance estimation (RVE) meta-regression. The omnibus RVE meta-analysis indicated a statistically significant, but small effect size (Hedge's g