Dissociating the cognitive underpinnings of recreational cannabis use from problematic use

The specific cognitive mechanisms that differentiate cannabis use disorder from recreational use remain unclear. Prior research has typically examined cognitive functions in isolation; here, we provide the first comprehensive assessment of both controlled and automatic processes and their dynamic interplay across the spectrum of cannabis use disorder. To address this gap, we compared three groups: non-users (n = 43), recreational users (n = 36) and problematic cannabis users (n = 43), classified via the Cannabis Use Disorder Identification Test-Revised, on a comprehensive neuropsychological battery. Our results revealed a specific cognitive signature for cannabis use disorder severity, with the problematic user group showing a selective deficit only in complex working memory capacity compared to non-users. In contrast, performance in other executive domains-including inhibitory control and cognitive flexibility-as well as implicit learning, was preserved across all groups. While the overall balance between controlled and automatic systems was similar across groups, results indicated a potential alteration in the specific crosstalk between inhibitory control and implicit learning was altered in recreational users compared to non-users. This study highlights that cognitive alterations in cannabis users are not uniformly present but instead emerge selectively in relation to addiction severity, emphasizing the importance of distinguishing between recreational and problematic use in both research and clinical assessment.