This longitudinal, cross-cultural online study examines an international sample of regular recreational and medicinal cannabis users from different cannabis jurisdictions using the Experience Sampling Method and a comprehensive battery of cognition and mental health assessments over a 2-year period to gain insight into the short- and long-term mental health and cognitive determinants and consequences of cannabis use and how these interact with broader contextual factors such as legislation.
Key Findings
Background
Cannabis use is increasing for both recreational and medicinal purposes, and simultaneously the prevalence of cannabis-related health harms, including cannabis use disorder (CUD), is increasing.
The paper identifies cannabis use disorder (CUD) as a growing health concern accompanying rising cannabis use.
Medicinal cannabis use is often aimed at improving mental health and cognition.
Much medicinal use occurs without medical supervision, representing a gap in oversight and research.
Background
Product potency, route of administration, and preexisting mental health symptoms are identified as factors that play a role in the effects of cannabis.
The paper notes limited research on how broader factors such as local cannabis legislation and perceptions of use may influence outcomes.
Knowledge remains sparse regarding the growing population of medicinal users, predominantly using without medical supervision.
These gaps motivate the design of the current study.
Methods
The study uses the Experience Sampling Method (ESM) delivered via mobile phone to assess cannabis users in real-world, ecologically valid settings.
ESM is combined with a comprehensive battery of cognition and mental health related assessments.
The study is conducted longitudinally over a 2-year period.
Data collection occurs via participants' mobile phones in their natural environment.
Methods
The study recruits an international sample of regular recreational and medicinal cannabis users aged 18-65 from multiple cannabis jurisdictions.
Participating countries and regions include the Netherlands, the United States, Brazil, Canada, and regions in Asia and Africa.
The jurisdictions represent varying legal frameworks for cannabis.
The study is described as cross-cultural and longitudinal in design.
Background
The study is described as one of the first cross-cultural studies assessing both positive and negative effects of cannabis longitudinally.
The study aims to examine the full range of effects that cannabis may have on the individual.
Both short- and long-term mental health and cognitive determinants and consequences of cannabis use are assessed.
The interaction of individual-level cannabis effects with broader contextual factors such as legislation is explicitly investigated.
de Bode N, Kroon E, Hsieh J, Cousijn J. (2026). Blowing Minds: A cross-cultural, longitudinal investigation to unravel the highs and lows of recreational and medicinal cannabis users.. Comprehensive psychiatry. https://doi.org/10.1016/j.comppsych.2025.152659