title: Balanced placebo design with marijuana: pharmacological and expectancy effects on impulsivity and risk taking.
abstract: BACKGROUND
  Marijuana is believed to increase impulsivity and risk taking, but the processes whereby it affects such behaviors are not understood. Indeed, either the pharmacologic effect of delta-9-tetrahydrocannabinol (THC) or the expectancy of receiving it may lead to deficits in cognitive processing and increases in risk taking.
  
  
  OBJECTIVE
  We examined the relative effects of expecting to receive active marijuana and the pharmacological drug effects using a balanced placebo design. Young adult regular marijuana users (N = 136) were randomly assigned into one of four groups in a two × two instructional set (Told THC vs. Told no THC) by drug administration (smoked marijuana with 2.8 % THC vs. placebo) design. Dependent measures included subjective intoxication, behavioral impulsivity, and decision-making related to risky behaviors.
  
  
  RESULTS
  Active THC, regardless of expectancy, impaired inhibition on the Stop Signal and Stroop Color-Word tasks. Expectancy of having smoked THC, regardless of active drug, decreased impulsive decision-making on a delay discounting task among participants reporting no deception and increased perception of sexual risk among women, consistent with a compensatory effect. Expectancy of smoking THC in combination with active THC increased negative perceptions from risky alcohol use. Active drug and expectancy independently increased subjective intoxication.
  
  
  CONCLUSIONS
  Results highlight the importance of marijuana expectancy effects as users believing they are smoking marijuana may compensate for expected intoxication effects when engaged in deliberate decision-making by making less impulsive and risky decisions. Effects of marijuana on impulsive disinhibition, by contrast, reflect direct pharmacologic effects for which participants did not compensate.
authors.affiliation: Center for Alcohol and Addiction Studies, Brown University, Box G-S121, Providence, RI 02912, USA. Jane_Metrik@brown.edu
authors.forename: Jane
authors.initials: J
authors.lastname: Metrik
authors.forename: Christopher W
authors.initials: CW
authors.lastname: Kahler
authors.forename: Brady
authors.initials: B
authors.lastname: Reynolds
authors.forename: John E
authors.initials: JE
authors.lastname: McGeary
authors.forename: Peter M
authors.initials: PM
authors.lastname: Monti
authors.forename: Margaret
authors.initials: M
authors.lastname: Haney
authors.forename: Harriet
authors.initials: H
authors.lastname: de Wit
authors.forename: Damaris J
authors.initials: DJ
authors.lastname: Rohsenow
mesh_terms: D000293:Adolescent; D000328:Adult; D003657:Decision Making / Q000187:drug effects; D013759:Dronabinol / Q000494:pharmacology*; D005260:Female; D006801:Humans; D007175:Impulsive Behavior / Q000139:chemically induced*; D008297:Male; D008385:Marijuana Smoking / Q000523:psychology*; D015990:Placebo Effect; D012309:Risk-Taking; D055815:Young Adult
chemical_list: D013759:Dronabinol