North African countries have made strides in recognizing and studying addiction. This is evident in recent epidemiological publications and changes in the enforcement of laws specific to substance use. The WHO warns that Africa is especially vulnerable to increased morbidity and mortality from non-communicable disease factors, including addiction and mental illness. Cannabis (marijuana) is the most widely used drug in the world; 72.8% of current illicit drug users report using cannabis. Persistent, negative, dose-related effects of marijuana on nearly all cognitive functions have been reported. Neuroimaging studies of both adolescent and adult marijuana users have documented alterations in brain structure, function, and neurochemistry. Substance abuse and dependence, in general, requires specialized training to treat and specialized tools to support scientist-practitioners who seek to improve existing care by developing new, evidence-based treatment strategies.
Many LMICs lack both basic addiction treatment and clinical research resources; thus, studying the effects of cannabis use in Morocco’s chronic, heavy use population will address an important, emerging public health issue while providing a fertile training ground for developing locally vetted, culturally sensitive, and rigorous clinical addiction research capacity. Our approach is grounded in the neurobiology of addiction and stress; and we expect the impact of chronic, heavy cannabis use to be evident in pathways and regions of the brain that are rich in cannabinoid CB1 receptors (e.g., insula, orbitofrontal cortex, and limbic regions) that subserve various cognitive, motivational, and stress response functions that are common to all forms of addictive behaviors.