As cannabis use rises in popularity and legality, understanding how the brain responds to marijuana-related cues becomes increasingly important—especially for those struggling with dependence or attempting to quit. While addiction neuroscience has long explored cravings related to alcohol, cocaine, and tobacco, cannabis has remained relatively understudied in this domain.
“Cue-elicited craving for marijuana activates the reward neurocircuitry associated with the neuropathology of addiction.”
Filbey et al., 2009
In a pivotal 2009 study published in Proceedings of the National Academy of Sciences, neuroscientist Dr. Francesca Filbey and her team used functional magnetic resonance imaging (fMRI) to explore how the brains of regular marijuana users react to cannabis-related cues. What they found was striking: even after 72 hours of abstinence, cannabis users exhibited heightened activation in brain regions associated with reward, emotion, and craving when exposed to marijuana-related stimuli. 
These findings not only affirm that marijuana craving activates the brain’s reward circuitry similarly to other addictive substances, but also suggest a measurable link between neural responses and real-world cannabis-related problems—an important insight for treatment development.
The Science of Craving: Why Cue Reactivity Matters
Craving is one of the core behavioral features of addiction. More than just a desire, it reflects deep-seated neurological responses that motivate continued drug use. These responses are often cue-elicited—triggered by sensory exposure to drug-related stimuli like smells, sights, or objects (e.g., a cigarette, a joint, or even the sound of a lighter).
In past decades, studies on alcohol, cocaine, nicotine, and heroin have shown that such cues activate specific regions in the brain’s reward pathway—especially the ventral tegmental area (VTA), nucleus accumbens, orbitofrontal cortex, and amygdala. This activation reflects what scientists call “incentive salience”—the brain tagging a stimulus as rewarding or motivationally important.
What about cannabis? Until this study, few had used brain imaging to systematically examine how marijuana cues might activate similar circuits.
Study Overview: How Cannabis Cues Were Tested in the Brain
Dr. Filbey’s research team recruited 38 regular marijuana users, all of whom had abstained from cannabis for three days before participating in the study. While in an fMRI scanner, participants were presented with two types of tactile cues:
• A marijuana-related object (e.g., a pipe), and
• A neutral object (e.g., a pencil), used as a control.
Each participant held the object for a brief period while viewing it through a mirror system. Afterward, they rated their urge to use marijuana on a scale of 0–10.
This “cue-elicited craving paradigm” aimed to measure both subjective craving and BOLD (blood-oxygen-level-dependent) brain activation in response to cannabis-related stimuli.
Key Findings: Brain Regions That Lit Up for Cannabis Cues
The marijuana cues (vs. neutral cues) triggered significantly greater activation in several areas of the brain, including:
• Ventral tegmental area (VTA) – the dopamine-rich hub of the reward system
• Anterior cingulate cortex (ACC) – involved in emotion, reward, and decision-making
• Insula – connected to bodily awareness, urges, and addiction
• Amygdala – key in processing emotional salience
• Thalamus – integrates sensory information
• Orbitofrontal cortex (OFC) – central to evaluating rewards and decision-making
• Nucleus accumbens (NAc) – a major player in the brain’s reward circuitry
Importantly, the OFC and NAc showed the strongest correlations with marijuana-related problems, as measured by a standardized problem scale (MPS). In other words, people whose brains showed more activity in these regions when presented with marijuana cues were also those who reported more difficulties associated with their cannabis use.
A Shared Addiction Pathway: Cannabis vs. Other Substances
This study’s findings align cannabis with other substances of abuse, confirming that marijuana also activates the brain’s addiction circuits. While each drug interacts with the brain differently on a chemical level, the craving response appears to share a common neural architecture across substances.
• Cocaine and alcohol users show similar ACC and NAc activation when exposed to cues.
• Smokers exhibit enhanced amygdala and insula activity in response to smoking images.
• Cue-induced brain activity in these areas often predicts likelihood of relapse in treatment settings.
By demonstrating parallel effects for cannabis, this study refutes the idea that marijuana is somehow “immune” to the neural dynamics of craving and addiction.
Craving Without Awareness? The Disconnect Between Brain and Urge Ratings
Interestingly, although the brain lit up strongly in response to cannabis cues, the participants’ subjective urge ratings didn’t always correlate with brain activity. That is, someone might say they felt only a mild craving, but their OFC or amygdala might tell a different story.
This highlights a key limitation of self-report methods in addiction research. Craving may involve both conscious and unconscious processes, and the brain might respond to cues before or even without the person realizing it.
Possible explanations for the disconnect include:
• Social desirability bias – underreporting urges due to stigma
• Measurement timing – self-reports may not capture transient neural responses
• Cue type mismatch – some participants preferred other paraphernalia (like joints or bongs) over pipes
Clinical Implications: Could fMRI Predict Relapse or Guide Treatment?
In alcohol and cocaine studies, greater cue-elicited activity in reward regions has been linked to higher relapse risk. If the same proves true for cannabis, then brain imaging could eventually help tailor interventions based on neural vulnerability.
For example:
• Patients with strong NAc or OFC activation may need more intensive support
• Treatments like cognitive behavioral therapy (CBT) or mindfulness could be targeted to dampen cue reactivity
• Future medications could aim to modulate craving circuits directly
The study authors suggest that baseline cue-elicited activity might one day be used to predict treatment outcomes or monitor progress.
Study Strengths: Tactile Cues and Abstinence Design
Most previous cannabis studies used visual or auditory cues (like images or guided scripts). This study used tactile cues, which are more immersive and personal—triggering memory and motor associations tied to use.
Additionally, the researchers ensured all participants were abstinent for 72 hours—a critical window when cravings often peak. Although abstinence wasn’t confirmed via urine testing (due to THC’s long half-life), self-reports were cross-validated with proven “bogus pipeline” techniques to enhance honesty.
Limitations and Future Research
Like any study, there are caveats:
• No control group – All participants were cannabis users, so comparisons to non-users were not possible
• Cue uniformity – Not all users preferred pipes, which could limit craving elicitation
• Subjective urge mismatch – Craving ratings didn’t align with brain activation, limiting behavioral interpretation
• No relapse tracking – The study didn’t follow participants post-scan to link brain activity with real-world outcomes
Future studies should:
• Include control participants
• Use personalized cues (e.g., joint vs. pipe vs. vape)
• Include longitudinal tracking of relapse
• Integrate other measures like heart rate or skin conductance
Final Takeaway: Cannabis Craving Is Real, and It’s Neurologically Measurable
This study is a landmark contribution to cannabis research, offering direct evidence that marijuana-related cues activate the brain’s addiction circuitry in ways similar to other drugs. For policymakers, clinicians, and users alike, this provides a scientific counterweight to the perception of cannabis as “non-addictive.”
While not everyone who uses cannabis will develop dependence, for those who do, understanding the brain mechanisms behind craving can inform better prevention and treatment strategies.
