BACKGROUND: Cannabis is the most prevalent illicit drug identified in impaired drivers. The effects of cannabis on driving continue to be debated, making prosecution and legislation difficult. Historically, delays in sample collection, evaluating the inactive Δ9-tetrahydrocannabinol (THC) metabolite 11-nor-9-carboxy-THC, and polydrug use have complicated epidemiologic evaluations of driver impairment after cannabis use.

CONTENT: We review and evaluate the current literature on cannabis' effects on driving, highlighting the epidemiologic and experimental data. Epidemiologic data show that the risk of involvement in a motor vehicle accident (MVA) increases approximately 2-fold after cannabis smoking. The adjusted risk of driver culpability also increases substantially, particularly with increased blood THC concentrations. Studies that have used urine as the biological matrix have not shown an association between cannabis and crash risk. Experimental data show that drivers attempt to compensate by driving more slowly after smoking cannabis, but control deteriorates with increasing task complexity. Cannabis smoking increases lane weaving and impaired cognitive function. Critical-tracking tests, reaction times, divided-attention tasks, and lane-position variability all show cannabis-induced impairment. Despite purported tolerance in frequent smokers, complex tasks still show impairment. Combining cannabis with alcohol enhances impairment, especially lane weaving.

SUMMARY: Differences in study designs frequently account for inconsistencies in results between studies. Participant-selection bias and confounding factors attenuate ostensible cannabis effects, but the association with MVA often retains significance. Evidence suggests recent smoking and/or blood THC concentrations 2–5 ng/mL are associated with substantial driving impairment, particularly in occasional smokers. Future cannabis-and-driving research should emphasize challenging tasks, such as divided attention, and include occasional and chronic daily cannabis smokers.

/pdf/cannabis-effects-on-driving-skills-wf3qftxe1p.pdf

Cannabis Effects on Driving Skills

The purpose of this review is to provide an overview of the existing literature on the relationship between the co-use of cannabis and alcohol including (1) epidemiology, comorbidity, and associated consequences of cannabis and alcohol use disorders; (2) preclinical and clinical laboratory studies examining behavioral pharmacology of cannabis and alcohol co-use; and (3) clinical outcomes related to co-use. Findings from the literature reviewed suggest that the co-use of alcohol and cannabis is associated with additive performance impairment effects, higher and more frequent consumption levels, increased social and behavioral consequences such as driving while impaired, and greater likelihood of the experiencing comorbid substance use and mental health disorders. Furthermore, co-use may be associated with worse clinical outcomes, yet there are few studies examining the development and evaluation of interventions on reducing the co-use of cannabis and alcohol. There is a need for more rigorous and longitudinal research studies on the co-use of cannabis and alcohol to glean a more complete understanding of the relationship between the two substances. Findings can be used to develop and refine intervention strategies to successfully reduce cannabis and alcohol co-use.

/pdf/co-use-of-alcohol-and-cannabis-a-review-4km8jgpw9v.pdf

Co-use of Alcohol and Cannabis: A Review.

https://www.cannabisskunksense.co.uk/uploads/site-files/Cannabis_effects_on_driving_lateral_control_with_and_without_alcohol.pdf

Cannabis effects on driving lateral control with and without alcohol

The effect of alcohol, THC and their combination on perceived effects, willingness to drive and performance of driving and non-driving tasks

The combined effects of alcohol and cannabis on driving: Impact on crash risk

SAM Survey on “Drugs and Fatal Accidents”: Search of Substances Consumed and Comparison between Drivers Involved under the Influence of Alcohol or Cannabis

Characterization and comparison of fractures caused by non-accidental injury and road traffic accident in cats

This article reports on a study that used data from fatal accidents in France between October 2001 and September 2003. This data collection was mandated by a law passed in June 1999 that requires all drivers involved in an immediately fatal accident must submit to a urine screening test and, when impossible or when screening was positive, to a blood sample to screen for drugs, including cannabis, cocaine, heroin, and amphetamines. The results were appended to the usual police records (accident reports), including blood alcohol levels about the legal limit. The data covers 10,000 accidents involving more than 17,000 drivers. This article reports on an analysis of data involving approximately 11,000 subjects. Results on the substances consumed before driving showed that alcohol above the legal limit was present in 20% of drivers involved in an accident (killed, injured or unharmed). Cannabis was the illicit psychoactive substance most frequently detected, with a prevalence of 6.7%; it was detected particularly in younger drivers. Approximately 40% of drivers under the influence of cannabis also had an illegal blood alcohol level. The other drugs, alone or in combination with cannabis, were relatively rare. The authors conclude with a discussion of intervention and prevention actions, particularly those focused on younger drivers.

Drugs and Fatal Accidents Survey: Screening for Consumed Substances

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SAM Survey on “Drugs and Fatal Accidents”: Search of Substances Consumed and Comparison between Drivers Involved under the Influence of Alcohol or Cannabis

Characterization and comparison of fractures caused by non-accidental injury and road traffic accident in cats

Drugs and Fatal Accidents Survey: Screening for Consumed Substances