1
|
Manning B, Downey LA, Narayan A, Hayley AC. A systematic review of oculomotor deficits associated with acute and chronic cannabis use. Addict Biol 2024; 29:e13359. [PMID: 38221807 PMCID: PMC10898834 DOI: 10.1111/adb.13359] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2023] [Revised: 09/29/2023] [Accepted: 11/17/2023] [Indexed: 01/16/2024]
Abstract
Driving is a critical everyday task necessitating the rapid and seamless integration of dynamic visually derived information to guide neurobehaviour. Biological markers are frequently employed to detect Δ9-tetrahydrocannabinol (THC) consumption among drivers during roadside tests, despite not necessarily indicating impairment. Characterising THC-specific alterations to oculomotor behaviour may offer a more sensitive measure for indexing drug-related impairment, necessitating discrimination between acute THC effects, chronic use and potential tolerance effects. The present review aims to synthesise current evidence on the acute and chronic effects of THC on driving-relevant oculomotor behaviour. The review was prospectively registered (10.17605/OSF.IO/A4H9W), and Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines informed reporting standards. Overall, 20 included articles comprising 12 experimental acute dosing trials, 5 cross-sectional chronic use studies and 3 roadside epidemiological studies examined the effects of cannabis/THC on oculomotor parameters including saccadic activity gaze behaviour, nystagmus, smooth pursuit and eyelid/blink characteristics. Acute THC consumption selectively impacts oculomotor control, notably increasing saccadic latency and inaccuracy and impairing inhibitory control. Chronic cannabis users, especially those with early age of use onset, display enduring oculomotor deficits that affect visual scanning efficiency. The presence of eyelid tremors appears to be a reliable indicator of cannabis consumption while remaining distinct from direct impairment associated with visual attention and motor control. Cannabis selectively influences oculomotor activity relevant to driving, highlighting the role of cannabinoid systems in these processes. Defining cannabis/THC-specific changes in oculomotor control may enhance the precision of roadside impairment assessments and vehicle safety systems to detect drug-related impairment and assess driving fitness.
Collapse
Affiliation(s)
- Brooke Manning
- Centre for Mental Health and Brain Science, School of Health SciencesSwinburne University of TechnologyHawthornVictoriaAustralia
- International Council for Alcohol, Drugs and Traffic Safety (ICADTS)RotterdamNetherlands
| | - Luke A. Downey
- Centre for Mental Health and Brain Science, School of Health SciencesSwinburne University of TechnologyHawthornVictoriaAustralia
- Institute for Breathing and SleepAustin HospitalMelbourneVictoriaAustralia
| | - Andrea Narayan
- Centre for Mental Health and Brain Science, School of Health SciencesSwinburne University of TechnologyHawthornVictoriaAustralia
| | - Amie C. Hayley
- Centre for Mental Health and Brain Science, School of Health SciencesSwinburne University of TechnologyHawthornVictoriaAustralia
- International Council for Alcohol, Drugs and Traffic Safety (ICADTS)RotterdamNetherlands
- Institute for Breathing and SleepAustin HospitalMelbourneVictoriaAustralia
| |
Collapse
|
2
|
Schnakenberg Martin AM, Flynn LT, Sefik E, Luddy C, Cortes-Briones J, Skosnik PD, Pittman B, Ranganathan M, D'Souza DC. Preliminary study of the interactive effects of THC and ethanol on self-reported ability and simulated driving, subjective effects, and cardiovascular responses. Psychopharmacology (Berl) 2023; 240:1235-1246. [PMID: 37045988 DOI: 10.1007/s00213-023-06356-0] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/29/2022] [Accepted: 03/15/2023] [Indexed: 04/14/2023]
Abstract
RATIONALE Drug- and alcohol-related motor vehicle accidents are a leading cause of morbidity and mortality worldwide. Compared to alcohol, less is known about the effects of cannabis on driving and even less about their combined effects. OBJECTIVE To characterize the combined and separate effects of ethanol and tetrahydrocannabinol (THC) on perceived ability to drive, subjective effects, and simulated driving. METHODS In a within-subject (crossover), randomized, placebo-controlled, double-blind, 2 × 2 design, the effects of oral THC (10 mg [dronabinol] or placebo) and low-dose intravenous ethanol (clamped at BAC 0.04% or placebo) on perceived ability to drive, simulated driving (standard deviation of lateral position [SDLP]), subjective effects (e.g., "high"), and physiological effects (e.g., heart rate) were studied in healthy humans (n = 18). RESULTS Subjects reported reductions in perceived ability to drive (THC < ethanol < combination) which persisted for ~ 6 h (placebo = ethanol, THC < combination). Ethanol and THC produced synergistic effects on heart rate, significant differences compared to either drug alone on perceived ability to drive and feeling states of intoxication (e.g., high), as well increases in SDLP compared to placebo. CONCLUSIONS Perceived ability to drive is reduced under the influence of THC against the backdrop of blood alcohol levels that are below the legal limit. People should be aware that the effects of oral THC on driving may persist for up to six hours from administration. Findings are relevant to the increasingly common practice of combining alcohol and cannabinoids and the effects on driving.
Collapse
Affiliation(s)
- Ashley M Schnakenberg Martin
- Department of Psychiatry, Yale University School of Medicine, New Haven, CT, USA
- VA Connecticut Healthcare System, 950 Campbell Ave, West Haven, CT, 05615, USA
| | - L Taylor Flynn
- Department of Psychiatry, Yale University School of Medicine, New Haven, CT, USA
- VA Connecticut Healthcare System, 950 Campbell Ave, West Haven, CT, 05615, USA
| | - Esra Sefik
- Department of Psychiatry, Yale University School of Medicine, New Haven, CT, USA
- VA Connecticut Healthcare System, 950 Campbell Ave, West Haven, CT, 05615, USA
| | - Christina Luddy
- Department of Psychiatry, Yale University School of Medicine, New Haven, CT, USA
- VA Connecticut Healthcare System, 950 Campbell Ave, West Haven, CT, 05615, USA
| | - Jose Cortes-Briones
- Department of Psychiatry, Yale University School of Medicine, New Haven, CT, USA
- VA Connecticut Healthcare System, 950 Campbell Ave, West Haven, CT, 05615, USA
| | - Patrick D Skosnik
- Department of Psychiatry, Yale University School of Medicine, New Haven, CT, USA
- VA Connecticut Healthcare System, 950 Campbell Ave, West Haven, CT, 05615, USA
| | - Brian Pittman
- Department of Psychiatry, Yale University School of Medicine, New Haven, CT, USA
| | - Mohini Ranganathan
- Department of Psychiatry, Yale University School of Medicine, New Haven, CT, USA
- VA Connecticut Healthcare System, 950 Campbell Ave, West Haven, CT, 05615, USA
| | - Deepak Cyril D'Souza
- Department of Psychiatry, Yale University School of Medicine, New Haven, CT, USA.
- VA Connecticut Healthcare System, 950 Campbell Ave, West Haven, CT, 05615, USA.
| |
Collapse
|
3
|
Simmons SM, Caird JK, Sterzer F, Asbridge M. The effects of cannabis and alcohol on driving performance and driver behaviour: a systematic review and meta-analysis. Addiction 2022; 117:1843-1856. [PMID: 35083810 DOI: 10.1111/add.15770] [Citation(s) in RCA: 25] [Impact Index Per Article: 12.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/01/2021] [Accepted: 11/03/2021] [Indexed: 11/27/2022]
Abstract
BACKGROUND AND AIMS Cannabis and alcohol are frequently detected in fatal and injury motor vehicle crashes. While epidemiological meta-analyses of cannabis and alcohol have found associations with an increase in crash risk, convergent evidence from driving performance measures is insufficiently quantitatively characterized. Our objectives were to quantify the magnitude of the effect of cannabis and alcohol-alone and in combination-on driving performance and behaviour. METHODS Systematic review and meta-analysis. We systematically searched Academic Search Complete, CINAHL, Embase, Scopus, Google Scholar, MEDLINE, PsycINFO, SPORTDiscus and TRID. Of the 616 studies that underwent full-text review, this meta-analysis represents 57 studies and 1725 participants. We extracted data for hazard response time, lateral position variability, lane deviations or excursions, time out of lane, driving speed, driving speed variability, speed violations, time speeding, headway, headway variability and crashes from experimental driving studies (i.e. driving simulator, closed-course, on-road) involving cannabis and/or alcohol administration. We reported meta-analyses of effect sizes using Hedges' g and r. RESULTS Cannabis alone was associated with impaired lateral control [e.g. g = 0.331, 95% confidence interval (CI) = 0.212-0.451 for lateral position variability; g = 0.198, 95% CI = 0.001-0.395 for lane excursions) and decreased driving speed (g = -0.176, 95% CI = -0.298 to -0.053]. The combination of cannabis and alcohol was associated with greater driving performance decrements than either drug in isolation [e.g. g = 0.480, 95% CI = 0.096-0.865 for lateral position variability (combination versus alcohol); g = 0.525, 95% CI = 0.049-1.002 for time out of lane (versus alcohol); g = 0.336, 95% CI = 0.036-0.636 for lateral position variability (combination versus cannabis; g = 0.475, 95% CI = 0.002-0.949 for time out of lane (combination versus cannabis)]. Subgroup analyses indicated that the effects of cannabis on driving performance measures were similar to low blood alcohol concentrations. A scarcity of data and study heterogeneity limited the interpretation of some measures. CONCLUSIONS This meta-analysis indicates that cannabis, like alcohol, impairs driving, and the combination of the two drugs is more detrimental to driving performance than either in isolation.
Collapse
Affiliation(s)
- Sarah M Simmons
- Department of Psychology, University of Calgary, Alberta, Canada
| | - Jeff K Caird
- Department of Psychology, University of Calgary, Alberta, Canada.,Community Health Sciences, Cumming School of Medicine, University of Calgary, Alberta, Canada.,O'Brien Institute of Public Health, University of Calgary, Alberta, Canada
| | - Frances Sterzer
- Department of Psychology, University of Calgary, Alberta, Canada
| | - Mark Asbridge
- Department of Community Health and Epidemiology, Dalhousie University, Halifax, NS, Canada
| |
Collapse
|
4
|
Fares A, Wickens CM, Mann RE, Di Ciano P, Wright M, Matheson J, Hasan OSM, Rehm J, George TP, Samokhvalov AV, Shuper PA, Huestis MA, Stoduto G, Brown T, Stefan C, Rubin-Kahana DS, Le Foll B, Brands B. Combined effect of alcohol and cannabis on simulated driving. Psychopharmacology (Berl) 2022; 239:1263-1277. [PMID: 33544195 DOI: 10.1007/s00213-021-05773-3] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/21/2020] [Accepted: 01/21/2021] [Indexed: 12/21/2022]
Abstract
RATIONALE With alcohol and cannabis remaining the most commonly detected drugs in seriously and fatally injured drivers, there is a need to understand their combined effects on driving. OBJECTIVES The present study examined the effects of combinations of smoked cannabis (12.5% THC) and alcohol (target BrAC 0.08%) on simulated driving performance, subjective drug effects, cardiovascular measures, and self-reported perception of driving ability. METHODS In this within-subjects, double-blind, double-dummy, placebo-controlled, randomized clinical trial, cannabis users (1-7 days/week) aged 19-29 years attended four drug administration sessions in which simulated driving, subjective effects, cardiovascular measures, and whole blood THC and metabolite concentrations were assessed following placebo alcohol and placebo cannabis (<0.1% THC), alcohol and placebo cannabis, placebo alcohol and active cannabis, and alcohol and active cannabis. RESULTS Standard deviation of lateral position in the combined condition was significantly different from the placebo condition (p < 0.001). Standard deviation of lateral position was also significantly different from alcohol and cannabis alone conditions in the single task overall drive (p = 0.029 and p = 0.032, respectively), from the alcohol alone condition in the dual task overall drive (p = 0.022) and the cannabis alone condition in the dual task straightaway drive (p = 0.002). Compared to the placebo condition, the combined and alcohol conditions significantly increased reaction time. Subjective effects in the combined condition were significantly greater than with either of the drugs alone at some time points, particularly later in the session. A driving ability questionnaire showed that participants seemed unaware of their level of impairment. CONCLUSION Combinations of alcohol and cannabis increased weaving and reaction time, and tended to produce greater subjective effects compared to placebo and the single drug conditions suggesting a potential additive effect. The fact that participants were unaware of this increased effect has important implications for driving safety.
Collapse
Affiliation(s)
- Andrew Fares
- Department of Pharmacology and Toxicology, University of Toronto, 27 King's College Circle, Toronto, Ontario, M5S 3H7, Canada.,Institute for Mental Health Policy Research, Centre for Addiction and Mental Health, 33 Ursula Franklin Street, Toronto, Ontario, M5S 2S1, Canada
| | - Christine M Wickens
- Institute for Mental Health Policy Research, Centre for Addiction and Mental Health, 33 Ursula Franklin Street, Toronto, Ontario, M5S 2S1, Canada.,Dalla Lana School of Public Health, University of Toronto, 155 College Street, Toronto, Ontario, M5T 3M7, Canada.,Campbell Family Mental Health Research Institute Centre for Addiction and Mental Health, Ursula Franklin Street, Toronto, Ontario, M5S 2S1, Canada.,Institute of Health Policy, Management and Evaluation, University of Toronto, 155 College Street, 425 - 155 College Street, Toronto, Ontario, M5T 1P8, Canada
| | - Robert E Mann
- Institute for Mental Health Policy Research, Centre for Addiction and Mental Health, 33 Ursula Franklin Street, Toronto, Ontario, M5S 2S1, Canada.,Dalla Lana School of Public Health, University of Toronto, 155 College Street, Toronto, Ontario, M5T 3M7, Canada
| | - Patricia Di Ciano
- Department of Pharmacology and Toxicology, University of Toronto, 27 King's College Circle, Toronto, Ontario, M5S 3H7, Canada.,Institute for Mental Health Policy Research, Centre for Addiction and Mental Health, 33 Ursula Franklin Street, Toronto, Ontario, M5S 2S1, Canada.,Campbell Family Mental Health Research Institute Centre for Addiction and Mental Health, Ursula Franklin Street, Toronto, Ontario, M5S 2S1, Canada
| | - Madison Wright
- Department of Pharmacology and Toxicology, University of Toronto, 27 King's College Circle, Toronto, Ontario, M5S 3H7, Canada.,Institute for Mental Health Policy Research, Centre for Addiction and Mental Health, 33 Ursula Franklin Street, Toronto, Ontario, M5S 2S1, Canada
| | - Justin Matheson
- Department of Pharmacology and Toxicology, University of Toronto, 27 King's College Circle, Toronto, Ontario, M5S 3H7, Canada.,Institute for Mental Health Policy Research, Centre for Addiction and Mental Health, 33 Ursula Franklin Street, Toronto, Ontario, M5S 2S1, Canada
| | - Omer S M Hasan
- Institute for Mental Health Policy Research, Centre for Addiction and Mental Health, 33 Ursula Franklin Street, Toronto, Ontario, M5S 2S1, Canada.,Dalla Lana School of Public Health, University of Toronto, 155 College Street, Toronto, Ontario, M5T 3M7, Canada
| | - Jurgen Rehm
- Institute for Mental Health Policy Research, Centre for Addiction and Mental Health, 33 Ursula Franklin Street, Toronto, Ontario, M5S 2S1, Canada.,Dalla Lana School of Public Health, University of Toronto, 155 College Street, Toronto, Ontario, M5T 3M7, Canada.,Campbell Family Mental Health Research Institute Centre for Addiction and Mental Health, Ursula Franklin Street, Toronto, Ontario, M5S 2S1, Canada.,Department of Psychiatry, University of Toronto, 250 College Street, Toronto, Ontario, M5T 1R8, Canada.,World Health Organization/Pan American Health Organization Collaborating Centre, Centre for Addiction and Mental Health, 33 Ursula Franklin Street, Toronto, Ontario, M5S 2S1, Canada.,Institute of Clinical Psychology and Psychotherapy & Center of Clinical Epidemiology and Longitudinal Studies (CELOS), Technische Universität Dresden, Chemnitzer Str. 46, 01187, Dresden, Germany.,Faculty of Medicine, Institute of Medical Science, University of Toronto, Medical Sciences Building, 1 King's College Circle, Room 2374, Toronto, Ontario, M5S 1A8, Canada.,Department of International Health Projects, Institute for Leadership and Health Management, I.M. Sechenov First Moscow State Medical University, Trubetskaya str., 8, b. 2, Moscow, Russian Federation, 119992
| | - Tony P George
- Department of Psychiatry, University of Toronto, 250 College Street, Toronto, Ontario, M5T 1R8, Canada.,Biobehavioural Addictions and Concurrent Disorders Research Laboratory, Addictions Division, CAMH, 33 Ursula Franklin Street, Suite 1910A, Toronto, Ontario, M5S 2S1, Canada
| | - Andriy V Samokhvalov
- Institute for Mental Health Policy Research, Centre for Addiction and Mental Health, 33 Ursula Franklin Street, Toronto, Ontario, M5S 2S1, Canada.,Department of Psychiatry, University of Toronto, 250 College Street, Toronto, Ontario, M5T 1R8, Canada
| | - Paul A Shuper
- Institute for Mental Health Policy Research, Centre for Addiction and Mental Health, 33 Ursula Franklin Street, Toronto, Ontario, M5S 2S1, Canada.,Dalla Lana School of Public Health, University of Toronto, 155 College Street, Toronto, Ontario, M5T 3M7, Canada.,Campbell Family Mental Health Research Institute Centre for Addiction and Mental Health, Ursula Franklin Street, Toronto, Ontario, M5S 2S1, Canada
| | - Marilyn A Huestis
- Institute of Emerging Health Professions, Thomas Jefferson University, 1020 Walnut Street, Philadelphia, PA, 19107, USA
| | - Gina Stoduto
- Institute for Mental Health Policy Research, Centre for Addiction and Mental Health, 33 Ursula Franklin Street, Toronto, Ontario, M5S 2S1, Canada
| | - Timothy Brown
- National Advanced Driving Simulator, University of Iowa, 2401 Oakdale Blvd, Iowa City, IA, 52242, USA
| | - Cristiana Stefan
- Clinical Laboratory and Diagnostic Services, Centre for Addiction and Mental Health, 100 Stokes Street, Toronto, Ontario, M6J 1H4, Canada.,Department of Laboratory Medicine and Pathobiology, University of Toronto, 1 King's College Circle, Toronto, Ontario, M5S 1A8, Canada
| | - Dafna Sara Rubin-Kahana
- Department of Psychiatry, University of Toronto, 250 College Street, Toronto, Ontario, M5T 1R8, Canada.,Translational Addiction Research Laboratory, Centre for Addiction and Mental Health, 33 Ursula Franklin Street, Toronto, Ontario, M5S 2S1, Canada
| | - Bernard Le Foll
- Department of Pharmacology and Toxicology, University of Toronto, 27 King's College Circle, Toronto, Ontario, M5S 3H7, Canada.,Campbell Family Mental Health Research Institute Centre for Addiction and Mental Health, Ursula Franklin Street, Toronto, Ontario, M5S 2S1, Canada.,Department of Psychiatry, University of Toronto, 250 College Street, Toronto, Ontario, M5T 1R8, Canada.,Translational Addiction Research Laboratory, Centre for Addiction and Mental Health, 33 Ursula Franklin Street, Toronto, Ontario, M5S 2S1, Canada.,Department of Family and Community Medicine, University of Toronto, 500 University Avenue, 5th Floor, Toronto, Ontario, M5G 1V7, Canada
| | - Bruna Brands
- Department of Pharmacology and Toxicology, University of Toronto, 27 King's College Circle, Toronto, Ontario, M5S 3H7, Canada. .,Institute for Mental Health Policy Research, Centre for Addiction and Mental Health, 33 Ursula Franklin Street, Toronto, Ontario, M5S 2S1, Canada. .,Controlled Substances and Cannabis Branch, Health Canada, Ottawa, Ontario, Canada.
| |
Collapse
|
5
|
Anzillotti L, Dagoli S, Calò L, Maglietta G, Cecchi R. Road traffic deaths: A retrospective analysis (2009-2019) in the north of the Italian region Emilia Romagna. TRAFFIC INJURY PREVENTION 2021; 23:29-33. [PMID: 34882488 DOI: 10.1080/15389588.2021.2002853] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/25/2021] [Revised: 09/24/2021] [Accepted: 11/02/2021] [Indexed: 06/13/2023]
Abstract
OBJECTIVE International literature and several national studies demonstrate that alcohol and illicit drugs impair driving abilities, diminishing the level of attention, and cause traffic accidents. In Italy, driving under the influence of alcohol or drugs is regulated by Articles 186 and 187 of the National Street Code, which defines penalties and fines for the convicted. The aim of this study was the collection of all available data from 2009 to 2019 focusing on deaths related to road accidents in the Unit of Legal Medicine of Department of Medicine and Surgery at the University of Parma, in order to assess any consumption of alcohol, illicit drugs, and medicinal drugs among drivers. METHODS Data were retrieved from autopsy reports found at the Unit of Legal Medicine of Parma University related to 327 subjects who died following road accidents in the Italian areas of Parma, Reggio-Emilia, and Piacenza. The population was divided into subgroups according to age, gender, crash time, and drug positivity. RESULTS Those in the age group 46 to 65 years old were involved in the most accidents, whereas the category with fewest members included subjects under 26 years old. The majority of road accidents occurred during the daytime and on weekends. Among the toxicological investigations carried out (only for drivers), the highest prevalence was found for alcohol (43.1%), followed by illicit drugs (14.4%) and medicinal drugs (7.8%). The prevalence of alcohol and illicit drugs in combination was 11.8%. Regarding subjects positive for alcohol and illicit drugs in combination, 44.4% had a blood alcohol concentration (BAC) > 1.5 g/L and overall, in 61.1% of the total cases a BAC > 0.81 g/L was detected. CONCLUSIONS Our results are in line with national and international studies highlighting the prevalence of high BAC levels in most of the cases. Confirmation analyses on blood collected from people who died following road accidents showed levels of BAC above 0.8 g/L (threshold for penal sanctions) in the majority of the subjects who tested positive for alcohol. They also revealed cocaine, cannabis, and benzodiazepines as the most common illicit drugs and medicinal drugs used, respectively, as demonstrated in several international studies.
Collapse
Affiliation(s)
- L Anzillotti
- Legal Medicine, Department of Medicine and Surgery, University of Parma, Parma, Italy
| | - S Dagoli
- Legal Medicine, Department of Medicine and Surgery, University of Parma, Parma, Italy
| | - L Calò
- Legal Medicine, Department of Medicine and Surgery, University of Parma, Parma, Italy
| | - G Maglietta
- Research and Innovation Unit, University Hospital of Parma, Parma, Italy
| | - R Cecchi
- Legal Medicine, Department of Medicine and Surgery, University of Parma, Parma, Italy
| |
Collapse
|
6
|
Smith AD, De Lillo C. Sources of variation in search and foraging: A theoretical perspective. Q J Exp Psychol (Hove) 2021; 75:197-231. [PMID: 34609229 DOI: 10.1177/17470218211050314] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Search-the problem of exploring a space of alternatives to identify target goals-is a fundamental behaviour for many species. Although its foundation lies in foraging, most studies of human search behaviour have been directed towards understanding the attentional mechanisms that underlie the efficient visual exploration of two-dimensional (2D) scenes. With this review, we aim to characterise how search behaviour can be explained across a wide range of contexts, environments, spatial scales, and populations, both typical and atypical. We first consider the generality of search processes across psychological domains. We then review studies of interspecies differences in search. Finally, we explore in detail the individual and contextual variables that affect visual search and related behaviours in established experimental psychology paradigms. Despite the heterogeneity of the findings discussed, we identify that variations in control processes, along with the ability to regulate behaviour as a function of the structure of search space and the sampling processes adopted, to be central to explanations of variations in search behaviour. We propose a tentative theoretical model aimed at integrating these notions and close by exploring questions that remain unaddressed.
Collapse
Affiliation(s)
| | - Carlo De Lillo
- Department of Neuroscience, Psychology and Behaviour, University of Leicester, Leicester, UK
| |
Collapse
|
7
|
Shahidi Zandi A, Comeau FJE, Mann RE, Di Ciano P, Arslan EP, Murphy T, Le Foll B, Wickens CM. Preliminary Eye-Tracking Data as a Nonintrusive Marker for Blood Δ-9-Tetrahydrocannabinol Concentration and Drugged Driving. Cannabis Cannabinoid Res 2021; 6:537-547. [PMID: 34432541 DOI: 10.1089/can.2020.0141] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Background: Cannabis is one of the drugs most often found in drivers involved in serious motor vehicle collisions. Validity and reliability of roadside cannabis detection strategies are questioned. This pilot study aimed to investigate the relationship between eye characteristics and cannabis effects in simulated driving to inform potential development of an alternative detection strategy. Materials and Methods: Multimodal data, including blood samples, eye-tracking recordings, and driving performance data, were acquired from 10 participants during a prolonged single-session driving simulator experiment. The study session included a baseline driving trial before cannabis exposure and seven trials at various times over ∼5 h after exposure. The multidimensional eye-tracking recording from each driving trial for each participant was segmented into nonoverlapping epochs (time windows); 34 features were extracted from each epoch. Blood Δ-9-tetrahydrocannabinol (THC) concentration, standard deviation of lateral position (SDLP), and mean vehicle speed were target variables. The cross-correlation between the temporal profile of each eye-tracking feature and target variable was assessed and a nonlinear regression analysis evaluated temporal trend of features following cannabis exposure. Results: Mean pupil diameter (r=0.81-0.86) and gaze pitch angle standard deviation (r=0.79-0.87) were significantly correlated with blood THC concentration (p<0.01) for all epoch lengths. For driving performance variables, saccade-related features were among those showing the most significant correlation (r=0.61-0.83, p<0.05). Epoch length significantly affected correlations between eye-tracking features and speed (p<0.05), but not SDLP or blood THC concentration (p>0.1). Temporal trend analysis of eye-tracking features after cannabis also showed a significant increasing trend (p<0.01) in saccade-related features, including velocity, scanpath, and duration, as the influence of cannabis decreased by time. A decreasing trend was observed for fixation percentage and mean pupil diameter. Due to the lack of placebo control in this study, these results are considered preliminary. Conclusion: Specific eye characteristics could potentially be used as nonintrusive markers of THC presence and driving-related effects of cannabis. clinicaltrials.gov (NCT03813602).
Collapse
Affiliation(s)
- Ali Shahidi Zandi
- Research & Development Department, Alcohol Countermeasure Systems (ACS), Toronto, Canada
| | - Felix J E Comeau
- Research & Development Department, Alcohol Countermeasure Systems (ACS), Toronto, Canada
| | - Robert E Mann
- Institute for Mental Health Policy Research, Centre for Addiction and Mental Health, Toronto, Canada.,Dalla Lana School of Public Health, University of Toronto, Toronto, Canada.,Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health, Toronto, Canada
| | - Patricia Di Ciano
- Institute for Mental Health Policy Research, Centre for Addiction and Mental Health, Toronto, Canada.,Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health, Toronto, Canada.,Department of Pharmacology and Toxicology, University of Toronto, Toronto, Canada
| | - Eliyas P Arslan
- Institute for Mental Health Policy Research, Centre for Addiction and Mental Health, Toronto, Canada.,Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health, Toronto, Canada.,Department of Pharmacology and Toxicology, University of Toronto, Toronto, Canada
| | - Thomas Murphy
- Institute for Mental Health Policy Research, Centre for Addiction and Mental Health, Toronto, Canada.,Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health, Toronto, Canada.,Department of Pharmacology and Toxicology, University of Toronto, Toronto, Canada
| | - Bernard Le Foll
- Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health, Toronto, Canada.,Department of Pharmacology and Toxicology, University of Toronto, Toronto, Canada.,Translational Addiction Research Laboratory, Centre for Addiction and Mental Health, and Centre for Addiction and Mental Health, Toronto, Canada.,Acute Care Program, Centre for Addiction and Mental Health, Toronto, Canada.,Department of Family and Community Medicine, Management and Evaluation, University of Toronto, Toronto, Canada.,Division of Brain and Therapeutics, Department of Psychiatry, Management and Evaluation, University of Toronto, Toronto, Canada.,Institute of Medical Sciences, and Management and Evaluation, University of Toronto, Toronto, Canada
| | - Christine M Wickens
- Institute for Mental Health Policy Research, Centre for Addiction and Mental Health, Toronto, Canada.,Dalla Lana School of Public Health, University of Toronto, Toronto, Canada.,Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health, Toronto, Canada.,Department of Pharmacology and Toxicology, University of Toronto, Toronto, Canada.,Institute of Health Policy, Management and Evaluation, University of Toronto, Toronto, Canada
| |
Collapse
|
8
|
Alcohol- and drug-related consequences across latent classes of substance use among American Indian adolescents. Addict Behav 2021; 113:106682. [PMID: 33038678 DOI: 10.1016/j.addbeh.2020.106682] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2020] [Revised: 08/30/2020] [Accepted: 09/24/2020] [Indexed: 01/08/2023]
Abstract
INTRODUCTION Substance use among American Indian (AI) adolescents is a significant public health concern, as they report greater health disparities related to substance use compared to other racial/ethnic groups. The present study examines differences across classes of substance use behaviors regarding alcohol- and drug-related consequences. METHODS The current study was a secondary analysis of the dataset used by Stanley and Swaim (2018). AI adolescents (n = 3498, 47.8% female, Mage = 14.8) completed a survey including substance use and related consequences. Protocols were approved by institutional IRB, tribal authority, school boards, and parental consent/child assent were obtained. RESULTS In line with Stanley and Swaim (2018), we identified four classes of substance use: no past month substance use; marijuana and cigarette use only; alcohol, marijuana, and cigarette use only; and polysubstance use. Cross-class comparisons revealed that adolescents in classes characterized by the use of a greater number of substances also reported experiencing greater alcohol- and drug-related consequences with one exception: the class characterized by marijuana and cigarette use reported greater drug-related consequences compared to the class characterized by alcohol, marijuana, and cigarette use. CONCLUSIONS AI adolescents who engage in the use of multiple substances should be provided with psychoeducation around the increased risk of associated negative consequences. Given the health disparity experienced by AI adolescents, interventions to alleviate the burden of negative consequences are necessary.
Collapse
|
9
|
Maurage P, Masson N, Bollen Z, D’Hondt F. Eye tracking correlates of acute alcohol consumption: A systematic and critical review. Neurosci Biobehav Rev 2020; 108:400-422. [DOI: 10.1016/j.neubiorev.2019.10.001] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2019] [Revised: 08/30/2019] [Accepted: 10/04/2019] [Indexed: 01/23/2023]
|
10
|
Brands B, Mann RE, Wickens CM, Sproule B, Stoduto G, Sayer GS, Burston J, Pan JF, Matheson J, Stefan C, George TP, Huestis MA, Rehm J, Le Foll B. Acute and residual effects of smoked cannabis: Impact on driving speed and lateral control, heart rate, and self-reported drug effects. Drug Alcohol Depend 2019; 205:107641. [PMID: 31678833 DOI: 10.1016/j.drugalcdep.2019.107641] [Citation(s) in RCA: 34] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/30/2018] [Revised: 08/27/2019] [Accepted: 08/30/2019] [Indexed: 11/18/2022]
Abstract
BACKGROUND Although driving under the influence of cannabis is increasingly common among young adults, little is known about residual effects on driver behavior. This study examined acute and residual effects of smoked cannabis on simulated driving performance of young cannabis users. METHODS In this double-blind, placebo-controlled, parallel-group randomized clinical trial, cannabis users (1-4 days/week) aged 19-25 years were randomized with a 2:1 allocation ratio to receive active (12.5% THC) or placebo (0.009% THC) cannabis in a single 750 mg cigarette. A median split (based on whole-blood THC concentrations at the time of driving) was used to divide the active group into low and high THC groups. Our primary outcome was simulated driving performance, assessed 30 min and 24 and 48 h after smoking. Secondary outcomes included blood THC concentrations, subjective drug effects, and heart rate. RESULTS Ninety-six participants were randomized, and 91 were included in the final analysis (30 high THC, 31 low THC, 30 placebo). Mean speed (but not lateral control) significantly differed between groups 30 min after smoking cannabis (p ≤ 0.02); low and high THC groups decreased their speed compared to placebo. Heart rate, VAS drug effect and drug high increased significantly immediately after smoking cannabis and declined steadily after that. There was little evidence of residual effects in any of the measures. CONCLUSION Acutely, cannabis caused decreased speed, increased heart rate, and increases in VAS drug effect and drug high. There was no evidence of residual effects on these measures over the two days following cannabis administration.
Collapse
Affiliation(s)
- Bruna Brands
- Controlled Substances Directorate, Health Canada, Ottawa, Ontario, Canada; Department of Pharmacology and Toxicology, University of Toronto, 27 King's College Circle, Toronto, Ontario, M5S3H7, Canada; Institute for Mental Health Policy Research, Centre for Addiction and Mental Health, 33 Russell Street, Toronto, Ontario, M5S2S1, Canada.
| | - Robert E Mann
- Institute for Mental Health Policy Research, Centre for Addiction and Mental Health, 33 Russell Street, Toronto, Ontario, M5S2S1, Canada; Dalla Lana School of Public Health, University of Toronto, 155 College Street, Toronto, Ontario, M5T3M7, Canada
| | - Christine M Wickens
- Institute for Mental Health Policy Research, Centre for Addiction and Mental Health, 33 Russell Street, Toronto, Ontario, M5S2S1, Canada; Dalla Lana School of Public Health, University of Toronto, 155 College Street, Toronto, Ontario, M5T3M7, Canada
| | - Beth Sproule
- Leslie Dan Faculty of Pharmacy, University of Toronto, 144 College Street, Toronto, Ontario, M5S3M2, Canada; Department of Psychiatry, University of Toronto, 250 College Street, Toronto, Ontario, M5T1R8, Canada; Pharmacy, Centre for Addiction and Mental Health, 1001 Queen Street, Toronto, Ontario, M6J1H4, Canada
| | - Gina Stoduto
- Institute for Mental Health Policy Research, Centre for Addiction and Mental Health, 33 Russell Street, Toronto, Ontario, M5S2S1, Canada
| | - Gillian S Sayer
- Department of Pharmacology and Toxicology, University of Toronto, 27 King's College Circle, Toronto, Ontario, M5S3H7, Canada; Institute for Mental Health Policy Research, Centre for Addiction and Mental Health, 33 Russell Street, Toronto, Ontario, M5S2S1, Canada
| | - Jillian Burston
- Department of Pharmacology and Toxicology, University of Toronto, 27 King's College Circle, Toronto, Ontario, M5S3H7, Canada; Institute for Mental Health Policy Research, Centre for Addiction and Mental Health, 33 Russell Street, Toronto, Ontario, M5S2S1, Canada
| | - Jie Fei Pan
- Department of Pharmacology and Toxicology, University of Toronto, 27 King's College Circle, Toronto, Ontario, M5S3H7, Canada; Institute for Mental Health Policy Research, Centre for Addiction and Mental Health, 33 Russell Street, Toronto, Ontario, M5S2S1, Canada
| | - Justin Matheson
- Department of Pharmacology and Toxicology, University of Toronto, 27 King's College Circle, Toronto, Ontario, M5S3H7, Canada; Institute for Mental Health Policy Research, Centre for Addiction and Mental Health, 33 Russell Street, Toronto, Ontario, M5S2S1, Canada
| | - Cristiana Stefan
- Clinical Laboratory and Diagnostic Services, Centre for Addiction and Mental Health, 100 Stokes Street, Toronto, Ontario, M6J1H4, Canada
| | - Tony P George
- Department of Psychiatry, University of Toronto, 250 College Street, Toronto, Ontario, M5T1R8, Canada; Addictions Division, Centre for Addiction and Mental Health, 100 Stokes Street, Toronto, Ontario, M6J1H4, Canada
| | - Marilyn A Huestis
- The Lambert Center for the Study of Medicinal Cannabis and Hemp, Thomas Jefferson University, 1020 Walnut Street Philadelphia, PA 19107, United States
| | - Jürgen Rehm
- Institute for Mental Health Policy Research, Centre for Addiction and Mental Health, 33 Russell Street, Toronto, Ontario, M5S2S1, Canada; Dalla Lana School of Public Health, University of Toronto, 155 College Street, Toronto, Ontario, M5T3M7, Canada; Department of Psychiatry, University of Toronto, 250 College Street, Toronto, Ontario, M5T1R8, Canada
| | - Bernard Le Foll
- Department of Pharmacology and Toxicology, University of Toronto, 27 King's College Circle, Toronto, Ontario, M5S3H7, Canada; Department of Psychiatry, University of Toronto, 250 College Street, Toronto, Ontario, M5T1R8, Canada; Translational Addiction Research Laboratory, Centre for Addiction and Mental Health, 33 Russell Street, Toronto, Ontario, M5S2S1, Canada; Department of Family and Community Medicine, University of Toronto, 500 University Avenue, 5th Floor, Toronto, Ontario, M5G 1V7, Canada; Institute of Medical Sciences, University of Toronto, 1 King's College Circle, Room 2374, Toronto, Ontario, M5S 1A8, Canada
| |
Collapse
|
11
|
Abstract
Abstract
Traffic medicine is an important part within the scope of concerns of forensic medicine. We are dealing with consequences of traffic accidents – fatal or survived – but this problem overlaps the borders of our specialization. Sustained injuries are the focus of various fields of medicine and in combination with alcohol and illicit drugs abuse this issue is growing. The following review has an ambition to bring more light into the problem concerning the effect of alcohol and cannabis (which is the most common illicit drug used worldwide) on driving abilities.
Collapse
|
12
|
Chow RM, Marascalchi B, Abrams WB, Peiris NA, Odonkor CA, Cohen SP. Driving Under the Influence of Cannabis: A Framework for Future Policy. Anesth Analg 2019; 128:1300-1308. [PMID: 31094805 DOI: 10.1213/ane.0000000000003575] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
Marijuana is the most widely consumed illicit substance in the United States, and an increasing number of states have legalized it for both medicinal and recreational purposes. As it becomes more readily available, there will be a concurrent rise in the number of users and, consequently, the number of motor vehicle operators driving under the influence. This article examines the cognitive and psychomotor effects of cannabis, as well as current policy concerning driving under the influence of drugs. The authors performed a MEDLINE search on the epidemiology of cannabis use, its cognitive and psychomotor effects, and policies regarding driving under the influence of drugs. Twenty-eight epidemiological studies, 16 acute cognitive and psychomotor studies, 8 chronic cognitive and psychomotor studies, and pertinent state and federal laws and policies were reviewed. These search results revealed that marijuana use is associated with significant cognitive and psychomotor effects. In addition, the legalization of marijuana varies from state to state, as do the laws pertaining to driving under the influence of drugs. Marijuana is a commonly found illicit substance in motor vehicle operators driving under the influence of drugs. Current evidence shows that blood levels of tetrahydrocannabinol do not correlate well with the level of impairment. In addition, although acute infrequent use of cannabis typically leads to cognitive and psychomotor impairment, this is not consistently the case for chronic heavy use. To establish the framework for driving under the influence of cannabis policy, we must review the current published evidence and examine existing policy at state and federal levels.
Collapse
Affiliation(s)
- Robert M Chow
- From the Department of Anesthesiology, Yale School of Medicine, New Haven, Connecticut
| | | | - Winfred B Abrams
- Physical Medicine & Rehabilitation, Johns Hopkins School of Medicine, Baltimore, Maryland
| | - Nathalie A Peiris
- Department of Anesthesiology, University of Maryland School of Medicine, Baltimore, Maryland
| | - Charles A Odonkor
- Physical Medicine & Rehabilitation, Johns Hopkins School of Medicine, Baltimore, Maryland
| | - Steven P Cohen
- Department of Anesthesiology, Neurology and Physical Medicine and Rehabilitation, Johns Hopkins School of Medicine, Baltimore, Maryland
- Department of Anesthesiology and Physical Medicine & Rehabilitation, Walter Reed National Military Medical Center, Uniformed Services University of the Health Sciences, Bethesda, Maryland
| |
Collapse
|
13
|
Cannabidiol (CBD) content in vaporized cannabis does not prevent tetrahydrocannabinol (THC)-induced impairment of driving and cognition. Psychopharmacology (Berl) 2019; 236:2713-2724. [PMID: 31044290 PMCID: PMC6695367 DOI: 10.1007/s00213-019-05246-8] [Citation(s) in RCA: 117] [Impact Index Per Article: 23.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/17/2019] [Accepted: 04/09/2019] [Indexed: 01/09/2023]
Abstract
BACKGROUND The main psychoactive component of cannabis, delta-9-tetrahydrocannabinol (THC), can impair driving performance. Cannabidiol (CBD), a non-intoxicating cannabis component, is thought to mitigate certain adverse effects of THC. It is possible then that cannabis containing equivalent CBD and THC will differentially affect driving and cognition relative to THC-dominant cannabis. AIMS The present study investigated and compared the effects of THC-dominant and THC/CBD equivalent cannabis on simulated driving and cognitive performance. METHODS In a randomized, double-blind, within-subjects crossover design, healthy volunteers (n = 14) with a history of light cannabis use attended three outpatient experimental test sessions in which simulated driving and cognitive performance were assessed at two timepoints (20-60 min and 200-240 min) following vaporization of 125 mg THC-dominant (11% THC; < 1% CBD), THC/CBD equivalent (11% THC, 11% CBD), or placebo (< 1% THC/CBD) cannabis. RESULTS/OUTCOMES Both active cannabis types increased lane weaving during a car-following task but had little effect on other driving performance measures. Active cannabis types impaired performance on the Digit Symbol Substitution Task (DSST), Divided Attention Task (DAT) and Paced Auditory Serial Addition Task (PASAT) with impairment on the latter two tasks worse with THC/CBD equivalent cannabis. Subjective drug effects (e.g., "stoned") and confidence in driving ability did not vary with CBD content. Peak plasma THC concentrations were higher following THC/CBD equivalent cannabis relative to THC-dominant cannabis, suggesting a possible pharmacokinetic interaction. CONCLUSIONS/INTERPRETATION Cannabis containing equivalent concentrations of CBD and THC appears no less impairing than THC-dominant cannabis, and in some circumstances, CBD may actually exacerbate THC-induced impairment.
Collapse
|
14
|
Doroudgar S, Mae Chuang H, Bohnert K, Canedo J, Burrowes S, Perry PJ. Effects of chronic marijuana use on driving performance. TRAFFIC INJURY PREVENTION 2018; 19:680-686. [PMID: 30411981 DOI: 10.1080/15389588.2018.1501800] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/27/2018] [Revised: 07/13/2018] [Accepted: 07/14/2018] [Indexed: 06/08/2023]
Abstract
OBJECTIVES The effects of marijuana on driving pose a significant public health concern. More studies on chronic marijuana use in driving are needed. The study objectives were to (1) assess differences in the Standardized Field Sobriety Test (SFST) and driving performance outcomes between chronic medical marijuana users and nonusers and (2) identify a cutoff tetrahydrocannabinol (THC) concentration above which chronic medical marijuana users demonstrate driving impairment. METHODS This prospective cross-sectional study assessed 31 chronic marijuana users and 41 nonusers. Rapid Detect Saliva Drug Screen 10-panel was administered to all participants. Participants were given a simple visual reaction time test (SVRT) and SFST consisting of the horizontal gaze nystagmus (HGN), the one leg stand (OLS), and the walk and turn (WAT) tests. The STISIM Drive M100 driving simulator assessed driving performance. Driving parameters included standard deviation of speed (SDS), deviation of mean lane position, off-road accidents, collisions, pedestrians hit, and car-following modulus, delay, and coherence. Cannabinoid blood plasma was obtained from marijuana users. RESULTS Marijuana users and nonusers did not differ in age (40.06 ± 13.92 vs. 41.53 ± 15.49, P = .6782). Marijuana users were more likely to fail the SFST (P = .005) and the WAT (P = .012) and HGN (P = .001) components. Marijuana users had slower SVRT (P = .031), less SDS (P = .039), and lower modulus (P = .003). Participants with THC >2 ng/mL (P = .017) and TCH >5 ng/mL (P = .008) had lower SDS. Participants with THC >2 ng/mL (P = .021) and THC >5 ng/mL (P = .044) had decreased modulus. CONCLUSION Chronic marijuana users had slower reaction times, deviated less in speed, and had difficulty matching a lead vehicle's speed compared to nonusers. The effects on SDS and modulus were present at cutoffs of 2 and 5 ng/mL.
Collapse
Affiliation(s)
- Shadi Doroudgar
- a College of Pharmacy , Touro University California , Mare Island, Vallejo , California
| | - Hannah Mae Chuang
- a College of Pharmacy , Touro University California , Mare Island, Vallejo , California
| | - Kimberly Bohnert
- a College of Pharmacy , Touro University California , Mare Island, Vallejo , California
| | - Joanne Canedo
- a College of Pharmacy , Touro University California , Mare Island, Vallejo , California
| | - Sahai Burrowes
- b Public Health Program, College of Education and Health Sciences , Touro University California , Mare Island, Vallejo , California
| | - Paul J Perry
- a College of Pharmacy , Touro University California , Mare Island, Vallejo , California
| |
Collapse
|
15
|
Terry-McElrath YM, Patrick ME. Simultaneous Alcohol and Marijuana Use Among Young Adult Drinkers: Age-Specific Changes in Prevalence from 1977 to 2016. Alcohol Clin Exp Res 2018; 42:2224-2233. [PMID: 30277588 DOI: 10.1111/acer.13879] [Citation(s) in RCA: 82] [Impact Index Per Article: 13.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2018] [Accepted: 08/21/2018] [Indexed: 12/11/2022]
Abstract
BACKGROUND The overall prevalence of U.S. young adult alcohol use has decreased, but little is known about historical change in related behaviors such as simultaneous alcohol and marijuana (SAM) use that may increase alcohol-related risks and societal costs. The purpose of this paper was to examine historical change in SAM use prevalence among U.S. young adult alcohol users from 1977 to 2016, and consider the extent to which observed historical change in SAM use among alcohol users reflects co-occurring change in marijuana use during these years. METHODS Data on past 12-month alcohol, marijuana, and SAM use at up to 6 modal ages (19/20, 21/22, 23/24, 25/26, 27/28, and 29/30) were collected from 11,789 individuals (45.0% men) participating in the Monitoring the Future panel study. Annual prevalence estimates within modal age group were obtained; historical SAM use trends among alcohol and marijuana users were estimated. RESULTS From 2014 to 2016, SAM use was reported by approximately 30% of alcohol users aged 19/20 and 21/22, and 20 to 25% of alcohol users aged 23/24 through 29/30. Since the mid-1990s, age-specific historical trends in SAM use prevalence among alcohol users followed 1 of 4 patterns: significant increase followed by oscillating increases/decreases (at modal age 19/20), consistent and significant increases (at modal ages 21/22, 23/24, and 25/26), stability followed by increase (at modal ages 27/28), or stability (at modal ages 29/30). In contrast, SAM use trends among marijuana users primarily reflected stability, with some evidence of a decrease across time at modal ages 19/20 and 23/24. Historical change in SAM prevalence among alcohol users was strongly and positively correlated with changes in overall marijuana use prevalence. CONCLUSIONS A growing proportion of early and mid-young adult alcohol users reported SAM use, with the highest risk among those in the early years of young adulthood. Young adult SAM use may continue to increase in proportion to the degree that young adult marijuana use continues to increase.
Collapse
Affiliation(s)
| | - Megan E Patrick
- Institute for Social Research, University of Michigan, Ann Arbor, Michigan
| |
Collapse
|
16
|
Ferrari D, Manca M, Premaschi S, Banfi G, Locatelli M. Toxicological investigation in blood samples from suspected impaired driving cases in the Milan area: Possible loss of evidence due to late blood sampling. Forensic Sci Int 2018; 288:211-217. [DOI: 10.1016/j.forsciint.2018.04.038] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2017] [Revised: 02/24/2018] [Accepted: 04/19/2018] [Indexed: 12/15/2022]
|
17
|
Micallef J, Dupouey J, Jouve E, Truillet R, Lacarelle B, Taillard J, Daurat A, Authié C, Blin O, Rascol O, Philip P, Mestre D. Cannabis smoking impairs driving performance on the simulator and real driving: a randomized, double-blind, placebo-controlled, crossover trial. Fundam Clin Pharmacol 2018; 32:558-570. [DOI: 10.1111/fcp.12382] [Citation(s) in RCA: 28] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2016] [Revised: 04/25/2018] [Accepted: 04/27/2018] [Indexed: 12/30/2022]
Affiliation(s)
- Joëlle Micallef
- Service de Pharmacologie Clinique et Pharmacovigilance & CIC-CPCET; Assistance Publique Hôpitaux de Marseille; 264 Rue Saint Pierre 13385 Marseille France
- Aix-Marseille Universite Faculté de Médecine; INS - Institut de Neurosciences des Systèmes INSERM UMR 1106 Marseille; Marseille France
| | - Julien Dupouey
- Service de Pharmacologie Clinique et Pharmacovigilance & CIC-CPCET; Assistance Publique Hôpitaux de Marseille; 264 Rue Saint Pierre 13385 Marseille France
- Aix-Marseille Universite Faculté de Médecine; INS - Institut de Neurosciences des Systèmes INSERM UMR 1106 Marseille; Marseille France
| | - Elisabeth Jouve
- Service de Pharmacologie Clinique et Pharmacovigilance & CIC-CPCET; Assistance Publique Hôpitaux de Marseille; 264 Rue Saint Pierre 13385 Marseille France
- Aix-Marseille Universite Faculté de Médecine; INS - Institut de Neurosciences des Systèmes INSERM UMR 1106 Marseille; Marseille France
| | - Romain Truillet
- Service de Pharmacologie Clinique et Pharmacovigilance & CIC-CPCET; Assistance Publique Hôpitaux de Marseille; 264 Rue Saint Pierre 13385 Marseille France
- Aix-Marseille Universite Faculté de Médecine; INS - Institut de Neurosciences des Systèmes INSERM UMR 1106 Marseille; Marseille France
| | - Bruno Lacarelle
- Laboratoire de Pharmacocinétique et Toxicologie; Assistance Publique Hôpitaux de Marseille; Marseille France
| | - Jacques Taillard
- Université de Bordeaux, CNRS, Sommeil Attention et Neuropsychiatrie, USR 3413; Bordeaux France
| | - Agnès Daurat
- Université Toulouse II, CNRS, EPHE, CLLE-LTC UMR 5263; Toulouse France
| | - Colas Authié
- Institut de la Vision, CNRS, UPMC, INSERM, UMR 7210; Paris France
| | - Olivier Blin
- Service de Pharmacologie Clinique et Pharmacovigilance & CIC-CPCET; Assistance Publique Hôpitaux de Marseille; 264 Rue Saint Pierre 13385 Marseille France
- Aix-Marseille Universite Faculté de Médecine; INS - Institut de Neurosciences des Systèmes INSERM UMR 1106 Marseille; Marseille France
| | - Olivier Rascol
- Department of Clinical Pharmacology and Neurosciences; Clinical Investigation Center INSERM CIC1436 and Clinique Spatiale MEDES; University Hospital and University of Toulouse3; Toulouse France
| | - Pierre Philip
- Université de Bordeaux, CNRS, Sommeil Attention et Neuropsychiatrie, USR 3413; Bordeaux France
| | - Daniel Mestre
- Aix-Marseille Université, CNRS, Institut des Sciences du Mouvement, UMR 7287; Marseille France
| |
Collapse
|
18
|
Alcohol and illicit drugs in drivers involved in road traffic crashes in the Milan area. A comparison with normal traffic reveals the possible inadequacy of current cut-off limits. Forensic Sci Int 2018; 282:127-132. [DOI: 10.1016/j.forsciint.2017.11.005] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2017] [Revised: 11/02/2017] [Accepted: 11/04/2017] [Indexed: 01/24/2023]
|
19
|
Mikulskaya E, Martin F. Visual attention to motion stimuli and its neural correlates in cannabis users. Eur J Neurosci 2017; 47:269-276. [PMID: 29266467 DOI: 10.1111/ejn.13810] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2017] [Revised: 11/21/2017] [Accepted: 12/07/2017] [Indexed: 11/28/2022]
Abstract
Attention to motion stimuli and correct motion perception are vital for road safety. Although cannabis use has been associated with increased road crash risks, there is limited research on attentional processing of moving stimuli in cannabis users. This study investigated the neural correlates of the three-stimulus oddball task in cannabis users (n = 18) and non-users (n = 23) in response to moving stimuli. Stimulus contrast was under 16% against a low luminance background (M luminance < 16 cd/m2 ). The two groups did not differ in accuracy or in N2 peak amplitude; however, N2 latency was longer for target and standard stimuli in the cannabis group than in the control group. The cannabis group also showed a significantly reduced P3b amplitude in response to target stimuli. The AUDIT score was added as a random factor to the anova to rule out the effects of uneven alcohol consumption in the two groups. A significant group effect was found for N2 latency in response to target and standard stimuli and a significant interaction between the group, and the AUDIT score was found for the P3b peak amplitude for the distractor and standard stimuli, but not for the target stimuli. The results of this study suggest that cannabis use relates to reduced neural activity underlying attention to motion stimuli. Implications for regular early-onset cannabis use road safety are discussed.
Collapse
Affiliation(s)
- Elena Mikulskaya
- School of Psychology, University of Newcastle, Newcastle, NSW, Australia.,Tula University, TIEI, Tula, Russian
| | - Frances Martin
- School of Psychology, University of Newcastle, Newcastle, NSW, Australia
| |
Collapse
|
20
|
Patrick ME, Kloska DD, Terry-McElrath YM, Lee CM, O'Malley PM, Johnston LD. Patterns of simultaneous and concurrent alcohol and marijuana use among adolescents. THE AMERICAN JOURNAL OF DRUG AND ALCOHOL ABUSE 2017; 44:441-451. [PMID: 29261344 DOI: 10.1080/00952990.2017.1402335] [Citation(s) in RCA: 93] [Impact Index Per Article: 13.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
Abstract
BACKGROUND Alcohol and marijuana are the most commonly used substances among adolescents but little is known about patterns of co-use. OBJECTIVES This study examined patterns of concurrent (not overlapping) and simultaneous (overlapping) use of alcohol and marijuana among adolescents. METHODS Data from US-national samples of 12th graders (N = 84,805, 48.4% female) who participated in the Monitoring the Future study from 1976 to 2016 and who used alcohol and/or marijuana in the past 12 months were used to identify latent classes of alcohol use, marijuana use, and simultaneous alcohol and marijuana (SAM) use. RESULTS A four-class solution indicated four patterns of use among adolescents: (1) Simultaneous alcohol and marijuana (SAM) use with binge drinking and recent marijuana use (SAM-Heavier Use; 11.2%); (2) SAM use without binge drinking and with recent marijuana use (SAM-Lighter Use; 21.6%); (3) Marijuana use and alcohol use but no SAM use (Concurrent Use; 10.7%); and (4) Alcohol use but no marijuana or SAM use (Alcohol-Only Use; 56.4%). Membership in either SAM use class was associated with a higher likelihood of truancy, evenings out, and use of illicit drugs other than marijuana. SAM-Heavier Use, compared to SAM-Lighter Use, class members were more likely to report these behaviors and be male, and less likely to have college plans. CONCLUSIONS Among 12th graders who use both alcohol and marijuana, the majority use simultaneously, although not all use heavily. Given the recognized increased public health risks associated with simultaneous use, adolescent prevention programming should include focus on particular risks of simultaneous use.
Collapse
Affiliation(s)
- Megan E Patrick
- a Institute for Social Research , University of Michigan , Ann Arbor , MI , USA
| | - Deborah D Kloska
- a Institute for Social Research , University of Michigan , Ann Arbor , MI , USA
| | | | - Christine M Lee
- b Department of Psychiatry and Behavioral Sciences , University of Washington , Seattle , WA , USA
| | - Patrick M O'Malley
- a Institute for Social Research , University of Michigan , Ann Arbor , MI , USA
| | - Lloyd D Johnston
- a Institute for Social Research , University of Michigan , Ann Arbor , MI , USA
| |
Collapse
|
21
|
Chihuri S, Li G, Chen Q. Interaction of marijuana and alcohol on fatal motor vehicle crash risk: a case-control study. Inj Epidemiol 2017; 4:8. [PMID: 28286930 PMCID: PMC5357617 DOI: 10.1186/s40621-017-0105-z] [Citation(s) in RCA: 48] [Impact Index Per Article: 6.9] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2016] [Accepted: 02/20/2017] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Concurrent use of marijuana and alcohol in drivers is of increasing concern but its role in crash causation has not been well understood. METHODS Using a case-control design, we assessed the individual and joint effects of marijuana and alcohol use on fatal crash risk. Cases (n = 1944) were drivers fatally injured in motor vehicle crashes in the United States at specific times in 2006, 2007 and 2008. Controls (n = 7719) were drivers who participated in the 2007 National Roadside Survey of Alcohol and Drug Use by Drivers. RESULTS Overall, cases were significantly more likely than controls to test positive for marijuana (12.2% vs. 5.9%, p < 0.0001), alcohol (57.8% vs. 7.7%, p < 0.0001) and both marijuana and alcohol (8.9% vs. 0.8%, p < 0.0001). Compared to drivers testing negative for alcohol and marijuana, the adjusted odds ratios of fatal crash involvement were 16.33 [95% confidence interval (CI): 14.23, 18.75] for those testing positive for alcohol and negative for marijuana, 1.54 (95% CI: 1.16, 2.03) for those testing positive for marijuana and negative for alcohol, and 25.09 (95% CI: 17.97, 35.03) for those testing positive for both alcohol and marijuana. CONCLUSIONS Alcohol use and marijuana use are each associated with significantly increased risks of fatal crash involvement. When alcohol and marijuana are used together, there exists a positive synergistic effect on fatal crash risk on the additive scale.
Collapse
Affiliation(s)
- Stanford Chihuri
- Center for Injury Epidemiology and Prevention, Columbia University Medical Center, 622 West 168th St, PH5-505, New York, NY 10032 USA
- Department of Anesthesiology, College of Physicians and Surgeons, Columbia University, New York, NY USA
| | - Guohua Li
- Center for Injury Epidemiology and Prevention, Columbia University Medical Center, 622 West 168th St, PH5-505, New York, NY 10032 USA
- Department of Anesthesiology, College of Physicians and Surgeons, Columbia University, New York, NY USA
- Department of Epidemiology, Mailman School of Public Health, Columbia University, New York, NY USA
| | - Qixuan Chen
- Department of Biostatistics, Mailman School of Public Health, Columbia University, New York, NY USA
| |
Collapse
|
22
|
Jawi ZM, Deros BM, Rashid AAA, Isa MHM, Awang A. The Roles and Performance of Professional Driving Instructors in Novice Driver Education. Sultan Qaboos Univ Med J 2017; 17:e277-e285. [PMID: 29062549 DOI: 10.18295/squmj.2017.17.03.004] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2017] [Revised: 04/11/2017] [Accepted: 07/06/2017] [Indexed: 11/16/2022] Open
Abstract
This review article aimed to analyse existing literature regarding the roles and performance of professional driving instructors (PDIs) in novice driver education (DE). A systematic classification scheme was adopted to analyse identified articles to determine the study context of PDIs in novice DE, the competency level of PDIs in relation to experienced and learner drivers and the contributions of PDIs to the novice driver learning process. A total of 14 original research articles were identified, with no systematic reviews or meta-analyses available. Overall, all of the articles were found to be inadequate in providing an in-depth understanding of the roles and performance of PDIs in novice DE. There is an urgent need to improve current understanding of the roles of PDIs in novice DE and to work towards an internationally recognised PDI management approach.
Collapse
Affiliation(s)
- Zulhaidi M Jawi
- Department of Vehicle Safety & Biomechanics, Malaysian Institute of Road Safety Research, Kajang, Selangor, Malaysia
| | - Baba M Deros
- Centre for Automotive Research, Faculty of Engineering & Built Environment, Universiti Kebangsaan Malaysia, Bangi, Selangor, Malaysia
| | - Ahmad A A Rashid
- Department of Vehicle Safety & Biomechanics, Malaysian Institute of Road Safety Research, Kajang, Selangor, Malaysia
| | - Mohd H M Isa
- Department of Vehicle Safety & Biomechanics, Malaysian Institute of Road Safety Research, Kajang, Selangor, Malaysia
| | - Azmi Awang
- Road Transport Department, Akademi Pengangkutan Jalan Malaysia, Melaka, Malaysia
| |
Collapse
|
23
|
Li G, Chihuri S, Brady JE. Role of alcohol and marijuana use in the initiation of fatal two-vehicle crashes. Ann Epidemiol 2017; 27:342-347.e1. [DOI: 10.1016/j.annepidem.2017.05.003] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2016] [Revised: 01/13/2017] [Accepted: 05/04/2017] [Indexed: 10/19/2022]
|
24
|
Laberge JC, Ward NJ. Research Note: Cannabis and Driving — Research Needs and Issues for Transportation Policy. JOURNAL OF DRUG ISSUES 2016. [DOI: 10.1177/002204260403400413] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
This paper summarizes current knowledge regarding the effects of cannabis use on driving. Psychopharmacological evidence has shown that cannabis, unlike alcohol, can be detected several days after consumption. Prevalence data has revealed that cannabis use is increasing, and that as many as 90% of study participants were willing to drive after consuming a typical dose. A review of laboratory studies found that cannabis and alcohol affect different driving tasks. When cannabis and alcohol use were evaluated in simulated and on-road driving situations, drivers were more aware of being intoxicated after using cannabis and thus invoked greater compensatory effort to offset impairment in the driving task. The effect of cannabis use on crash risk has shown that recent use increases crash risk, but not as much as alcohol consumption. This paper concludes that further research is needed before specific transportation policy can be developed for cannabis.
Collapse
|
25
|
Jongen S, Vuurman EFPM, Ramaekers JG, Vermeeren A. The sensitivity of laboratory tests assessing driving related skills to dose-related impairment of alcohol: A literature review. ACCIDENT; ANALYSIS AND PREVENTION 2016; 89:31-48. [PMID: 26802474 DOI: 10.1016/j.aap.2016.01.001] [Citation(s) in RCA: 26] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/19/2015] [Revised: 11/06/2015] [Accepted: 01/02/2016] [Indexed: 06/05/2023]
Abstract
Laboratory tests assessing driving related skills can be useful as initial screening tools to assess potential drug induced impairment as part of a standardized behavioural assessment. Unfortunately, consensus about which laboratory tests should be included to reliably assess drug induced impairment has not yet been reached. The aim of the present review was to evaluate the sensitivity of laboratory tests to the dose dependent effects of alcohol, as a benchmark, on performance parameters. In total, 179 experimental studies were included. Results show that a cued go/no-go task and a divided attention test with primary tracking and secondary visual search were consistently sensitive to the impairing effects at medium and high blood alcohol concentrations. Driving performance assessed in a simulator was less sensitive to the effects of alcohol as compared to naturalistic, on-the-road driving. In conclusion, replicating results of several potentially useful tests and their predictive validity of actual driving impairment should deserve further research. In addition, driving simulators should be validated and compared head to head to naturalistic driving in order to increase construct validity.
Collapse
Affiliation(s)
- S Jongen
- Department of Neuropsychology and Psychopharmacology, Faculty of Psychology and Neuroscience, Maastricht University, The Netherlands.
| | - E F P M Vuurman
- Department of Neuropsychology and Psychopharmacology, Faculty of Psychology and Neuroscience, Maastricht University, The Netherlands.
| | - J G Ramaekers
- Department of Neuropsychology and Psychopharmacology, Faculty of Psychology and Neuroscience, Maastricht University, The Netherlands.
| | - A Vermeeren
- Department of Neuropsychology and Psychopharmacology, Faculty of Psychology and Neuroscience, Maastricht University, The Netherlands.
| |
Collapse
|
26
|
Vearrier D, Vearrier L, McKeever R, Okaneku J, LaSala G, Goldberger D, McCloskey K. Issues in driving impairment. Dis Mon 2016; 62:72-116. [DOI: 10.1016/j.disamonth.2016.02.002] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/22/2023]
|
27
|
Hartman RL, Brown TL, Milavetz G, Spurgin A, Pierce RS, Gorelick DA, Gaffney G, Huestis MA. Cannabis effects on driving longitudinal control with and without alcohol. J Appl Toxicol 2016; 36:1418-29. [DOI: 10.1002/jat.3295] [Citation(s) in RCA: 61] [Impact Index Per Article: 7.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2015] [Revised: 12/31/2015] [Accepted: 01/04/2016] [Indexed: 11/09/2022]
Affiliation(s)
- Rebecca L. Hartman
- Chemistry and Drug Metabolism, Intramural Research Program; National Institute on Drug Abuse, NIH; 251 Bayview Boulevard Street, 200 Rm 05A721 Baltimore MD USA
| | - Timothy L. Brown
- National Advanced Driving Simulator; University of Iowa; 2401 Oakdale Boulevard Iowa City IA USA
| | - Gary Milavetz
- College of Pharmacy; University of Iowa; Iowa City IA USA
| | - Andrew Spurgin
- College of Pharmacy; University of Iowa; Iowa City IA USA
| | | | - David A. Gorelick
- Department of Psychiatry; University of Maryland School of Medicine; Baltimore MD USA
| | - Gary Gaffney
- Carver College of Medicine; University of Iowa; Iowa City IA USA
| | - Marilyn A. Huestis
- Chemistry and Drug Metabolism, Intramural Research Program; National Institute on Drug Abuse, NIH; 251 Bayview Boulevard Street, 200 Rm 05A721 Baltimore MD USA
| |
Collapse
|
28
|
Wilkinson ST, Yarnell S, Radhakrishnan R, Ball SA, D'Souza DC. Marijuana Legalization: Impact on Physicians and Public Health. Annu Rev Med 2015; 67:453-66. [PMID: 26515984 DOI: 10.1146/annurev-med-050214-013454] [Citation(s) in RCA: 122] [Impact Index Per Article: 13.6] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Abstract
Marijuana is becoming legal in an increasing number of states for both medical and recreational use. Considerable controversy exists regarding the public health impact of these changes. The evidence for the legitimate medical use of marijuana or cannabinoids is limited to a few indications, notably HIV/AIDS cachexia, nausea/vomiting related to chemotherapy, neuropathic pain, and spasticity in multiple sclerosis. Although cannabinoids show therapeutic promise in other areas, robust clinical evidence is still lacking. The relationship between legalization and prevalence is still unknown. Although states where marijuana use is legal have higher rates of use than nonlegal states, these higher rates were generally found even prior to legalization. As states continue to proceed with legalization for both medical and recreational use, certain public health issues have become increasingly relevant, including the effects of acute marijuana intoxication on driving abilities, unintentional ingestion of marijuana products by children, the relationship between marijuana and opioid use, and whether there will be an increase in health problems related to marijuana use, such as dependence/addiction, psychosis, and pulmonary disorders. In light of this rapidly shifting legal landscape, more research is urgently needed to better understand the impact of legalization on public health.
Collapse
Affiliation(s)
- Samuel T Wilkinson
- Department of Psychiatry, Yale School of Medicine, New Haven, Connecticut 06511;
| | - Stephanie Yarnell
- Department of Psychiatry, Yale School of Medicine, New Haven, Connecticut 06511;
| | - Rajiv Radhakrishnan
- Department of Psychiatry, Yale School of Medicine, New Haven, Connecticut 06511; .,VA Connecticut Healthcare System, West Haven, Connecticut 06516.,Abraham Ribicoff Research Facilities, Connecticut Mental Health Center, New Haven, Connecticut 06511
| | - Samuel A Ball
- Department of Psychiatry, Yale School of Medicine, New Haven, Connecticut 06511; .,VA Connecticut Healthcare System, West Haven, Connecticut 06516.,The National Center on Addiction and Substance Abuse at Columbia University, New York, NY 10027
| | - Deepak Cyril D'Souza
- Department of Psychiatry, Yale School of Medicine, New Haven, Connecticut 06511; .,VA Connecticut Healthcare System, West Haven, Connecticut 06516.,Abraham Ribicoff Research Facilities, Connecticut Mental Health Center, New Haven, Connecticut 06511
| |
Collapse
|
29
|
Desrosiers NA, Ramaekers JG, Chauchard E, Gorelick DA, Huestis MA. Smoked cannabis' psychomotor and neurocognitive effects in occasional and frequent smokers. J Anal Toxicol 2015; 39:251-61. [PMID: 25745105 DOI: 10.1093/jat/bkv012] [Citation(s) in RCA: 92] [Impact Index Per Article: 10.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Δ9-Tetrahydrocannabinol (THC), the primary psychoactive constituent in cannabis, impairs psychomotor performance, cognition and driving ability; thus, driving under the influence of cannabis is a public safety concern. We documented cannabis' psychomotor, neurocognitive, subjective and physiological effects in occasional and frequent smokers to investigate potential differences between these smokers. Fourteen frequent (≥4x/week) and 11 occasional (<2x/week) cannabis smokers entered a secure research unit ∼19 h prior to smoking one 6.8% THC cigarette. Cognitive and psychomotor performance was evaluated with the critical tracking (CTT), divided attention (DAT), n-back (working memory) and Balloon Analog Risk (BART) (risk-taking) tasks at -1.75, 1.5, 3.5, 5.5 and 22.5 h after starting smoking. GLM (General Linear Model) repeated measures ANOVA was utilized to compare scores. Occasional smokers had significantly more difficulty compensating for CTT tracking error compared with frequent smokers 1.5 h after smoking. Divided attention performance declined significantly especially in occasional smokers, with session × group effects for tracking error, hits, false alarms and reaction time. Cannabis smoking did not elicit session × group effects on the n-back or BART. Controlled cannabis smoking impaired psychomotor function, more so in occasional smokers, suggesting some tolerance to psychomotor impairment in frequent users. These data have implications for cannabis-associated impairment in driving under the influence of cannabis cases.
Collapse
Affiliation(s)
- Nathalie A Desrosiers
- Chemistry and Drug Metabolism Section, Clinical Pharmacology and Therapeutic Research Branch, NIDA IRP, 251 Bayview Boulevard, Suite 200 Room 05A-721, Baltimore, MD 21224, USA Program in Toxicology, University of Maryland Baltimore, Baltimore, MD, USA
| | - Johannes G Ramaekers
- Department of Neuropsychology and Psychopharmacology, Faculty of Psychology and Neuroscience, Maastricht University, Maastricht, The Netherlands
| | - Emeline Chauchard
- Chemistry and Drug Metabolism Section, Clinical Pharmacology and Therapeutic Research Branch, NIDA IRP, 251 Bayview Boulevard, Suite 200 Room 05A-721, Baltimore, MD 21224, USA Present address: Laboratoire de Psychologie des Pays de la Loire, Faculté de Psychologie, Université de Nantes, Nantes, France
| | - David A Gorelick
- Chemistry and Drug Metabolism Section, Clinical Pharmacology and Therapeutic Research Branch, NIDA IRP, 251 Bayview Boulevard, Suite 200 Room 05A-721, Baltimore, MD 21224, USA Present address: Department of Psychiatry, University of Maryland School of Medicine, Baltimore, MD, USA
| | - Marilyn A Huestis
- Chemistry and Drug Metabolism Section, Clinical Pharmacology and Therapeutic Research Branch, NIDA IRP, 251 Bayview Boulevard, Suite 200 Room 05A-721, Baltimore, MD 21224, USA
| |
Collapse
|
30
|
Dubois S, Mullen N, Weaver B, Bédard M. The combined effects of alcohol and cannabis on driving: Impact on crash risk. Forensic Sci Int 2015; 248:94-100. [DOI: 10.1016/j.forsciint.2014.12.018] [Citation(s) in RCA: 91] [Impact Index Per Article: 10.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2014] [Revised: 12/10/2014] [Accepted: 12/14/2014] [Indexed: 11/28/2022]
|
31
|
Terry-McElrath YM, O’Malley PM, Johnston LD. Simultaneous alcohol and marijuana use among U.S. high school seniors from 1976 to 2011: trends, reasons, and situations. Drug Alcohol Depend 2013; 133:71-9. [PMID: 23806871 PMCID: PMC3786028 DOI: 10.1016/j.drugalcdep.2013.05.031] [Citation(s) in RCA: 105] [Impact Index Per Article: 9.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/14/2013] [Revised: 05/21/2013] [Accepted: 05/23/2013] [Indexed: 11/25/2022]
Abstract
BACKGROUND Simultaneous alcohol and marijuana (SAM) use raises significant concern due to the potential for additive or interactive psychopharmacological effects. However, no nationally representative studies are available that document prevalence, trends, or related factors in US youth SAM use. METHODS Nationally representative cross-sectional samples of 12th grade students surveyed in the Monitoring the Future project from 1976 to 2011 provided data on SAM use. Analyses were conducted in 2012. RESULTS In 2011, 23% of all U.S. high school seniors reported any SAM use. Among seniors reporting any past 12-month marijuana use, 62% reported any SAM use and 13% reported SAM use most or every time they used marijuana. SAM use consistently followed trends for past 30-day alcohol use over time. SAM use showed significant variation by psychosocial and demographic characteristics and was strongly associated with higher substance use levels, but occurred across the substance use spectrum. Certain reasons for alcohol or marijuana use (to increase effects of another drug; I'm hooked) and situations of alcohol or marijuana use (park/beach, car, party) were strongly associated with SAM use. CONCLUSIONS A sizable proportion of US high school seniors reported SAM use, and it appeared to occur frequently in social use situations that could impact both the public as well as youth drug users. SAM use appears to be a complex behavior that is incidental to general substance use patterns as well as associated with (a) specific simultaneous reasons (or expectancies), and (b) heavy substance use and perceived dependence, especially on alcohol.
Collapse
Affiliation(s)
- Yvonne M. Terry-McElrath
- Institute for Social Research, University of Michigan, PO Box 1248, Ann Arbor, Michigan 48106-1248
| | - Patrick M. O’Malley
- Institute for Social Research, University of Michigan, PO Box 1248, Ann Arbor, Michigan 48106-1248
| | - Lloyd D. Johnston
- Institute for Social Research, University of Michigan, PO Box 1248, Ann Arbor, Michigan 48106-1248
| |
Collapse
|
32
|
|
33
|
Abstract
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 Δ(9)-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.
Collapse
Affiliation(s)
- Rebecca L. Hartman
- Chemistry and Drug Metabolism, Intramural Research Program, National Institute on Drug Abuse, National Institutes of Health, Baltimore, MD
- Program in Toxicology, Graduate Program in Life Sciences, University of Maryland Baltimore, Baltimore, MD
| | - Marilyn A. Huestis
- Chemistry and Drug Metabolism, Intramural Research Program, National Institute on Drug Abuse, National Institutes of Health, Baltimore, MD
| |
Collapse
|
34
|
Armentano P. Cannabis and psychomotor performance: a rational review of the evidence and implications for public policy. Drug Test Anal 2012; 5:52-6. [PMID: 22972702 DOI: 10.1002/dta.1404] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2012] [Revised: 07/18/2012] [Accepted: 07/18/2012] [Indexed: 11/05/2022]
Affiliation(s)
- Paul Armentano
- National Organization for the Reform of Marijuana Laws-NORML, 1600 K Street, NW, Mezzanine Level, Washington, DC 20006-2832, USA.
| |
Collapse
|
35
|
Schwope DM, Bosker WM, Ramaekers JG, Gorelick DA, Huestis MA. Psychomotor performance, subjective and physiological effects and whole blood Δ⁹-tetrahydrocannabinol concentrations in heavy, chronic cannabis smokers following acute smoked cannabis. J Anal Toxicol 2012; 36:405-12. [PMID: 22589524 DOI: 10.1093/jat/bks044] [Citation(s) in RCA: 71] [Impact Index Per Article: 5.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Δ⁹-Tetrahydrocannabinol (THC) is the illicit drug most frequently observed in accident and driving under the influence of drugs investigations. Whole blood is often the only available specimen collected during such investigations, yet few studies have examined relationships between cannabis effects and whole blood concentrations following cannabis smoking. Nine male and one female heavy, chronic cannabis smokers resided on a closed research unit and smoked ad libitum one 6.8% THC cannabis cigarette. THC, 11-hydroxy-THC and 11-nor-9-carboxy-THC were quantified in whole blood and plasma. Assessments were performed before and up to 6 h after smoking, including subjective [visual analog scales (VAS) and Likert scales], physiological (heart rate, blood pressure and respirations) and psychomotor (critical-tracking and divided-attention tasks) measures. THC significantly increased VAS responses and heart rate, with concentration-effect curves demonstrating counter-clockwise hysteresis. No significant differences were observed for critical-tracking or divided-attention task performance in this cohort of heavy, chronic cannabis smokers. The cannabis influence factor was not suitable for quantifying psychomotor impairment following cannabis consumption and was not precise enough to determine recent cannabis use with accuracy. These data inform our understanding of impairment and subjective effects following acute smoked cannabis and interpretation of whole blood cannabinoid concentrations in forensic investigations.
Collapse
Affiliation(s)
- David M Schwope
- Chemistry and Drug Metabolism, Intramural Research Program, National Institute on Drug Abuse, National Institutes of Health, Biomedical Research Center, 251 Bayview Blvd, Suite 200, Baltimore, Maryland 21224, USA
| | | | | | | | | |
Collapse
|
36
|
Ramaekers JG, Theunissen EL, de Brouwer M, Toennes SW, Moeller MR, Kauert G. Tolerance and cross-tolerance to neurocognitive effects of THC and alcohol in heavy cannabis users. Psychopharmacology (Berl) 2011; 214:391-401. [PMID: 21049267 PMCID: PMC3045517 DOI: 10.1007/s00213-010-2042-1] [Citation(s) in RCA: 107] [Impact Index Per Article: 8.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/13/2010] [Accepted: 10/01/2010] [Indexed: 11/01/2022]
Abstract
INTRODUCTION Previous research has shown that heavy cannabis users develop tolerance to the impairing effects of Δ9-tetrahydrocannabinol (THC) on neurocognitive functions. Animal studies suggest that chronic cannabis consumption may also produce cross-tolerance for the impairing effects of alcohol, but supportive data in humans is scarce. PURPOSE The present study was designed to assess tolerance and cross-tolerance to the neurocognitive effects of THC and alcohol in heavy cannabis users. METHODS Twenty-one heavy cannabis users participated in a double-blind, placebo-controlled, three-way study. Subjects underwent three alcohol-dosing conditions that were designed to achieve a steady blood alcohol concentration of about 0, 0.5, and 0.7 mg/ml during a 5-h time window. In addition, subjects smoked a THC cigarette (400 μg/kg) at 3 h post-onset of alcohol dosing during every alcohol condition. Performance tests were conducted repeatedly between 0 and 7 h after onset of drinking and included measures of perceptual motor control (critical tracking task), dual task processing (divided-attention task), motor inhibition (stop-signal task), and cognition (Tower of London). RESULTS Alcohol significantly impaired critical tracking, divided attention, and stop-signal performance. THC generally did not affect task performance. However, combined effects of THC and alcohol on divided attention were bigger than those by alcohol alone. CONCLUSION In conclusion, the present study generally confirms that heavy cannabis users develop tolerance to the impairing effects of THC on neurocognitive task performance. Yet, heavy cannabis users did not develop cross-tolerance to the impairing effects of alcohol, and the presence of the latter even selectively potentiated THC effects on measures of divided attention.
Collapse
Affiliation(s)
- Johannes G. Ramaekers
- Department Neuropsychology and Psychopharmacology, Faculty of Psychology and Neuroscience, Maastricht University, Maastricht, The Netherlands
| | - Eef L. Theunissen
- Department Neuropsychology and Psychopharmacology, Faculty of Psychology and Neuroscience, Maastricht University, Maastricht, The Netherlands
| | - Marjolein de Brouwer
- Department Neuropsychology and Psychopharmacology, Faculty of Psychology and Neuroscience, Maastricht University, Maastricht, The Netherlands
| | - Stefan W. Toennes
- Department of Forensic Toxicology, Institute of Legal Medicine, Goethe University of Frankfurt, Frankfurt, Germany
| | | | - Gerhold Kauert
- Department of Forensic Toxicology, Institute of Legal Medicine, Goethe University of Frankfurt, Frankfurt, Germany
| |
Collapse
|
37
|
Combined effects of acute, very-low-dose ethanol and delta(9)-tetrahydrocannabinol in healthy human volunteers. Pharmacol Biochem Behav 2010; 97:627-31. [PMID: 21110996 DOI: 10.1016/j.pbb.2010.11.013] [Citation(s) in RCA: 39] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/02/2010] [Revised: 10/12/2010] [Accepted: 11/17/2010] [Indexed: 11/21/2022]
Abstract
RATIONALE Previous studies examining the combined effects of ethanol and cannabis, or its primary psychoactive ingredient, ∆⁹-tetrahydrocannabinol (THC), have provided mixed results. Data from an in vitro study suggests that combined, sub-threshold doses of these drugs may interact to produce synergistic effects. Very low doses of the two drugs in combination have not been tested in humans. MATERIALS AND METHODS This study assessed whether combinations of acute, very low doses of ethanol and THC produce synergistic effects on subjective, cognitive, and physiological measures. Healthy volunteers (n=11) received capsules containing placebo or THC (2.5 mg), and beverages containing placebo or ethanol (0.1 and 0.2 g/kg) alone, and in combination, across separate sessions, in a within-subjects, randomized, double-blind design. During each session, participants completed measures of working memory, psychomotor ability, and simple reaction time, and provided subjective mood and drug effect ratings. Cardiovascular measures were obtained at regular intervals. RESULTS As intended, when administered alone, these very low doses of ethanol and THC had only moderate effects on isolated measures. The combined effects of these drugs were not synergistic, and in some cases appeared to be less-than-additive. CONCLUSIONS Our data provide no evidence for synergistic effects of acute combinations of very-low-dose ethanol and THC on subjective or physiologic response, or on cognitive performance.
Collapse
|
38
|
Anderson BM, Rizzo M, Block RI, Pearlson GD, O'Leary DS. Sex differences in the effects of marijuana on simulated driving performance. J Psychoactive Drugs 2010; 42:19-30. [PMID: 20464803 DOI: 10.1080/02791072.2010.10399782] [Citation(s) in RCA: 38] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
Abstract
In the United States, one in six teenagers has driven under the influence of marijuana. Driving under the influence of marijuana and alcohol is equally prevalent, despite the fact that marijuana use is less common than alcohol use. Much of the research examining the effects of marijuana on driving performance was conducted in the 1970s and led to equivocal findings. During that time, few studies included women and driving simulators were rudimentary. Further, the potency of marijuana commonly used recreationally has increased. This study examined sex differences in the acute effects of marijuana on driving performance using a realistic, validated driving simulator. Eighty-five subjects (n = 50 males, 35 females) participated in this between-subjects, double-blind, placebo controlled study. In addition to an uneventful, baseline segment of driving, participants were challenged with collision avoidance and distracted driving scenarios. Under the influence of marijuana, participants decreased their speed and failed to show expected practice effects during a distracted drive. No differences were found during the baseline driving segment or collision avoidance scenarios. No differences attributable to sex were observed. This study enhances the current literature by identifying distracted driving and the integration of prior experience as particularly problematic under the influence of marijuana.
Collapse
Affiliation(s)
- Beth M Anderson
- Olin Neuropsychiatry Research Center, 200 Retreat Avenue - Whitehall Bldg, Hartford Hospital Institute of Living, Hartford, CT 06106, USA.
| | | | | | | | | |
Collapse
|
39
|
Lenné MG, Dietze PM, Triggs TJ, Walmsley S, Murphy B, Redman JR. The effects of cannabis and alcohol on simulated arterial driving: Influences of driving experience and task demand. ACCIDENT; ANALYSIS AND PREVENTION 2010; 42:859-866. [PMID: 20380913 DOI: 10.1016/j.aap.2009.04.021] [Citation(s) in RCA: 133] [Impact Index Per Article: 9.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/14/2008] [Revised: 12/23/2008] [Accepted: 04/21/2009] [Indexed: 05/29/2023]
Abstract
This study compared the effects of three doses of cannabis and alcohol (placebo, low and high doses), both alone and in combination, on the driving performance of young, novice drivers and more experienced drivers. Alcohol was administered as ethanol (95%) mixed with orange juice in doses of approximately 0, 0.4 and 0.6g/kg. Cannabis was administered by inhalation of smoke from pre-rolled cannabis cigarettes (supplied by the National Institute of Drug Abuse, USA). Active cigarettes contained 19 mg delta-9-THC. Using a counterbalanced design, the simulated driving performance of 25 experienced and 22 inexperienced drivers was tested under the nine different drug conditions in an arterial driving environment during which workload was varied through the drive characteristics as well as through the inclusion of a secondary task. High levels of cannabis generally induced greater impairment than lower levels, while alcohol at the doses used had few effects and did not produce synergistic effects when combined with cannabis. Both cannabis and alcohol were associated with increases in speed and lateral position variability, high dose cannabis was associated with decreased mean speed, increased mean and variability in headways, and longer reaction time, while in contrast alcohol was associated with a slight increase in mean speed. Given the limitations of the study, it is of great interest to further explore the qualitative impairments in driving performance associated with cannabis and alcohol separately and how these impairments may manifest in terms of crash characteristics.
Collapse
Affiliation(s)
- Michael G Lenné
- Monash University Accident Research Centre, Monash University, Victoria 3800, Australia.
| | | | | | | | | | | |
Collapse
|
40
|
Zuurman L, Ippel AE, Moin E, van Gerven JMA. Biomarkers for the effects of cannabis and THC in healthy volunteers. Br J Clin Pharmacol 2009; 67:5-21. [PMID: 19133057 DOI: 10.1111/j.1365-2125.2008.03329.x] [Citation(s) in RCA: 85] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022] Open
Abstract
An increasing number of novel therapeutic agents are targeted at cannabinoid receptors. Drug development programmes of new cannabinoid drugs may be facilitated by the identification of useful biomarkers. This systemic literature review aims to assess the usefulness of direct biomarkers for the effects of cannabis and tetrahydrocannabinol (THC) in healthy volunteers. One hundred and sixty-five useful articles were found that investigated the acute effects of cannabis or THC on the central nervous system (CNS) and heart rate in healthy volunteers. Three hundred and eighteen tests (or test variants) were grouped in test clusters and functional domains, to allow their evaluation as a useful biomarker and to study their dose-response effects. Cannabis/THC affected a wide range of CNS domains. In addition to heart rate, subjective effects were the most reliable biomarkers, showing significant responses to cannabis in almost all studies. Some CNS domains showed indications of depression at lower and stimulation at higher doses. Subjective effects and heart rate are currently the most reliable biomarkers to study the effect of cannabis. Cannabis affects most CNS domains, but too many different CNS tests are used to quantify the drug-response relationships reliably. Test standardization, particularly in motor and memory domains, may reveal additional biomarkers.
Collapse
Affiliation(s)
- Lineke Zuurman
- Centre for Human Drug Research, Leiden, The Netherlands.
| | | | | | | |
Collapse
|
41
|
Ramaekers JG, Kauert G, Theunissen EL, Toennes SW, Moeller MR. Neurocognitive performance during acute THC intoxication in heavy and occasional cannabis users. J Psychopharmacol 2009; 23:266-77. [PMID: 18719045 DOI: 10.1177/0269881108092393] [Citation(s) in RCA: 233] [Impact Index Per Article: 15.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Performance impairment during Delta(9)-tetrahydrocannabinol (THC) intoxication has been well described in occasional cannabis users. It is less clear whether tolerance develops to the impairing effects of THC in heavy users of cannabis. The aim of the present study was to assess neurocognitive performance during acute THC intoxication in occasional and heavy users. Twenty-four subjects (12 occasional cannabis users and 12 heavy cannabis users) participated in a double-blind, placebo-controlled, two-way mixed model design. Both groups received single doses of THC placebo and 500 microg/kg THC by smoking. Performance tests were conducted at regular intervals between 0 and 8 h after smoking, and included measures of perceptual motor control (critical tracking task), dual task processing (divided attention task), motor inhibition (stop signal task) and cognition (Tower of London). THC significantly impaired performance of occasional cannabis users on critical tracking, divided attention and the stop signal task. THC did not affect the performance of heavy cannabis users except in the stop signal task, i.e. stop reaction time increased, particularly at high THC concentrations. Group comparisons of overall performance in occasional and heavy users did not reveal any persistent performance differences due to residual THC in heavy users. These data indicate that cannabis use history strongly determines the behavioural response to single doses of THC.
Collapse
Affiliation(s)
- J G Ramaekers
- Department of Neuropsychology and Psychopharmacology, Faculty of Psychology, Maastricht University, Maastricht, The Netherlands.
| | | | | | | | | |
Collapse
|
42
|
Dumont GJH, Wezenberg E, Valkenberg MMGJ, de Jong CAJ, Buitelaar JK, van Gerven JMA, Verkes RJ. Acute neuropsychological effects of MDMA and ethanol (co-)administration in healthy volunteers. Psychopharmacology (Berl) 2008; 197:465-74. [PMID: 18305926 PMCID: PMC2270918 DOI: 10.1007/s00213-007-1056-9] [Citation(s) in RCA: 36] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/13/2007] [Accepted: 12/19/2007] [Indexed: 10/27/2022]
Abstract
RATIONALE In Western societies, a considerable percentage of young people expose themselves to 3,4-methylenedioxymethamphetamine (MDMA or "ecstasy"). Commonly, ecstasy is used in combination with other substances, in particular alcohol (ethanol). MDMA induces both arousing as well as hallucinogenic effects, whereas ethanol is a general central nervous system depressant. OBJECTIVE The aim of the present study is to assess the acute effects of single and co-administration of MDMA and ethanol on executive, memory, psychomotor, visuomotor, visuospatial and attention function, as well as on subjective experience. MATERIALS AND METHODS We performed a four-way, double-blind, randomised, crossover, placebo-controlled study in 16 healthy volunteers (nine male, seven female) between the ages of 18-29. MDMA was given orally (100 mg) and blood alcohol concentration was maintained at 0.6 per thousand by an ethanol infusion regime. RESULTS Co-administration of MDMA and ethanol was well tolerated and did not show greater impairment of performance compared to the single-drug conditions. Impaired memory function was consistently observed after all drug conditions, whereas impairment of psychomotor function and attention was less consistent across drug conditions. CONCLUSIONS Co-administration of MDMA and ethanol did not exacerbate the effects of either drug alone. Although the impairment of performance by all drug conditions was relatively moderate, all induced significant impairment of cognitive function.
Collapse
Affiliation(s)
- G. J. H. Dumont
- Unit for Clinical Psychopharmacology and Neuropsychiatry (UCPN), Department of Psychiatry, University Medical Centre St Radboud, Nijmegen, The Netherlands ,University Medical Centre Nijmegen, P.O. Box 9101, 6500 HB Nijmegen, The Netherlands
| | - E. Wezenberg
- Unit for Clinical Psychopharmacology and Neuropsychiatry (UCPN), Department of Psychiatry, University Medical Centre St Radboud, Nijmegen, The Netherlands
| | - M. M. G. J. Valkenberg
- Unit for Clinical Psychopharmacology and Neuropsychiatry (UCPN), Department of Psychiatry, University Medical Centre St Radboud, Nijmegen, The Netherlands
| | - C. A. J. de Jong
- Nijmegen Institute for Science Practitioners in Addiction, Radboud University Nijmegen, Nijmegen, The Netherlands
| | - J. K. Buitelaar
- Unit for Clinical Psychopharmacology and Neuropsychiatry (UCPN), Department of Psychiatry, University Medical Centre St Radboud, Nijmegen, The Netherlands
| | | | - R. J. Verkes
- Unit for Clinical Psychopharmacology and Neuropsychiatry (UCPN), Department of Psychiatry, University Medical Centre St Radboud, Nijmegen, The Netherlands
| |
Collapse
|
43
|
Stein LAR, Colby SM, Barnett NP, Monti PM, Golembeske C, Lebeau-Craven R. Effects of motivational interviewing for incarcerated adolescents on driving under the influence after release. Am J Addict 2007; 15 Suppl 1:50-7. [PMID: 17182420 PMCID: PMC2754141 DOI: 10.1080/10550490601003680] [Citation(s) in RCA: 41] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022] Open
Abstract
Motivational Interviewing (MI) to reduce alcohol and marijuana-related driving events among incarcerated adolescents was evaluated. Adolescents were randomly assigned to receive MI or Relaxation Training. Follow-up assessment showed that, as compared to RT, adolescents who received MI had lower rates of drinking and driving, and being a passenger in a car with someone who had been drinking. Effects were moderated by levels of depression. At low levels of depression, MI evidenced lower rates of these behaviors; at high levels of depression, effects for MI and RT were equivalent. Similar patterns were found for marijuana-related risky driving, but effects were non-significant.
Collapse
Affiliation(s)
- L A R Stein
- University of Rhode Island, Psychology Department and Cancer Prevention Research Center, Kingston, RI 02881, USA.
| | | | | | | | | | | |
Collapse
|
44
|
Abstract
BACKGROUND Cannabis is known to have detrimental effects on human performance and may also affect driving adversely. However, studies designed to examine this issue have provided equivocal findings. We set up this study to further determine the effect of cannabis on driving. METHODS We used a cross-sectional, case-control design with drivers aged 20-49 who were involved in a fatal crash in the United States from 1993 to 2003; drivers were included if they had been tested for the presence of cannabis and had a confirmed blood alcohol concentration of zero. Cases were drivers who had at least one potentially unsafe driving action recorded in relation to the crash (e.g., speeding); controls were drivers who had no such driving action recorded. We calculated the crude and adjusted odds ratios (ORs) of any potentially unsafe driving action in drivers who tested positive for cannabis but negative for alcohol consumption. In computing for the adjusted OR, we controlled for age, sex, and prior driving record. RESULTS Five percent of drivers tested positive for cannabis. The crude OR of a potentially unsafe action was 1.39 (99% CI = 1.21-1.59) for drivers who tested positive for cannabis. Even after controlling for age, sex, and prior driving record, the presence of cannabis remained associated with a higher risk of a potentially unsafe driving action (1.29, 99% CI = 1.11-1.50). CONCLUSION Cannabis had a negative effect on driving, as would be predicted from human performance studies. This finding supports the need for interventions to decrease the prevalence of driving under the influence of cannabis, and indicates that further studies should be conducted to investigate the dose-response relationship between cannabis and safe driving.
Collapse
|
45
|
Ramaekers JG, Moeller MR, van Ruitenbeek P, Theunissen EL, Schneider E, Kauert G. Cognition and motor control as a function of Delta9-THC concentration in serum and oral fluid: limits of impairment. Drug Alcohol Depend 2006; 85:114-22. [PMID: 16723194 DOI: 10.1016/j.drugalcdep.2006.03.015] [Citation(s) in RCA: 204] [Impact Index Per Article: 11.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/14/2005] [Revised: 03/22/2006] [Accepted: 03/23/2006] [Indexed: 11/20/2022]
Abstract
Cannabis use has been associated with increased risk of becoming involved in traffic accidents; however, the relation between THC concentration and driver impairment is relatively obscure. The present study was designed to define performance impairment as a function of THC in serum and oral fluid in order to provide a scientific framework to the development of per se limits for driving under the influence of cannabis. Twenty recreational users of cannabis participated in a double-blind, placebo-controlled, three-way cross-over study. Subjects were administered single doses of 0, 250 and 500 microg/kg THC by smoking. Performance tests measuring skills related to driving were conducted at regular intervals between 15 min and 6h post smoking and included measures of perceptual-motor control (Critical tracking task), motor impulsivity (Stop signal task) and cognitive function (Tower of London). Blood and oral fluid were collected throughout testing. Results showed a strong and linear relation between THC in serum and oral fluid. Linear relations between magnitude of performance impairment and THC in oral fluid and serum, however, were low. A more promising way to define threshold levels of impairment was found by comparing the proportion of observations showing impairment or no impairment as a function of THC concentration. The proportion of observations showing impairment progressively increased as a function of serum THC in every task. Binomial tests showed an initial and significant shift toward impairment in the Critical tracking task for serum THC concentrations between 2 and 5 ng/ml. At concentrations between 5 and 10 ng/ml approximately 75-90% of the observations were indicative of significant impairment in every performance test. At THC concentrations >30 ng/ml the proportion of observations indicative of significant impairment increased to a full 100% in every performance tests. It is concluded that serum THC concentrations between 2 and 5 ng/ml establish the lower and upper range of a THC limit for impairment.
Collapse
Affiliation(s)
- J G Ramaekers
- Experimental Psychopharmacology Unit, Department of Neurocognition, Faculty of Psychology, Maastricht University, 6200 MD Maastricht, The Netherlands.
| | | | | | | | | | | |
Collapse
|
46
|
Degia A, Meadows R, Johnsen S, Dixon P, Hindmarch I, Boyle J. Investigation into the suitability of a portable psychometric device to be used in the field: An illicit drugs field investigation. ACTA ACUST UNITED AC 2006; 13:242-6. [PMID: 16442832 DOI: 10.1016/j.jcfm.2005.11.007] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/08/2005] [Indexed: 11/17/2022]
Abstract
RATIONALE Driving performance is easily disrupted as a direct consequence of the use of alcohol, licit and illicit drugs. The use of such drugs has a high degree of correlation with increased accident risk. Europe wide research projects into drugged driving have called for the development of a portable objective device capable of screening those impaired through drug use which can be used at the roadside. OBJECTIVE This study investigated the cognitive and psychomotor performance of a cohort of polydrug drug users in field conditions. Volunteers completed a psychometric test battery on a hand held device in music festival conditions. The test battery comprised a critical tracking task (CTT) and a sustained attention to response task (SART). Volunteers also took a breathanalyser and provided a saliva sample for a DOA screen. RESULTS On the CTT significance was observed for tracking error following response to a peripheral stimulus in the high alcohol (>80 mg/100 ml) illicit drug group (p=0.0090) and approached significance for the low alcohol (<80 mg/100 ml) illicit drug group (p=0.088). For the SART, incorrect presses to the target stimulus was impaired for volunteers in both the low (<80 mg/100 ml) alcohol illicit drug group (p=0.0080) and the high alcohol (>80 mg/100 ml) illicit drug group (p=0.0415). Discrimination analysis demonstrated that the impairment device was able to discriminate between those individuals who had consumed neither alcohol nor drugs (94.12%), those in the low alcohol drug group (46.67%) and those in the high alcohol drug group (60.00%). CONCLUSION It is possible to derive an impairment ratio. Further research will demonstrate whether this device could significantly contribute to drug driving detection and road traffic safety.
Collapse
Affiliation(s)
- A Degia
- HPRU Medical Research Centre, School of Biomedical and Molecular Sciences, University of Surrey, Guildford GU2 7XP, United Kingdom.
| | | | | | | | | | | |
Collapse
|
47
|
Monti PM, Miranda R, Nixon K, Sher KJ, Swartzwelder HS, Tapert SF, White A, Crews FT. Adolescence: Booze, Brains, and Behavior. Alcohol Clin Exp Res 2005; 29:207-20. [PMID: 15714044 DOI: 10.1097/01.alc.0000153551.11000.f3] [Citation(s) in RCA: 155] [Impact Index Per Article: 8.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
This article represents the proceedings of a symposium at the 2004 Research Society on Alcoholism meeting in Vancouver, British Columbia, Canada, organized and chaired by Peter M. Monti and Fulton T. Crews. The presentations and presenters were (1) Introduction, by Peter M. Monti; (2) Adolescent Binge Drinking Causes Life-Long Changes in Brain, by Fulton T. Crews and Kim Nixon; (3) Functional Neuroimaging Studies in Human Adolescent Drinkers, by Susan F. Tapert; (4) Abnormal Emotional Reactivity as a Risk Factor for Alcoholism, by Robert Miranda, Jr.; (5) Alcohol-Induced Memory Impairments, Including Blackouts, and the Changing Adolescent Brain, by Aaron M. White and H. Scott Swartzwelder; and (6) Discussion, by Kenneth Sher.
Collapse
Affiliation(s)
- Peter M Monti
- Veterans Affairs Medical Center, Brown University, Providence, Rhode Island 02912, USA.
| | | | | | | | | | | | | | | |
Collapse
|
48
|
Drummer OH, Gerostamoulos J, Batziris H, Chu M, Caplehorn J, Robertson MD, Swann P. The involvement of drugs in drivers of motor vehicles killed in Australian road traffic crashes. ACCIDENT; ANALYSIS AND PREVENTION 2004; 36:239-248. [PMID: 14642878 DOI: 10.1016/s0001-4575(02)00153-7] [Citation(s) in RCA: 229] [Impact Index Per Article: 11.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/24/2023]
Abstract
A multi-center case-control study was conducted on 3398 fatally-injured drivers to assess the effect of alcohol and drug use on the likelihood of them being culpable. Crashes investigated were from three Australian states (Victoria, New South Wales and Western Australia). The control group of drug- and alcohol-free drivers comprised 50.1% of the study population. A previously validated method of responsibility analysis was used to classify drivers as either culpable or non-culpable. Cases in which the driver "contributed" to the crash (n=188) were excluded. Logistic regression was used to examine the association of key attributes such as age, gender, type of crash and drug use on the likelihood of culpability. Drivers positive to psychotropic drugs were significantly more likely to be culpable than drug-free drivers. Drivers with Delta(9)-tetrahydrocannabinol (THC) in their blood had a significantly higher likelihood of being culpable than drug-free drivers (odds ratio (OR) 2.7, 95% CI 1.02-7.0). For drivers with blood THC concentrations of 5 ng/ml or higher the odds ratio was greater and more statistically significant (OR 6.6, 95% CI 1.5-28.0). The estimated odds ratio is greater than that for drivers with a blood alcohol concentration (BAC) of 0.10-0.15% (OR 3.7, 95% CI 1.5-9.1). A significantly stronger positive association with culpability was seen with drivers positive to THC and with BAC > or =0.05% compared with BAC > or =0.05 alone (OR 2.9, 95% CI 1.1-7.7). Strong associations were also seen for stimulants, particularly in truck drivers. There were non-significant, weakly positive associations of opiates and benzodiazepines with culpability. Drivers positive to any psychoactive drug were significantly more likely to be culpable (OR 1.8, 95% CI 1.3-2.4). Gender differences were not significant, but differences were apparent with age. Drivers showing the highest culpability rates were in the under 25 and over 65 age groups.
Collapse
Affiliation(s)
- Olaf H Drummer
- Department of Forensic Medicine, Victorian Institute of Forensic Medicine, Monash University, 57-83 Kavanagh Street, Vic. 3006, Southbank, Australia.
| | | | | | | | | | | | | |
Collapse
|
49
|
Abstract
The role of Delta(9)-tetrahydrocannabinol (THC) in driver impairment and motor vehicle crashes has traditionally been established in experimental and epidemiological studies. Experimental studies have repeatedly shown that THC impairs cognition, psychomotor function and actual driving performance in a dose related manner. The degree of performance impairment observed in experimental studies after doses up to 300 microg/kg THC were equivalent to the impairing effect of an alcohol dose producing a blood alcohol concentration (BAC) >/=0.05 g/dl, the legal limit for driving under the influence in most European countries. Higher doses of THC, i.e. >300 microg/kg THC have not been systematically studied but can be predicted to produce even larger impairment. Detrimental effects of THC were more prominent in certain driving tasks than others. Highly automated behaviors, such as road tracking control, were more affected by THC as compared to more complex driving tasks requiring conscious control. Epidemiological findings on the role of THC in vehicle crashes have sometimes contrasted findings from experimental research. Case-control studies generally confirmed experimental data, but culpability surveys showed little evidence that crashed drivers who only used cannabis are more likely to cause accidents than drug free drivers. However, most culpability surveys have established cannabis use among crashed drivers by determining the presence of an inactive metabolite of THC in blood or urine that can be detected for days after smoking and can only be taken as evidence for past use of cannabis. Surveys that established recent use of cannabis by directly measuring THC in blood showed that THC positives, particularly at higher doses, are about three to seven times more likely to be responsible for their crash as compared to drivers that had not used drugs or alcohol. Together these epidemiological data suggests that recent use of cannabis may increase crash risk, whereas past use of cannabis does not. Experimental and epidemiological research provided similar findings concerning the combined use of THC and alcohol in traffic. Combined use of THC and alcohol produced severe impairment of cognitive, psychomotor, and actual driving performance in experimental studies and sharply increased the crash risk in epidemiological analyses.
Collapse
Affiliation(s)
- J G Ramaekers
- Experimental Psychopharmacology Unit, Department of Neurocognition, Faculty of Psychology, Maastricht University, P.O. Box 616, MD 6200 Maastricht, The Netherlands.
| | | | | | | |
Collapse
|
50
|
Lamers CTJ, Ramaekers JG, Muntjewerff ND, Sikkema KL, Samyn N, Read NL, Brookhuis KA, Riedel WJ. Dissociable effects of a single dose of ecstasy (MDMA) on psychomotor skills and attentional performance. J Psychopharmacol 2003; 17:379-87. [PMID: 14870949 DOI: 10.1177/0269881103174015] [Citation(s) in RCA: 51] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Ecstasy (3,4-methylenedioxymethamphetamine, MDMA) is a psychoactive recreational drug widely used by young people visiting dance parties, and has been associated with poor cognitive function. The current study assessed the influence of a single dose of MDMA 75 mg and alcohol 0.5 g/kg on cognition, psychomotor performance and driving-related task performance. Twelve healthy recreational ecstasy users participated in an experimental study conducted according to a double-blind, double-dummy, placebo-controlled three-way cross-over design. MDMA improved psychomotor performance, such as movement speed and tracking performance in a single task, as well as in a divided attention task. MDMA impaired the ability to predict object movement under divided attention. However, the inability to accurately predict object movement after MDMA may indicate impairment of particular performance skills relevant to driving. There was no effect of MDMA on visual search, planning or retrieval from semantic memory.
Collapse
Affiliation(s)
- C T J Lamers
- Experimental Psychopharmacology Unit, Brain and Behaviour Institute, Maastricht University, Maastricht, The Netherlands.
| | | | | | | | | | | | | | | |
Collapse
|