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Bedillion MF, Claus ED, Wemm SE, Fox HC, Ansell EB. The effects of simultaneous alcohol and cannabis use on subjective drug effects: A narrative review across methodologies. ALCOHOL, CLINICAL & EXPERIMENTAL RESEARCH 2024; 48:988-999. [PMID: 38641546 DOI: 10.1111/acer.15322] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/06/2023] [Revised: 03/08/2024] [Accepted: 03/09/2024] [Indexed: 04/21/2024]
Abstract
Over 75% of young adults who use cannabis also report drinking alcohol, leading to increased risks that include impaired cognition, substance use disorders, and more heavy and frequent substance use. Studies suggest that subjective responses to either alcohol or cannabis can serve as a valuable indicator for identifying individuals at risk of prolonged substance use and use disorder. While laboratory studies show additive effects when alcohol and cannabis are used together, the impact of co-using these substances, specifically with respect to cannabidiol, on an individual's subjective experience remains unclear. This narrative review explores the effects of simultaneous alcohol and cannabis (SAM) use on subjective drug effects, drawing from qualitative research, laboratory experiments, and naturalistic studies. Experimental findings are inconsistent regarding the combined effects of alcohol and cannabis, likely influenced by factors such as dosage, method of administration, and individual substance use histories. Similarly, findings from qualitative and naturalistic studies are mixed regarding subjective drug effects following SAM use. These discrepancies may be due to recall biases, variations in assessment methods, and the measurement in real-world contexts of patterns of SAM use and related experiences. Overall, this narrative review highlights the need for more comprehensive research to understand more fully subjective drug effects of SAM use in diverse populations and settings, emphasizing the importance of frequent and nuanced assessment of SAM use and subjective responses in naturalistic settings.
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Affiliation(s)
| | - Eric D Claus
- The Pennsylvania State University, University Park, Pennsylvania, USA
| | | | - Helen C Fox
- Stony Brook University, Stony Brook, New York, USA
| | - Emily B Ansell
- The Pennsylvania State University, University Park, Pennsylvania, USA
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2
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Asbridge M, Brubacher J. Cannabis and Alcohol Involvement in Motor Vehicle Crashes: Reflections in the Era of Legalization. Am J Public Health 2024; 114:550-552. [PMID: 38635944 PMCID: PMC11079830 DOI: 10.2105/ajph.2024.307657] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/20/2024]
Affiliation(s)
- Mark Asbridge
- Mark Asbridge is with the Department of Community Health and Epidemiology, Dalhousie University, Halifax, Nova Scotia, Canada. Jeff Brubacher is with the Department of Emergency Medicine, Faculty of Medicine, University of British Columbia, Vancouver, BC, Canada
| | - Jeff Brubacher
- Mark Asbridge is with the Department of Community Health and Epidemiology, Dalhousie University, Halifax, Nova Scotia, Canada. Jeff Brubacher is with the Department of Emergency Medicine, Faculty of Medicine, University of British Columbia, Vancouver, BC, Canada
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Zamarripa CA, Spindle TR, Panlilio LV, Strickland JC, Feldman JD, Novak MD, Epstein DH, Dunn KE, McCurdy CR, Sharma A, Kuntz MA, Mukhopadhyay S, Raju KSR, Rogers JM, Smith KE. Effects of kratom on driving: Results from a cross-sectional survey, ecological momentary assessment, and pilot simulated driving Study. TRAFFIC INJURY PREVENTION 2024; 25:594-603. [PMID: 38497810 PMCID: PMC11149710 DOI: 10.1080/15389588.2024.2327827] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/13/2023] [Accepted: 03/01/2024] [Indexed: 03/19/2024]
Abstract
OBJECTIVES Despite widespread kratom use, there is a lack of knowledge regarding its effects on driving. We evaluated the self-reported driving behaviors of kratom consumers and assessed their simulated-driving performance after self-administering kratom products. METHODS We present results from: 1) a remote, national study of US adults who regularly use kratom, and 2) an in-person substudy from which we re-recruited participants. In the national study (N = 357), participants completed a detailed survey and a 15-day ecological momentary assessment (EMA) that monitored naturalistic kratom use. For the remote study, outcomes were self-reported general and risky driving behaviors, perceived impairment, and driving confidence following kratom administration. For the in-person substudy, 10 adults consumed their typical kratom products and their driving performance on a high-fidelity driving simulator pre- and post-kratom administration was evaluated. RESULTS Over 90% of participants surveyed self-reported driving under the influence of kratom. Most reported low rates of risky driving behavior and expressed high confidence in their driving ability after taking kratom. This was consistent with EMA findings: participants reported feeling confident in their driving ability and perceived little impairment within 15-180 min after using kratom. In the in-person substudy, there were no significant changes in simulated driving performance after taking kratom. CONCLUSIONS Using kratom before driving appears routine, however, self-reported and simulated driving findings suggest kratom effects at self-selected doses among regular kratom consumers do not produce significant changes in subjective and objective measures of driving impairment. Research is needed to objectively characterize kratom's impact on driving in regular and infrequent consumers.
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Affiliation(s)
- C Austin Zamarripa
- Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
| | - Tory R Spindle
- Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
| | - Leigh V Panlilio
- Real-World, Assessment, Prediction, Treatment Unit, Intramural Research Program, National Institute on Drug Abuse, Baltimore, Maryland, USA
| | - Justin C Strickland
- Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
| | - Jeffrey D Feldman
- Real-World, Assessment, Prediction, Treatment Unit, Intramural Research Program, National Institute on Drug Abuse, Baltimore, Maryland, USA
| | - Matthew D Novak
- Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
| | - David H Epstein
- Real-World, Assessment, Prediction, Treatment Unit, Intramural Research Program, National Institute on Drug Abuse, Baltimore, Maryland, USA
| | - Kelly E Dunn
- Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
| | - Christopher R McCurdy
- Department of Medicinal Chemistry, College of Pharmacy, University of Florida, Gainesville, Florida, USA
| | - Abhisheak Sharma
- Department of Pharmaceutics, College of Pharmacy, University of Florida, Gainesville, Florida, USA
| | - Michelle A Kuntz
- Department of Pharmaceutics, College of Pharmacy, University of Florida, Gainesville, Florida, USA
| | - Sushobhan Mukhopadhyay
- Department of Medicinal Chemistry, College of Pharmacy, University of Florida, Gainesville, Florida, USA
| | - Kanumuri Siva Rama Raju
- Department of Pharmaceutics, College of Pharmacy, University of Florida, Gainesville, Florida, USA
| | - Jeffrey M Rogers
- San Diego State University/University of California San Diego Joint Doctoral Program in Clinical Psychology, San Diego, California, USA
| | - Kirsten E Smith
- Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
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Miller R, Brown T, Schmitt R, Gaffney G, Milavetz G. Predicting changes in driving performance in individuals who use cannabis following acute use based on self-reported readiness to drive. ACCIDENT; ANALYSIS AND PREVENTION 2024; 195:107376. [PMID: 37984112 DOI: 10.1016/j.aap.2023.107376] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/01/2023] [Revised: 10/30/2023] [Accepted: 11/06/2023] [Indexed: 11/22/2023]
Abstract
OBJECTIVE It is unclear to what extent individuals who use cannabis can accurately assess their ability to drive safely following cannabis use, and lack of understanding as to what factors influence changes in driving performance following cannabis use. This research explores whether self-reported readiness to drive (RTD) and previous experience (PE) using cannabis within 2 h of driving can predict observed changes in driving performance following acute cannabis use. METHODS Individuals who used cannabis at least monthly completed a baseline simulated drive, were dosed with cannabis of approximately 6.18% THC, then drove at approximately 30-minutes, 90-minutes, and 180-minutes post-dose. Before each drive, participants were asked if they felt safe to drive (on real roadways, not the simulator), a yes/no question (RTD-yes/RTD-no). Venous blood was drawn at baseline and approximately 15-minutes post-dose. Cannabis use history was obtained and included whether the participant had ever driven within 2 h of use (PE-yes/PE-no) and how many days out of the past 30 they had done so (NPD). Drives were segmented into events delineated by changes in the driving environment. Within events, standard deviation of lateral position (SDLP), average speed, and number of lane departures were calculated, and differences from baseline were modeled using mixed-effects regression. Models considered covariates of time, event, and speed, and used RTD-yes/RTD-no, PE-yes/PE-no, NPD, and their interactions as potential predictors. Conditional R2 was used to compare the predictive ability of RTD versus change in Delta-9-THC. DATA SOURCES Data were collected from 30 individuals who use cannabis and included cannabis use patterns, driving behaviors after use, self-reported RTD, measures of driving performance, and cannabinoid blood levels. RESULTS RTD-no predicted a 2.60 cm increase in SDLP relative to baseline (95 % CI: 0.43, 4.73, p = 0.018). Average speeds generally decreased relative to baseline, except for RTD-yes with PE-yes (+1.08 mph, 95 % CI: 0.05, 2.11). NPD predicted increased speed among RTD-yes (+0.11 mph per additional day, 95 % CI: 0.01, 0.22) and decreased speed among RTD-no (-0.06 mph per additional day, 95 % CI: -0.18, 0.32). The difference in these effects was statistically significant (p = 0.038). RTD, PE, and NPD were not significant predictors of changes in number of lane departures. For all outcomes, models using RTD achieved higher conditional R2 than models that replaced this variable with change in Delta-9-THC. Differences were most prominent when modeling change in speed with NPD (R2=0.544 with RTD vs. R2=0.481 with change in Delta-9-THC). SIGNIFICANCE OF RESULTS These results suggest individuals who use cannabis can somewhat self-identify when they are likely to exhibit greater degraded lateral control, although RTD does not fully explain observed degradation in performance. Past research suggests drivers may reduce speed to compensate for recognized impairment following acute cannabis use. Our findings suggest this to be true for those who reported never having previously driven within 2 h of cannabis use or reported RTD-no, but not for those who had previously driven within 2 h of cannabis use and reported RTD-yes. This indicates compensatory behavior is not uniform and helps focus public health outreach efforts.
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Affiliation(s)
- Ryan Miller
- Grinnell College, 1115 8(th) Avenue, Grinnell, IA 50112, USA.
| | - Timothy Brown
- University of Iowa Driving Safety Research Institute, 2401 Oakdale Blvd, Iowa City, IA 52242, USA
| | - Rose Schmitt
- University of Iowa Driving Safety Research Institute, 2401 Oakdale Blvd, Iowa City, IA 52242, USA
| | - Gary Gaffney
- University of Iowa Driving Safety Research Institute, 2401 Oakdale Blvd, Iowa City, IA 52242, USA
| | - Gary Milavetz
- University of Iowa, College of Pharmacy, 180 S Grand Ave, Iowa City, IA 52242, USA
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Di Ciano P, Rajji TK, Hong L, Zhao S, Byrne P, Elzohairy Y, Brubacher JR, McGrath M, Brands B, Chen S, Wang W, Hasan OSM, Wickens CM, Kaduri P, Le Foll B. Cannabis and Driving in Older Adults. JAMA Netw Open 2024; 7:e2352233. [PMID: 38236599 PMCID: PMC10797455 DOI: 10.1001/jamanetworkopen.2023.52233] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/06/2023] [Accepted: 11/29/2023] [Indexed: 01/19/2024] Open
Abstract
Importance Epidemiological studies have found that cannabis increases the risk of a motor vehicle collision. Cannabis use is increasing in older adults, but laboratory studies of the association between cannabis and driving in people aged older than 65 years are lacking. Objective To investigate the association between cannabis, simulated driving, and concurrent blood tetrahydrocannabinol (THC) levels in older adults. Design, Setting, and Participants Using an ecologically valid counterbalanced design, in this cohort study, regular cannabis users operated a driving simulator before, 30 minutes after, and 180 minutes after smoking their preferred legal cannabis or after resting. This study was conducted in Toronto, Canada, between March and November 2022 with no follow-up period. Data were analyzed from December 2022 to February 2023. Exposures Most participants chose THC-dominant cannabis with a mean (SD) content of 18.74% (6.12%) THC and 1.46% (3.37%) cannabidiol (CBD). Main outcomes and measures The primary end point was SD of lateral position (SDLP, or weaving). Secondary outcomes were mean speed (MS), maximum speed, SD of speed, and reaction time. Driving was assessed under both single-task and dual-task (distracted) conditions. Blood THC and metabolites of THC and CBD were also measured at the time of the drives. Results A total of 31 participants (21 male [68%]; 29 White [94%], 1 Latin American [3%], and 1 mixed race [3%]; mean [SD] age, 68.7 [3.5] years), completed all study procedures. SDLP was increased and MS was decreased at 30 but not 180 minutes after smoking cannabis compared with the control condition in both the single-task (SDLP effect size [ES], 0.30; b = 1.65; 95% CI, 0.37 to 2.93; MS ES, -0.58; b = -2.46; 95% CI, -3.56 to -1.36) and dual-task (SDLP ES, 0.27; b = 1.75; 95% CI, 0.21 to 3.28; MS ES, -0.47; b = -3.15; 95% CI, -5.05 to -1.24) conditions. Blood THC levels were significantly increased at 30 minutes but not 180 minutes. Blood THC was not correlated with SDLP or MS at 30 minutes, and SDLP was not correlated with MS. Subjective ratings remained elevated for 5 hours and participants reported that they were less willing to drive at 3 hours after smoking. Conclusions and relevance In this cohort study, the findings suggested that older drivers should exercise caution after smoking cannabis.
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Affiliation(s)
- Patricia Di Ciano
- Institute for Mental Health Policy Research, Centre for Addiction and Mental Health, Toronto, Ontario, Canada
- Department of Pharmacology and Toxicology, University of Toronto, Toronto, Ontario, Canada
- Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health, Toronto, Ontario, Canada
| | - Tarek K. Rajji
- Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health, Toronto, Ontario, Canada
- Institute of Medical Sciences, University of Toronto, Toronto, Ontario, Canada
- Toronto Dementia Research Alliance, Temerty Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada
| | - Lauren Hong
- Institute for Mental Health Policy Research, Centre for Addiction and Mental Health, Toronto, Ontario, Canada
| | - Sampson Zhao
- Institute for Mental Health Policy Research, Centre for Addiction and Mental Health, Toronto, Ontario, Canada
- Department of Pharmacology and Toxicology, University of Toronto, Toronto, Ontario, Canada
| | - Patrick Byrne
- Ontario Ministry of Transportation, Toronto, Ontario, Canada
| | | | - Jeffrey R. Brubacher
- Department of Emergency Medicine, University of British Columbia, Vancouver, British Columbia, Canada
| | - Michael McGrath
- Ontario Ministry of Transportation, Toronto, Ontario, Canada
| | - Bruna Brands
- Institute for Mental Health Policy Research, Centre for Addiction and Mental Health, Toronto, Ontario, Canada
- Department of Pharmacology and Toxicology, University of Toronto, Toronto, Ontario, Canada
- Health Canada, Ottawa, Ontario, Canada
| | - Sheng Chen
- Biostatistics Core, Centre for Addiction and Mental Health, Toronto, Ontario, Canada
| | - Wei Wang
- Biostatistics Core, Centre for Addiction and Mental Health, Toronto, Ontario, Canada
| | - Omer S. M. Hasan
- Institute for Mental Health Policy Research, Centre for Addiction and Mental Health, Toronto, Ontario, Canada
- Institute of Medical Sciences, University of Toronto, Toronto, Ontario, Canada
| | - Christine M. Wickens
- Institute for Mental Health Policy Research, Centre for Addiction and Mental Health, Toronto, Ontario, Canada
- Department of Pharmacology and Toxicology, University of Toronto, Toronto, Ontario, Canada
- Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada
- Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health, Toronto, Ontario, Canada
- Institute of Health Policy, Management and Evaluation, University of Toronto, Toronto, Ontario, Canada
| | - Pamela Kaduri
- Addictions Division, Centre for Addiction and Mental Health, Toronto, Ontario, Canada
- Department of Psychiatry, University of Toronto, Toronto, Ontario, Canada
- Department of Psychiatry and Mental Health, Muhimbill University of Health and Allied Sciences, Tanzania
| | - Bernard Le Foll
- Institute for Mental Health Policy Research, Centre for Addiction and Mental Health, Toronto, Ontario, Canada
- Department of Pharmacology and Toxicology, University of Toronto, Toronto, Ontario, Canada
- Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health, Toronto, Ontario, Canada
- Department of Psychiatry, University of Toronto, Toronto, Ontario, Canada
- Translational Addiction Research Laboratory, Centre for Addiction and Mental Health, Toronto, Ontario, Canada
- Institute of Medical Sciences, University of Toronto, Toronto, Ontario, Canada
- Acute Care Program, Centre for Addiction and Mental Health, Toronto, Ontario, Canada
- Department of Family and Community Medicine, University of Toronto, Toronto, Ontario, Canada
- Waypoint Research Institute, Waypoint Centre for Mental Health Care, Penetanguishene, Ontario, Canada
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Li F. A retrospective study of traffic offenses associated with driving under the influence of drugs in China. TRAFFIC INJURY PREVENTION 2024; 25:103-109. [PMID: 38054845 DOI: 10.1080/15389588.2023.2285714] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/27/2023] [Accepted: 11/15/2023] [Indexed: 12/07/2023]
Abstract
OBJECTIVE This study aimed to investigate the prevalence and pattern of traffic offenses associated with driving under the influence of drugs (DUID) in 31 provinces of mainland China. METHODS Traffic offenses were extracted from the nationally representative court file disclosure website. Drivers convicted of traffic offenses associated with DUID were included. The monthly percentage change (MPC) in rates was estimated by fitting negative binomial regression models to assess the time trends. Moran's I was used to determine the correlations of DUID-related rates among surrounding provinces. RESULTS In total, 896 individuals convicted of DUID offenses were identified (April 2007 to March 2022). Of these, 769 individuals were involved in traffic crashes, and they killed 629 people. Regarding the types of drugs, 638 used amphetamine-type stimulants (ATS; methamphetamine, 3,4-methylenedioxymethamphetamine, amphetamine, and tenamfetamine), 104 used ketamine, 104 used opioids (heroin, morphine, methadone, codeine, and tramadol), 20 used caffeine, 4 used tetrahydrocannabinol, and 1 used gamma-hydroxybutyric acid. The offense trends among overall drug users (MPC, -1.1; p < .001) declined from 2014 to 2020. The trends also decreased for DUID-related traffic crashes (-1.5; p < .001) and deaths (-1.7; p < .001) during the same period. Except in three provinces, ATS-related offense rates were higher than opioid-related offense rates. Ketamine-related offense rates showed a significant positive correlation among the surrounding provinces (Moran's I, 0.22; p < .01), and South China had the highest ketamine-related offense rates. CONCLUSIONS In the sample, the case fatality rate was 70.7%, which was a strong indicator of underreporting, and most minor DUID-related offenses could not be captured by Chinese court files. The frequency of drug screening tests for people should be increased. The traffic police in Qinghai, Tibet, and Xinjiang should always be equipped with fast screening test kits for drugs, which could increase the possibility of identifying DUID offenders.
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Affiliation(s)
- Feng Li
- School of Humanities, Southeast University, Nanjing, China
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Manning B, Hayley AC, Catchlove S, Shiferaw B, Stough C, Downey LA. Effect of CannEpil ® on simulated driving performance and co-monitoring of ocular activity: A randomised controlled trial. J Psychopharmacol 2023; 37:472-483. [PMID: 37129083 PMCID: PMC10184186 DOI: 10.1177/02698811231170360] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 05/03/2023]
Abstract
BACKGROUND Medicinal cannabis products containing Δ9-tetrahydrocannabinol (THC) are increasingly accessible. Yet, policy guidelines regarding fitness to drive are lacking, and cannabinoid-specific indexations of impairment are underdeveloped. AIMS To determine the impact of a standardised 1 mL sublingual dose of CannEpil®, a medicinal cannabis oil containing 100 mg cannabidiol (CBD) and 5 mg THC on simulated driving performance, relative to placebo and whether variations in vehicle control can be indexed by ocular activity. METHODS A double-blind, within-subjects, randomised, placebo-controlled, crossover trial assessed 31 healthy fully licensed drivers (15 male, 16 female) aged between 21 and 58 years (M = 38.0, SD = 10.78). Standard deviation of lateral position (SDLP), standard deviation of speed (SDS) and steering variability were assessed over time and as a function of treatment during a 40 min simulated drive, with oculomotor parameters assessed simultaneously. Oral fluid and plasma were collected at 30 min and 2.5 h. RESULTS CannEpil did not significantly alter SDLP across the full drive, although increased SDLP was observed between 20 and 30 min (p < 0.05). CannEpil increased SDS across the full drive (p < 0.05), with variance greatest at 20-30 min (p < 0.001). CannEpil increased fixation duration (p < 0.05), blink rate (trend p = 0.051) and decreased blink duration (p < 0.001) during driving. No significant correlations were observed between biological matrices and performance outcomes. CONCLUSIONS CannEpil impairs select aspects of vehicle control (speed and weaving) over time. Alterations to ocular behaviour suggest that eye tracking may assist in determining cannabis-related driver impairment or intoxication. Australian and New Zealand Clinician Trials Registry, https://anzctr.org.au(ACTRN12619000932167).
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Affiliation(s)
- Brooke Manning
- Centre for Human Psychopharmacology, Swinburne University of Technology, Hawthorn, VIC, Australia
| | - Amie C Hayley
- Centre for Human Psychopharmacology, Swinburne University of Technology, Hawthorn, VIC, Australia
- International Council for Alcohol, Drugs, and Traffic Safety
- Institute for Breathing and Sleep, Austin Health, Melbourne, VIC, Australia
| | - Sarah Catchlove
- Centre for Human Psychopharmacology, Swinburne University of Technology, Hawthorn, VIC, Australia
| | - Brook Shiferaw
- Centre for Human Psychopharmacology, Swinburne University of Technology, Hawthorn, VIC, Australia
- Seeing Machines, Melbourne, VIC, Australia
| | - Con Stough
- Centre for Human Psychopharmacology, Swinburne University of Technology, Hawthorn, VIC, Australia
| | - Luke A Downey
- Centre for Human Psychopharmacology, Swinburne University of Technology, Hawthorn, VIC, Australia
- Institute for Breathing and Sleep, Austin Health, Melbourne, VIC, Australia
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Corli G, Tirri M, Bilel S, Giorgetti A, Bernardi T, Boccuto F, Borsari M, Giorgetti R, Marti M. Ethanol enhances JWH-018-induced impairment of sensorimotor and memory functions in mice: From preclinical evidence to forensic implication in Driving Under the Influence of Drugs. Drug Alcohol Depend 2023; 247:109888. [PMID: 37120918 DOI: 10.1016/j.drugalcdep.2023.109888] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/06/2023] [Revised: 04/03/2023] [Accepted: 04/14/2023] [Indexed: 05/02/2023]
Abstract
BACKGROUND Several new Synthetic Cannabinoids have appeared each year since their introduction into the illicit drug market as recreational drugs. Among these, naphtalen-1-yl-(1-pentylindol-3-yl) methanone (JWH-018) is one of the most detected compounds in biological samples from patients involved in intoxication or death cases. Furthermore, consumption of JWH-018 has been linked to several cases of Driving Under the Influence of Drugs (DUID) suggesting that effects induced by this compound can affect individuals' ability to drive. METHODS Given the high spread of polydrug consumption and the wide number of alcohol-related traffic accidents, this study aims to investigate the acute effects induced by co-administration of JWH-018 with ethanol on sensorimotor and motor responses, grip strength and memory functions in CD-1 male mice. Acute impairments induced by JWH-018 and ethanol alone have also been investigated, in order to compare their effects with that induced by their concurrent administration. RESULTS In vivo behavioral experiments revealed a worsening of the cognitive and sensorimotor disruption after the co-administration of JWH-018 with ethanol compared to single compounds. CONCLUSIONS These animal-based findings suggest a potential increased impairment on psychomotor performances which could be related to driving abilities posed by poly-drug consumption involving SCs and ethanol.
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Affiliation(s)
- Giorgia Corli
- Department of Translational Medicine, Section of Legal Medicine, LTTA Center and University Center of Gender Medicine, University of Ferrara, Ferrara, Italy
| | - Micaela Tirri
- Department of Translational Medicine, Section of Legal Medicine, LTTA Center and University Center of Gender Medicine, University of Ferrara, Ferrara, Italy
| | - Sabrine Bilel
- Department of Translational Medicine, Section of Legal Medicine, LTTA Center and University Center of Gender Medicine, University of Ferrara, Ferrara, Italy
| | - Arianna Giorgetti
- Department of Medical and Surgical Sciences, Unit of Legal Medicine, University of Bologna, Via Irnerio 49, Bologna, 40126, Italy
| | - Tatiana Bernardi
- Department of Environmental Sciences and Prevention, University of Ferrara, Ferrara, 44121, Italy
| | - Federica Boccuto
- Department of Translational Medicine, Section of Legal Medicine, LTTA Center and University Center of Gender Medicine, University of Ferrara, Ferrara, Italy
| | - Martina Borsari
- Department of Translational Medicine, Section of Legal Medicine, LTTA Center and University Center of Gender Medicine, University of Ferrara, Ferrara, Italy
| | - Raffaele Giorgetti
- Department of Excellence of Biomedical Science and Public Health, Faculty of Medicine, Polytechnic University of Marche, Ancona, Italy
| | - Matteo Marti
- Department of Translational Medicine, Section of Legal Medicine, LTTA Center and University Center of Gender Medicine, University of Ferrara, Ferrara, Italy; Collaborative Center for the Italian National Early Warning System, Department of Anti-Drug Policies, Presidency of the Council of Ministers, Italy.
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Khanehshenas F, Mazloumi A, Dabiri R, Adinevand SN. Fatigue in transportation operations: A contextual factors survey among Iranian suburban drivers. Work 2023; 75:1439-1454. [PMID: 36463482 DOI: 10.3233/wor-220272] [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] [Indexed: 11/30/2022] Open
Abstract
BACKGROUND Fatigue, as a persistent and serious occupational hazard, plays an important role in traffic accidents by reducing the driver's ability to maneuver with the vehicle and increasing the likelihood of falling asleep at the wheel. OBJECTIVE The purpose of this study was to identify the individual contextual factors, sleep condition, lifestyle, job characteristics, environmental, and economic conditions that affect the fatigue and alertness of Iranian suburban bus drivers. METHODS A questionnaire-based cross-sectional survey was used for this study. Non-probability sampling was used to study 401 suburban bus drivers from Tehran province, Iran, ranging in age from 24 to 67 years. The SPSS22 statistical software V27 was used for the analysis. RESULTS Approximately half of the participants (50.5%) had experienced fatigue while driving in the previous six months. According to a logistic regression analysis, the contextual factors were all independently related to falling asleep and fatigue while driving. CONCLUSION This study provides a thorough understanding of the contextual factors related to drowsy driving and emphasizes the importance of taking these things into consideration when developing interventions aimed at improving the driver's wellbeing and health and lowering the risk of errors and accidents.
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Affiliation(s)
- Farin Khanehshenas
- Department of Occupational Health Engineering, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran
| | - Adel Mazloumi
- Department of Occupational Health Engineering, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran
| | - Roya Dabiri
- Department of Occupational Health Engineering, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran
| | - Somaye Noorali Adinevand
- Department of Occupational Health Engineering, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran
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Rius C, Saint-Marcoux F. Expérimentation du cannabis médical : une impasse pour la réglementation sur la conduite automobile ? TOXICOLOGIE ANALYTIQUE ET CLINIQUE 2022. [DOI: 10.1016/j.toxac.2022.11.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
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11
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Rock KL, Englund A, Morley S, Rice K, Copeland CS. Can cannabis kill? Characteristics of deaths following cannabis use in England (1998-2020). J Psychopharmacol 2022; 36:1362-1370. [PMID: 35946604 PMCID: PMC9716494 DOI: 10.1177/02698811221115760] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/05/2023]
Abstract
BACKGROUND Cannabis is the most widely used illegal drug but is rarely considered a causal factor in death. AIMS This study aimed to understand trends in deaths in England where cannabinoids were detected at post-mortem, and to evaluate the clinical utility of post-mortem cannabinoid concentrations in coronial investigations. METHODS Deaths with cannabinoid detections reported to the National Programme on Substance Abuse Deaths (NPSAD) were extracted and analysed. RESULTS From 1998 to 2011, on average 7% of all cases reported to NPSAD had a cannabinoid detected (n = 110 deaths per year), rising to 18% in 2020 (n = 350). Death following cannabis use alone was rare (4% of cases, n = 136/3455). Traumatic injury was the prevalent underlying cause in these cases (62%, n = 84/136), with cannabis toxicity cited in a single case. Polydrug use was evident in most cases (96%, n = 3319/3455), with acute drug toxicity the prevalent underlying cause (74%, n = 2458/3319). Cardiac complications were the most cited physiological underlying cause of death (4%, n = 144/3455). The median average Δ9-tetrahydrocannabinol post-mortem blood concentrations were several magnitudes lower than previously reported median blood concentrations in living users (cannabis alone: 4.3 µg/L; cannabis in combination with other drugs: 3.5 µg/L). CONCLUSIONS Risk of death due to cannabis toxicity is negligible. However, cannabis can prove fatal in circumstances with risk of traumatic physical injury, or in individuals with cardiac pathophysiologies. These indirect harms need careful consideration and further study to better elucidate the role cannabis plays in drug-related mortality. Furthermore, the relevance of cannabinoid quantifications in determining cause of death in coronial investigations is limited.
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Affiliation(s)
- Kirsten L Rock
- Centre for Pharmaceutical Medicine Research, Institute of Pharmaceutical Sciences, King’s College London, London, UK
| | - Amir Englund
- Department of Addictions, Institute of Psychiatry, Psychology & Neuroscience, King’s College London, South London and Maudsley NHS Foundation Trust, London, UK
| | - Stephen Morley
- Toxicology Unit, Leicester Royal Infirmary, Leicester, UK
| | - Kathleen Rice
- Toxicology Unit, Leicester Royal Infirmary, Leicester, UK
| | - Caroline S Copeland
- Centre for Pharmaceutical Medicine Research, Institute of Pharmaceutical Sciences, King’s College London, London, UK,National Programme on Substance Abuse Deaths, London, UK,Caroline Copeland, Centre for Pharmaceutical Medicine Research, Institute of Pharmaceutical Sciences, King’s College London, London, UK.
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12
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Wickens CM, Wright M, Mann RE, Brands B, Di Ciano P, Stoduto G, Fares A, Matheson J, George TP, Rehm J, Shuper PA, Sproule B, Samohkvalov A, Huestis MA, Le Foll B. Separate and combined effects of alcohol and cannabis on mood, subjective experience, cognition and psychomotor performance: A randomized trial. Prog Neuropsychopharmacol Biol Psychiatry 2022; 118:110570. [PMID: 35551928 DOI: 10.1016/j.pnpbp.2022.110570] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/10/2022] [Revised: 05/04/2022] [Accepted: 05/05/2022] [Indexed: 11/22/2022]
Abstract
Co-use of alcohol and cannabis is associated with increased frequency and intensity of use and related problems. This study examined acute effects of alcohol and cannabis on mood, subjective experience, cognition, and psychomotor performance. Twenty-eight healthy cannabis users aged 19-29 years with recent history of binge drinking completed this within-subjects, double-blind, double-dummy, placebo-controlled, randomized clinical trial. Participants received: placebo alcohol and placebo cannabis (<0.1% THC); alcohol (target breath alcohol content [BrAC] 80 mg/dL) and placebo cannabis; placebo alcohol and active cannabis (12.5% THC); and active alcohol and cannabis over four sessions. Profile of Mood States (POMS), Addiction Research Centre Inventory (ARCI), verbal free recall (VFR), Digit Symbol Substitution Test (DSST), Continuous Performance Test (CPT), and grooved pegboard (GPB) task were administered before and approximately 75 min after drinking alcohol (1 h after smoking cannabis ad libitum). Significant effects of condition were found for the POMS (Tension-Anxiety, Confusion) and ARCI (MBG, LSD, PCAG, Euphoria, Sedation), predominantly with greater increases emerging after cannabis or alcohol-cannabis combined relative to placebo. Significant effects were found for VFR (immediate total and delayed recall, percent retained), DSST (trials attempted, trials correct, reaction time), and GPB (non-dominant hand) predominantly with greater declines in performance after alcohol and alcohol-cannabis combined relative to placebo and/or cannabis. Cannabis appeared to affect mood and subjective experience, with minimal impact on cognitive performance. Alcohol appeared to impair cognitive and psychomotor performance, with minimal impact on mood and subjective experience. Acute effects of alcohol and cannabis combined were additive at most.
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Affiliation(s)
- Christine M Wickens
- Institute for Mental Health Policy Research, Centre for Addiction and Mental Health, Toronto, Ontario, Canada; Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health, Toronto, Ontario, Canada; Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada; Institute of Health Policy, Management and Evaluation, University of Toronto, Toronto, Ontario, Canada; Department of Pharmacology and Toxicology, University of Toronto, Toronto, Ontario, Canada.
| | - Madison Wright
- Institute for Mental Health Policy Research, Centre for Addiction and Mental Health, Toronto, Ontario, Canada; Department of Pharmacology and Toxicology, University of Toronto, Toronto, Ontario, Canada
| | - Robert E Mann
- Institute for Mental Health Policy Research, Centre for Addiction and Mental Health, Toronto, Ontario, Canada; Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health, Toronto, Ontario, Canada; Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada
| | - Bruna Brands
- Institute for Mental Health Policy Research, Centre for Addiction and Mental Health, Toronto, Ontario, Canada; Department of Pharmacology and Toxicology, University of Toronto, Toronto, Ontario, Canada; Controlled Substances and Cannabis Directorate, Health Canada, Ottawa, Ontario, Canada
| | - Patricia Di Ciano
- Institute for Mental Health Policy Research, Centre for Addiction and Mental Health, Toronto, Ontario, Canada; Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health, Toronto, Ontario, Canada; Department of Pharmacology and Toxicology, University of Toronto, Toronto, Ontario, Canada
| | - Gina Stoduto
- Institute for Mental Health Policy Research, Centre for Addiction and Mental Health, Toronto, Ontario, Canada
| | - Andrew Fares
- Institute for Mental Health Policy Research, Centre for Addiction and Mental Health, Toronto, Ontario, Canada; Department of Pharmacology and Toxicology, University of Toronto, Toronto, Ontario, Canada
| | - Justin Matheson
- Institute for Mental Health Policy Research, Centre for Addiction and Mental Health, Toronto, Ontario, Canada; Department of Pharmacology and Toxicology, University of Toronto, Toronto, Ontario, Canada; Translational Addiction Research Laboratory, Centre for Addiction and Mental Health, Toronto, Ontario, Canada
| | - Tony P George
- Department of Psychiatry, Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada; Addictions Division, Centre for Addiction and Mental Health, Toronto, Ontario, Canada; Institute of Medical Sciences, University of Toronto, Toronto, Ontario, Canada
| | - Jürgen Rehm
- Institute for Mental Health Policy Research, Centre for Addiction and Mental Health, Toronto, Ontario, Canada; Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health, Toronto, Ontario, Canada; Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada; Institute of Health Policy, Management and Evaluation, University of Toronto, Toronto, Ontario, Canada; Department of Psychiatry, Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada; Institute of Medical Sciences, University of Toronto, Toronto, Ontario, Canada; Sechenov First Moscow State Medical University (Sechenov University), Moscow, Russian Federation; Klinische Psychologie & Psychotherapie, Technische Universität Dresden, Dresden, Germany
| | - Paul A Shuper
- Institute for Mental Health Policy Research, Centre for Addiction and Mental Health, Toronto, Ontario, Canada; Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health, Toronto, Ontario, Canada; Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada
| | - Beth Sproule
- Institute of Health Policy, Management and Evaluation, University of Toronto, Toronto, Ontario, Canada; Pharmacy Department, Centre for Addiction and Mental Health, Toronto, Ontario, Canada; Leslie Dan Faculty of Pharmacy, University of Toronto, Toronto, Ontario, Canada
| | - Andriy Samohkvalov
- Institute for Mental Health Policy Research, Centre for Addiction and Mental Health, Toronto, Ontario, Canada; Addictions Division, Centre for Addiction and Mental Health, Toronto, Ontario, Canada
| | - Marilyn A Huestis
- Institute of Emerging Health Professions, Thomas Jefferson University, Philadelphia, PA, USA
| | - Bernard Le Foll
- Department of Pharmacology and Toxicology, University of Toronto, Toronto, Ontario, Canada; Translational Addiction Research Laboratory, Centre for Addiction and Mental Health, Toronto, Ontario, Canada; Department of Psychiatry, Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada; Klinische Psychologie & Psychotherapie, Technische Universität Dresden, Dresden, Germany; Department of Family and Community Medicine, University of Toronto, Toronto, Ontario, Canada
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13
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Cannabis use and subjective response to alcohol in the human laboratory. Drug Alcohol Depend 2022; 236:109481. [PMID: 35523112 PMCID: PMC9203930 DOI: 10.1016/j.drugalcdep.2022.109481] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/29/2021] [Revised: 04/04/2022] [Accepted: 04/27/2022] [Indexed: 11/22/2022]
Abstract
BACKGROUND Cannabis is often used in combination with alcohol; yet, whether cannabis use impacts risk factors for alcohol use disorder (AUD) remains unknown. Subjective response (SR) to alcohol represents a biobehavioral risk factor for subsequent heavy drinking and for developing AUD. Given the high prevalence of alcohol and cannabis co-use, it is plausible to hypothesize that cannabis users differ in SR to alcohol compared to non-cannabis users. The purpose of this study is to examine the influence of past-month cannabis use on subjective response to alcohol in the human laboratory. METHODS This study culled data from multiple alcohol administration trials to test whether cannabis users, compared to non-cannabis users, differed in subjective response to alcohol, comprised of four domains: stimulation, sedation, negative affect, and craving. Non-treatment-seeking heavy drinkers (N = 168) completed a battery of self-report scales of mood and alcohol/cigarette/cannabis use and problems. All participants completed an intravenous alcohol administration session wherein SR domains were measured at the following breath alcohol concentrations (BrAC): baseline (i.e., 0), 20, 40, and 60 mg%. RESULTS Multilevel statistical analyses revealed that cannabis users had a greater reduction in negative affect during alcohol administration, compared to non-cannabis users. No significant differences were found for the other SR domains. CONCLUSIONS Using a large sample and advanced data analytic methods, this study extends the literature by suggesting that cannabis users are more sensitive to alcohol-induced reductions in negative affect compared to non-cannabis users. This work extends research on how cannabis use may influence risk factors for AUD, such as subjective response to alcohol.
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14
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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.
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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
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15
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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.
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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.
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16
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Hicks DL, Resko SM, Ellis JD, Agius E, Early TJ. Driving After Cannabis Use Among Young Adults in Michigan. Cannabis Cannabinoid Res 2022; 7:100-106. [PMID: 33998875 PMCID: PMC8864414 DOI: 10.1089/can.2020.0096] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Introduction: Driving after cannabis use is associated with a number of risks. Examination of driving after cannabis use among young adults is particularly important, as young adults have the highest rates of cannabis use and among the highest rates of traffic crashes. The current study examines rates and correlates of driving after cannabis use among young adults (aged 18-25) who reported past month cannabis use. Methods: Participants were from Michigan and recruited through paid Facebook and Instagram advertisements between February and March 2018 (n=461). Results: Nearly a third (31.9%) of the sample reported driving after cannabis use in the past month. Young adults who were employed (aOR=1.872, p=0.045), had medical cannabis cards (aOR=2.877, p<0.001), endorsed coping reasons for use (aOR=2.992, p=0.007), and endorsed social/recreational reasons for use (aOR=1.861, p=0.034) had greater odds of driving after cannabis use. Students had lower odds of driving after use (aOR=0.573, p=0.011). Conclusions: Employment and having a medical cannabis card may be important risk markers for identifying individuals more likely to drive after use of cannabis. Prevention efforts could provide psychoeducation at dispensaries to individuals with medical cannabis cards about the risks of driving after use. Coping motives for cannabis use may also be useful in identifying young adults at the greatest risk of driving after use of cannabis.
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Affiliation(s)
- Danielle L. Hicks
- Wayne State University School of Social Work, Detroit, Michigan, USA.,*Address correspondence to: Danielle L. Hicks, MSCJ, LLMSW, Wayne State University School of Social Work, 5447 Woodward Avenue, Detroit, MI 48202, USA,
| | - Stella M. Resko
- Wayne State University School of Social Work & Merrill Palmer Skillman Institute, Detroit, Michigan, USA
| | - Jennifer D. Ellis
- Wayne State University School of Social Work & Department of Psychology, Detroit, Michigan, USA
| | - Elizabeth Agius
- Wayne State University School of Social Work, Detroit, Michigan, USA
| | - Theresa J. Early
- Ohio State University College of Social Work, Columbus, Ohio, USA
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17
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Laudanski K, Wain J. Considerations for Cannabinoids in Perioperative Care by Anesthesiologists. J Clin Med 2022; 11:jcm11030558. [PMID: 35160010 PMCID: PMC8836924 DOI: 10.3390/jcm11030558] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2021] [Revised: 01/17/2022] [Accepted: 01/18/2022] [Indexed: 02/07/2023] Open
Abstract
Increased usage of recreational and medically indicated cannabinoid compounds has been an undeniable reality for anesthesiologists in recent years. These compounds’ complicated pharmacology, composition, and biological effects result in challenging issues for anesthesiologists during different phases of perioperative care. Here, we review the existing formulation of cannabinoids and their biological activity to put them into the context of the anesthesia plan execution. Perioperative considerations should include a way to gauge the patient’s intake of cannabinoids, the ability to gain consent properly, and vigilance to the increased risk of pulmonary and airway problems. Intraoperative management in individuals with cannabinoid use is complicated by the effects cannabinoids have on general anesthetics and depth of anesthesia monitoring while simultaneously increasing the potential occurrence of intraoperative hemodynamic instability. Postoperative planning should involve higher vigilance to the risk of postoperative strokes and acute coronary syndromes. However, most of the data are not up to date, rending definite conclusions on the importance of perioperative cannabinoid intake on anesthesia management difficult.
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Affiliation(s)
- Krzysztof Laudanski
- Department of Anesthesiology and Critical Care, University of Pennsylvania, Philadelphia, PA 19104, USA
- Correspondence: (K.L.); (J.W.)
| | - Justin Wain
- School of Osteopathic Medicine, Campbell University, Buies Creek, NC 27506, USA
- Correspondence: (K.L.); (J.W.)
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18
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Cloutier RM, Calhoun BH, Lanza ST, Linden-Carmichael AN. Assessing subjective cannabis effects in daily life with contemporary young adult language. Drug Alcohol Depend 2022; 230:109205. [PMID: 34890928 PMCID: PMC8714699 DOI: 10.1016/j.drugalcdep.2021.109205] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/03/2021] [Revised: 11/02/2021] [Accepted: 11/06/2021] [Indexed: 01/03/2023]
Abstract
INTRODUCTION Subjective ratings of cannabis effects are important predictors of use-related consequences. However, psychometric research is fairly limited, particularly for measures to capture variability in daily life when diverse modes of cannabis administration and co-substance use are common. METHODS This study evaluated the predictive utility of a revised item to assess perceived cannabis effects and examined modes of cannabis administration and alcohol and nicotine co-use as moderators. Participants were 106 young adults (18-25 years; 51% female) who completed up to 14 consecutive daily reports of substance use (n = 1405 person-days). Two measures of subjective effects were examined: a standard item (0-100 rating of "how high do you feel?") and a revised item that uses four crowd-sourced anchor points ranging from relaxed (0), calm/chill (33), high (67), and stoned/baked (100). The items shared substantial variance (Pseudo-R2 = 59.5%), however, the revised item showed greater within-person variability (77.0% vs. 68.8%) and stronger day-level associations with consumption levels (Pseudo-R2 = 25.0% vs. 16.7%). RESULTS The cannabis consumption-subjective effects link was weaker on blunt-only days compared to vape-only days. Subjective cannabis effects were higher on nicotine co-use days after controlling for cannabis consumption; neither alcohol nor nicotine co-use moderated the cannabis consumption-subjective effects link. DISCUSSION The revised subjective cannabis effects item is a viable alternative to the standard item among young adults who engage in simultaneous alcohol and cannabis use. CONCLUSIONS Future research focused on characterizing the variability in cannabis effects is needed.
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Affiliation(s)
- Renee M. Cloutier
- 314 Biobehavioral Health, The Edna Bennett Pierce Prevention Research Center, College of Health and Human Development, The Pennsylvania State University, University Park, PA, 16802, USA
| | - Brian H. Calhoun
- The University of Washington, Department of Psychiatry and Behavioral Sciences, 1100 NE 45th Street, Suite 300, Box 354944, Seattle, WA 98105, USA
| | - Stephanie T. Lanza
- 314 Biobehavioral Health, The Edna Bennett Pierce Prevention Research Center, College of Health and Human Development, The Pennsylvania State University, University Park, PA, 16802, USA
| | - Ashley N. Linden-Carmichael
- 314 Biobehavioral Health, The Edna Bennett Pierce Prevention Research Center, College of Health and Human Development, The Pennsylvania State University, University Park, PA, 16802, USA
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Traccis F, Presciuttini R, Pani PP, Sinclair JMA, Leggio L, Agabio R. Alcohol-medication interactions: A systematic review and meta-analysis of placebo-controlled trials. Neurosci Biobehav Rev 2021; 132:519-541. [PMID: 34826511 DOI: 10.1016/j.neubiorev.2021.11.019] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2021] [Revised: 09/20/2021] [Accepted: 11/15/2021] [Indexed: 11/28/2022]
Abstract
Alcohol and other xenobiotics may limit the therapeutic effects of medications. We aimed at investigating alcohol-medication interactions (AMI) after the exclusion of confounding effects related to other xenobiotics. We performed a systematic review and meta-analysis of controlled studies comparing the effects induced by alcohol versus placebo on pharmacodynamic and/or pharmacokinetic parameters of approved medications. Certainty in the evidence of AMI was assessed when at least 3 independent studies and at least 200 participants were available. We included 107 articles (3097 participants): for diazepam, cannabis, opioids, and methylphenidate, we found significant AMI and enough data to assign the certainty of evidence. Alcohol consumption significantly increases the peak plasma concentration of diazepam (low certainty; almost 290 participants), cannabis (high certainty; almost 650 participants), opioids (low certainty; 560 participants), and methylphenidate (moderate certainty; 290 participants). For most medications, we found some AMI but not enough data to assign them the certainty grades; for some medications, we found no differences between alcohol and placebo in any outcomes evaluated. Our results add further evidence for interactions between alcohol and certain medications after the exclusion of confounding effects related to other xenobiotics. Physicians should advise patients who use these specific medications to avoid alcohol consumption. Further studies with appropriate control groups, enough female participants to investigate sex differences, and elderly population are needed to expand our knowledge in this field. Short phrases suitable for indexing terms.
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Affiliation(s)
- Francesco Traccis
- Department of Biomedical Sciences, Section of Neuroscience and Clinical Pharmacology, University of Cagliari, Cagliari, Italy.
| | - Riccardo Presciuttini
- Department of Biomedical Sciences, Section of Neuroscience and Clinical Pharmacology, University of Cagliari, Cagliari, Italy.
| | - Pier Paolo Pani
- Health Social Services Public Health Trust Sardinia, Cagliari, Italy.
| | | | - Lorenzo Leggio
- Clinical Psychoneuroendocrinology and Neuropsychopharmacology Section, Translational Addiction Medicine Branch, National Institute on Drug Abuse Intramural Research Program and National Institute on Alcohol Abuse and Alcoholism, Division of Intramural Clinical and Basic Research, National Institutes of Health, Baltimore and Bethesda, MD, United States; Medication Development Program, National Institute on Drug Abuse Intramural Research Program, National Institutes of Health, Baltimore, United States; Center for Alcohol and Addiction Studies, Brown University, Providence, RI, United States; Division of Addiction Medicine, Department of Medicine, Johns Hopkins University, Baltimore, MD, United States; Department of Neuroscience, Georgetown University, Washington, DC, United States.
| | - Roberta Agabio
- Department of Biomedical Sciences, Section of Neuroscience and Clinical Pharmacology, University of Cagliari, Cagliari, Italy.
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McCartney D, Arkell TR, Irwin C, Kevin RC, McGregor IS. Are blood and oral fluid Δ 9-tetrahydrocannabinol (THC) and metabolite concentrations related to impairment? A meta-regression analysis. Neurosci Biobehav Rev 2021; 134:104433. [PMID: 34767878 DOI: 10.1016/j.neubiorev.2021.11.004] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2021] [Revised: 10/29/2021] [Accepted: 11/05/2021] [Indexed: 12/17/2022]
Abstract
Blood and oral fluid Δ9-tetrahydrocannabinol (THC) concentrations are often used to identify cannabis-impaired drivers. We used meta-analytic techniques to characterise the relationships between biomarkers of cannabis use, subjective intoxication, and impairment of driving and driving-related cognitive skills. Twenty-eight publications and 822 driving-related outcomes were reviewed. Each outcome was measured in concert with one or more biomarkers of cannabis/THC use and/or subjective intoxication. Higher blood THC and 11-OH-THC concentrations, oral fluid THC concentrations and subjective ratings of intoxication were associated with greater impairment in 'other' (mostly occasional) cannabis users (p's<0.05). Blood 11-COOH-THC concentrations were associated with impairment after inhaling, but not orally ingesting, cannabis/THC. However t these 'biomarker-performance' relationships (R) were only very weak (blood THCpost-ingestion: -0.08; blood THCpost-inhalation: -0.10; blood 11-OH-THCpost-ingestion: -0.13), weak (blood 11-OH-THCpost-inhalation: -0.24; oral fluid THCpost-inhalation: -0.36; subjective intoxication: -0.29) or moderate (blood 11-COOH-THCpost-inhalation: -0.43) in strength. No significant biomarker-performance relationships were observed in 'regular' (weekly or more often) cannabis users (p's>0.10), although the analyses were less robust. Blood and oral fluid THC concentrations are relatively poor indicators of cannabis/THC-induced impairment.
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Affiliation(s)
- Danielle McCartney
- The University of Sydney, Lambert Initiative for Cannabinoid Therapeutics, Sydney, New South Wales, Australia; The University of Sydney, Brain and Mind Centre, Sydney, New South Wales, Australia; The University of Sydney, Faculty of Science, School of Psychology, Sydney, New South Wales, Australia.
| | - Thomas R Arkell
- Centre for Human Psychopharmacology, Swinburne University of Technology, Melbourne, Victoria, Australia
| | - Christopher Irwin
- Menzies Health Institute Queensland and School of Health Sciences and Social Work, Griffith University, Gold Coast, Queensland, Australia
| | - Richard C Kevin
- The University of Sydney, Lambert Initiative for Cannabinoid Therapeutics, Sydney, New South Wales, Australia; The University of Sydney, Brain and Mind Centre, Sydney, New South Wales, Australia; The University of Sydney, Faculty of Science, School of Psychology, Sydney, New South Wales, Australia
| | - Iain S McGregor
- The University of Sydney, Lambert Initiative for Cannabinoid Therapeutics, Sydney, New South Wales, Australia; The University of Sydney, Brain and Mind Centre, Sydney, New South Wales, Australia; The University of Sydney, Faculty of Science, School of Psychology, Sydney, New South Wales, Australia
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Zhu L, Pei W, DiCiano P, Brands B, Wickens CM, Foll BL, Kwong B, Parashar M, Sivananthan A, Mahadevan R. Physiologically-based pharmacokinetic model for predicting blood and tissue tetrahydrocannabinol concentrations. Comput Chem Eng 2021. [DOI: 10.1016/j.compchemeng.2021.107461] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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22
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Abstract
As more states in the U.S legalize recreational and medicinal cannabis, rates of driving under the influence of this drug are increasing significantly. Aspects of this emerging public health issue potentially pit science against public policy. The authors believe that the legal cart is currently significantly ahead of the scientific horse. Issues such as detection procedures for cannabis-impaired drivers, and use of blood THC levels to gauge impairment, should rely heavily on current scientific knowledge. However, there are many, often unacknowledged research gaps in these and related areas, that need to be addressed in order provide a more coherent basis for public policies. This review focuses especially on those areas. In this article we review in a focused manner, current information linking cannabis to motor vehicle accidents and examine patterns of cannabis-impairment of driving related behaviors, their time courses, relationship to cannabis dose and THC blood levels, and compare cannabis and alcohol-impaired driving patterns directly. This review also delves into questions of alcohol-cannabis combinations and addresses the basis for of per-se limits in cannabis driving convictions. Finally, we distinguish between areas where research has provided clear answers to the above questions, areas that remain unclear, and make recommendations to fill gaps in current knowledge.
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Affiliation(s)
- Godfrey D. Pearlson
- Department of Psychiatry, Olin Neuropsychiatry Research Center, Institute of Living, Hartford Healthcare Corporation, Hartford, CT, United States
- Department of Psychiatry, Yale University School of Medicine, New Haven, CT, United States
- Department of Neuroscience, Yale University School of Medicine, New Haven, CT, United States
| | - Michael C. Stevens
- Department of Psychiatry, Olin Neuropsychiatry Research Center, Institute of Living, Hartford Healthcare Corporation, Hartford, CT, United States
- Department of Psychiatry, Yale University School of Medicine, New Haven, CT, United States
| | - Deepak Cyril D'Souza
- Department of Psychiatry, Yale University School of Medicine, New Haven, CT, United States
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Jackson KM, Stevens AK, Sokolovsky AW, Hayes KL, White HR. Real-world simultaneous alcohol and cannabis use: An ecological study of situational motives and social and physical contexts. PSYCHOLOGY OF ADDICTIVE BEHAVIORS 2021; 35:698-711. [PMID: 34472880 DOI: 10.1037/adb0000765] [Citation(s) in RCA: 23] [Impact Index Per Article: 7.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/04/2023]
Abstract
OBJECTIVE Given the adverse outcomes associated with simultaneous alcohol and marijuana (SAM) use, understanding factors that give rise to occasions of simultaneous use is critical. This study examines the relationships between situational motives and contexts and three situational outcomes: simultaneous alcohol and marijuana use (SAM) use versus cannabis-only use, number of cannabis uses, and subjective effects. METHOD Past-month SAM users (n = 341; 52% female; 75% White; 10% Latinx/Hispanic; age 18-24) from three U.S. college campuses completed 8 weeks of surveys up to five times a day. Three-level generalized linear mixed-effects models tested the effects of situational motives and social and physical contexts on occasion type (SAM vs. cannabis-only), cannabis use, and subjective effects. RESULTS Situational social and enhancement motives were related to greater odds of SAM relative to cannabis-only use; expansion motives were reported more often on cannabis-only occasions. Using with others and at friends' places, being with others consuming cannabis, and being with others who are intoxicated were more likely when combining alcohol with cannabis. Increased number of cannabis uses and subjective effects in a social context were evident only on cannabis-only occasions. Using alone and using at home were greater on cannabis-only occasions and were associated with lower cannabis use and subjective effects. CONCLUSIONS The combination of alcohol and cannabis use occurs during social situations and when motivated by positive reinforcement but number of cannabis uses is not increased when consuming cannabis with alcohol in social situations. Characterizing the complex interplay of situational factors that contribute to risky use will inform interventions. (PsycInfo Database Record (c) 2021 APA, all rights reserved).
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24
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Mitropoulos-Rundus C, Schwarz C, McGehee D. Benefits estimation of regenerative braking versus service braking. ERGONOMICS 2021; 64:1217-1227. [PMID: 33781173 DOI: 10.1080/00140139.2021.1908601] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/17/2020] [Accepted: 03/19/2021] [Indexed: 06/12/2023]
Abstract
A central question not yet examined in the literature is whether regenerative braking provides a kinematic deceleration safety advantage in time and distance over traditional service braking. This research explores three conditions of braking (traditional service braking, low level of regenerative braking, and high level of regenerative braking) to determine any safety advantages regenerative braking offers. Thirty participants took part in a simulator study with a between-subjects study design, allocating 10 participants per condition. The study drive took place in a simulator and involved three braking events. The results showed a significant difference between the means of the three conditions for average deceleration of the vehicle in the time interval between the driver releasing the accelerator and pressing the brake for all three events showing RB did provide the drivers with a braking advantage. When events 1 and 2 were combined, there was also significance with maximum brake force. Practitioner summary: This research looked to determine whether regenerative braking provides a deceleration safety advantage over traditional service braking. The results showed RB did provide the drivers with a braking advantage. The results also showed driver foot behaviour differed with the RB High condition.
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Affiliation(s)
| | - Chris Schwarz
- National Advanced Driving Simulator, The University of Iowa, Coralville, IA, USA
| | - Daniel McGehee
- Industrial and Systems Engineering, The University of Iowa, Iowa City, IA, USA
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Smiley CE, Saleh HK, Nimchuk KE, Garcia-Keller C, Gass JT. Adolescent exposure to delta-9-tetrahydrocannabinol and ethanol heightens sensitivity to fear stimuli. Behav Brain Res 2021; 415:113517. [PMID: 34389427 PMCID: PMC8404161 DOI: 10.1016/j.bbr.2021.113517] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2021] [Revised: 08/02/2021] [Accepted: 08/05/2021] [Indexed: 01/05/2023]
Abstract
Cannabis use disorder (CUD) has doubled in prevalence over the past decade as a nation-wide trend toward legalization allows for increased drug accessibility. As a result, marijuana has become the most commonly used illicit drug in the United States particularly among the adolescent population. This is especially concerning since there is greater risk for the harmful side effects of drug use during this developmental period due to ongoing brain maturation. Increasing evidence indicates that CUD often occurs along with other debilitating conditions including both alcohol use disorder (AUD) and anxiety disorders such post-traumatic stress disorder (PTSD). Additionally, exposure to cannabis, alcohol, and stress can induce alterations in glutamate regulation and homeostasis in the prefrontal cortex (PFC) that may lead to impairments in neuronal functioning and cognition. Therefore, in order to study the relationship between drug exposure and the development of PTSD, these studies utilized rodent models to determine the impact of adolescent exposure to delta-9-tetrahydrocannabinol (THC) and ethanol on responses to fear stimuli during fear conditioning and used calcium imaging to measure glutamate activity in the prelimbic cortex during this behavioral paradigm. The results from these experiments indicate that adolescent exposure to THC and ethanol leads to enhanced sensitivity to fear stimuli both behaviorally and neuronally. Additionally, these effects were attenuated when animals were treated with the glutamatergic modulator N-acetylcysteine (NAC). In summary, these studies support the hypothesis that adolescent exposure to THC and ethanol leads to alterations in fear stimuli processing through glutamatergic reliant modifications in PFC signaling.
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Affiliation(s)
- Cora E Smiley
- Department of Neuroscience, Medical University of South Carolina, Basic Science Building, 173 Ashley Avenue, Room 403, Charleston, SC, 29425, United States.
| | - Heyam K Saleh
- Department of Neuroscience, Medical University of South Carolina, Basic Science Building, 173 Ashley Avenue, Room 403, Charleston, SC, 29425, United States
| | - Katherine E Nimchuk
- Department of Neuroscience, Medical University of South Carolina, Basic Science Building, 173 Ashley Avenue, Room 403, Charleston, SC, 29425, United States
| | - Constanza Garcia-Keller
- Department of Neuroscience, Medical University of South Carolina, Basic Science Building, 173 Ashley Avenue, Room 403, Charleston, SC, 29425, United States
| | - Justin T Gass
- Department of Neuroscience, Medical University of South Carolina, Basic Science Building, 173 Ashley Avenue, Room 403, Charleston, SC, 29425, United States
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Yadav AK, Velaga NR. Modelling brake transition time of young alcohol-impaired drivers using hazard-based duration models. ACCIDENT; ANALYSIS AND PREVENTION 2021; 157:106169. [PMID: 33965845 DOI: 10.1016/j.aap.2021.106169] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/12/2020] [Revised: 03/23/2021] [Accepted: 04/29/2021] [Indexed: 06/12/2023]
Abstract
Braking performance of drivers is a crucial factor in evaluating the collision patterns and implementing road safety measures. Further, alcohol is known to impair driving control. The present study aims to examine the influence of a comprehensive range of Blood Alcohol Concentration (BAC) levels (0%, 0.03 %, 0.05 % and 0.08 %) on brake transition times of drivers. As young drivers show significantly higher crash risks compared to the experienced drivers, fifty-four young Indian drivers in the age group of 21-25 years (forty males and fourteen females) participated in the driving simulator experiments. The study adopted the framework of a within-subjects design, where each driver encountered rural and urban driving scenarios in a counterbalanced order, during experimental driving at each of the four BAC levels. Their brake transition times were estimated with respect to sudden pedestrian crossing events. Weibull Accelerated Failure Time (AFT) models with shared frailty were developed for quantifying the effects of BAC levels along with driver attributes on brake transition time. Preliminary analysis showed significant main effects of BAC (p < 0.001) and driving environment (p = 0.002) on brake transition time; however, their interaction effect was not significant (p = 0.485). The models revealed that 0.03 %, 0.05 % and 0.08 % BACs significantly reduced the brake transition times by 16 %, 28 % and 52 % in rural driving environment, and by 23 %, 37 % and 53 % in urban driving environment, compared to 0% BAC. The study outcomes may find application in assisting collision warning systems which take into account the braking behaviour of drivers.
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Affiliation(s)
- Ankit Kumar Yadav
- Transportation Systems Engineering, Department of Civil Engineering, Indian Institute of Technology (IIT) Bombay Powai, Mumbai, 400 076, India.
| | - Nagendra R Velaga
- Transportation Systems Engineering, Department of Civil Engineering, Indian Institute of Technology (IIT) Bombay Powai, Mumbai, 400 076, India.
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27
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Valuation system connectivity is correlated with poly-drug use in young adults. Neurosci Res 2021; 173:114-120. [PMID: 34214618 DOI: 10.1016/j.neures.2021.06.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2020] [Revised: 06/03/2021] [Accepted: 06/27/2021] [Indexed: 11/23/2022]
Abstract
Poly-drug consumption contributes to fatal overdose in more than half of all poly-drug users. Analyzing decision-making networks may give insight into the motivations behind poly-drug use. We correlated average functional connectivity of the valuation system (VS), executive control system (ECS) and valuation-control complex (VCC) in a large population sample (n = 992) with drug use behaviour. VS connectivity is correlated with sedative use, ECS connectivity is separately correlated with hallucinogens and opiates. Network connectivity is also correlated with drug use via two-way interactions with other substances including alcohol and tobacco. These preliminary findings can contribute to our understanding of the common combinations of substance co-use and associated neural patterns.
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Kearns NT, Blumenthal H, Contractor AA, Aston ER, Metrik J. Effect of trauma-related stress after alcohol consumption on perceived likelihood of negative consequences and willingness to drive. Addict Behav 2021; 117:106836. [PMID: 33529850 PMCID: PMC7956021 DOI: 10.1016/j.addbeh.2021.106836] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2020] [Revised: 01/06/2021] [Accepted: 01/13/2021] [Indexed: 01/20/2023]
Abstract
BACKGROUND Alcohol-related motor vehicle crashes are a major preventable cause of death in the United States. One potential factor that may modulate the influence of alcohol on driving-related cognitions and decision-making is trauma-related stress. Indeed, in addition to compelling research indicating that both acute trauma-related stress and acute alcohol consumption may independently affect driving-related risky decision-making, there is reason to believe that the combination of these antecedents may have an exacerbating effect. METHODS The current study evaluated the influence of induction of acute trauma-related stress (via script-driven imagery) after alcohol consumption (0.06% Breath Alcohol Concentration [BrAC]) on driving-related cognitions - perceived likelihood of negative consequences and willingness to drive - among 25 trauma-exposed (currently symptomatic) adult drinkers from the community (M = 24.08; 36.0% female). RESULTS Participants who were acutely exposed to trauma-related stress after alcohol consumption evidenced lower perceived likelihood of being pulled over by a police officer (ηp2 = 0.38, large effect size) and lower perceived likelihood of getting in an accident (ηp2 = 0.17, medium-to-large effect size) relative to participants exposed to a neutral cue; conversely, participants exposed to trauma-related stress after alcohol consumption evidenced greater willingness to drive (d = 1.16, large effect size) than participants exposed to a neutral cue. CONCLUSIONS Generally, findings suggest that individuals with a trauma history that are acutely exposed to trauma-related stressors (e.g., reminders of their traumatic experience) may be particularly vulnerable to poorer driving-related decision-making after alcohol consumption. Results provide a meaningful target for the development of intoxicated driving prevention and intervention efforts geared specifically for individuals with trauma history.
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Affiliation(s)
- Nathan T Kearns
- Brown University, School of Public Health, Center for Alcohol and Addiction Studies, 121 S. Main St., Providence, RI 02912, USA.
| | - Heidemarie Blumenthal
- University of North Texas, Department of Psychology, 1155 Union Circle, Denton, TX 76201, USA.
| | - Ateka A Contractor
- University of North Texas, Department of Psychology, 1155 Union Circle, Denton, TX 76201, USA.
| | - Elizabeth R Aston
- Brown University, School of Public Health, Center for Alcohol and Addiction Studies, 121 S. Main St., Providence, RI 02912, USA.
| | - Jane Metrik
- Brown University, School of Public Health, Center for Alcohol and Addiction Studies, 121 S. Main St., Providence, RI 02912, USA.
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Aggressive Driving Behaviours in Cannabis Users. The Influence of Consumer Characteristics. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18083911. [PMID: 33917856 PMCID: PMC8068208 DOI: 10.3390/ijerph18083911] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/02/2021] [Revised: 04/05/2021] [Accepted: 04/07/2021] [Indexed: 11/30/2022]
Abstract
This study analysed dangerous driving behaviours in twenty young occasional cannabis users through objective and self-reported data, studying the relationship between the two aspects. Visual function was assessed in a baseline session and after smoking cannabis, as well as speed-related behaviour in a driving simulator. The participants responded to questionnaires on sociodemographic factors, their consumption profile, and the incidence of dangerous behaviours (Dula Dangerous Driving Index; DDDI). After cannabis use, the results revealed a significant deterioration in visual function. In terms of speed management, they showed significantly greater acceleration force in the two different sections of the route, and they drove significantly faster. Our correlations indicate that males and heavier users display more risky speed management. Likewise, the heavier cannabis users admitted to increased dangerous driving behaviour, and an accident in the preceding year was associated with a trend towards aggressive driving behaviour according to the DDDI questionnaire. The findings of this study suggest that cannabis users adopt dangerous behaviours when driving, despite the effect this drug has on certain important functions, such as vision. The results suggest a need for awareness-raising and information campaigns.
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Cherpitel CJ, Witbrodt J, Ye Y, Monteiro MG, Málaga H, Báez J, Valdés MPDL. Road traffic injuries and substance use among emergency department patients in the Dominican Republic and Peru. Rev Panam Salud Publica 2021; 45:e31. [PMID: 33790955 PMCID: PMC7993299 DOI: 10.26633/rpsp.2021.31] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/13/2020] [Accepted: 11/25/2020] [Indexed: 11/24/2022] Open
Abstract
Objective. To report demographic and substance use characteristics and risk of road traffic injury (RTI) from alcohol use, cannabis use, and combined use in a sample of emergency department patients from two countries in Latin America and the Caribbean. Methods. A cross-sectional study in which patients 18 years and older admitted within six hours of suffering an RTI to one emergency department in Santa Domingo, Dominican Republic (n = 501) and in Lima, Peru (n = 431) were interviewed. Case-crossover analysis, based on self-reported use prior to the RTI, was used to analyze risk from alcohol, cannabis, and co-use. Results. Overall, 15.3% reported alcohol use prior to the event and 2.5% cannabis use. Drivers using alcohol only were over twice as likely to have an RTI (OR = 2.46, p < 0.001), and nearly eight times more likely if using both alcohol and cannabis (OR = 6.89, p < 0.01), but risk was not elevated for cannabis alone. Significant differences were not found for passengers or pedestrians. Conclusions. Risk of RTI for drivers in these two samples is significantly elevated from alcohol use, and more so for co-use with cannabis. Differences between the two countries underscore the need for similar data from the region to determine risk of RTI from substance use, including risk for passengers and pedestrians. Data suggest that alcohol contributes significantly to the burden of RTI, which calls for more stringent enforcement of alcohol control policy related to drink driving in the region.
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Affiliation(s)
- Cheryl J Cherpitel
- Alcohol Research Group EmeryvilleCalif. United States of America Alcohol Research Group, Emeryville, Calif., United States of America
| | - Jane Witbrodt
- Alcohol Research Group EmeryvilleCalif. United States of America Alcohol Research Group, Emeryville, Calif., United States of America
| | - Yu Ye
- Alcohol Research Group EmeryvilleCalif. United States of America Alcohol Research Group, Emeryville, Calif., United States of America
| | - Maristela G Monteiro
- Pan American Health Organization Washington, D.C. United States of America Pan American Health Organization, Washington, D.C., United States of America
| | - Hernán Málaga
- Ricardo Palma University Lima Peru Ricardo Palma University, Lima, Peru
| | - Jeannette Báez
- National Center of Investigations in Maternal Child Health Santo Domingo Dominican Republic National Center of Investigations in Maternal Child Health, Santo Domingo, Dominican Republic
| | - Marisela Ponce de León Valdés
- Inter-American Development Bank Washington, D.C. United States of America Inter-American Development Bank, Washington, D.C., United States of America
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Alvarez L, Colonna R, Kim S, Chen C, Chippure K, Grewal J, Kimm C, Randell T, Leung V. Young and under the influence: A systematic literature review of the impact of cannabis on the driving performance of youth. ACCIDENT; ANALYSIS AND PREVENTION 2021; 151:105961. [PMID: 33421731 DOI: 10.1016/j.aap.2020.105961] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/16/2020] [Revised: 11/20/2020] [Accepted: 12/19/2020] [Indexed: 05/16/2023]
Abstract
BACKGROUND Young drivers ages 15-24 continue to constitute a high-risk population for fatal motor vehicle collisions (MVCs) compared to all other age groups. Driving under the influence of cannabis is an important contributor to the high rates of MVCs among youth. Understanding the specific impact of cannabis on the driving performance outcomes of young drivers can inform injury prevention, education, and intervention strategies. OBJECTIVES This systematic literature review (SLR) aims to determine the Class (I- highest to IV-lowest) of evidence and level of confidence (A-high to U-insufficient) in the effects of cannabis on the driving performance of young drivers. METHODS Registered in PROSPERO (#CRD42020180541), this SLR searched seven data bases and appraised the quality and confidence in the evidence using an established research methodology. RESULTS Class II evidence suggests that THC is likely to reduce mean speed, headway distance, and reaction time; and increase lane and steering wheel position variability among young drivers (Level B, moderate confidence). CONCLUSIONS This study shows that there is a moderate to low level of confidence on the impact of cannabis on the specific driving performance outcomes of young drivers. A need remains for Class I and II studies that focus on the specific effects on young drivers, distinguish between the biological and socially constructed variables of sex and gender, and includes larger and more representative samples.
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Affiliation(s)
- Liliana Alvarez
- School of Occupational Therapy, Faculty of Health Sciences, Western University, London, Canada.
| | - Robert Colonna
- Health and Rehabilitation Sciences Graduate Program, Western University, London, Canada
| | - Sean Kim
- Schulich School of Medicine and Dentistry, Western University, London, Canada
| | - Caron Chen
- School of Occupational Therapy, Faculty of Health Sciences, Western University, London, Canada
| | - Katherine Chippure
- School of Occupational Therapy, Faculty of Health Sciences, Western University, London, Canada
| | - Jasleen Grewal
- School of Occupational Therapy, Faculty of Health Sciences, Western University, London, Canada
| | - Chris Kimm
- School of Occupational Therapy, Faculty of Health Sciences, Western University, London, Canada
| | - Travis Randell
- School of Occupational Therapy, Faculty of Health Sciences, Western University, London, Canada
| | - Victoria Leung
- Schulich School of Medicine and Dentistry, Western University, London, Canada
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32
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McCartney D, Arkell TR, Irwin C, McGregor IS. Determining the magnitude and duration of acute Δ 9-tetrahydrocannabinol (Δ 9-THC)-induced driving and cognitive impairment: A systematic and meta-analytic review. Neurosci Biobehav Rev 2021; 126:175-193. [PMID: 33497784 DOI: 10.1016/j.neubiorev.2021.01.003] [Citation(s) in RCA: 68] [Impact Index Per Article: 22.7] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2020] [Revised: 11/24/2020] [Accepted: 01/04/2021] [Indexed: 02/04/2023]
Abstract
The increasing legal availability of cannabis has important implications for road safety. This systematic review characterised the acute effects of Δ9-THC on driving performance and driving-related cognitive skills, with a particular focus on the duration of Δ9-THC-induced impairment. Eighty publications and 1534 outcomes were reviewed. Several measures of driving performance and driving-related cognitive skills (e.g. lateral control, tracking, divided attention) demonstrated impairment in meta-analyses of "peak" Δ9-THC effects (p's<0.05). Multiple meta-regression analyses further found that regular cannabis users experianced less impairment than 'other' (mostly occasional) cannabis users (p = 0.003) and that the magnitude of oral (n = 243 effect estimates [EE]) and inhaled (n = 481 EEs) Δ9-THC-induced impairment depended on various factors (dose, post-treatment time interval, the performance domain (skill) assessed) in other cannabis users (p's<0.05). The latter model predicted that most driving-related cognitive skills would 'recover' (Hedges' g=-0.25) within ∼5-hs (and almost all within ∼7-hs) of inhaling 20 mg of Δ9-THC; oral Δ9-THC-induced impairment may take longer to subside. These results suggest individuals should wait at least 5 -hs following inhaled cannabis use before performing safety-sensitive tasks.
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Affiliation(s)
- Danielle McCartney
- The University of Sydney, Lambert Initiative for Cannabinoid Therapeutics, Sydney, New South Wales, Australia; The University of Sydney, Brain and Mind Centre, Sydney, New South Wales, Australia; The University of Sydney, Faculty of Science, School of Psychology, Sydney, New South Wales, Australia.
| | - Thomas R Arkell
- The University of Sydney, Lambert Initiative for Cannabinoid Therapeutics, Sydney, New South Wales, Australia; The University of Sydney, Brain and Mind Centre, Sydney, New South Wales, Australia; The University of Sydney, Faculty of Science, School of Psychology, Sydney, New South Wales, Australia
| | - Christopher Irwin
- School of Allied Health Sciences, Griffith University, Gold Coast, Queensland, Australia; Menzies Health Institute Queensland, Gold Coast, Queensland, Australia
| | - Iain S McGregor
- The University of Sydney, Lambert Initiative for Cannabinoid Therapeutics, Sydney, New South Wales, Australia; The University of Sydney, Brain and Mind Centre, Sydney, New South Wales, Australia; The University of Sydney, Faculty of Science, School of Psychology, Sydney, New South Wales, Australia
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Brands B, Di Ciano P, Mann RE. Cannabis, Impaired Driving, and Road Safety: An Overview of Key Questions and Issues. Front Psychiatry 2021; 12:641549. [PMID: 34489746 PMCID: PMC8416748 DOI: 10.3389/fpsyt.2021.641549] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/14/2020] [Accepted: 07/01/2021] [Indexed: 12/19/2022] Open
Abstract
The road safety impact of cannabis has been a topic of much discussion and debate over the years. These discussions have been revitalized in recent years by initiatives in several jurisdictions to legalize non-medical cannabis. Canada became the second country to legalize non-medical cannabis use in October, 2018, preceded by Uruguay in December 2013. Road safety concerns were key issues in the Canadian government's deliberations on the issue. In this paper, we identify several key questions related to the impact of cannabis on road safety, and provide a consideration of the relevant literature on these questions. These questions cover several perspectives. From an epidemiological perspective, perhaps the central question is whether cannabis use contributes to the chances of being involved in a collision. The answer to this question has evolved in recent years as the ability to conduct the relevant studies has evolved. A related question is the extent to which cannabis plays an important role in road safety, and recent research has made progress in estimating the collisions, injuries, and deaths that may be attributed to cannabis use. Several questions relate to the behavioral and pharmacological effects of cannabis. One central question is whether cannabis affects driving skills in ways that can increase the chances of being involved in a collision. Another important question is whether the effects of the drug on the driving behavior of medical users is similar to, or different from, the effects on non-medical users and whether there are sex differences in the pharmacological and behavioral effects of cannabis. Other important questions are the impact of tolerance to the effects of cannabis on road safety as well as different routes of administration (e.g., edibles, vaped). It remains unclear if there is a dose-response relationship of cannabis to changes in driving. These and other key questions and issues are identified and discussed in this paper.
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Affiliation(s)
- Bruna Brands
- Health Canada, Ottawa, ON, Canada.,Institute for Mental Health Policy Research, Centre for Addiction and Mental Health, Toronto, ON, Canada.,Department of Pharmacology and Toxicology, University of Toronto, Toronto, ON, Canada
| | - Patricia Di Ciano
- Institute for Mental Health Policy Research, Centre for Addiction and Mental Health, Toronto, ON, Canada.,Department of Pharmacology and Toxicology, University of Toronto, Toronto, ON, Canada.,Campbell Family Mental Health Research Institute, Toronto, ON, Canada
| | - Robert E Mann
- Institute for Mental Health Policy Research, Centre for Addiction and Mental Health, Toronto, ON, Canada.,Campbell Family Mental Health Research Institute, Toronto, ON, Canada.,Dalla Lana School of Public Health, Toronto, ON, Canada
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Motschman CA, Warner OM, Wycoff AM, Davis-Stober CP, McCarthy DM. Context, acute tolerance, and subjective response affect alcohol-impaired driving decisions. Psychopharmacology (Berl) 2020; 237:3603-3614. [PMID: 32851420 PMCID: PMC7686294 DOI: 10.1007/s00213-020-05639-0] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/31/2020] [Accepted: 08/10/2020] [Indexed: 10/23/2022]
Abstract
RATIONALE Alcohol intoxication produces effects that can impair judgment and increase engagement in risky behaviors, including alcohol-impaired driving (AID). Real-world AID decisions are informed by contextual circumstances and judgments of associated risk. How individuals vary in their AID decision-making across contexts and whether subjective alcohol responses (stimulation, sedation, acute tolerance) differentially affect AID decisions are critical, but under-studied research questions. OBJECTIVES We systematically investigated predictors of AID decisions at different hypothetical driving distances across the blood alcohol concentration (BAC) curve. METHODS Young adults (n = 40; 55% female) completed two laboratory sessions in a within-subjects alcohol/placebo design. At multiple points along the BAC curve (M peak BAC = 0.101 g%), participants rated their subjective intoxication, stimulation, sedation, and perceived dangerousness of driving prior to indicating their willingness to drive distances of 1, 3, and 10 miles. Multilevel mixed models assessed within- and between-person predictors of the maximum distance participants were willing to drive at matched BACs on the ascending and descending limb. RESULTS Under intoxication (but not placebo), participants were willing to drive greater distances on the descending versus ascending limb. At the momentary level, participants were willing to drive further when they felt less intoxicated, stimulated, and sedated, and perceived driving as less dangerous. CONCLUSIONS Individuals differed in the distance they were willing to drive as a function of indicators of intoxication, implicating driving distance as an important contextual factor relevant to AID decisions. Individuals may simultaneously perceive themselves as "unsafe" to drive, but "safe enough" to drive short distances, particularly when BAC is falling.
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Affiliation(s)
- Courtney A Motschman
- Department of Psychological Sciences, University of Missouri, 212D McAlester Hall, Columbia, MO, 65211, USA
| | - Olivia M Warner
- Department of Psychological Sciences, University of Missouri, 212D McAlester Hall, Columbia, MO, 65211, USA
| | - Andrea M Wycoff
- Department of Psychological Sciences, University of Missouri, 212D McAlester Hall, Columbia, MO, 65211, USA
| | - Clintin P Davis-Stober
- Department of Psychological Sciences, University of Missouri, 212D McAlester Hall, Columbia, MO, 65211, USA
| | - Denis M McCarthy
- Department of Psychological Sciences, University of Missouri, 212D McAlester Hall, Columbia, MO, 65211, USA.
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Lloyd SL, Lopez-Quintero C, Striley CW. Sex differences in driving under the influence of cannabis: The role of medical and recreational cannabis use. Addict Behav 2020; 110:106525. [PMID: 32711286 DOI: 10.1016/j.addbeh.2020.106525] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2019] [Revised: 06/18/2020] [Accepted: 06/23/2020] [Indexed: 12/17/2022]
Abstract
BACKGROUND Existing evidence suggest that cannabis may impair driving and is the most prevalent drug identified in drivers. Males exhibit an excess risk for driving under the influence of drugs or alcohol compared to females. We assessed sex differences in the association between the reason for cannabis use (medical, recreational, or both) and driving under the influence of cannabis (DUIC). METHODS A sample of 17,405 past 12-month cannabis users (18 + years old) were analyzed from the 2016-17 National Survey on Drug Use and Health. Multivariable logistic regression was used to assess the interaction of sex and reason for cannabis use on DUIC using predicted probabilities. RESULTS Among cannabis users in the sample, 88.1% used for recreational reasons, 7.8% used for medical reasons, and 4.1% used for medical and recreational reasons. The probability of DUIC was as low as 20% among female medical only users, and as high as 40% among male combined medical and recreational users. Females showed more similar probabilities of DUIC across reasons of use (range 20% to 25%s) than males (range 28% to 40%). The difference in the probability of DUIC between combined medical and recreational users and recreational only users was significantly greater among males than among females (Δ 0.1, p < 0.05). CONCLUSIONS The observed effects of sex and reasons for cannabis use on DUIC suggests a need for targeted educational interventions, particularly among males reporting combined medical and recreational marijuana use.
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Jackson KM, Sokolovsky AW, Gunn RL, White HR. Consequences of alcohol and marijuana use among college students: Prevalence rates and attributions to substance-specific versus simultaneous use. PSYCHOLOGY OF ADDICTIVE BEHAVIORS 2020; 34:370-381. [PMID: 31944787 PMCID: PMC7064425 DOI: 10.1037/adb0000545] [Citation(s) in RCA: 80] [Impact Index Per Article: 20.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Abstract
College students who use alcohol and marijuana often use them simultaneously, so that their effects overlap. The present study examined whether negative consequences experienced by simultaneous alcohol and marijuana (SAM) users vary from those experienced by individuals who use alcohol and marijuana concurrently but not simultaneously (CAM) or single-substance users. We considered 9 types of consequences: cognitive, blackout, vomiting, academic/occupational, social, self-care, physical dependence, risky behaviors, and driving under the influence (DUI). Further, we examined whether consequences experienced by SAM users are attributed to using alcohol, marijuana, or both simultaneously. The sample included past-year alcohol and marijuana users age 18-24 (N = 1,390; 62% female; 69% White; 12% Hispanic) recruited from 3 U.S. college campuses. SAM users experienced a greater overall number of consequences than CAM or alcohol-only users, even controlling for frequency and intensity of alcohol and marijuana use and potentially confounding psychosocial and sociodemographic factors. Experiencing specific consequences differed between simultaneous and concurrent users, but after adjusting for consumption and other covariates, only blackouts differed. In contrast, SAM users were more likely to experience each consequence than alcohol-only users, with strongest effects for DUI, blackouts, and cognitive consequences. Among SAM users, consequences were most likely to be attributed to alcohol and were rarely attributed to simultaneous use. Being a user of both alcohol and marijuana and using alcohol and marijuana together so that their effects overlap each contribute to risk, suggesting there is value in targeting the mechanisms underlying type of user as well as those underlying type of use. (PsycINFO Database Record (c) 2020 APA, all rights reserved).
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Affiliation(s)
- Kristina M Jackson
- Department of Behavioral and Social Sciences, Center for Alcohol and Addiction Studies, Brown University
| | - Alexander W Sokolovsky
- Department of Behavioral and Social Sciences, Center for Alcohol and Addiction Studies, Brown University
| | - Rachel L Gunn
- Department of Behavioral and Social Sciences, Center for Alcohol and Addiction Studies, Brown University
| | - Helene R White
- Center of Alcohol Studies, Rutgers, The State University of New Jersey
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Dahlgren MK, Sagar KA, Smith RT, Lambros AM, Kuppe MK, Gruber SA. Recreational cannabis use impairs driving performance in the absence of acute intoxication. Drug Alcohol Depend 2020; 208:107771. [PMID: 31952821 PMCID: PMC9036916 DOI: 10.1016/j.drugalcdep.2019.107771] [Citation(s) in RCA: 30] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/29/2019] [Revised: 11/20/2019] [Accepted: 11/21/2019] [Indexed: 11/12/2022]
Abstract
BACKGROUND Across the nation, growing numbers of individuals are exploring the use of cannabis for medical or recreational purposes, and the proportion of cannabis-positive drivers involved in fatal crashes increased from 8 percent in 2013 to 17 percent in 2014, raising concerns about the impact of cannabis use on driving. Previous studies have demonstrated that cannabis use is associated with impaired driving performance, but thus far, research has primarily focused on the effects of acute intoxication. METHODS The current study assessed the potential impact of cannabis use on driving performance using a customized driving simulator in non-intoxicated, heavy, recreational cannabis users and healthy controls (HCs) without a history of cannabis use. RESULTS Overall, cannabis users demonstrated impaired driving relative to HC participants with increased accidents, speed, and lateral movement, and reduced rule-following. Interestingly, however, when cannabis users were divided into groups based on age of onset of regular cannabis use, significant driving impairment was detected and completely localized to those with early onset (onset before age 16) relative to the late onset group (onset ≥16 years old). Further, covariate analyses suggest that impulsivity had a significant impact on performance differences. CONCLUSIONS Chronic, heavy, recreational cannabis use was associated with worse driving performance in non-intoxicated drivers, and earlier onset of use was associated with greater impairment. These results may be related to other factors associated with early exposure such as increased impulsivity.
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Affiliation(s)
- M. Kathryn Dahlgren
- Cognitive and Clinical Neuroimaging Core, McLean Imaging Center, McLean Hospital, Belmont, MA, USA,Marijuana Investigations for Neuroscientific Discovery (MIND) Program, McLean Imaging Center, McLean Hospital, Belmont, MA, USA,Department of Psychiatry, Harvard Medical School, Boston, MA, USA
| | - Kelly A. Sagar
- Cognitive and Clinical Neuroimaging Core, McLean Imaging Center, McLean Hospital, Belmont, MA, USA,Marijuana Investigations for Neuroscientific Discovery (MIND) Program, McLean Imaging Center, McLean Hospital, Belmont, MA, USA,Department of Psychiatry, Harvard Medical School, Boston, MA, USA
| | - Rosemary T. Smith
- Cognitive and Clinical Neuroimaging Core, McLean Imaging Center, McLean Hospital, Belmont, MA, USA,Marijuana Investigations for Neuroscientific Discovery (MIND) Program, McLean Imaging Center, McLean Hospital, Belmont, MA, USA
| | - Ashley M. Lambros
- Cognitive and Clinical Neuroimaging Core, McLean Imaging Center, McLean Hospital, Belmont, MA, USA,Marijuana Investigations for Neuroscientific Discovery (MIND) Program, McLean Imaging Center, McLean Hospital, Belmont, MA, USA
| | - Madeline K. Kuppe
- Cognitive and Clinical Neuroimaging Core, McLean Imaging Center, McLean Hospital, Belmont, MA, USA,Marijuana Investigations for Neuroscientific Discovery (MIND) Program, McLean Imaging Center, McLean Hospital, Belmont, MA, USA
| | - Staci A. Gruber
- Cognitive and Clinical Neuroimaging Core, McLean Imaging Center, McLean Hospital, Belmont, MA, USA,Marijuana Investigations for Neuroscientific Discovery (MIND) Program, McLean Imaging Center, McLean Hospital, Belmont, MA, USA,Department of Psychiatry, Harvard Medical School, Boston, MA, USA,Corresponding author at: Cognitive and Clinical Neuroimaging Core, McLean Hospital, 115 Mill Street, Belmont, 021478, MA USA. (S.A. Gruber)
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38
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Wade NE, Thomas AM, Gruber SA, Tapert SF, Filbey FM, Lisdahl KM. Binge and Cannabis Co-Use Episodes in Relation to White Matter Integrity in Emerging Adults. Cannabis Cannabinoid Res 2020; 5:62-72. [PMID: 32322677 DOI: 10.1089/can.2018.0062] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Background: Growing evidence suggests that cannabis and alcohol (and especially binge alcohol drinking) use independently alters neural structure and functioning, particularly during sensitive developmental time periods (e.g., emerging adulthood). However, few studies have investigated the effects of same-day use of these two substances. Here, white matter (WM) integrity was investigated in relation to binge alcohol drinking, cannabis, and same-day binge and cannabis co-use in adolescents and emerging adults. Methods: FreeSurfer's TRACULA was used to assess WM in emerging adults (n=75; 16-26 years old). Timeline Followback calculated past month cannabis use, binge episodes, and same-day cannabis and binge drinking co-use. Multiple regressions investigated WM by past month cannabis, binge, and co-use. Results: Results revealed co-use episodes were related to lower fractional anisotropy (FA), an overall measure of neuronal integrity, in three tracts (left inferior longitudinal fasciculus [ILF], p=0.02; right anterior thalamic radiation [ATR], p=0.01; and left cingulum cingulate gyrus [CCG], p=0.01); and lower axial diffusivity in left ILF (p=0.03). Cannabis use was significantly related to greater FA in left ILF (p=0.005), left ATR (p=0.02), right ATR (p=0.05), left CCG (p=0.006), right CCG (p=0.03), and right superior longitudinal fasciculus parietal (p=0.03). Binge episodes related to greater FA in right ATR (p=0.03). Conclusions: These findings suggest that co-use was associated with lower WM integrity across frontolimbic tracts. In addition, greater FA was related to greater cannabis use across several tracts and binge alcohol use in one tract. Co-users also appeared to be more severe substance users. Future research should investigate the potential independent and interactive effects of these substances on pre-clinical and clinical levels.
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Affiliation(s)
- Natasha E Wade
- Department of Psychiatry, University of California San Diego, La Jolla, California
| | - Alicia M Thomas
- Department of Psychology, University of Wisconsin-Milwaukee, Milwaukee, Wisconsin
| | - Staci A Gruber
- Imaging Center, McLean Hospital, Belmont, Massachusetts.,Department of Psychiatry, Harvard Medical School, Boston, Massachusetts
| | - Susan F Tapert
- Department of Psychiatry, University of California San Diego, La Jolla, California
| | - Francesca M Filbey
- School of Behavioral and Brain Sciences, The University of Texas at Dallas, Richardson, Texas
| | - Krista M Lisdahl
- Department of Psychology, University of Wisconsin-Milwaukee, Milwaukee, Wisconsin
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Grigsby TM, Hoffmann LM, Moss MJ. Marijuana Use and Potential Implications of Marijuana Legalization. Pediatr Rev 2020; 41:61-72. [PMID: 32005683 DOI: 10.1542/pir.2018-0347] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/07/2023]
Abstract
Most states in the United States have legalized medical and/or recreational cannabis in response to public demand. Trends in states adopting such legislation demonstrate an increasing prevalence of cannabis use coincident to decreasing perceptions of risk of harm from cannabis products. When providing anticipatory guidance, pediatricians should be prepared to address childhood unintentional ingestion management and prevention, adolescent problem use, and cannabis as an alternative therapy for seizure disorders and other conditions.
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Affiliation(s)
- Tamara M Grigsby
- Doernbecher Children's Hospital, Oregon Health & Science University, Portland, OR
| | - Laurel M Hoffmann
- Doernbecher Children's Hospital, Oregon Health & Science University, Portland, OR
| | - Michael J Moss
- Utah Poison Center, University of Utah College of Pharmacy, Salt Lake City, UT.,Division of Emergency Medicine, University of Utah, Salt Lake City, UT
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40
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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.
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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
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Aydelotte JD, Mardock AL, Mancheski CA, Quamar SM, Teixeira PG, Brown CVR, Brown LH. Fatal crashes in the 5 years after recreational marijuana legalization in Colorado and Washington. ACCIDENT; ANALYSIS AND PREVENTION 2019; 132:105284. [PMID: 31518764 DOI: 10.1016/j.aap.2019.105284] [Citation(s) in RCA: 38] [Impact Index Per Article: 7.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/16/2019] [Revised: 08/15/2019] [Accepted: 08/26/2019] [Indexed: 06/10/2023]
Abstract
Colorado and Washington legalized recreational marijuana in 2012, but the effects of legalization on motor vehicle crashes remains unknown. Using Fatality Analysis Reporting System data, we performed difference-in-differences (DD) analyses comparing changes in fatal crash rates in Washington, Colorado and nine control states with stable anti-marijuana laws or medical marijuana laws over the five years before and after recreational marijuana legalization. In separate analyses, we evaluated fatal crash rates before and after commercial marijuana dispensaries began operating in 2014. In the five years after legalization, fatal crash rates increased more in Colorado and Washington than would be expected had they continued to parallel crash rates in the control states (+1.2 crashes/billion vehicle miles traveled, CI: -0.6 to 2.1, p = 0.087), but not significantly so. The effect was more pronounced and statistically significant after the opening of commercial dispensaries (+1.8 crashes/billion vehicle miles traveled, CI: +0.4 to +3.7, p = 0.020). These data provide evidence of the need for policy strategies to mitigate increasing crash risks as more states legalize recreational marijuana.
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Affiliation(s)
- Jayson D Aydelotte
- Division of Acute Care Surgery, Department of Surgery and Perioperative Care, Dell Medical School at the University of Texas Austin, 1500 Red River St., Austin, TX 78701, USA
| | - Alexandra L Mardock
- UCLA David Geffen School of Medicine, 10833 Le Conte Ave, Los Angeles, CA 90095, USA
| | - Christine A Mancheski
- Division of Emergency Medicine, Department of Surgery and Perioperative Care, Dell Medical School at the University of Texas Austin, 1400 N IH35, Suite 2.230, Austin, TX 78701, USA
| | - Shariq M Quamar
- University of Texas, c/o Division of Emergency Medicine, 1400 N IH35, Suite 2.230, Austin, TX 78701, USA
| | - Pedro G Teixeira
- Division of Acute Care Surgery, Department of Surgery and Perioperative Care, Dell Medical School at the University of Texas Austin, 1500 Red River St., Austin, TX 78701, USA
| | - Carlos V R Brown
- Division of Acute Care Surgery, Department of Surgery and Perioperative Care, Dell Medical School at the University of Texas Austin, 1500 Red River St., Austin, TX 78701, USA
| | - Lawrence H Brown
- Division of Emergency Medicine, Department of Surgery and Perioperative Care, Dell Medical School at the University of Texas Austin, 1400 N IH35, Suite 2.230, Austin, TX 78701, USA.
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42
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Ginsburg BC. Strengths and limitations of two cannabis-impaired driving detection methods: a review of the literature. THE AMERICAN JOURNAL OF DRUG AND ALCOHOL ABUSE 2019; 45:610-622. [DOI: 10.1080/00952990.2019.1655568] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Affiliation(s)
- Brett C. Ginsburg
- Department of Psychiatry and Behavioral Sciences, The University of Texas Health Science Center at San Antonio, San Antonio, TX, USA
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Duckworth JC, Lee CM. Associations among simultaneous and co-occurring use of alcohol and marijuana, risky driving, and perceived risk. Addict Behav 2019; 96:39-42. [PMID: 31030178 DOI: 10.1016/j.addbeh.2019.03.019] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2019] [Revised: 03/23/2019] [Accepted: 03/31/2019] [Indexed: 11/26/2022]
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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.
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Linden-Carmichael AN, Stamates AL, Lau-Barraco C. Simultaneous Use of Alcohol and Marijuana: Patterns and Individual Differences. Subst Use Misuse 2019; 54:2156-2166. [PMID: 31304834 PMCID: PMC6803060 DOI: 10.1080/10826084.2019.1638407] [Citation(s) in RCA: 61] [Impact Index Per Article: 12.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
Background: Simultaneous alcohol and marijuana (SAM) use, or using alcohol and marijuana in such a way that their effects overlap, is associated with negative health and behavioral outcomes. Objectives: Our study sought to fill gaps in our knowledge on this emerging public health concern by comparing SAM users and alcohol-only users on individual-level factors and substance use outcomes as well as examining associations of SAM use frequency, within users. Methods: Participants were recruited through online postings. Our analytic sample consisted of 1017 young adults (18-25 years) who reported past-month alcohol use. Most were male (67.8%), Caucasian (71.5%), and had attended at least some college (74.8%). Results: Past-year SAM users reported higher levels of sensation seeking and greater perceptions of their close friends' drinking behavior in comparison to alcohol-only users. SAM users reported heavier and more frequent alcohol use than alcohol-only users. Within past-year SAM users, 70% reported SAM use at least weekly. More frequent SAM use was associated with all alcohol use outcomes (e.g., weekly quantity, frequency, alcohol-related problems) and marijuana use outcomes (e.g., quantity, frequency, peak use) and higher drinking norms. Conclusions/Importance: It is clear that SAM users are a vulnerable sub-population of young adult drinkers. SAM users are differentiated from alcohol-only users in terms of their personality characteristics and perceptions of peer groups' drinking. SAM users and more frequent users are also at heightened risk for substance use outcomes. Prevention and intervention efforts targeting high-risk drinking may benefit from also assessing whether they simultaneously use alcohol and marijuana.
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Affiliation(s)
- Ashley N Linden-Carmichael
- Department of Biobehavioral Health, Edna Bennett Pierce Prevention Research Center, The Pennsylvania State University , University Park , PA , USA
| | - Amy L Stamates
- Department of Psychology, Old Dominion University , Norfolk , VA , USA
| | - Cathy Lau-Barraco
- Department of Psychology, Old Dominion University , Norfolk , VA , USA
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Yambe T, Shiraishi Y, Inoue Y, Yamada A. Cloud Database Construction for the Expressway Design by the use of the Medical Information. ANNUAL INTERNATIONAL CONFERENCE OF THE IEEE ENGINEERING IN MEDICINE AND BIOLOGY SOCIETY. IEEE ENGINEERING IN MEDICINE AND BIOLOGY SOCIETY. ANNUAL INTERNATIONAL CONFERENCE 2019; 2019:1448-1451. [PMID: 31946166 DOI: 10.1109/embc.2019.8856546] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/10/2023]
Abstract
Your heart rate and blood pressure are respond to the curve, slope, lane width, and road surface friction coefficient of the expressway design. However, no report was reported concerning about the Expressway design from the viewpoint of medical information of the driver until now. To prevent the traffic accident, human factor is of course one of the most important factors. In this study, the Cloud Database Construction for the Expressway Design by the use of the Medical Information had been tried to carry out. HR response and PWV responses had been tried to be analyzed by the sensors in the car during driving. LF, HF and LF/HF of Heart rate variability had been calculated and tagged with expressway information including left and right curve, slope, lane width, and road surface friction coefficient. Furthermore, pulse of the descending aorta had been tried to be recorded from the sensor in a driver seat, so, the pulse wave velocity and blood pressure could be evaluated. Recording system of an Eye movement, pupil diameter, cerebral blood flow, and EEG are now under construction. So, all human driver's data will be combined in the Cloud of the Central office. this method will be useful for the development of the designing method the Expressway in near future.
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DINI G, BRAGAZZI N, MONTECUCCO A, RAHMANI A, DURANDO P. Psychoactive drug consumption among truck-drivers: a systematic review of the literature with meta-analysis and meta-regression. JOURNAL OF PREVENTIVE MEDICINE AND HYGIENE 2019; 60:E124-E139. [PMID: 31312742 PMCID: PMC6614564 DOI: 10.15167/2421-4248/jpmh2019.60.2.1245] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/03/2019] [Accepted: 04/02/2019] [Indexed: 11/16/2022]
Abstract
Few studies have assessed the extent of psychoactive drug consumption in the occupational setting. The trucking sector, in particular, is an important cause for concern, since psychoactive substance use has a relevant impact on the drivers' health and safety, increasing the risk of injuries and traffic accidents, potentially affecting the general public health as well. A systematic review of the literature and meta-analysis was performed in order to provide Occupational Health Professionals and policy-makers with an updated epidemiological perspective regarding this important issue. The results showed a prevalence of overall drug consumption of 27.6% [95%CI 17.8-40.1], particularly high considering illicit CNS-stimulants (amphetamine consumption of 21.3% [95%CI 15.7-28.1], and cocaine consumption of 2.2% [95%CI 1.2-4.1]). It appears that truck-drivers choose stimulant substances as a form of performance enhancing drug, in order to increase productivity. However, chronic and high dose consumption has been shown to decrease driving skills, placing these professional drivers at risk for health and road safety. Further research is required, particularly in Europe, in order to fill the knowledge gap and improve the strength of evidence.
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Affiliation(s)
- G. DINI
- Department of Health Sciences (DISSAL), Occupational Medicine, University of Genoa, Italy
- Occupational Medicine Unit, Policlinico San Martino Hospital IRCCS, Genoa, Italy
| | - N.L. BRAGAZZI
- Department of Health Sciences (DISSAL), Occupational Medicine, University of Genoa, Italy
- Correspondence: Nicola Luigi Bragazzi, Dipartimento di Scienze della Salute (DISSAL), Università degli Studi di Genova, l.go R. Benzi 10 (Padiglione 3), 16132 Genova, Italy - E-mail:
| | - A. MONTECUCCO
- Department of Health Sciences (DISSAL), Occupational Medicine, University of Genoa, Italy
- Occupational Medicine Unit, Policlinico San Martino Hospital IRCCS, Genoa, Italy
| | - A. RAHMANI
- Department of Health Sciences (DISSAL), Occupational Medicine, University of Genoa, Italy
- Occupational Medicine Unit, Policlinico San Martino Hospital IRCCS, Genoa, Italy
| | - P. DURANDO
- Department of Health Sciences (DISSAL), Occupational Medicine, University of Genoa, Italy
- Occupational Medicine Unit, Policlinico San Martino Hospital IRCCS, Genoa, Italy
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“Just a Habit”: Driving Under the Influence of Cannabis as Ordinary, Convenient, and Controllable Experiences According to Drivers in a Remedial Program. JOURNAL OF DRUG ISSUES 2019. [DOI: 10.1177/0022042619842375] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
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Alsherbiny MA, Li CG. Medicinal Cannabis-Potential Drug Interactions. MEDICINES 2018; 6:medicines6010003. [PMID: 30583596 PMCID: PMC6473892 DOI: 10.3390/medicines6010003] [Citation(s) in RCA: 79] [Impact Index Per Article: 13.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/30/2018] [Revised: 12/19/2018] [Accepted: 12/21/2018] [Indexed: 02/06/2023]
Abstract
The endocannabinoids system (ECS) has garnered considerable interest as a potential therapeutic target in various carcinomas and cancer-related conditions alongside neurodegenerative diseases. Cannabinoids are implemented in several physiological processes such as appetite stimulation, energy balance, pain modulation and the control of chemotherapy-induced nausea and vomiting (CINV). However, pharmacokinetics and pharmacodynamics interactions could be perceived in drug combinations, so in this short review we tried to shed light on the potential drug interactions of medicinal cannabis. Hitherto, few data have been provided to the healthcare practitioners about the drug–drug interactions of cannabinoids with other prescription medications. In general, cannabinoids are usually well tolerated, but bidirectional effects may be expected with concomitant administered agents via affected membrane transporters (Glycoprotein p, breast cancer resistance proteins, and multidrug resistance proteins) and metabolizing enzymes (Cytochrome P450 and UDP-glucuronosyltransferases). Caution should be undertaken to closely monitor the responses of cannabis users with certain drugs to guard their safety, especially for the elderly and people with chronic diseases or kidney and liver conditions.
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Affiliation(s)
- Muhammad A Alsherbiny
- NICM Health Research Institute, Western Sydney University, Westmead, NSW 2145, Australia.
- Department of Pharmacognosy, Faculty of Pharmacy, Cairo University, Cairo 11562, Egypt.
| | - Chun Guang Li
- NICM Health Research Institute, Western Sydney University, Westmead, NSW 2145, Australia.
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Subbaraman MS, Metrik J, Patterson D, Stout RL. Cannabis use during alcohol treatment is associated with alcohol-related problems one-year post-treatment. Drug Alcohol Depend 2018; 193:29-34. [PMID: 30336390 PMCID: PMC6239961 DOI: 10.1016/j.drugalcdep.2018.08.020] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/03/2018] [Revised: 07/25/2018] [Accepted: 08/12/2018] [Indexed: 02/07/2023]
Abstract
BACKGROUND Prior research shows that cannabis use during treatment for Alcohol Use Disorders (AUD) is related to fewer abstinent days from alcohol, although only among those who use cannabis 1-2x/month. Here we extend prior research by assessing the relationship between the frequency of cannabis use during AUD treatment and post-treatment alcohol-related consequences. METHODS Data come from the Combined Pharmacotherapies and Behavioral Interventions (COMBINE) Study, a large US randomized control trial of treatments for AUD. The current analyses include 206 cannabis users and 999 cannabis abstainers and compare longitudinal drinking data between those who used cannabis versus those who abstained during COMBINE treatment. The primary exposure was quartiles of cannabis use (Q1: less than 1x/month during treatment, Q2: 1-2x/month, Q3: 4-8x/month, Q4: 12x/month or more), with cannabis abstainers as the reference group. Outcomes were alcohol-related problems at the end of treatment and one-year post-treatment as measured by the Drinker Inventory Consequences. RESULTS Compared to cannabis abstinence, the most frequent use during treatment was related to 1.44 times as many physical consequences one-year post-treatment. Cannabis use was not related to physical consequences immediately after treatment, or to intrapersonal, interpersonal, social responsibility or impulse control problems at either post-treatment time point. CONCLUSIONS In a sample of individuals in treatment for AUD, using cannabis 12x/month or more during treatment is associated with increased rates of physical consequences attributed to alcohol use. Individuals in treatment for AUD who also use cannabis might benefit from reducing or stopping cannabis use to avoid alcohol-related physical problems.
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Affiliation(s)
- Meenakshi S Subbaraman
- Alcohol Research Group, Public Health Institute, 6001 Shellmound St., Emeryville, CA, 94608, USA.
| | - Jane Metrik
- Center for Alcohol and Addiction Studies, Brown University School of Public Health, G-S121-4, Providence, RI, 02903, USA; Providence Veterans Affairs Medical Center, 830 Chalkstone Ave., Providence, RI, 02908, USA.
| | - Deidre Patterson
- Alcohol Research Group, Public Health Institute, 6001 Shellmound St., Emeryville, CA, 94608, USA.
| | - Robert L Stout
- Decision Sciences Institute, Pacific Institute for Research and Evaluation, 1005 Main Street, Pawtucket, RI, 02860, USA.
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