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Huỳnh C, Beaulieu-Thibodeau A, Fallu JS, Bergeron J, Jacques A, Brochu S. Factors related to the low-risk perception of driving after cannabis use. ACCIDENT; ANALYSIS AND PREVENTION 2024; 202:107584. [PMID: 38692126 DOI: 10.1016/j.aap.2024.107584] [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: 04/12/2023] [Revised: 11/15/2023] [Accepted: 04/12/2024] [Indexed: 05/03/2024]
Abstract
INTRODUCTION Modifying risk perceptions related to driving after cannabis use (DACU) could deter individuals from enacting this behavior, as low-risk perception is associated with DACU engagement. This study identified sociodemographic characteristics, substance use, other driving behaviors, peer norms, and psychological characteristics that are associated with lower risk perception regarding DACU. METHODS Canadian drivers aged 17-35 who have used cannabis in the past year (n = 1,467) completed an online questionnaire. A multivariate linear regression model allowed for identifying variables associated with the low-risk perception of DACU (i.e. believing it to be safe as one's driving ability is not impaired by cannabis or by being high). RESULTS Lower risk perception of DACU was associated with identifying as male, weekly to daily cannabis use, engagement in DACU, general risky driving behaviors, being a passenger of a driver who engages in DACU, number of friends who engage in DACU, and peer approval of DACU. Having driven under the influence of alcohol, living in urban areas, having received traffic tickets in the past three years, and declaring past-week irritability and cognitive problems were associated with holding a higher risk perception related to DACU. DISCUSSION Road education and prevention programs should target attitudes and perceptions regarding risks shaped by sociocultural norms and past risky driving experiences. They need to reach out more specifically to drivers with the identified characteristics associated with the low-risk perception of DACU. These interventions can potentially help reduce the rate of individuals who engage in this behavior.
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Affiliation(s)
- Christophe Huỳnh
- University Institute on Addictions, CIUSSS du Centre-Sud-de-l'Île-de-Montréal, Montréal, Québec, Canada; Department of Psychiatry and Addiction, Université de Montréal, Montréal, Québec, Canada.
| | - Alexis Beaulieu-Thibodeau
- University Institute on Addictions, CIUSSS du Centre-Sud-de-l'Île-de-Montréal, Montréal, Québec, Canada; Department of Community Health Sciences, Université de Sherbrooke, Sherbrooke, Québec, Canada
| | - Jean-Sébastien Fallu
- University Institute on Addictions, CIUSSS du Centre-Sud-de-l'Île-de-Montréal, Montréal, Québec, Canada; School of Psychoeducation, Université de Montréal, Montréal, Québec, Canada; Centre for Public Health Research, Université de Montréal and CIUSSS du Centre-Sud-de-l'Île-de-Montréal, Montréal, Québec, Canada
| | - Jacques Bergeron
- University Institute on Addictions, CIUSSS du Centre-Sud-de-l'Île-de-Montréal, Montréal, Québec, Canada; Department of Psychology, Université de Montréal, Montréal, Québec, Canada
| | - Alain Jacques
- Program to Assess and Reduce the Risk of Impaired Driving, CIUSSS du Centre-Sud-de-l'Île-de-Montréal, Montréal, Québec, Canada
| | - Serge Brochu
- University Institute on Addictions, CIUSSS du Centre-Sud-de-l'Île-de-Montréal, Montréal, Québec, Canada; School of Criminology, Université de Montréal, Montréal, Québec, Canada
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Kourgiantakis T, Vicknarajah R, Logan J, Edwards T, Lee E, Craig S, Kaura A, Williams CC, Marshall S. Understanding youth and young adult cannabis use in Canada post-legalization: a scoping review on a public health issue. Subst Abuse Treat Prev Policy 2024; 19:30. [PMID: 38886804 PMCID: PMC11184772 DOI: 10.1186/s13011-024-00615-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/03/2024] [Accepted: 06/10/2024] [Indexed: 06/20/2024] Open
Abstract
BACKGROUND Canada legalized recreational cannabis in 2018, and one of the primary objectives of the Cannabis Act was to protect youth by reducing their access to cannabis and providing public education. Canada has the highest prevalence of cannabis use worldwide, particularly among youth and young adults under the age of 25. Cannabis use is linked with many adverse effects for youth and young adults including psychosis, anxiety, depression, respiratory distress, cannabinoid hyperemesis syndrome, and impaired cognitive performance. Despite the high prevalence of cannabis use and the evolution of policies in Canada and globally, significant knowledge and research gaps remain regarding youth and young adult cannabis use. The aim of this scoping review is to map the extent, nature, and range of evidence available on youth and young adult cannabis use in Canada since its legalization, in order to strengthen policies, services, treatments, training, and public education strategies. METHODS Using a scoping review framework developed by Arksey and O'Malley, along with the PRISMA-ScR guidelines, we conducted a rigorous search in five academic databases: MEDLINE, Embase, APA PsycINFO, CINAHL and Web of Science Core Collection. We included empirical studies that collected data in Canada after the legalization of recreational cannabis (October 2018) and focused on youth or young adults < 30. Two reviewers independently screened articles in two stages and extracted relevant information from articles meeting the inclusion criteria. RESULTS Of the 47 articles meeting our inclusion criteria, 92% used quantitative methods, 6% were qualitative, and 2% used a mixed-methods approach. Over two-thirds (68%) used secondary data. These studies were categorized into six focus areas: (1) prevalence, patterns, and trends, (2) cannabis-related injuries and emergency department (ED) visits, (3) rates and patterns during the pandemic, (4) perceptions of cannabis use, (5) prevention tools, and (6) cannabis-related offenses. Key findings from the studies reviewed include an increase in cannabis use among 18-24-year-olds post-legalization, with mixed results for youth under 18. ED visits for intentional and unintentional cannabis-related injuries have increased in young children and teens. Perception studies show a mix of concern and normalization of cannabis use. Though limited, prevention studies are promising in raising awareness. A decline in cannabis-related offenses was noted by one study. The review highlights several research gaps, including the need for more qualitative data, disaggregation of demographic data, intervention research, and comprehensive studies on the physical and mental health impacts of cannabis use among youth and young adults. CONCLUSION Maintaining a public health approach is critical, with a focus on reducing the high prevalence of cannabis use among youth and young adults. This involves implementing prevention strategies to minimize harms, enhancing public education, minimizing commercialization, reducing youth access to cannabis, promoting guidelines for lower-risk cannabis use and harm reduction strategies, and increasing training for healthcare providers.
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Affiliation(s)
- Toula Kourgiantakis
- École de travail social et de criminologie, Université Laval, 1030, avenue des Sciences-Humaines, Pavillon Charles-De-Koninck (local 6489), Québec, QC, G1V 0A6, Canada.
| | - Ragave Vicknarajah
- Factor-Inwentash Faculty of Social Work, University of Toronto, Toronto, ON, Canada
| | - Judith Logan
- John P. Robarts Library, University of Toronto, Toronto, ON, Canada
| | - Travonne Edwards
- School of Child and Youth Care, Toronto Metropolitan University, Toronto, ON, Canada
| | - Eunjung Lee
- Factor-Inwentash Faculty of Social Work, University of Toronto, Toronto, ON, Canada
| | - Shelley Craig
- Factor-Inwentash Faculty of Social Work, University of Toronto, Toronto, ON, Canada
| | - Ashima Kaura
- Factor-Inwentash Faculty of Social Work, University of Toronto, Toronto, ON, Canada
| | - Charmaine C Williams
- Factor-Inwentash Faculty of Social Work, University of Toronto, Toronto, ON, Canada
| | - Savannah Marshall
- Factor-Inwentash Faculty of Social Work, University of Toronto, Toronto, ON, Canada
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Zhao S, Brands B, Kaduri P, Wickens CM, Hasan OSM, Chen S, Le Foll B, Di Ciano P. The effect of cannabis edibles on driving and blood THC. J Cannabis Res 2024; 6:26. [PMID: 38822413 PMCID: PMC11140993 DOI: 10.1186/s42238-024-00234-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2023] [Accepted: 04/16/2024] [Indexed: 06/03/2024] Open
Abstract
BACKGROUND Cannabis has been shown to impact driving due to changes produced by delta-9-tetrahydrocannabinol (THC), the psychoactive component of cannabis. Current legal thresholds for blood THC while driving are based predominantly on evidence utilizing smoked cannabis. It is known that levels of THC in blood are lower after eating cannabis as compared to smoking yet the impact of edibles on driving and associated blood THC has never been studied. METHODS Participants drove a driving simulator before and after ingesting their preferred legally purchased cannabis edible. In a counterbalanced control session, participants did not consume any THC or cannabidiol (CBD). Blood was collected for measurement of THC and metabolites as well as CBD. Subjective experience was also assessed. RESULTS Participants consumed edibles with, on average, 7.3 mg of THC, which is less than the maximum amount available in a single retail package in Ontario, providing an ecologically valid test of cannabis edibles. Compared to control, cannabis edibles produced a decrease in mean speed 2 h after consumption but not at 4 and 6 h. Under dual task conditions in which participants completed a secondary task while driving, changes in speed were not significant after the correction for multiple comparison. No changes in standard deviation of lateral position (SDLP; 'weaving'), maximum speed, standard deviation of speed or reaction time were found at any time point or under either standard or dual task conditions. Mean THC levels were significantly increased, relative to control, after consuming the edible but remained relatively low at approximately 2.8 ng/mL 2 h after consumption. Driving impairment was not correlated with blood THC. Subjective experience was altered for 7 h and participants were less willing/able to drive for up to 6 h, suggesting that the edible was intoxicating. INTERPRETATION This is the first study of the impact of cannabis edibles on simulated driving. Edibles were intoxicating as revealed by the results of subjective assessments (VAS), and there was some impact on driving. Detection of driving impairment after the use of cannabis edibles may be difficult.
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Affiliation(s)
- S Zhao
- Institute for Mental Health Policy Research, Centre for Addiction and Mental Health, Toronto, Canada
- Department of Pharmacology and Toxicology, University of Toronto, Toronto, Canada
| | - B Brands
- Institute for Mental Health Policy Research, Centre for Addiction and Mental Health, Toronto, Canada
- Department of Pharmacology and Toxicology, University of Toronto, Toronto, Canada
- Health Canada, Ottawa, ON, Canada
| | - P Kaduri
- Addictions Division, Centre for Addiction and Mental Health, Toronto, Canada
- Department of Psychiatry, University of Toronto, Toronto, Canada
- Department of Psychiatry and Mental Health, Muhimbili University of Health and Allied Sciences, Dar es Salaam, Tanzania
| | - C M Wickens
- Institute for Mental Health Policy Research, Centre for Addiction and Mental Health, Toronto, Canada
- Department of Pharmacology and Toxicology, University of Toronto, Toronto, Canada
- Campbell Family Mental Health Research Institute, Toronto, Canada
- Institute of Health Policy, Management and Evaluation, University of Toronto, Toronto, Canada
- Dalla Lana School of Public Health, University of Toronto, Toronto, Canada
| | - O S M Hasan
- Institute for Mental Health Policy Research, Centre for Addiction and Mental Health, Toronto, Canada
- Institute of Medical Sciences, University of Toronto, Toronto, Canada
| | - S Chen
- Biostatistics Core, Centre for Addiction and Mental Health, Toronto, Canada
| | - B Le Foll
- Institute for Mental Health Policy Research, Centre for Addiction and Mental Health, Toronto, Canada
- Department of Pharmacology and Toxicology, University of Toronto, Toronto, Canada
- Institute of Medical Sciences, University of Toronto, Toronto, Canada
- Translational Addiction Research Laboratory, Centre for Addiction and Mental Health, Toronto, Canada
- Department of Family and Community Medicine, University of Toronto, Toronto, Canada
| | - P Di Ciano
- Institute for Mental Health Policy Research, Centre for Addiction and Mental Health, Toronto, Canada.
- Department of Pharmacology and Toxicology, University of Toronto, Toronto, Canada.
- Campbell Family Mental Health Research Institute, Toronto, Canada.
- Dalla Lana School of Public Health, University of Toronto, Toronto, Canada.
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Noel JK, Rosenthal SR, Torres JN, Gately KA, Borden SK. Driving after substance use in Rhode Island adolescents: A cross-sectional analysis of surveillance data. TRAFFIC INJURY PREVENTION 2024; 25:562-570. [PMID: 38578273 DOI: 10.1080/15389588.2024.2335317] [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: 12/14/2023] [Accepted: 03/22/2024] [Indexed: 04/06/2024]
Abstract
OBJECTIVE Existing literature on driving under the influence during adolescence is sparse, especially for driving after the use of non-medical prescription drugs (DAP). This study examines the prevalence of driving after use of alcohol (DAA), cannabis (DAC), and DAP, and examines the role of several potential risk and protective factors. METHODS This was a secondary analysis of the 2022 Rhode Island Study Survey, a cross-sectional survey of middle and high school students. Separate multivariable regressions were conducted for each outcome among lifetime users for each substance, controlling for current substance use, individual-, perceived parental-, and perceived friend-substance use risk perception, age, sexual/gender minority (SGM) status, race, ethnicity, school level, and town poverty level. RESULTS Among lifetime users of alcohol (n = 3849), cannabis (n = 2289), and non-medical prescription drugs (n = 611), the prevalence of DAA, DAC, and DAP was 4.9, 14.3, and 16.9%, respectively. Current substance use, high individual risk perception, being nonwhite, and being Hispanic were risk factors for DAA while perceiving parent's risk perception as negative and being heterosexual cisgender-female were protective. Current substance use, negative individual risk perception, and being nonwhite were risk factors for DAC while perceiving parent's risk perception as negative and being in high school were protective. Current substance use and older age were risk factors for DAP while perceiving parent's risk perception as negative and perceiving friend's risk perception as negative were protective. CONCLUSIONS Driving under the influence is a concern among adolescent substance users. Current substance use and perceived parental risk perception as negative are common risks and protective factors, respectively. Findings suggest substance-specific, heterogeneous interventions are needed. For example, interventions focusing on peer perceptions are most relevant for DAP, while shifting personal perceptions of harm are most relevant for DAC.
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Affiliation(s)
- Jonathan K Noel
- Department of Health Science, College of Health & Wellness, Johnson & Wales University, Providence, Rhode Island
- Center for Student Research & Interdisciplinary Collaboration, Johnson & Wales University, Providence, Rhode Island
| | - Samantha R Rosenthal
- Department of Health Science, College of Health & Wellness, Johnson & Wales University, Providence, Rhode Island
- Center for Student Research & Interdisciplinary Collaboration, Johnson & Wales University, Providence, Rhode Island
- Department of Epidemiology, Brown School of Public Health, Providence, Rhode Island
| | - Jadyn N Torres
- Center for Student Research & Interdisciplinary Collaboration, Johnson & Wales University, Providence, Rhode Island
| | - Kelsey A Gately
- Department of Health Science, College of Health & Wellness, Johnson & Wales University, Providence, Rhode Island
- Center for Student Research & Interdisciplinary Collaboration, Johnson & Wales University, Providence, Rhode Island
| | - Samantha K Borden
- Data Evaluation, and Compliance Unit, RI Department of Behavioral Healthcare, Developmental Disabilities and Hospitals, Cranston, Rhode Island
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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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Holman POS, Høiseth G, Bachs L, Thaulow CH, Vevelstad MS, Mørland J, Strand MC. A two-sample approach to retrograde extrapolation of blood THC concentrations - Is it feasible? Forensic Sci Int 2023; 352:111833. [PMID: 37793282 DOI: 10.1016/j.forsciint.2023.111833] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2022] [Revised: 09/11/2023] [Accepted: 09/18/2023] [Indexed: 10/06/2023]
Abstract
BACKGROUND Retrograde extrapolation of drug concentrations in blood can be relevant in cases of drug-impaired driving and is regularly used in forensic toxicology in Norway. Δ9-tetrahydrocannabinol (THC) has complex, multi-compartmental pharmacokinetics, which makes retrograde extrapolation of blood THC concentrations problematic. In the present study, we evaluated an approach to retrograde extrapolation in which momentary rates of decrease of THC were estimated from two consecutive blood samples in apprehended drivers. MATERIAL AND METHODS Data were collected from apprehended drivers in Norway 2000-2020. We included 548 cases in which THC was detected in two consecutive blood samples collected ≥ 20 min apart. THC concentrations were measured by GC-MS and UHPLC-MS/MS. In each case, THC concentrations and the time between the two sampling points (Δt) were used to estimate the rate constant k. The relationship between THC concentration and k was modelled by linear regression. RESULTS The median Δt was 31 min (interquartile range, IQR = 9). The median blood THC concentration was 2.4 μg/L (IQR = 3.4) at the first sampling point and 2.3 μg/L (IQR =3.1) at the second. The concentration decreased in 62% and increased in 38% of all cases. However, considering measurement uncertainty, the changes were not statistically significant in 87% of cases. The mean of k was 0.12 h-1, corresponding to an apparent t1/2 of 6.0 h. The t1/2 predicted from linear regression of k against THC concentration ranged from 0.93 to 13 h for the highest and lowest concentrations observed (36 and 0.63 μg/L, respectively). The time from driving to blood collection had a median of 1.7 h (IQR = 1.5), and did not correlate with k. CONCLUSIONS The apparent t1/2 of THC calculated from the mean of k was 6.0 h, which is shorter than the terminal elimination t1/2 suggested in previous population studies. This indicates that blood samples were often taken during the late distribution phase of THC. Because Δt was short relative to the rates of decrease expected in the late distribution and elimination phases, the underlying true concentration changes related to in vivo pharmacokinetics were small and masked by the relatively larger "false" changes introduced by random analytical and pre-analytical error. Therefore, individual values of k calculated from only two blood samples taken a short time apart are unreliable, and a two-sample approach to retrograde extrapolation of THC cannot be recommended.
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Affiliation(s)
- Peder Olai Skjeflo Holman
- Department of Forensic Sciences, Oslo University Hospital, PO Box 4950 Nydalen, 0424 Oslo, Norway; Department of Pharmacology, Oslo University Hospital, PO Box 4950 Nydalen, 0424 Oslo, Norway.
| | - Gudrun Høiseth
- Department of Forensic Sciences, Oslo University Hospital, PO Box 4950 Nydalen, 0424 Oslo, Norway
| | - Liliana Bachs
- Department of Forensic Sciences, Oslo University Hospital, PO Box 4950 Nydalen, 0424 Oslo, Norway
| | - Cecilie H Thaulow
- Department of Forensic Sciences, Oslo University Hospital, PO Box 4950 Nydalen, 0424 Oslo, Norway
| | - Merete S Vevelstad
- Department of Forensic Sciences, Oslo University Hospital, PO Box 4950 Nydalen, 0424 Oslo, Norway
| | - Jørg Mørland
- Norwegian Institute of Public Health, PO Box 4404 Nydalen, 0403 Oslo, Norway; Institute of Clinical Medicine, University of Oslo, PO Box 1171 Blindern, 0318 Oslo, Norway
| | - Maren Cecilie Strand
- Department of Forensic Sciences, Oslo University Hospital, PO Box 4950 Nydalen, 0424 Oslo, Norway
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Ortiz-Peregrina S, Oviedo-Trespalacios O, Ortiz C, Anera RG. Self-Regulation of Driving Behavior Under the Influence of Cannabis: The Role of Driving Complexity and Driver Vision. HUMAN FACTORS 2023; 65:1506-1524. [PMID: 34601949 DOI: 10.1177/00187208211047799] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/13/2023]
Abstract
OBJECTIVE This study analyzed the self-regulation behaviors of drivers under the influence of cannabis and its relationship with road complexity and some driver traits, including visual deterioration. BACKGROUND Cannabis is the illicit drug most often detected in drivers; its use results in significant negative effects in terms of visual function. Self-regulation behaviors involve the mechanisms used by drivers to maintain or reduce the risk resulting from different circumstances or the driving environment. METHODS Thirty-one young, occasional cannabis users were assessed both in a baseline session and after smoking cannabis. We evaluated the visual function (visual acuity and contrast sensitivity) and driver self-regulation variables of both longitudinal and lateral control as the speed adaptation and standard deviation of lateral position (SDLP). RESULTS Visual function was significantly impaired after cannabis use. Recreational cannabis use did not result in self-regulation, although some road features such as curved roads did determine self-regulation. Male participants adopted mean faster driving speeds with respect to the speed limit. Driver age also determined better lateral control with lower SDLPs. In addition, visual impairment resulting from cannabis use (contrast sensitivity) was linked with self-regulation by changes in longitudinal and lateral control. CONCLUSION Contrast sensitivity could be a good indicator of individual visual status to help determine how drivers self-regulate their driving both in normal conditions and while under the influence of cannabis. APPLICATION The findings provide new insights about driver self-regulation under cannabis effects and are useful for policy making and awareness campaigns.
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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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9
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Di Ciano P, Brands B, Fares A, Wright M, Stoduto G, Byrne P, McGrath M, Hasan OSM, Le Foll B, Wickens CM. The Utility of THC Cutoff Levels in Blood and Saliva for Detection of Impaired Driving. Cannabis Cannabinoid Res 2023. [PMID: 36730769 DOI: 10.1089/can.2022.0187] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/04/2023] Open
Abstract
Background: Δ9-Tetrahydrocannabinol (THC) is the psychoactive component in cannabis and a relationship of THC to driving impairment is expected. Despite this, there are discrepant findings with respect to the relationship of blood THC to driving. This study investigated the relationship of blood, urine, and saliva THC/THC-COOH levels to "weaving," as measured by a driving simulator. Methods: Participants smoked cannabis alone or with alcohol. THC/THC-COOH levels in blood, urine, and saliva were correlated with standard deviation of lateral position (SDLP), measuring "weaving." In addition, SDLP after cannabis and/or alcohol were compared with SDLP after placebo when THC/THC-COOH levels were above or below specified thresholds in blood (5 ng/mL), urine (50 ng/mL), or saliva (25 ng/mL). Results: A clear linear relationship between blood THC concentration and SDLP was not observed based on calculation of Spearman coefficients. When compared with placebo, SDLP was significantly increased after cannabis and cannabis combined with alcohol when THC in the blood was above the legal limit. SDLP was increased in drug conditions when saliva cutoffs were above the legal limit. Conclusions: The findings of this study suggest that specified thresholds for THC in blood and saliva may be able to detect driving impairment, but future studies are needed. ClinicalTrials.gov ID: NCT03106363.
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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
| | - 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 Directorate, Health Canada, Ottawa, 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
| | - 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
| | - Gina Stoduto
- Institute for Mental Health Policy Research, Centre for Addiction and Mental Health, Toronto, Ontario, Canada
| | - Patrick Byrne
- Research and Evaluation Office, Ontario Ministry of Transportation, Toronto, Ontario, Canada
| | - Michael McGrath
- Research and Evaluation Office, Ontario Ministry of Transportation, 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 Science, University of Toronto, Medical Sciences Building, Toronto, Ontario, Canada
| | - Bernard Le Foll
- 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.,Department of Family and Community Medicine, University of Toronto, Toronto, Ontario, Canada.,Waypoint Centre for Mental Health Care, Penetanguishene, 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.,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
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10
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Fischer B. Cannabis-Legalisierung in Deutschland. SUCHT 2023. [DOI: 10.1024/0939-5911/a000804] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/10/2023]
Abstract
Zusammenfassung: Zielsetzung: Die deutsche Bundesregierung hat beschlossen, den nicht-medizinischen Cannabis-Gebrauch und -Vertrieb zu legalisieren, und Kernpunkte des vorgesehenen Regelwerks vorgelegt. Einige dieser Kernpunkte werden aus der Sicht internationaler Erfahrungen und wissenschaftlicher Evidenz zur Legalisierung – insbesondere mit Blick auf Massnahmen und Ziele öffentlicher Gesundheit – eingeschätzt und kommentiert. Methodik: Selektive Zusammenfassung und policy-analytische Anwendung wissenschaftlicher Evidenz. Ergebnisse: Ein erheblicher Anteil von Cannabis-bezogenen Gesundheitsproblemen hängt mit dem Konsum von Hochpotenz- (THC) Produkten zusammen; allerdings würden kategorische THC-Grenzwerte für legal verfügbares Cannabis diese im Gesamten wahrscheinlich nicht reduzieren sondern primär Hochrisiko-Konsumenten weiter in der Illegalität belassen. Die Mindestalter-Grenze von 18 Jahren für legales Cannabis macht primär politischen Sinn und repräsentiert nicht unbedingt optimalen Gesundheits- oder sozialen Schutz für junge Konsumenten; allerdings wird der Cannabis-Konsum bei Minderjährigen wahrscheinlich weiter hoch blieben. Eine substanz-übergreifende, gesundheits-orientierte Angleichung mit den Gesetzesregelungen für andere Substanzen (z. B. Alkohol) wäre sinnvoll. Das Fahren unter Cannabis-Einfluss ist relativ häufig, und kann zu Verletzungs- und Todesfällen, und damit erheblicher Gesundheitsbelastung führen; seine Kontrolle braucht gezielte Aufklärungs- und Abschreckungs-Maßnahmen. Cannabis-Legalisierung ist mit einschlägigen internationalen (z. B. UN) Konventionen generell schwierig zu vereinbaren, sollte aber dazu genutzt werden, diese grundsätzlich auf der Basis von Prinzipien des Gesundheitsschutzes zu erneuern. Schlussfolgerungen: Für die Cannabis-Legalisierung in Deutschland gibt es kein perfektes Regelwerk; einige Kern-Ziele werden nur über Kompromiss-Ansätze zu erreichen sein, die im Zweifelsfall angepasst werden müssen. Wenn implementiert, wird Deutschland wichtige Daten zur Cannabis-Legalisierung als Politik-Option bieten können, wozu ein systematisches und umfassendes Prozess- und Ergebnis-Monitoring durchgeführt werden muss.
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Affiliation(s)
- Benedikt Fischer
- Faculty of Health Sciences, Centre for Applied Research in Mental Health and Addiction, Simon Fraser University, Vancouver, British Columbia, Canada
- Department of Psychiatry, University of Toronto, Toronto, Canada
- School of Population Health, University of Auckland, New Zealand
- Department of Psychiatry, Federal University of Sao Paulo, Brazil
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11
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Donnan JR, Drakes DH, Rowe EC, Najafizada M, Bishop LD. Driving under the influence of cannabis: perceptions from Canadian youth. BMC Public Health 2022; 22:2384. [PMID: 36536347 PMCID: PMC9764522 DOI: 10.1186/s12889-022-14658-9] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2022] [Accepted: 11/17/2022] [Indexed: 12/23/2022] Open
Abstract
BACKGROUND Cannabis legalization is intended to protect the public from potential harm by restricting access and promoting greater awareness of cannabis-related risks. Youth are at a greater risk for experiencing road-related harms due to their own or others' use of cannabis. This qualitative research explored youths' perceptions about cannabis and road safety. METHODS A qualitative study using focus groups (FG) was conducted with youth (age 13-18) and young adults (age 19-25) who resided in Newfoundland and Labrador. Using semi-structured interview questions, the facilitator asked participants to share their opinions about cannabis and road safety. All sessions were hosted virtually using Zoom with recruitment until saturation was met. All sessions were audio recorded, de-identified, and transcribed. Analysis utilized an inductive thematic approach informed by Braun and Clarke's (2006) method and inductive coding was facilitated using NVivo. RESULTS Six youth (n = 38) and five young adult (n = 53) FG were conducted. Five prominent themes emerged throughout discussions across both age groups including: a) normalization of driving under the influence of cannabis, b) knowledge and awareness, c) perceptions of risk, d) modes of transportation, and e) detection. Variation in perceptions appeared to be influenced by lack of awareness of the impact of cannabis on driving ability, residence in urban versus rural locations, type of vehicle driven (e.g., car vs. off-road vehicles), and gender. CONCLUSION The themes uncovered from this research will help inform future enhancement of cannabis policy to ensure the safety of all citizens. These findings will also support the inclusion of youth-focused education that will equip youth with informed decision-making strategies regarding road safety. Furthermore, these findings can be utilized to inform the refinement of cannabis driving policies to ensure the safety of all citizens on or off the road.
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Affiliation(s)
- Jennifer R. Donnan
- grid.25055.370000 0000 9130 6822School of Pharmacy, Memorial University of Newfoundland, 300 Prince Philip Drive, St. John’s, NL A1B 3V6 Canada
| | - Dalainey H. Drakes
- grid.25055.370000 0000 9130 6822School of Pharmacy, Memorial University of Newfoundland, 300 Prince Philip Drive, St. John’s, NL A1B 3V6 Canada
| | - Emily C. Rowe
- grid.25055.370000 0000 9130 6822Department of Psychology, Memorial University of Newfoundland, St. John’s, NL Canada
| | - Maisam Najafizada
- grid.25055.370000 0000 9130 6822Faculty of Medicine, Memorial University of Newfoundland, St. John’s, NL Canada
| | - Lisa D. Bishop
- grid.25055.370000 0000 9130 6822School of Pharmacy, Memorial University of Newfoundland, 300 Prince Philip Drive, St. John’s, NL A1B 3V6 Canada ,grid.25055.370000 0000 9130 6822Faculty of Medicine, Memorial University of Newfoundland, St. John’s, NL Canada
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12
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Kaye SA, Rodwell D, Watson-Brown N, Rose C, Buckley L. Road users' engagement in prosocial and altruistic behaviors: A systematic review. JOURNAL OF SAFETY RESEARCH 2022; 82:342-351. [PMID: 36031262 DOI: 10.1016/j.jsr.2022.06.010] [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: 11/07/2021] [Revised: 01/17/2022] [Accepted: 06/15/2022] [Indexed: 06/15/2023]
Abstract
INTRODUCTION Engagement in prosocial and altruistic on-road behaviors is a new area of research with potential safety benefits for road users. This paper systematically reviewed studies on road users' engagement in prosocial and altruistic behaviors to provide guidance regarding the next steps in this area of research, particularly to inform targeted interventions. The objective was to identify the types of on-road prosocial and altruistic behaviors that have been studied, and the factors associated with these behaviors. Road users were defined as drivers, passengers, or vulnerable road users (e.g., pedestrian, motorcyclists, and bicyclists). METHOD The database search was conducted following the Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRIMSA) guidelines and was conducted in June 2021. A total of 23,090 articles were identified in four databases including APA PsycINFO, Embase, Web of Science, and the Transportation Research Information Database. Eleven articles (13 studies) published between 2004 and 2021 met the inclusion criteria and were included in the review. RESULTS Six studies focused on intervening behaviors, specifically relating to passengers' willingness or intentions to speak up to a driver engaging in unsafe driving behaviors, four studies focused on drivers' yielding behaviors at crosswalks, and one study each focused on altruistic driving behaviors, prosocial driving behavior at long-wait stops, and prosocial behavior towards cyclists. Studies typically examined characteristics of the prosocial road user, including self-esteem, efficacy, and subjective norms, as well as contextual factors, such as other road users' behaviors and on-road messaging. CONCLUSIONS This review highlights specific factors that may predict road users' engagement in prosocial and altruistic on-road behaviors. PRACTICAL APPLICATIONS The outcomes from this review may be used to guide the development of future road safety public education messages designed to encourage greater participation in prosocial and altruistic on-road behaviors that act to benefit all road users.
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Affiliation(s)
- Sherrie-Anne Kaye
- Queensland University of Technology (QUT), Centre for Accident Research & Road Safety - Queensland (CARRS-Q), Brisbane, Australia.
| | - David Rodwell
- Queensland University of Technology (QUT), Centre for Accident Research & Road Safety - Queensland (CARRS-Q), Brisbane, Australia; Queensland University of Technology (QUT), Australian Centre for Health Services and Innovation (AusHSI), School of Public Health and Social Work, Centre for Healthcare Transformation, Brisbane, Australia.
| | - Natalie Watson-Brown
- Queensland University of Technology (QUT), Centre for Accident Research & Road Safety - Queensland (CARRS-Q), Brisbane, Australia.
| | - Chae Rose
- Queensland University of Technology (QUT), Centre for Accident Research & Road Safety - Queensland (CARRS-Q), Brisbane, Australia.
| | - Lisa Buckley
- The University of Queensland, School of Public Health, Brisbane, Australia.
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13
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Boboc RG, Voinea GD, Buzdugan ID, Antonya C. Talking on the Phone While Driving: A Literature Review on Driving Simulator Studies. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph191710554. [PMID: 36078267 PMCID: PMC9517811 DOI: 10.3390/ijerph191710554] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/14/2022] [Revised: 08/12/2022] [Accepted: 08/20/2022] [Indexed: 05/13/2023]
Abstract
Distracted driving is a growing concern around the world and has been the focus of many naturalistic and simulator-based studies. Driving simulators provide excellent practical and theoretical help in studying the driving process, and considerable efforts have been made to prove their validity. This research aimed to review relevant simulator-based studies focused on investigating the effects of the talking-on-the-phone-while-driving distraction on drivers' behavior. This work is a scoping review which followed the Preferred Reporting Items for Systematic Reviews and Meta-Analysis Extension for Scoping Reviews (PRISMA-ScR) guidelines. The search was performed on five databases, covering twenty years of research results. It was focused on finding answers to three research questions that could offer an overview of the main sources of distraction, the research infrastructure, and the measures that were used to analyze and predict the effects of distractions. A number of 4332 studies were identified in the database search, from which 83 were included in the review. The main findings revealed that TPWD distraction negatively affects driving performance, exposing drivers to dangerous traffic situations. Moreover, there is a general understanding that the driver's cognitive, manual, visual, and auditory resources are all involved, to a certain degree, when executing a secondary task while driving.
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14
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Comparison of the effects of alcohol and cannabis on visual function and driving performance. Does the visual impairment affect driving? Drug Alcohol Depend 2022; 237:109538. [PMID: 35717788 DOI: 10.1016/j.drugalcdep.2022.109538] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/17/2022] [Revised: 05/23/2022] [Accepted: 06/09/2022] [Indexed: 11/20/2022]
Abstract
BACKGROUND Alcohol and cannabis are the most widely consumed psychoactive substances worldwide. This study compared the effects of alcohol and cannabis on visual function and driving performance, as well as self-perceived effects. Also, the relationship between visual effects under the influence and driving performance was studied. METHODS Sixty-four young drivers, with a history of alcohol and/or cannabis use were included. Of these, 33 were allocated to the alcohol group and 31 to the cannabis group. All participants were evaluated in a baseline session. The alcohol group underwent two sessions: after drinking 300 ml and 450 ml of red wine (A1 and A2). The cannabis group attended one session after smoking cannabis (C). Visual function was evaluated at the contrast sensitivity, stereoacuity, and intraocular straylight level. Participants drove a driving simulator. A general score (overall visual score, OVS; overall driving performance score, ODPS) was obtained for both visual functioning and driving performance. RESULTS The evaluation of visual function demonstrated a significant impairment in OVS for all conditions studied (A1, p = 0.005; A2, p < 0.001; C, p < 0.001) with respect to the baseline session. General driving performance (ODPS) demonstrated a significant worsening for the A2 condition (p = 0.003). Finally, a significant relationship between driving performance and visual function was found (rho=0.163, p = 0.039 and χ2 = 4.801, p = 0.028). CONCLUSIONS Cannabis and alcohol use negatively impact visual function. However, driving performance was only significantly affected by the higher alcohol dose. This impairment in visual function was significantly associated with worse driving performance.
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15
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Pollard MA, Drakes DH, Harris N. Perceptions of the Risk and Social Acceptability of Driving Under the Influence of Cannabis. Int J Ment Health Addict 2022. [DOI: 10.1007/s11469-022-00879-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/01/2022] Open
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16
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Colonna R, Tucker P, Holmes J, Wilson J, Alvarez L. Mobile-based brief interventions targeting cannabis-impaired driving among youth: A Delphi study. J Subst Abuse Treat 2022; 141:108802. [DOI: 10.1016/j.jsat.2022.108802] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2021] [Revised: 04/20/2022] [Accepted: 05/03/2022] [Indexed: 10/18/2022]
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17
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Marcotte TD, Umlauf A, Grelotti DJ, Sones EG, Sobolesky PM, Smith BE, Hoffman MA, Hubbard JA, Severson J, Huestis MA, Grant I, Fitzgerald RL. Driving Performance and Cannabis Users' Perception of Safety: A Randomized Clinical Trial. JAMA Psychiatry 2022; 79:201-209. [PMID: 35080588 PMCID: PMC8792796 DOI: 10.1001/jamapsychiatry.2021.4037] [Citation(s) in RCA: 29] [Impact Index Per Article: 14.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Abstract
IMPORTANCE Expanding cannabis medicalization and legalization increases the urgency to understand the factors associated with acute driving impairment. OBJECTIVE To determine, in a large sample of regular cannabis users, the magnitude and time course of driving impairment produced by smoked cannabis of different Δ9-tetrahydrocannabinol (THC) content, the effects of use history, and concordance between perceived impairment and observed performance. DESIGN, SETTING, AND PARTICIPANTS This double-blind, placebo-controlled parallel randomized clinical trial took place from February 2017 to June 2019 at the Center for Medicinal Cannabis Research, University of California San Diego. Cannabis users were recruited for this study, and analysis took place between April 2020 and September 2021. INTERVENTIONS Placebo or 5.9% or 13.4% THC cannabis smoked ad libitum. MAIN OUTCOMES AND MEASURES The primary end point was the Composite Drive Score (CDS), which comprised key driving simulator variables, assessed prior to smoking and at multiple time points postsmoking. Additional measures included self-perceptions of driving impairment and cannabis use history. RESULTS Of 191 cannabis users, 118 (61.8%) were male, the mean (SD) age was 29.9 (8.3) years, and the mean (SD) days of use in the past month was 16.7 (9.8). Participants were randomized to the placebo group (63 [33.0%]), 5.9% THC (66 [34.6%]), and 13.4% THC (62 [32.5%]). Compared with placebo, the THC group significantly declined on the Composite Drive Score at 30 minutes (Cohen d = 0.59 [95% CI, 0.28-0.90]; P < .001) and 1 hour 30 minutes (Cohen d = 0.55 [95% CI, 0.24-0.86]; P < .001), with borderline differences at 3 hours 30 minutes (Cohen d = 0.29 [95% CI, -0.02 to 0.60]; P = .07) and no differences at 4 hours 30 minutes (Cohen d = -0.03 [95% CI, -0.33 to 0.28]; P = .87). The Composite Drive Score did not differ based on THC content (likelihood ratio χ24 = 3.83; P = .43) or use intensity (quantity × frequency) in the past 6 months (likelihood ratio χ24 = 1.41; P = .49), despite postsmoking blood THC concentrations being higher in those with the highest use intensity. Although there was hesitancy to drive immediately postsmoking, increasing numbers (81 [68.6%]) of participants reported readiness to drive at 1 hour 30 minutes despite performance not improving from initial postsmoking levels. CONCLUSIONS AND RELEVANCE Smoking cannabis ad libitum by regular users resulted in simulated driving decrements. However, when experienced users control their own intake, driving impairment cannot be inferred based on THC content of the cigarette, behavioral tolerance, or THC blood concentrations. Participants' increasing willingness to drive at 1 hour 30 minutes may indicate a false sense of driving safety. Worse driving performance is evident for several hours postsmoking in many users but appears to resolve by 4 hours 30 minutes in most individuals. Further research is needed on the impact of individual biologic differences, cannabis use history, and administration methods on driving performance. TRIAL REGISTRATION ClinicalTrials.gov Identifier: NCT02849587.
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Affiliation(s)
| | - Anya Umlauf
- Department of Psychiatry, University of California San Diego, San Diego
| | - David J. Grelotti
- Department of Psychiatry, University of California San Diego, San Diego
| | - Emily G. Sones
- Department of Psychiatry, University of California San Diego, San Diego
| | - Philip M. Sobolesky
- Department of Pathology, University of California San Diego, San Diego,Department of Pathology and Laboratory Medicine, Santa Clara Valley Medical Center, San Jose, California
| | - Breland E. Smith
- Department of Pathology, University of California San Diego, San Diego,LetsGetChecked Labs, Monrovia, California
| | - Melissa A. Hoffman
- Department of Pathology, University of California San Diego, San Diego,Vividion Therapeutics, San Diego, California
| | - Jacqueline A. Hubbard
- Department of Pathology, University of California San Diego, San Diego,Department of Pathology and Laboratory Medicine, Dartmouth-Hitchcock Medical Center, Lebanon, New Hampshire
| | | | - Marilyn A. Huestis
- Institute for Emerging Health Professions, Thomas Jefferson University, Philadelphia, Pennsylvania
| | - Igor Grant
- Department of Psychiatry, University of California San Diego, San Diego
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Fischer B, Robinson T, Bullen C, Curran V, Jutras-Aswad D, Medina-Mora ME, Pacula RL, Rehm J, Room R, van den Brink W, Hall W. Lower-Risk Cannabis Use Guidelines (LRCUG) for reducing health harms from non-medical cannabis use: A comprehensive evidence and recommendations update. THE INTERNATIONAL JOURNAL OF DRUG POLICY 2022; 99:103381. [PMID: 34465496 DOI: 10.1016/j.drugpo.2021.103381] [Citation(s) in RCA: 55] [Impact Index Per Article: 27.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2021] [Revised: 07/05/2021] [Accepted: 07/07/2021] [Indexed: 02/08/2023]
Abstract
BACKGROUND Cannabis use is common, especially among young people, and is associated with risks for various health harms. Some jurisdictions have recently moved to legalization/regulation pursuing public health goals. Evidence-based 'Lower Risk Cannabis Use Guidelines' (LRCUG) and recommendations were previously developed to reduce modifiable risk factors of cannabis-related adverse health outcomes; related evidence has evolved substantially since. We aimed to review new scientific evidence and to develop comprehensively up-to-date LRCUG, including their recommendations, on this evidence basis. METHODS Targeted searches for literature (since 2016) on main risk factors for cannabis-related adverse health outcomes modifiable by the user-individual were conducted. Topical areas were informed by previous LRCUG content and expanded upon current evidence. Searches preferentially focused on systematic reviews, supplemented by key individual studies. The review results were evidence-graded, topically organized and narratively summarized; recommendations were developed through an iterative scientific expert consensus development process. RESULTS A substantial body of modifiable risk factors for cannabis use-related health harms were identified with varying evidence quality. Twelve substantive recommendation clusters and three precautionary statements were developed. In general, current evidence suggests that individuals can substantially reduce their risk for adverse health outcomes if they delay the onset of cannabis use until after adolescence, avoid the use of high-potency (THC) cannabis products and high-frequency/-intensity of use, and refrain from smoking-routes for administration. While young people are particularly vulnerable to cannabis-related harms, other sub-groups (e.g., pregnant women, drivers, older adults, those with co-morbidities) are advised to exercise particular caution with use-related risks. Legal/regulated cannabis products should be used where possible. CONCLUSIONS Cannabis use can result in adverse health outcomes, mostly among sub-groups with higher-risk use. Reducing the risk factors identified can help to reduce health harms from use. The LRCUG offer one targeted intervention component within a comprehensive public health approach for cannabis use. They require effective audience-tailoring and dissemination, regular updating as new evidence become available, and should be evaluated for their impact.
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Affiliation(s)
- Benedikt Fischer
- Schools of Population Health and Pharmacy, Faculty of Medical and Health Sciences, University of Auckland, Auckland, New Zealand; Centre for Applied Research in Mental Health and Addiction, Faculty of Health Sciences, Simon Fraser University, Vancouver, Canada; Department of Psychiatry, Federal University of Sao Paulo, Sao Paulo, Brazil.
| | - Tessa Robinson
- Centre for Applied Research in Mental Health and Addiction, Faculty of Health Sciences, Simon Fraser University, Vancouver, Canada; Department of Health Research Methods, Evidence & Impact, Faculty of Health Sciences, McMaster University, Hamilton, ON, Canada
| | - Chris Bullen
- Schools of Population Health and Pharmacy, Faculty of Medical and Health Sciences, University of Auckland, Auckland, New Zealand; National Institute for Health Innovation (NIHI), The University of Auckland, Auckland, New Zealand
| | - Valerie Curran
- Clinical Psychopharmacology Unit, Research Department of Clinical, Educational and Health Psychology, University College London, London, United Kingdom; NIHR University College London Hospitals Biomedical Research Centre, London, United Kingdom
| | - Didier Jutras-Aswad
- Department of Psychiatry and Addictology, Université de Montréal, Montreal, Canada; Research Centre of the Centre Hospitalier de l'Université de Montréal (CRCHUM), Montreal, Canada
| | - Maria Elena Medina-Mora
- Center for Global Mental Health Research, National Institute of Psychiatry Ramón de la Fuente Muñiz, Mexico City, Mexico; Department of Psychiatry and Mental Health, Faculty of Medicine, National Autonomous University of Mexico, Mexico City, Mexico
| | - Rosalie Liccardo Pacula
- Schaeffer Center for Health Policy and Economics, Sol Price School of Public Policy, University of Southern California, Los Angeles, United States
| | - Jürgen Rehm
- Institute for Mental Health Policy Research, Centre for Addiction & Mental Health, Toronto, Canada; Dalla Lana School of Public Health, University of Toronto, Toronto, Canada
| | - Robin Room
- Centre for Alcohol Policy Research, La Trobe University, Melbourne, Australia; Centre for Social Research on Alcohol and Drugs, Department of Public Health Sciences, Stockholm University, Stockholm, Sweden
| | - Wim van den Brink
- Department of Psychiatry, University of Amsterdam, Amsterdam, the Netherlands; Amsterdam University Medical Centre, University of Amsterdam, Amsterdam, the Netherlands
| | - Wayne Hall
- National Centre for Youth Substance Use Research, Faculty of Health and Behavioural Sciences, University of Queensland, St Lucia, QLD 4072, Australia; National Addiction Centre, Institute of Psychiatry, Kings College London, United Kingdom
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19
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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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Abstract
The aim of this review is to discuss recent evidence on cannabis and driving ability. In particular, the review examines experimental research on the acute effects of tetrahydrocannabinol (THC) on driving-related neurobehavioral skills and driving performance based on simulator and road course studies. The evidence indicates that certain driving abilities are significantly, albeit modestly, impaired in individuals experiencing the acute effects of THC. Treatment effects are moderated by dose, delivery method, recency of use, and tolerance development, with inconclusive evidence concerning the moderating influence of cannabidiol. Emerging research priorities include linking neurobehavioral deficits to specific decrements in driving performance, estimating the real-world implications of experimental impaired driving research, understanding how tolerance differentially affects driving impairment across subgroups, and developing more evidence on cannabidiol's potential role in mitigating THC-induced impairment.
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Affiliation(s)
- Eric L Sevigny
- Department of Criminal Justice and Criminology, Andrew Young School of Policy Studies, Georgia State University, 55 Park Place NE, Suite 519, Atlanta, GA, 30303, United States.
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