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Brubacher JR, Chan H, Erdelyi S, Yuan Y, Daoust R, Vaillancourt C, Rowe B, Lee J, Mercier E, Atkinson P, Davis P, Clarke D, Taylor J, Macpherson A, Emond M, Al-Hakim D, Horwood C, Wishart I, Magee K, Rao J, Eppler J. High-'n'-dry? A comparison of cannabis and alcohol use in drivers presenting to hospital after a vehicular collision. Addiction 2023; 118:1507-1516. [PMID: 36898848 DOI: 10.1111/add.16186] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/09/2022] [Accepted: 02/20/2023] [Indexed: 03/12/2023]
Abstract
DESIGN This was a prospective observational study. BACKGROUND AND AIMS The characteristics of cannabis-involved motor vehicle collisions are poorly understood. This study of injured drivers identifies demographic and collision characteristics associated with high tetrahydrocannabinol (THC) concentrations. SETTING The study was conducted in 15 Canadian trauma centres between January 2018 and December 2021. CASES The cases (n = 6956) comprised injured drivers who required blood testing as part of routine trauma care. MEASUREMENTS We quantified whole blood THC and blood alcohol concentration (BAC) and recorded driver sex, age and postal code, time of crash, crash type and injury severity. We defined three driver groups: high THC (THC ≥ 5 ng/ml and BAC = 0), high alcohol (BAC ≥ 0.08% and THC = 0) and THC/BAC-negative (THC = 0 = BAC). We used logistic regression techniques to identify factors associated with group membership. FINDINGS Most injured drivers (70.2%) were THC/BAC-negative; 1274 (18.3%) had THC > 0, including 186 (2.7%) in the high THC group; 1161 (16.7%) had BAC > 0, including 606 (8.7%) in the high BAC group. Males and drivers aged less than 45 years had higher adjusted odds of being in the high THC group (versus the THC/BAC-negative group). Importantly, 4.6% of drivers aged less than 19 years had THC ≥ 5 ng/ml, and drivers aged less than 19 years had higher unadjusted odds of being in the high THC group than drivers aged 45-54 years. Males, drivers aged 19-44 years, rural drivers, seriously injured drivers and drivers injured in single-vehicle, night-time or weekend collisions had higher adjusted odds ratios (aORs) for being in the high alcohol group (versus THC/BAC-negative). Drivers aged less than 35 or more than 65 years and drivers involved in multi-vehicle, daytime or weekday collisions had higher adjusted odds for being in the high THC group (versus the high BAC group). CONCLUSIONS In Canada, risk factors for cannabis-related motor vehicle collisions appear to differ from those for alcohol-related motor vehicle collisions. The collision factors associated with alcohol (single-vehicle, night-time, weekend, rural, serious injury) are not associated with cannabis-related collisions. Demographic factors (young drivers, male drivers) are associated with both alcohol and cannabis-related collisions, but are more strongly associated with cannabis-related collisions.
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Affiliation(s)
- J R Brubacher
- Department of Emergency Medicine, University of British Columbia, Columbia, BC, Canada
| | - H Chan
- Department of Emergency Medicine, University of British Columbia, Columbia, BC, Canada
| | - S Erdelyi
- Department of Emergency Medicine, University of British Columbia, Columbia, BC, Canada
| | - Y Yuan
- Department of Emergency Medicine, University of British Columbia, Columbia, BC, Canada
| | - R Daoust
- Department of Emergency Medicine, University of Montréal, Montréal, QC, Canada
| | - C Vaillancourt
- Department of Emergency Medicine, The Ottawa Hospital Research Institute, University of Ottawa, Ottawa, ON, Canada
| | - B Rowe
- Department of Emergency Medicine, University of Alberta, Edmonton, AB, Canada
| | - J Lee
- Department of Emergency Medicine, University of Toronto, Toronto, ON, Canada
| | - E Mercier
- Department of Emergency Medicine, Université Laval, Québec City, QC, Canada
| | - P Atkinson
- Department of Emergency Medicine, Dalhousie Medicine New Brunswick, St John, NB, Canada
| | - P Davis
- Department of Emergency Medicine, University of Saskatchewan, Saskatoon, SK, Canada
| | - D Clarke
- Department of Surgery (Neurosurgery), Dalhousie University, Halifax, NS, Canada
| | - J Taylor
- Department of Emergency Medicine, University of British Columbia, Columbia, BC, Canada
| | - A Macpherson
- Department of Emergency Medicine, University of British Columbia, Columbia, BC, Canada
| | - M Emond
- Department of Emergency Medicine, Université Laval, Québec City, QC, Canada
| | - D Al-Hakim
- Department of Emergency Medicine, University of British Columbia, Columbia, BC, Canada
| | - C Horwood
- Department of Emergency Medicine, Memorial University, St John, NB, Canada
| | - I Wishart
- Department of Emergency Medicine, University of Calgary, Calgary, AB, Canada
| | - K Magee
- Department of Emergency Medicine, Dalhousie University, Halifax, NS, Canada
| | - J Rao
- Department of Surgery, University of Saskatchewan, Saskatoon, SK, Canada
| | - J Eppler
- Department of Emergency Medicine, University of British Columbia, Columbia, BC, Canada
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