A new Canadian study suggests that drivers who use cannabis up to three hours before driving are twice as likely to cause a collision as those not under the influence of drugs or alcohol. The researchers say that this is because Marijuana/Cannabis impairs brain and motor functions needed for safe driving. The study in bmj.com reviewed nine studies of 50,000 people worldwide who had been in serious or fatal crashes.
The study analysis was carried out by researchers at Dalhousie University in Halifax, Canada. The researchers looked at observational studies of collisions between one or more moving vehicles on a public road which involved the consumption of cannabis. Drivers of cars, sports utility vehicles, vans, lorries, buses and motorcycles featured in the studies.
“To our knowledge this meta-analysis is the first to examine the association between acute cannabis use and the risk of motor vehicle collisions in real life,” the researchers write in the latest issue of the British Medical Journal.
They noted that there was a near doubling of risk of a driver being involved in a motor vehicle collision resulting in serious injury or death if cannabis had been consumed less than three hours before. However, it added that the impact of acute cannabis consumption on the risk of minor crashes was still unclear.
Mark Asbridge, study author and associate professor at the department of community health and epidemiology at Dalhousie University, said the research was important. “Our findings provide clarity to the large body of research on cannabis and collision risk. They also offer support to existing policies, in many jurisdictions, that restrict driving under the influence of cannabis, and direct public health officials to devote greater attention to this issue.”
All studies tested for tetrahydrocannabinol, or THC, the active chemical in cannabis, by analyzing blood samples or using direct reports of cannabis use from those involved. Most studies used one nanogram per millilitre of cannabis or any amount greater than zero as the cut-off for a positive test result, with one study using a 2ng/ml cut-off.
Duncan Vernon, a road safety manager at the Royal Society for the Prevention of Accidents (RoSPA), said that previous studies in controlled lab conditions had shown that cannabis can impair a driver's ability to respond to potential dangers. “This new research strengthens the evidence that driving under the influence of cannabis increases the likelihood of being seriously injured or killed in a collision. This adds to the argument that a system needs to be put in place to monitor the number of serious and fatal accidents where impairment from illegal drugs was a contributory factor, so that appropriate action can be taken to prevent them,” he said.
Julie Townsend, deputy chief executive of road safety charity Brake, said that tackling drug driving should be a top priority. “This report highlights the danger posed by drivers who have smoked cannabis and adds weight to Brake's calls for widespread testing and prosecution of drivers.” In the UK, 18% of people killed in road crashes have traces of illegal drugs in their blood, with cannabis the most common, Brake says.
The European Monitoring Centre for Drugs and Drug Addiction found, in 2008 that between 0.3% and 7.4% of drivers tested positive for cannabis from roadside surveys in the United Kingdom, Denmark, the Netherlands, Norway, the United States, and Australia. National data collected in 2004 suggested that four per cent of Canadian adults reported driving within an hour of using pot, the researchers said.
The researchers conclude that despite the increased risk posed by cannabis to car drivers, alcohol remains the substance most often present in crashes. The observed association between alcohol and crash risk is more significant than that for cannabis, the study adds.
“The level of impairment might not be as severe as alcohol intoxication, but it's there and it does require a public health response,” says Professor Wayne Hall from the University of Queensland Centre for Clinical Research. But it is unclear whether road side drug testing is effective, argues Hall in a separate commentary in the BMJ. “We've implemented this policy in most states and territories [in Australia] and there just doesn't seem to be the commitment to finding out whether this has been effective or not,” he says.
The problem, argues Hall, is that roadside drug testing has been modeled on the success of random breath testing, but hasn't been evaluated or implemented with the same rigor. “We don't really know if that's worked and there are very important differences in which road side drug testing has been done compared with random breath testing,” he says. While it is relatively easy to measure blood alcohol levels using a breath test, it is much harder to gauge impairment from concentrations of THC in the saliva, so governments use 'zero tolerance' to define impairment, he says. “They've [governments] simplified it in a sense and avoided the issue of what the level [where driving is impaired] might be.”
The other issue is that road side testing hasn't been as widely implemented or as well publicized as random breath testing, he says. “I think we need to look at the extent to which people who use cannabis are deterred from driving when they use cannabis. Are they fearful of being detected? Is this a realistic deterrent? We need to do similar things with cannabis [that we did with random breath testing], and probably focus more on younger drivers because that's where use is likely to be highest.”
NORML, the National Organization for the Reform of Marijuana Laws, wrote its own report on stoned driving in 2011. The report concluded that driving high may be riskier than driving sober, but it's much safer than driving drunk, according to HealthDay.
“Unlike subjects impaired by alcohol, individuals under the influence of cannabis tend to be aware of their impairment and try to compensate for it accordingly, either by driving more cautiously or by expressing an unwillingness to drive altogether,” wrote the report's author, Paul Armentano, deputy director of NORML.
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