Driving Under the Influence: Cannabis

Medical cannabis has become much more popular, and legal in several states across the nation, although still illegal under federal law. It can be very helpful for people with chronic pain, yet is it safe on the roads?

More than 50 percent of people who take medical cannabis for chronic pain said they’ve driven within two hours of using it and at least one time in the last six months. This is according to a new study by the University of Michigan Addiction Center report in the journal Drug & Alcohol Dependence. And one in five of them said they’d driven while “very high” in the past six months.

These results of a survey of 790 Michigan medical cannabis users are troubling for lead author Erin E. Bonar, Ph.D., assistant professor of psychiatry and a practicing clinical psychologist at the U-M Addiction Treatment Services.

When drivers are under the influence of marijuana, medical or not, their coordination and reaction time may be slowed down and make it more difficult for them to respond to unexpected road hazards. This means that the likelihood of them becoming involved in a automobile crash is much higher than normal, says Bonar.

There are almost 270,000 Americans in the state of Michigan who have state approval to use medical marijuana as of May 2018, and more in California; in fact California has the highest number of medical marijuana patients in a state, followed by Michigan.

“There is a low perceived risk about driving after using marijuana, but we want people to know that they should ideally wait several hours to operate a vehicle after using cannabis, regardless of whether it is for medical use or not,” Bonar said. “The safest strategy is to not drive at all on the day you used marijuana.”

In addition, Bonar says there is uncertainty about how marijuana could affect the driving of those who are chronic users, as the cannabis can have longer lasting effects lingering in their system.

To add complexity to the issue, several states, including California and Michigan, allow recreational marijuana use now. Residents over the age of 21 can use marijuana inside a private residence, and to grow up to 12 plants for personal use. Retail sales are only allowed for those with medical marijuana cards issued by the state. Marijuana use and possession remains illegal under federal law.

Bonar wants people to know, especially cannabis users, to have a clear understanding of the side effects of this drug, especially in light of this policy change.

“When it comes to driving, we haven’t yet figured out the best way to know how impaired marijuana users are at any given time,” she remarks. “With alcohol, you can do some quick math based on the amount you drank, and take an educated guess at your blood alcohol level. For marijuana, an estimate like this would be complicated. It’s hard to quantify because there is a lot of variation in marijuana dosing, THC potency, and route of administration. We also don’t have specific guidelines yet about when exactly it would be safe to operate a vehicle.”

Bonar says the goal of her team’s study is to help medical marijuana users to be safer on the roads.

“We believe more research is needed to inform a larger public education effort that will help individuals understand the risks for themselves, and others, of driving while under the influence of cannabis,” Bonar says. “It is especially needed during this time of rapid policy change as many states are determining how to manage marijuana legalization. We also need clearer guidelines about marijuana dosing and side effects with an understanding of how individual differences in things like sex and body weight interact as well.”

This study was funded by the National Institute on Drug Abuse. The lead project investigator was Mark Ilgen, Ph.D., director of UMATS. Additional study authors include James Cranford, Ph.D., Brooke Arterberry, Ph.D., Maureen Walton, M.P.H., Ph.D., and Kipling M. Bohnert, Ph.D.

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