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Abstract
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Does medical cannabis differ from recreational cannabis with respect to driving?
Defining medical cannabis.
Medical cannabis can refer to a wide variety of products and methods of preparation including herbal cannabis (the dried flowers of the cannabis plant) and cannabis extracts (e.g., oils, tinctures). In general, these products contain either THC or CBD as the primary active ingredient, or some combination of the two compounds. There is an ever-growing number of cannabis strains (varieties of the plant) which can vary substantially with respect to concentrations of THC, CBD, and other plant compounds. There are also several medical products with market authorization, such as Dronabinol and Sativex® (an oromucosal spray containing a 1:1 ratio of THC and CBD which is used to treat spasticity associated with multiple sclerosis).
An important issue in the provision of cannabis preparations for medical use is how it is consumed. Smoking is a common route of administration (and the traditional mode of consumption for recreational consumers) because it produces a rapid onset of drug effects. Safer and more precise methods of administration are available, however, such as vaporizing below the point of combustion (vaping) or ingesting oils or extracts. Smoking is not recommended as a route of administration because of its adverse health effects.
Relief of Symptoms ...
Tolerance
To date, most experimental studies of the effects of cannabis on driving have been conducted on healthy young drivers who use cannabis recreationally. By contrast, people who use cannabis medically typically use the drug more frequently than recreational consumers and, as a result, may develop pharmacological and behavioural tolerance to the effects of THC. In a study of occasional (less than once per week) versus heavy (primarily daily) cannabis consumers,4 there was no difference between groups in the subjective high experienced after a 10mg and 20mg dose of synthetic, medical THC. However, driving ...
THC content
Medical consumers may be more likely than recreational consumers to use cannabis products with lower THC content potentially reducing their collision risk ...
Should patients who are prescribed medical cannabis be given a medical designation for driving?
Those who use cannabis medically should do so under the supervision of a qualified medical professional. They are advised to titrate doses upward slowly as needed and as approved by a medical professional. They should refrain from driving in the first two weeks after initiation of cannabis use and after each increase in dose. They should also be made aware of legislation pertaining to medical use of cannabis in their jurisdiction.
Does CBD affect driving performance and can it counteract the effects of THC?
A recent on-road driving study showed CBD-dominant cannabis did not produce any driving impairment compared to placebo,13 although at least one study suggested CBD might be associated with impairment ...
Do novel synthetic cannabinoids (SCs) pose a risk to traffic safety?
Yes, novel SCs potentially pose a serious traffic safety risk.
While some medical cannabinoids have been synthetically manufactured for decades, novel SCs represent a large group of new psychoactive substances with 209 identified in the European Union (EU) over the 13 years between 1 January 2008 and 31 December 2020, including 11 identified for the first time in 2020.16 SCs are often sold as herbal smoking blends with names such as Spice, K2 and Kronic. SCs bind to the same receptors as tetrahydrocannabinol (THC) but often have far higher potency and efficacy ...
What is the prevalence of SCs in traffic crashes?
To date, research suggests the prevalence of SCs in traffic crashes is relatively low ...
How do the effects of synthetic cannabis differ/compare to natural cannabis?
SCs produce much stronger and more unpredictable effects than cannabis.
Both THC and SCs bind to the same cannabinoid receptor (CB1). Whereas natural THC acts as a relatively weak CB1 partial agonist, most SCs are full agonists. As a result, SCs are often much more potent (up to 85 times more potent than THC).17 SCs can also induce psychotomimetic (i.e., producing an effect similar to a psychotic state) more often and more strongly than natural cannabis ...
Can standard roadside tests detect SCs?
Current roadside tests have limited ability to detect SCs ...
Keywords: cannabis impaired driving |