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Journal Article

Citation

Bhatia G, Sharma P. Asian J. Psychiatry 2022; 73: e103173.

Copyright

(Copyright © 2022, Elsevier Publishing)

DOI

10.1016/j.ajp.2022.103173

PMID

35623272

Abstract

Cannabis is the most commonly used illicit substance globally (Preuss et al., 2021). Several nations decriminalized and/or legalized cannabis use for medical and recreational purposes in the past two decades. The change that started with California in 1996, grew to 37 states in the US along with 4 territories and the District of Columbia (The State of U.S. Cannabis Legalization in 2022, 2022). South- Asian countries, initially reluctant to accept these changes of policy, also took a few steps in this direction in the last 3-4 years. Thailand, South Korea and Japan legalized medical marijuana in 2019, while India, Malaysia, Myanmar, Singapore, Afghanistan, Nepal, Pakistan and other countries continue to maintain their punitive stance against cannabis use (Root, 2022).

Legal or not, the association between cannabis and road traffic accidents cannot and should not be ignored. Several meta-analyses and systematic reviews indicated significantly increased odds (OR ranging from 1.31 to 3.63) of road traffic accidents while driving after cannabis use (Aydelotte et al., 2021, Martin et al., 2017). There is also an indication of a dose-dependent delay in responsiveness among drivers under the influence of cannabis (Li et al., 2012). After alcohol, Tetra-hydro cannabinol (THC) is the most frequently found psychoactive substance in the blood of drivers involved in road traffic accidents (Hostiuc et al., 2018). In the past decade, rates of driving under the influence of cannabis have increased. The 2012 DRUID (Driving Under the Influence of Drugs, Alcohol and Medicines) Project under EMCDDA (European Monitoring Centre for Drugs Drug Addiction), included 50,000 drivers from 13 countries and reported cannabis use while driving in 1.32% drivers, out of whom 27% were involved in car crashes and up to 7.6% of them were severely injured. More recent data from the US reported prevalence of "cannabis positive driving" as high as 11.1% (Martin et al., 2017). Research has also indicated a noticeable increase in road traffic accidents in the nations that legalized recreational cannabis. The AAA Foundation for Traffic Safety's report in 2020 from Washington stated that prior to the legalization of marijuana in the state, about 8.8% of drivers involved in fatal traffic crashes tested positive for THC. This figure doubled to 18% in the next 2 years and within 5 years of legalization, 21.7% of drivers involved in fatal accidents were THC-positive (Aydelotte et al., 2017, Watkins, 2021). Similar observations have been reported from the states of California, Colorado, Nevada and Oregon among others (Insurance Institute for Highway Safety and Highway Loss Data Institute, 2021).

Studies estimate more than 24 million cannabis users in South East Asia region, out of which up to 1.6% belong to the age group of 15-64 years, a population group most likely to be driving or engaged in associated activities...

Keywords: Cannabis impaired driving


Language: en

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