People Against Drink/Drug Driving

Cannabis-Involved Traffic Injury Emergency Department Visits After Cannabis Legalization and Commercialization

JAMA Netw Open. 2023;6(9):e2331551. doi:10.1001/jamanetworkopen.2023.31551

Key Points

Question  Have cannabis-involved traffic injury emergency department visits changed after cannabis legalization and the subsequent commercialization of the cannabis retail market (ie, store and product expansion) in Ontario, Canada?

Findings  In this cross-sectional study capturing 426 cannabis-involved traffic injury emergency department visits, annual rates of cannabis involvement increased by 475.3% over 13 years. After accounting for time trends, legalization with restrictions was not associated with increased cannabis involvement during traffic injury emergency department visits; however, market commercialization, which overlapped with the COVID-19 pandemic, was.

Conclusions and Relevance  This cross-sectional study found large increases in cannabis involvement in ED visits for traffic injury over time, which may have accelerated following nonmedical cannabis commercialization. Although the frequency of visits was rare, they may reflect broader changes in cannabis-impaired driving. Greater prevention efforts, including targeted education and policy measures, in regions with legal cannabis are indicated.

(Source: Emergency Medicine | JAMA Network Open | JAMA Network

Subtle but pervasive changes can occur between uses.

Understanding THC’s interaction with the brain’s important natural cannabinoid chemistry and physiology will now make sense of the impact that overly frequent cannabis use has on the brain and mental functioning.

Because THC stimulates our brain’s natural cannabinoid receptors (CB1) far more strongly and longer than the endogenous cannabinoid neurotransmitters anandamide and 2-AG, cannabis use throws brain chemistry out of balance temporarily, usually to people’s enjoyment. This loss of chemical equilibrium lasts an average of 4 hours when cannabis is inhaled and 8 hours when ingested orally before the liver metabolizes the THC and it is eliminated in the feces (55%) and urine (20%).

Most occasional cannabis users feel little or no effect the following day, but an interesting experiment reveals a subtle impact 24 hours after smoking a single joint. Private licensed pilots with over 200 hours of flight experience had their baseline skills measured in a flight simulator, then were provided a joint containing 10 or 20 mgs of THC to smoke. This was considered the equivalent of a moderate social dose in the mid-1980s.

A variety of pilot actions during routine landings were impaired 24 hours after smoking the joint, including the number and size of adjustments to stabilize the plane, distance off center on landing, and vertical and lateral deviation on approach to landing. Pilots showed no awareness of these impairments. Performance returned to baseline 48 hours after being high.

When the task became more complex by introducing turbulent weather conditions calling on pilots to react in real time to avoid trouble, responses were slower and less well organized than their baseline performance. In other words, the pilots’ response to novel events was altered (see the post How Cannabis Makes Everything So Interesting for clarification on the role our internal cannabinoid system plays in the experience of novelty.)

When THC stimulates CB1 receptors in the amygdala, cannabinoid tone increases, lowering the bar for any stimulus being imbued with a sense of novelty. Novelty draws our attention to unexpected stimuli. This phenomenon is largely responsible for cannabis making everything more interesting. But this is not the end of the story.

Whenever neurons containing CB1 receptors are over-stimulated by THC’s stronger and longer activation, a homeostatic response follows in an effort to rebalance the brain. The phrase “over-stimulated” means only that THC’s stimulation of CB1 receptors exceeds normal physiologic levels, leading to greater than normal negative feedback on the neuron’s release of transmitters with each firing. THC quells neuronal activity not by reducing the rate of nerve cell firing, but rather the amount of transmitter released each time the neuron fires.

As a result, neurons immediately react to THC’s over-stimulation by reducing the number of CB1 receptors. This reduction of receptors is called downregulation. A variety of mechanisms, including pulling receptors inside the cell so they are no longer available to be stimulated, begins with a single exposure to cannabis. By downregulating CB1 receptors, neurons partially regain some balance. Fewer receptors reduce the amount of negative feedback produced by cannabinoid stimulation and a more physiologic balance is re-established.

After THC has been metabolized and eliminated, CB1 receptors begin upregulating back to their normal level of availability. Upregulation after a single or occasional dose of cannabis occurs rapidly. Most people feel unaffected the following day.

For More: Source

Anyone claiming they’re “fine to drive” after a couple of beers may think again after seeing the results of a scary test in Japan.

We’ve all heard it: “I’m fine, mate”, “It’s only 10 minutes away”, “I’m not coming back for my car tomorrow”.

But anyone claiming they’re “fine to drive” after a quiet couple of beers might want to think again after seeing the results of a peculiar test undertaken by this Japanese driving school.

Marking 17 years since the tragic drunk driving death of three small children in the city of Fukuoka, authorities opted for an unorthodox approach to getting the message across.

Chikushino Driving School has now begun offering controlled drink-driving experiences as part of a police campaign to convince motorists to never drink and drive.

Two reporters from the local Mainichi Shimbun newspaper took the test to see exactly how just a few drinks can impair someone.

The participants are asked to navigate three road sections, including a slalom, S-bend, and tight curves. First while sober, and then again after a social amount of booze.

One of the reporters, Hyelim Ha, was then told to down a 350ml can of beer, along with cups of umeshu plum wine and shochu spirit over about an hour.

A breathalyser test on Ha indicated an alcohol level of 0.30mg per litre of breath, twice the threshold of 0.15mg.

Despite saying she felt confident to drive, as many do, Ms Ha’s driving ability plummeted. But not in a way that she would immediately notice herself.

Drink driving causes approximately 30 per cent of fatal crashes in Australia, with over one in four drivers and passengers killed showing a blood-alcohol content over the legal limit.

In 2022, there were 1192 road fatalities in Australia, marking a 5.6 per cent increase on 2021. While fatalities have generally decreased over the past decade, from about 1300 to 1100 per year, there were 107 deaths on Australian roads in March alone.

For complete story   Alex Blair

Channel 7 released news on State governments Cannabis and Driving Trials…“It is currently illegal for residents to drive while under the influence of THC, the main psychoactive chemical in marijuana.

Victorian medicinal cannabis users will be put through a closed-track trial to see when it’s safe for them to get behind the wheel. The 18-month trial will look at the level of impairment medicinal cannabis can cause.

It will not take place on public roads to ensure there’s no safety risk to participants or members of the public, a government spokeswoman said.  Victorian medicinal cannabis users will be put through a closed-track trial to see when it’s safe for them to get behind the wheel. The 18-month trial will look at the level of impairment medicinal cannabis can cause.

It will not take place on public roads to ensure there’s no safety risk to participants or members of the public, a government spokeswoman said. “Safety on our roads is our No.1 priority,” the statement read. “This trial will give us more data about when medicinal cannabis patients can safely drive on the road.” (source: 7NEWS)

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So, another trial? But why?  Extensive research has been done globally on this issue around THC and driving impairment, and pretty much all of it uncovers what we intuitively know, that is DOES! Ah, but there was some ‘outliers’ and one such ‘study’ was from a Melbourne based University. A group commissioned by pro-cannabis legalisation groups to conduct a study. 

Not unsurprisingly, the findings in this study were far more ‘agnostic’ and even producing a finding that THC and driving wasn’t really a problem – for ‘medical users’ of course!

We here at People Against Drink and Drug Driving will be interested to see where this ‘study’ will land - in agreement with the current research or contra to it?

See also 

• 'Medicinal’ Cannabis & Driving – Is it an Issue? (DRR)
• Cannabis & Driving – Research continues to Affirm the Risks & Dangers of THC (Cannabis) Use and Driving
• Legalizing Cannabis and Impaired Driving – Canadian Report
• Cannabis Effects on Driving Performance: Clinical Consideration
• ‘Medical cannabis’ and Driving, Australia (AJGP 21)
• Expanding Law Enforcement Training, Forensic Lab Capacity and Research to Better Detect Cannabis Impaired Driving

Drinking and driving continue to be a serious problem, but it has been eclipsed by drugging and driving – such is the power of ‘education’. Education against drink driving and education for ‘normalising’ drug use.

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