Combined effect of alcohol and cannabis on simulated driving

Fares, Andrew; Wickens, Christine M.; Mann, Robert E.; Ciano, Patricia Di; Wright, Madison; Matheson, Justin; Hasan, Omer Syed Muhammad; Rehm, Jürgen; George, Tony P.; Samokhvalov, Andriy V.; Shuper, Paul A.; Huestis, Marilyn A.; Stoduto, Gina; Brown, Timothy L.; Stefan, Cristiana; Rubin-Kahana, Dafna Sara; Foll, Bernard Le; Brands, Bruna

doi:10.1007/s00213-021-05773-3

Cited by 26 publications

(33 citation statements)

References 36 publications

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“…With respect to the use of cannabis, simulator studies have found important changes in driving after use of cannabis. Where effects on simulated driving have been found, the most consistent are on measures of lane control (Arkell et al, 2019;Fares et al, 2021;Hartman et al, 2015;Micallef et al, 2018;Ramaekers et al, 2000;Robbe, 1998;Ronen et al, 2008Ronen et al, , 2010. Another reported finding is a decrease in speed (Anderson et al, 2010a;Brands et al, 2019;Hartman, Brown, Milavetz, Spurgin, Pierce, et al, 2016;Lenné et al, 2010;Ronen et al, 2008), but this is not a consistent result (Arkell et al, 2019;Ronen et al, 2010).…”

Section: Overview Of the Effects Of Alcohol Or Cannabis Alone On Simu...mentioning

confidence: 99%

“…More recently, a study evaluated the effects of higher doses of alcohol and THC than previously reported on simulated driving performance (Fares et al, 2021). Participants were given alcohol to attain a target BrAC was 0.08%, but at the time of driving the average BrAC was approximately 0.09%.…”

Section: Effects Of Combinations Of Alcohol and Cannabis On Simulated...mentioning

confidence: 99%

“…Conversely, some studies have found that alcohol has no effect on THC blood concentrations. Fares et al (2021) observed that an intoxicating dose of alcohol (0.08 BrAC) combined with smoked cannabis (12.5% THC) did not result in blood THC levels that were different in the combined or cannabis alone conditions, despite smoking the same amount in the two conditions (Fares et al, 2021). A similar study administered alcohol (0.42, 0.85 g/kg) and 15 min later administered a smoked cannabis cigarette (2.4% THC) and found that alcohol did not significantly affect THC plasma concentrations (Perez-Reyes et al, 1988).…”

Section: Effects Of Alcohol On Blood Thc Concentrationsmentioning

confidence: 99%

“…Some studies have examined sex differences in simulated driver behaviour while under the influence of cannabis and found no differences between males and females (Anderson et al, 2010a(Anderson et al, , 2010bBrands et al, 2019). Similarly, Fares et al (2021) examined driver performance under the influence of alcohol and cannabis and did not find any sex differences (Fares et al, 2021), although more research is required in this area.…”

Section: Sex and Gender Considerationsmentioning

confidence: 99%

“…The effects of use of both drugs on speed variables are less consistent. While Ronen et al (2010) found that the combination had no effect on speed relative to double placebo, Fares et al (2021) reported a significant increase in standard deviation of speed, compared to double placebo and cannabis alone, and maximum speed, compared to double placebo, in their dual task drive (Fares et al, 2021). However, there was no effect of the drug combinations on mean speed.…”

Section: Effects Of Combinations Of Alcohol and Cannabis On Simulated...mentioning

confidence: 99%

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Effects of combining alcohol and cannabis on driving, breath alcohol level, blood THC, cognition, and subjective effects: A narrative review.

Fares¹,

Wright²,

Matheson³

et al. 2022

Experimental and Clinical Psychopharmacology

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Alcohol and cannabis are the two most commonly found intoxicating substances in fatally injured drivers. Epidemiological studies have demonstrated that the use of alcohol or cannabis can lead to an increase in the risk of a motor vehicle collision. Reducing the risks associated with driving under the influence of alcohol or cannabis is achieved partly through roadside detection of breath alcohol concentrations (BrAC) or blood delta-9-tetrahydrocannabinol (THC) levels. The purpose of the present review is to compile the laboratory studies on the combined effects of alcohol and cannabis on simulated driving as well as those evaluating combinations of these drugs on BrAC or blood THC. Given that driving can be affected by a number of cognitive processes, the literature on the cognitive effects of combinations of alcohol and cannabis is also reviewed, along with a discussion of a potential additive effect on the subjective qualities of these drugs. In sum, it is concluded that alcohol and cannabis have additive effects on driving skills, cognition and subjective effects. Public Health SignificanceAlcohol and cannabis are the two most commonly found intoxicating substances in fatally injured drivers. In the present review, we present evidence that the use of these two drugs at the same time produces additive effects on driving and other measures. Despite this, evidence that breath alcohol levels or blood delta-9-tetrahydrocannabinol (THC) are impacted by co-use of these drugs is inconclusive.

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Section: Overview Of the Effects Of Alcohol Or Cannabis Alone On Simu...mentioning

confidence: 99%

Section: Effects Of Combinations Of Alcohol and Cannabis On Simulated...mentioning

confidence: 99%

Section: Effects Of Alcohol On Blood Thc Concentrationsmentioning

confidence: 99%

Section: Sex and Gender Considerationsmentioning

confidence: 99%

Section: Effects Of Combinations Of Alcohol and Cannabis On Simulated...mentioning

confidence: 99%

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Effects of combining alcohol and cannabis on driving, breath alcohol level, blood THC, cognition, and subjective effects: A narrative review.

Fares¹,

Wright²,

Matheson³

et al. 2022

Experimental and Clinical Psychopharmacology

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Cannabis and Driving in Older Adults

Di Ciano,

Rajji,

Hong

et al. 2024

JAMA Netw Open

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ImportanceEpidemiological studies have found that cannabis increases the risk of a motor vehicle collision. Cannabis use is increasing in older adults, but laboratory studies of the association between cannabis and driving in people aged older than 65 years are lacking.ObjectiveTo investigate the association between cannabis, simulated driving, and concurrent blood tetrahydrocannabinol (THC) levels in older adults.Design, Setting, and ParticipantsUsing an ecologically valid counterbalanced design, in this cohort study, regular cannabis users operated a driving simulator before, 30 minutes after, and 180 minutes after smoking their preferred legal cannabis or after resting. This study was conducted in Toronto, Canada, between March and November 2022 with no follow-up period. Data were analyzed from December 2022 to February 2023.ExposuresMost participants chose THC-dominant cannabis with a mean (SD) content of 18.74% (6.12%) THC and 1.46% (3.37%) cannabidiol (CBD).Main outcomes and measuresThe primary end point was SD of lateral position (SDLP, or weaving). Secondary outcomes were mean speed (MS), maximum speed, SD of speed, and reaction time. Driving was assessed under both single-task and dual-task (distracted) conditions. Blood THC and metabolites of THC and CBD were also measured at the time of the drives.ResultsA total of 31 participants (21 male [68%]; 29 White [94%], 1 Latin American [3%], and 1 mixed race [3%]; mean [SD] age, 68.7 [3.5] years), completed all study procedures. SDLP was increased and MS was decreased at 30 but not 180 minutes after smoking cannabis compared with the control condition in both the single-task (SDLP effect size [ES], 0.30; b = 1.65; 95% CI, 0.37 to 2.93; MS ES, −0.58; b = −2.46; 95% CI, −3.56 to −1.36) and dual-task (SDLP ES, 0.27; b = 1.75; 95% CI, 0.21 to 3.28; MS ES, −0.47; b = −3.15; 95% CI, −5.05 to −1.24) conditions. Blood THC levels were significantly increased at 30 minutes but not 180 minutes. Blood THC was not correlated with SDLP or MS at 30 minutes, and SDLP was not correlated with MS. Subjective ratings remained elevated for 5 hours and participants reported that they were less willing to drive at 3 hours after smoking.Conclusions and relevanceIn this cohort study, the findings suggested that older drivers should exercise caution after smoking cannabis.

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Alignment of subjective and objective driving impairment following alcohol and cannabis use: A systematic review

Love

Larue

Rowland

2023

Applied Cognitive Psychology

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This systematic review investigated the alignment of objective and subjective driving impairment following alcohol and cannabis administration. Under PRISMA guidelines, a literature search was conducted on various research databases. Studies (N = 20) were included if they were within‐subjects designs, included acute alcohol or cannabis administration, and implemented both objective and subjective measures of driving performance. The review revealed that although the current evidence was limited, there was an apparent (albeit inconsistent) alignment between subjective and objective measures of driving impairment for both alcohol and cannabis conditions. Notably, preliminary evidence suggested that heavier alcohol users may be inclined to underestimate their impairment, whilst cannabis users may overestimate the level of their impairment. However, the current literature was considered limited due to the absence of adequate analytical support, the simplistic (and potentially misleading) approaches to measuring impairment, and the lack of inquiry into how interpersonal differences mediate the subjective‐objective relationship.

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Combined effect of alcohol and cannabis on simulated driving

Cited by 26 publications

References 36 publications

Effects of combining alcohol and cannabis on driving, breath alcohol level, blood THC, cognition, and subjective effects: A narrative review.

Effects of combining alcohol and cannabis on driving, breath alcohol level, blood THC, cognition, and subjective effects: A narrative review.

Cannabis and Driving in Older Adults

Alignment of subjective and objective driving impairment following alcohol and cannabis use: A systematic review

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