Bondallaz Percy, Favrat Bernard, Chtioui Haïthem, Fornari Eleonora, Maeder Philippe, Giroud Christian
Traffic Medicine and Psychology Unit, University Center of Legal Medicine, University Hospital of Geneva, Rue Gabrielle-Perret-Gentil 4, 1205 Genève, Switzerland.
Traffic Medicine and Psychology Unit, University Center of Legal Medicine, University Hospital of Geneva, Rue Gabrielle-Perret-Gentil 4, 1205 Genève, Switzerland; Department of Ambulatory Care and Community Medicine, University of Lausanne, Rue du Bugnon 44, 1011 Lausanne, Switzerland; Traffic Medicine and Psychology Unit, University Center of Legal Medicine, University Hospital of Lausanne, Lausanne, Switzerland.
Forensic Sci Int. 2016 Nov;268:92-102. doi: 10.1016/j.forsciint.2016.09.007. Epub 2016 Sep 16.
Traffic policies show growing concerns about driving under the influence of cannabis, since cannabinoids are one of the most frequently encountered psychoactive substances in the blood of drivers who are drug-impaired and/or involved in accidents, and in the context of a legalization of medical marijuana and of recreational use. The neurobiological mechanisms underlying the effects of cannabis on safe driving remain poorly understood. In order to better understand its acute and long-term effects on psychomotor functions involved in the short term ability and long-term fitness to drive, experimental research has been conducted based on laboratory, simulator or on-road studies, as well as on structural and functional brain imaging. Results presented in this review show a cannabis-induced impairment of actual driving performance by increasing lane weaving and mean distance headway to the preceding vehicle. Acute and long-term dose-dependent impairments of specific cognitive functions and psychomotor abilities were also noted, extending beyond a few weeks after the cessation of use. Some discrepancies found between these studies could be explained by factors such as history of cannabis use, routes of administration, dose ranges, or study designs (e.g. treatment blinding). Moreover, use of both alcohol and cannabis has been shown to lead to greater odds of making an error than use of either alcohol or cannabis alone. Although the correlation between blood or oral fluid concentrations and psychoactive effects of THC needs a better understanding, blood sampling has been shown to be the most effective way to evaluate the level of impairment of drivers under the influence of cannabis. The blood tests have also shown to be useful to highlight a chronic use of cannabis that suggests an addiction and therefore a long-term unfitness to drive. Besides blood, hair and repeated urine analyses are useful to confirm abstinence.
交通政策显示出对大麻影响下驾驶的日益关注，因为大麻素是在药物影响下和/或发生事故的驾驶员血液中最常遇到的精神活性物质之一，且处于医用大麻和娱乐用大麻合法化的背景下。大麻对安全驾驶影响的神经生物学机制仍知之甚少。为了更好地了解其对涉及短期驾驶能力和长期驾驶适应性的心理运动功能的急性和长期影响，已基于实验室、模拟器或道路研究以及结构和功能脑成像进行了实验研究。本综述中呈现的结果表明，大麻会通过增加车道偏移和与前车的平均车头间距来损害实际驾驶性能。还注意到特定认知功能和心理运动能力存在急性和长期的剂量依赖性损害，这种损害在停止使用后数周仍会持续。这些研究之间发现的一些差异可以用大麻使用史、给药途径、剂量范围或研究设计（如治疗盲法）等因素来解释。此外，已表明同时使用酒精和大麻比单独使用酒精或大麻更容易出错。尽管血液或口腔液浓度与四氢大麻酚精神活性作用之间的相关性需要更好地理解，但血液采样已被证明是评估受大麻影响的驾驶员受损程度的最有效方法。血液检测也已证明有助于发现长期使用大麻的情况，这表明存在成瘾问题，因此长期不适合驾驶。除了血液检测，毛发和多次尿液分析有助于确认戒断情况。
