Pressley Joyce C, Arora Arushi, Sarmah Raina
1Columbia University Mailman School of Public Health Departments of Epidemiology and Health Policy and Management, 722 West 168th St., New York, NY 10032 USA.
Health Policy and Management, New York, NY USA.
Inj Epidemiol. 2019 May 29;6(Suppl 1):25. doi: 10.1186/s40621-019-0204-0. eCollection 2019.
Although the growth of state-level legalization of marijuana is aimed at increasing availability for adults and the chronically ill, one fear is that this trend may also increase accessibility in younger populations. The objectives of this study are to evaluate marijuana use in teen driver study participants and to compare their survey self-reported use with oral fluid and blood tests for psychoactive metabolites of tetrahydrocannabinol (THC).
The National Roadside Survey (NRS) of 2013-2014 was used to examine marijuana use in drivers aged 16-19 years. Of 11,100 drivers surveyed at 300 U.S. locations in 24 states, 718 were 16-19 years, and 666 (92.8%) provided oral fluid and/or blood. We examined weighted and unweighted data, but present unweighted findings. Kappa statistics, Chi square, and multivariable logistic regressions were used to assess agreement, associations and independent predictors of outcomes.
More than one-quarter (203/718) of teen drivers reported either using marijuana in the last year or were THC positive. Overall incidence of a THC positive fluid test was 13.7%. In addition to 175 (27.3%) teen drivers who reported use in the last year, 28 (4.4%) who denied using in the past year, tested positive for THC. Of 45 teen drivers reporting use in the last 24 h, more than two-thirds (71.1%) were THC positive. Disagreement between the oral and blood test for 305 teen drivers who had both tests was 17 (5.6%), with a Kappa of 0.78 (95% CI 0.69-0.88). Of THC-positive drivers, nearly 20% started drinking alcohol by age 14 and more than 70% by age 16. Age, gender- and income-adjusted independent predictors of a positive THC test included survey completion during the school year (OR 3.2, 95% CI 1.6-6.2), survey-reported marijuana use in last year (OR 5.3, 95% CI 3.0-9.2), current smoker (OR 2.1, 95% CI 1.1-3.7), and alcohol consumption before age 16 (OR 2.3, 95% CI 1.1-3.7).
Although specific THC thresholds for safe driving have not been established, taken in the context of teen crash statistics, THC documented impairments and rapidly relaxing marijuana laws, these findings suggest the need for increased vigilance and stepped-up surveillance in teen drivers.
尽管州级大麻合法化的发展旨在使成年人和慢性病患者更容易获取大麻，但人们担心这一趋势可能也会增加年轻人群体获取大麻的机会。本研究的目的是评估青少年驾驶员研究参与者中大麻的使用情况，并将他们在调查中自我报告的使用情况与针对四氢大麻酚（THC）精神活性代谢物的唾液和血液检测结果进行比较。
使用2013 - 2014年的全国路边调查（NRS）来研究16 - 19岁驾驶员中大麻的使用情况。在24个州的300个美国地点对11100名驾驶员进行了调查，其中718名年龄在16 - 19岁，666名（92.8%）提供了唾液和/或血液样本。我们检查了加权和未加权数据，但呈现的是未加权结果。使用卡方统计、卡方检验和多变量逻辑回归来评估一致性、关联性和结果的独立预测因素。
超过四分之一（203/718）的青少年驾驶员报告在过去一年中使用过大麻或THC检测呈阳性。THC唾液检测呈阳性的总体发生率为13.7%。除了175名（27.3%）报告在过去一年中使用过大麻的青少年驾驶员外，28名（4.4%）否认在过去一年中使用过大麻的驾驶员THC检测呈阳性。在45名报告在过去24小时内使用过大麻的青少年驾驶员中，超过三分之二（71.1%）的人THC检测呈阳性。对305名同时进行了唾液和血液检测的青少年驾驶员来说，唾液和血液检测结果的不一致率为17例（5.6%），卡方值为0.78（95%可信区间0.69 - 0.88）。在THC检测呈阳性的驾驶员中，近20%在14岁前开始饮酒，超过70%在16岁前开始饮酒。经年龄、性别和收入调整后，THC检测呈阳性的独立预测因素包括在学年期间完成调查（比值比3.2，95%可信区间1.6 - 6.2）、调查中报告在过去一年中使用过大麻（比值比5.3，95%可信区间3.0 - 9.2）、当前吸烟者（比值比2.1，95%可信区间1.1 - 3.7）以及在16岁前饮酒（比值比2.3，95%可信区间1.1 - 3.7）。
尽管尚未确定安全驾驶的具体THC阈值，但结合青少年车祸统计数据、记录在案的THC损害以及迅速放宽的大麻法律来看，这些发现表明有必要提高对青少年驾驶员的警惕并加强监测。
