National Advanced Driving Simulator, University of Iowa, Iowa City, IA, USA; Department of Industrial and Systems Engineering, University of Iowa, Iowa City, IA, USA.
National Advanced Driving Simulator, University of Iowa, Iowa City, IA, USA; Department of Industrial and Systems Engineering, University of Iowa, Iowa City, IA, USA.
Forensic Sci Int. 2021 Nov;328:110902. doi: 10.1016/j.forsciint.2021.110902. Epub 2021 Jul 7.
Past research on cannabis has been limited in scope to THC potencies lower than legally available and efforts to integrate the effects into models of driving performance have not been attempted to date. The purpose of this systematic review is to understand the implications for modeling driving performance and describe future research needs. The risk of motor vehicle crashes increases 2-fold after smoking marijuana. Driving during acute cannabis intoxication impairs concentration, reaction time, along with a variety of other necessary driving-related skills. Changes to legislation in North America and abroad have led to an increase in cannabis' popularity. This has given rise to more potent strains, with higher THC concentrations than ever before. There is also rising usage of novel ingestion methods other than smoking, such as oral cannabis products (e.g., brownies, infused drinks, candies), vaping, and topicals. The PRISMA guidelines were followed to perform a systematic search of the PubMed database for peer-reviewed literature. Search terms were combined with keywords for driving performance: driving, performance, impairment. Grey literature was also reviewed, including congressional reports, committee reports, and roadside surveys. There is a large discrepancy between the types of cannabis products sold and what is researched. Almost all studies that used inhalation as the mode of ingestion with cannabis that is around 6% THC. This pales in comparison to the more potent strains being sold today which can exceed 20%. Which is to say nothing of extracts, which can contain 60% or more THC. Experimental protocol is another gap in research that needs to be filled. Methodologies that involve naturalistic (real world) driving environments, smoked rather than vaporized cannabis, and non-lab certified products introduce uncontrollable variables. When considering the available literature and the implications of modeling the impacts of cannabis on driving performance, two critical areas emerge that require additional research: The first is the role of cannabis potency. Second is the route of administration. Does the lower peak THC level result in smaller impacts on performance? How long does potential impairment last along the longer time-course associated with different pharmacokinetic profiles. It is critical for modeling efforts to understand the answers to these questions, accurately model the effects on driver performance, and by extension understand the risk to the public.
过去对大麻的研究范围仅限于比合法可用的 THC 效力更低的范围，并且迄今为止，尚未尝试将这些影响纳入驾驶表现模型中。本系统评价的目的是了解对建模驾驶表现的影响，并描述未来的研究需求。吸食大麻后，机动车事故的风险增加一倍。在急性大麻中毒期间驾驶会损害注意力、反应时间以及其他各种必要的驾驶相关技能。北美和其他国家/地区的立法变化导致大麻的普及度增加。这导致了更高的 THC 浓度和更高效力的菌株的出现。吸食大麻的新方法（例如，口服大麻产品，例如布朗尼、注入饮料、糖果）、蒸气和外用制剂的使用也在增加。按照 PRISMA 指南，对 PubMed 数据库中的同行评议文献进行了系统搜索。搜索术语与驾驶表现的关键词结合在一起：驾驶、表现、障碍。还审查了灰色文献，包括国会报告、委员会报告和路边调查。销售的大麻产品类型与研究内容之间存在很大差异。几乎所有使用 6% THC 左右的大麻吸入方式进行的研究都使用了吸入作为摄入方式。与当今销售的更有效力的菌株相比，这相形见绌，今天销售的更有效力的菌株可以超过 20%。更不用说含量可以达到 60%或更高的提取物了。实验方案是另一个需要填补的研究空白。涉及自然（现实世界）驾驶环境、吸食而不是蒸发大麻以及非实验室认证产品的方法学引入了不可控变量。考虑到现有的文献以及建模大麻对驾驶表现的影响的影响，有两个关键领域需要进一步研究：第一个是大麻效力的作用。第二个是给药途径。较低的 THC 峰值水平是否会导致对性能的影响较小？与不同药代动力学特征相关的较长时间过程中，潜在的损害会持续多长时间。了解这些问题的答案对于建模工作至关重要，以便准确地模拟对驾驶员表现的影响，并由此了解对公众的风险。
