Institute for Mental Health Policy Research, Centre for Addiction and Mental Health, Toronto, Ontario, Canada.
Department of Pharmacology and Toxicology, University of Toronto, Toronto, Ontario, Canada.
JAMA Netw Open. 2024 Jan 2;7(1):e2352233. doi: 10.1001/jamanetworkopen.2023.52233.
Epidemiological 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.
To investigate the association between cannabis, simulated driving, and concurrent blood tetrahydrocannabinol (THC) levels in older adults.
DESIGN, SETTING, AND PARTICIPANTS: Using 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.
Most participants chose THC-dominant cannabis with a mean (SD) content of 18.74% (6.12%) THC and 1.46% (3.37%) cannabidiol (CBD).
The 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.
A 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.
In this cohort study, the findings suggested that older drivers should exercise caution after smoking cannabis.
流行病学研究发现，大麻会增加发生机动车碰撞的风险。大麻在老年人中的使用正在增加，但缺乏针对 65 岁以上人群中大麻与驾驶之间关联的实验室研究。
调查大麻、模拟驾驶以及 65 岁以上老年人同时存在的血液四氢大麻酚 (THC) 水平之间的关联。
设计、地点和参与者：在这项队列研究中，使用生态有效的平衡设计，经常使用大麻的人在吸烟后 30 分钟和 180 分钟以及休息后驾驶模拟驾驶装置。该研究于 2022 年 3 月至 11 月在加拿大多伦多进行，无随访期。数据分析于 2022 年 12 月至 2023 年 2 月进行。
大多数参与者选择了 THC 含量高的大麻，其平均（SD）含量为 18.74%（6.12%）的 THC 和 1.46%（3.37%）的大麻二酚 (CBD)。
主要终点是横向位置标准差 (SDLP，或编织)。次要结果是平均速度 (MS)、最大速度、速度标准差和反应时间。在单任务和双任务（分心）条件下评估驾驶。在驾驶时还测量了血液 THC 及其代谢物 THC 和 CBD 的水平。
共有 31 名参与者（21 名男性[68%]；29 名白人[94%]，1 名拉丁裔[3%]，1 名混合种族[3%]；平均[SD]年龄，68.7 [3.5] 岁）完成了所有研究程序。与对照条件相比，吸烟大麻后 30 分钟但不是 180 分钟，SDLP 增加，MS 降低，无论是在单任务（SDLP ES，0.30；b = 1.65；95%CI，0.37 至 2.93；MS ES，-0.58；b = -2.46；95%CI，-3.56 至-1.36）还是双任务（SDLP ES，0.27；b = 1.75；95%CI，0.21 至 3.28；MS ES，-0.47；b = -3.15；95%CI，-5.05 至-1.24）条件下。30 分钟时血液 THC 水平显著升高，但 180 分钟时未升高。30 分钟时血液 THC 与 SDLP 或 MS 无相关性，而 SDLP 与 MS 无相关性。主观评分在 5 小时内保持升高，参与者报告在吸烟后 3 小时内不太愿意驾驶。
在这项队列研究中，研究结果表明，老年司机在吸烟后应谨慎驾驶。
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