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Drivers With Common THC Limit Are Not More Likely To Cause Accidents, Study Finds

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To deter impaired driving in areas where marijuana use is legal, several jurisdictions have set per se limits ranging from 2 to 5 nanograms of THC per milliliter in motorists’ blood. New research, however, finds no evidence that drivers whose blood samples tested in that range are more likely to cause a traffic accident.

The study, published last month in the journal Addiction by a team of Canadian researchers, supports a key message relayed in a recent U.S. Congressional Research Service report on marijuana’s impact on driving: That is, experts aren’t convinced yet that cannabis use is associated with a higher risk of crashes.

“In this multi-site observational study of non-fatally injured drivers,” the study’s authors write, “we found no increase in crash risk, after adjustment for age, sex, and use of other impairing substances, in drivers with THC<5ng/mL.”

There may be an increased risk of crash responsibility for drivers with greater than that amount, the paper concluded, but it was “statistically non-significant and further study is required.”

“[T]here was no evidence of increased crash risk in drivers with THC<5ng/mL and a statistically non‐significant increased risk of crash responsibility in drivers with THC≥5ng/mL.”

While the authors acknowledge a number of other studies that have linked marijuana consumption with increased road safety risks, they also argue that those analyses have “significant limitations,” including the ways those experiments were conducted.

For the new study, researchers utilized a responsibility analysis design, which they said helped them avoid bias. The blood they analyzed for THC and other impairing substances, for example, came from excess samples gathered by treating physicians at hospitals following drivers’ accidents. To determine whether or not a driver was responsible for a crash, they looked at police reports and scored them using a computerized algorithm.

The authors sampled car crash patients from seven British Columbia trauma centers from January 2010 to July 2016 and ultimately tested the blood of 2,318 drivers who had police reports associated with their car accidents.

According to their results, 886 drivers were found to have at least one substance in their blood sample that may have impacted their ability to drive safely. “Alcohol was detected in 334 drivers (14.4%), THC in 192 (8.3%), other recreational drugs in 207 (8.9%), and sedating medications in 460 (19.8%),” the study states. “Polysubstance use was common and many drivers (11.4%) tested positive for more than one impairing substance.” Overall, more than half of drivers (1,178) were deemed responsible for the crash.

Among those drivers whose blood samples included THC—less than 2 ng/mL and up to 5 ng/mL—the study’s authors found there were “non-statistically significant increases in unadjusted risk of responsibility.”

“Our findings, of a low prevalence of drivers with THC>5 ng/mL, combined with a modest and statistically nonsignificant risk of crash responsibility, suggest that the impact of cannabis on road safety is relatively small at present time,” they write.

When the authors modeled THC as a continuous variable—meaning, the possible factors impacting their analysis were infinite— they found “there was a statistically significant but small increase in unadjusted risk for each 1ng/mL increase in THC. However, after adjustment for other predictors, there was no statistically significant association between THC level and risk of responsibility.”

There was, however, “significantly increased risk in drivers who had used alcohol, sedating medications, or recreational drugs other than cannabis.” As a result, “the road safety risk associated with alcohol or with other impairing substances is higher than for cannabis.”

But, as the authors point out, it’s possible crash risk may increase following legalization: As more people gain access to marijuana, it’s likely more people will drive after using the substance, including “occasional users with less tolerance to the impairing effects of cannabis.” In particular, they note, the risks for traffic accidents may be higher for younger drivers or inexperienced cannabis consumers.

They also caution that their findings don’t “necessarily apply to fatal crashes where the association with cannabis may be stronger.” Past research, however, has found that marijuana legalization is not associated with an increase in traffic fatalities.

Study co-author Dr. Jeff Brubacher, an associate professor of emergency medicine at the University of British Columbia, said in an interview released prior to the completion of the new research that marijuana consumption does impact a person’s ability to drive. And he strongly cautioned against getting behind the wheel after using any form of cannabis.

“Marijuana affects motor ability—reaction times are slower so people can’t respond quickly enough to a dangerous situation,” Brubacher said. “Drivers who have used cannabis may have trouble staying in their lane and tend to weave. The ability to maintain a consistent speed is also impaired and they tend to slow down and speed up erratically. Marijuana also makes for a more easily distracted driver.”

Congressional Report Raises Questions About Whether Marijuana Impairs Driving

Marijuana Moment is made possible with support from readers. If you rely on our cannabis advocacy journalism to stay informed, please consider a monthly Patreon pledge.

Kimberly Lawson is a former altweekly newspaper editor turned freelance writer based in Georgia. Her writing has been featured in the New York Times, O magazine, Broadly, Rewire.News, The Week and more.

Science & Health

A ‘Significant’ Number Of Patients Stopped Taking Benzodiazepines After Starting Medical Marijuana

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Nearly half of patients using marijuana to help with their respective medical conditions stopped taking prescribed benzodiazepines, a new study reports.

“Within a cohort of 146 patients initiated on medical cannabis therapy, 45.2% patients successfully discontinued their pre-existing benzodiazepine therapy,” the study’s authors write. “This observation merits further investigation into the risks and benefits of the therapeutic use of medical cannabis and its role relating to benzodiazepine use.”

While much research has been dedicated to understanding how medical cannabis could potentially replace opioids for patients who deal with chronic pain and other ailments, the new study suggests patients who take Valium, Xanax and other popular tranquilizers for neurological conditions (such as anxiety, insomnia and seizures) may find relief through marijuana. The findings were published last month in the journal Cannabis and Cannabinoid Research.

Researchers in Canada conducted a retrospective analysis of data collected from a group of patients who had been referred to the Canabo Medical Clinic for medical cannabis to treat a variety of medical conditions. They identified 146 patients who reported taking benzodiazepines regularly at the start of their cannabis therapy.

According to their findings, 44 patients (30 percent) had discontinued their benzodiazepines by their first follow-up visit. Another 21 had stopped the benzodiazepine treatment by their second follow-up visit, and one more person reported doing so at the third visit. All in all, 66 patients, or 45 percent of the sample, stopped taking benzodiazepines after starting a medical marijuana regimen.

“Patients initiated on medical cannabis therapy showed significant benzodiazepine discontinuation rates after their first follow-up visit to their medical cannabis prescriber, and continued to show significant discontinuation rates thereafter,” the study states. “Discontinuation was not associated with any measured demographic characteristic. Patients also reported decreased daily distress due to their medical condition(s) following prescription cannabinoids.”

The amount of CBD and THC content did not appear to play a role in who continued to discontinued taking the tranquilizers.

The design of the study, however, limited the authors’ ability to speculate about the mechanisms underscoring their results. Additionally, because they didn’t have access to information on what marijuana strains patients used or how they consumed it, the authors caution that their results can’t be generalized to what’s available in legal commercial markets today.

“The study results are encouraging, and this work is concurrent with growing public interest in a rapidly developing Canadian cannabis market,” said lead author Chad Purcell in a statement. “We are advising the public to observe caution. The results do not suggest that cannabis should be used an alternative to conventional therapies. Our purpose is inspiring others to advance current cannabis understanding as we collect stronger efficacy and safety data that will lead to responsible policy and recommended practices for use.”

The study also serves as an opportunity to draw more attention to the potential risks associated with benzodiazepines, Purcell told PsyPost. “I was interested in this project because it presented an opportunity to address benzodiazepines and cannabis use, both of which are becoming increasingly socially relevant. Benzodiazepines can be effective in treating many medical conditions but unlike opioids, there seems to be little public awareness of the risks associated with these commonly used prescription medications.”

According to the Centers for Disease Control and Prevention, overdose deaths related to benzodiazepines rose 830 percent between 1999 and 2017.

Patients Are Substituting Marijuana For Addictive Pharmaceutical Drugs, Two New Studies Show

Photo courtesy of Ndispensable

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Marijuana Legalization Doesn’t Cause Increased Crime, Federally Funded Study Finds

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Legalizing marijuana has little to no impact on rates of violent or property crime, according to a new study that was funded by a federal agency. The policy change did seem connected to a long-term decline in burglaries in one state, however.

While previous attempts to understand the relationship between legal cannabis markets and crime have turned up mixed results, researchers involved in this study used an enhanced methodology—a “quasi-experimental, multi-group interrupted time-series design”—to produce stronger evidence.

The study, published in the journal Justice Quarterly and funded by the federal National Institute of Justice, found that violent and property crimes rates were not affected in a statistically significant way in the years after Colorado and Washington State became the first in the nation to legalize marijuana for adult use.

“Our results suggest that marijuana legalization and sales have had minimal to no effect on major crimes in Colorado or Washington,” the paper concluded. “We observed no statistically significant long-term effects of recreational cannabis laws or the initiation of retail sales on violent or property crime rates in these states.”

The study authors explicitly cited claims made by prohibitionist group Smart Approaches to Marijuana and author Alex Berenson as being contradicted by their findings.

To determine the impact of legalization, researchers designed experimental models that compared crime rates in Colorado and Washington to those in 21 non-legal states from 1999 to 2016. The analysis was based on FBI data on violent, property, aggravated assault, auto theft, burglary, larceny and robbery crime rates.

Following legalization, there were one-time increases in property crime in the two states, as well as a spike in aggravated assault in Washington, but those did not reflect long-term trends, “suggesting that if marijuana legalization influenced crime, it was short-lived,” the study authors wrote.

Via Justice Quarterly.

Via Justice Quarterly.

There was one statistically significant long-term impact that the researchers did attribute to state marijuana laws: The burglary rate in Washington decreased, and that trend has held.

Via Justice Quarterly.

Via Justice Quarterly.

It’s not immediately clear why that is the case, and the study’s conclusion encourages future research that replicates and refines the design used for this experiment to solve answered questions.

“In summary, our results suggest that there may have been some immediate increases in crime at the point of legalization, yet there have been essentially no longterm shifts in crime rates because of legalization, aside from a decline in Burglary in Washington. Though the short-term increases might appear to suggest that marijuana increased crime, we caution against this interpretation as the increases do not reflect permanent shifts (that is, these are shifts in intercepts, not slopes) and could be artificially induced by the small number of time units between legalization and sales.”

Dale Willits, a study coauthor, said in a press release that in light of the “nationwide debate about legalization, the federal classification of cannabis under the Controlled Substances Act, and the consequences of legalization for crime continues, it is essential to center that discussion on studies that use contextualized and robust research designs with as few limitations as possible.”

“This is but one study and legalization of marijuana is still relatively new, but by replicating our findings, policymakers can answer the question of how legalization affects crime,” he said.

Study authors also noted that their analysis did not take into account other crimes such as drug impaired driving.

“Given the likelihood of further liberalization of state and even federal marijuana laws, it is imperative that policy makers and research funders allocate the necessary resources to conduct these more rigorous and intensive types of contextualized studies,” they concluded. “Large-scale policy shifts can take a considerable amount of time to produce stable and understandable effects.”

This is the second recent study that’s received Justice Department funding and arrived at a conclusion that runs against the logic of prohibition. Another example looked at the impact of legalization on law enforcement resources and trafficking trends.

Study Funded By Feds Debunks Myths About Marijuana Legalization’s Alleged Harms

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Pilot Study Shows Marijuana Can Help Chronic Pain Patients Stop Taking Opioids

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When chronic pain patients participated in a program to reduce their use of opioids with medical marijuana, a quarter of them completely stopped taking opioid medications within half a year, a new pilot study reports.

“After 6 months, 156 patients (26%) had ceased taking opioids,” the paper states. “An additional 329 patients (55%) had reduced their opioid use by an average of 30%. One hundred fourteen patients (19%) neither increased nor decreased their opioid use.”

The study, led by Toronto-based chronic pain specialist Dr. Kevin Rod, was published in American Journal of Psychiatry and Neuroscience.

Research shows that marijuana can help patients with pain. In fact, when states legalize access to marijuana, the rates of opioid-related deaths and opioid prescriptions for pain decline.

For his pilot study, Rod recruited 600 chronic pain patients who received care at his practice, Toronto Poly Clinic. Their daily opioid doses averaged 120mg morphine equivalent; among the sample, 95 patients were taking between 180mg to 240mg a day to manage their pain.

Rod created a tapering plan for each patient based on their individual needs. Usually, that meant opioid doses were reduced approximately 10 percent every one to two weeks. As the study’s participants lowered the dosage of pharmaceuticals they were taking to deal with pain, they were authorized to consume CBD and THC products in the range of 4 to 6 percent. The cannabis doses were related to the amount of opioids were tapered: that is, half a gram of marijuana a day for each 10 percent reduction in opioid dose as needed. To reduce the risk of additional harm, patients were advised to consume sublingually, orally or by vaping.

Additionally, patients received psychological support via a web-based mental health tool called Zendose, and were monitored regularly by physicians. During their visits to the clinic, patients were assessed for pain, quality of life, whether tapering appeared to be effective, and if there were any withdrawal symptoms, among other things.

Six months after beginning the program, 156 patients were weaned off opioids completely, while more than half of the sample (329) had reduced their intake by an average of 30 percent. These patients reported consuming 1 to 3 grams of cannabis per day. Nineteen percent (114), however, were unable to reduce the amount of opioids they were taking, though they also did not increase their dosage either. One participant did increase their opioid dosage due to “poorly controlled pain and an aggravated pain condition,” the study states. “With that one exception, all patients expressed satisfaction with their pain control, sleep and quality of life. No opioid withdrawal symptoms were noted in follow-up appointments.”

“This [Medical Cannabis – Opioid Reduction Program] pilot study outlines a patient-centered approach, with an individualized program for tapering opioid use,” the study concludes. “The positive results justify further investigation.”

Last year, Rod was a speaker at the World Cannabis Congress in New Brunswick. There, he advocated for the use of cannabis as a tool in the opioid crisis. “As front line fighters in the fight against pain,” he said, “we’re always looking for new ways to treat or manage chronic pain, and it’s not very often that we have a new solution.”

After Legalizing Marijuana, Colorado Saw ‘Significant Decrease’ In Opioid Prescriptions, Study Finds

Photo courtesy of Get Budding.

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