The Effect of Cannabis Compared With Alcohol on Driving

Am J Addict. May-Jun 2009;18(3):185-93. doi: 10.1080/10550490902786934.

Abstract

The prevalence of both alcohol and cannabis use and the high morbidity associated with motor vehicle crashes has lead to a plethora of research on the link between the two. Drunk drivers are involved in 25% of motor vehicle fatalities, and many accidents involve drivers who test positive for cannabis. Cannabis and alcohol acutely impair several driving-related skills in a dose-related fashion, but the effects of cannabis vary more between individuals than they do with alcohol because of tolerance, differences in smoking technique, and different absorptions of Delta(9)-tetrahydrocannabinol (THC), the active ingredient in marijuana. Detrimental effects of cannabis use vary in a dose-related fashion, and are more pronounced with highly automatic driving functions than with more complex tasks that require conscious control, whereas alcohol produces an opposite pattern of impairment. Because of both this and an increased awareness that they are impaired, marijuana smokers tend to compensate effectively while driving by utilizing a variety of behavioral strategies. Combining marijuana with alcohol eliminates the ability to use such strategies effectively, however, and results in impairment even at doses which would be insignificant were they of either drug alone. Epidemiological studies have been inconclusive regarding whether cannabis use causes an increased risk of accidents; in contrast, unanimity exists that alcohol use increases crash risk. Furthermore, the risk from driving under the influence of both alcohol and cannabis is greater than the risk of driving under the influence of either alone. Future research should focus on resolving contradictions posed by previous studies, and patients who smoke cannabis should be counseled to wait several hours before driving, and avoid combining the two drugs.

Publication types

  • Research Support, N.I.H., Extramural
  • Research Support, Non-U.S. Gov't
  • Review

MeSH terms

  • Accidents, Traffic / statistics & numerical data*
  • Alcohol Drinking / adverse effects
  • Alcohol Drinking / epidemiology
  • Automobile Driving*
  • Cannabis / adverse effects*
  • Case-Control Studies
  • Cognition / drug effects
  • Dose-Response Relationship, Drug
  • Ethanol / adverse effects*
  • Humans
  • Marijuana Smoking / adverse effects*
  • Marijuana Smoking / epidemiology
  • Prevalence
  • Risk Assessment

Substances

  • Ethanol