Lower-Risk Cannabis Use Guidelines (LRCUG) for reducing health harms from non-medical cannabis use: A comprehensive evidence and recommendations update.

Lower-Risk Cannabis Use Guidelines (LRCUG) for reducing health harms from non-medical cannabis use: A comprehensive evidence and recommendations update

In this review, state-of-the-art evidence on the relationship between cannabis use, traffic crash risks, and driving safety were analyzed. Systematic reviews, meta-analyses, and other relevant papers published within the last decade were systematically searched and synthesized. Findings show that meta-analyses and culpability studies consistently indicate a slightly but significantly increased risk of crashes after acute cannabis use. These risks vary across included study type, crash severity, and method of substance application and measurement. Some studies show a significant correlation between high THC blood concentrations and car crash risk. Most studies do not support this relationship at lower THC concentrations. However, no scientifically supported clear cut-off concentration can be derived from these results. Further research is needed to determine dose-response effects on driving skills combined with measures of neuropsychological functioning related to driving skills and crash risk.

/pdf/cannabis-use-and-car-crashes-a-review-2p662asigh.pdf

Cannabis Use and Car Crashes: A Review

country. The fact that isoflurane was not found to be carcinogenic in another laboratory would seem to be indicative of a variation in strain susceptibility -I have been led to understand that this is a common occurrence in cancer studies. Corbett's original observations of 15 hepatic neoplasms in 67 male mice with none in his control animals cannot be dismissed as lightly as Dr Nunn and his colleagues would wish. Finally, I am accused of taking the Health Departments to task (Drs A A Spence and R P Knill-Jones (28 April, p 1144)) in my article. In fact, the opposite is true. In view of their previous criticisms of me-I was called vexatious-I deliberately made no criticism of the activities of the Health Departments and any reference to these activities was strictly factual. But Dr Spence does raise an interesting question: are the Health Departments to be regarded as being immune from any criticism ?

/pdf/minor-tranquillisers-and-road-accidents-4fyahtyhqm.pdf

Minor tranquillisers and road accidents.

Serious motor vehicle collisions involving young drivers on Norwegian roads 2013-2016: Speeding and driver-related errors are the main challenge.

Odds of culpability associated with use of impairing drugs in injured drivers in Victoria, Australia.

Drivers taken to hospital in Victoria after a collision must provide blood for analysis for the proscribed drugs (cannabis, MDMA, methamphetamine). A longitudinal study is examining a range of other substances including benzodiazepines, opiates, and other psychotropic medication and matching toxicology results to police collision reports. Each driver is assigned a degree of responsibility according to the method of Robertson. If a substance causes impairment, then drivers in whom the substance is found are likely to be “responsible” for the collision than those who are drug or alcohol free. 1802 samples have been analysed to date. Of the alcohol-positive drivers, 96 per cent were responsible for their collision. This paper focuses on the benzodiazepine tranquilisers. Benzodiazepines were detected in 10.2 per cent of samples (n=184). Preliminary evidence suggests there is a dose relationship with small increase in collision risk at therapeutic levels and high risk at toxic levels. Abuse of prescription drugs is a road safety issue worthy of specific study and targeted interventions. The combination of benzodiazepines and alcohol was associated with increased responsibility for collision even when the prescribed drugs were present at therapeutic levels. Combining drugs increased the likelihood of responsibility for collision: drug-free drivers – 45 per cent were responsible; with 1-2 drugs – 80 per cent were responsible; with 3 drugs – 94 per cent were responsible; and with 4+ drugs – 96 per cent were responsible. It is now possible to test for benzodiazepines at the roadside. An enforcement measure that may improve road safety would be to adopt zero tolerance for alcohol when benzodiazepines are prescribed. The ongoing study will continue to examine dose relationships and specific drug interactions, which will inform development of targeted counter-measures.

Tania Frederiksen

Papers

Odds of culpability associated with use of impairing drugs in injured drivers in Victoria, Australia.

Do minor tranquilisers (benzodiazepines) increase risk of collision in which the driver is injured