Analysis: Drivers in Traffic Collisions More Likely to Test Positive for High Levels of Alcohol Than THC
Drivers treated for traffic-related injuries are more likely to test positive for high levels of alcohol (BAC ≥ 0.08 percent) than they are likely to test positive for elevated levels of THC (THC in blood ≥ 5 ng/mL), according to data published in the journal Addiction.
Canadian investigators quantified and reviewed alcohol and THC concentrations in a cohort of nearly 7,000 injured drivers.
They reported, “In this sample, there were over three times as many drivers with BAC ≥ 0.08% (12.6 percent) than with THC ≥ 5 ng/mL (3.5 percent), suggesting that alcohol remains a greater threat to road safety.”
Authors also acknowledged that drivers who tested positive for high levels of alcohol were more likely to be involved in single vehicle accidents as well as in motor vehicle accidents resulting in serious injuries.
Because THC can remain present in blood for extended periods of time, the study’s authors emphasized that at least some subjects who tested positive for cannabis may not necessarily have had recent exposure to it. They further emphasized that subjects testing positive for the presence of THC at levels below 5 ng/ml are typically not under the influence and likely do not possess a significantly increased risk of being involved in a motor vehicle accident.
Driving simulator studies generally report that cannabis administration is associated with compensatory driving behavior, such as decreased mean speed and increased mean following distance, whereas alcohol administration is associated with more aggressive driving behavior. Nevertheless, cannabis exposure can influence certain psychomotor skills necessary for safe driving, such as reaction time and drivers’ ability to maintain lane positioning.
A study conducted by the US National Highway Traffic Safety Administration reported that drivers who test positive for any amount of THC possess, on average, a far lower risk of being involved in a traffic collision than do drivers who test positive for alcohol at or near legal limits.
By contrast, drivers who test positive for the presence of both THC and alcohol in their system tend to possess significantly higher odds of being involved in a motor vehicle accident than do those who test positive for either substance alone.
Full text of the study, “A comparison of cannabis and alcohol use in drivers presenting to hospital after a vehicular collision,” appears in Addiction.
Study: Short-Term Use of Prescription Medication Containing THC and CBD Not Associated with Cardiovascular Complications in High-Risk Patients
Genova, Italy: Patients with a history of stroke are not at an increased risk of cardiovascular complications following the use of nabiximols (a/k/a Sativex – an oromucosal spray containing a balanced ratio of plant-derived THC and CBD), according to clinical trial data published in the journal Frontiers in Cardiovascular Medicine. Nabiximols is available by prescription in various countries, but not in the United States, for patients suffering from symptoms of multiple sclerosis.
Italian researchers compared the cardiovascular impact of nabiximols versus placebo in a cohort of 34 stroke survivors. Subjects in the study suffered from symptoms of spasticity. Patients in the study took either nabiximols or placebo in addition to their standard medications for a period of one-month.
Investigators reported: “No … adverse drug effects emerged during nabiximols treatment, namely no significant fluctuation of blood pressure and heart rate, nor ischemic or hemorrhagic events occurred. During nabiximols treatment, self-assessed blood pressure and heart rate did not change compared to the baseline condition. No patients showed significant acceleration or decrease in heart rate or change in rhythm and none required an additional ECG or cardiological evaluation during the study.”
Authors concluded: “The present study is the first to evaluate the effects of a cannabinoid drug (nabiximols) in patients with post-stroke spasticity. … This ancillary study adds evidence that, in patients who already underwent a cerebrovascular accident, nabiximols does not determine significant blood pressure and heart rate variation or cardiovascular complications. These data support the cardiovascular safety of nabiximols, encouraging more extensive studies involving cannabinoids characterized by slow absorption rates.”
Numerous studies demonstrate the ability of cannabinoids to influence blood pressure and other cardiovascular responses. However, data is inconsistent with respect to whether the frequent use of cannabis may increase one’s risk of stroke, heart attack, or other adverse cardiovascular events. While some studies report an increased risk of stroke and other cardiovascular diseases among marijuana consumers, others report either no risk or provide evidence of possible cardioprotection. A 2021 literature review of 67 studies published in The American Journal of Medicine concluded, “[M]arijuana itself does not appear to be independently associated with excessive cardiovascular risk factors.” Authors did caution, however, that “it can be associated with other unhealthy behaviors such as alcohol use and tobacco smoking that can be detrimental” to cardiovascular health.
Full text of the study, “Nabiximols effect on blood pressure and heart rate in post-stroke patients: A randomized controlled study,” appears in Frontiers in Cardiovascular Medicine.
Mississippi: Bill Amending Medical Cannabis Access Regulations Advanced to Governor
Jackson, MS: Lawmakers have approved legislation, House Bill 1158, amending provisions of the state’s medical cannabis access law.
Proposed changes to the law will make it easier for qualified patients to register for the program and for physicians to participate in it. Language in the bill also expedites the timeline during which officials must approve patients’ registry applications. Other proposed changes require designated caregivers to undergo criminal background checks.
The measure now goes to Republican Gov. Tate Reeves for final approval.
State-licensed dispensaries began selling medical cannabis to qualified patients in January, nearly one year after legislators passed comprehensive legislation regulating its production and dispensing.
Voters in 2020 had initially decided in favor of a citizens’ initiative legalizing medical cannabis use. However, the state Supreme Court later struck down the state’s initiative process, thereby nullifying the election result.
Tourette Syndrome Patients Report Quality of Life Improvements Following Cannabis Therapy
Tel Aviv, Israel: Tourette Syndrome (TS) patients report improvements in their quality of life and reductions in their use of prescription medications following cannabis therapy, according to data published in the journal Cannabis and Cannabinoid Research.
Israeli investigators surveyed patients prior to and six-months following cannabis treatment. Subjects in the study consumed products containing roughly twice as much THC as CBD.
Participants reported statistically significant improvements in their quality of life and employment status following cannabis treatment. Most subjects also reported reduced symptoms of anxiety and obsessive-compulsive tendencies. Patients reduced their use of prescription medicines.
By contrast, subjects did not report statistically significant improvements in their frequency of either vocal or motor tics during the study period.
Authors concluded: “Subjective reports from TS patients suggest that medical cannabis may improve their quality of life and comorbidities. More studies are needed to evaluate the efficacy and safety of medical cannabis.”
A limited number of clinical trials have shown both oral THC and inhaled cannabis to be associated with symptom improvements in TS patients, including decreased tic severity and reductions in obsessive-compulsive behaviors. The results of a randomized, placebo-controlled trial published last month in the journal Psychiatry Research reported that patients with more severe TS symptoms experienced symptomatic improvements following the consumption of a balanced formulation of oral THC and CBD.
Full text of the study, “Using medical cannabis in patients with Gilles de la Tourette’s Syndrome in a real-world setting” appears in Cannabis and Cannabinoid Research.
CBD Administration Mitigates Opioid Cravings in Animals
Portland, OR: The administration of plant-derived CBD significantly reduces opioid cravings in animals, according to preclinical data published in the journal Addiction Neuroscience.
Investigators affiliated with Washington State University in Spokane and with the Legacy Research Institute in Portland assessed the efficacy and safety profile of vaporized CBD in a cohort of female rats.
They reported that rats provided with CBD were less likely to self-administer morphine.
“[T]he ability of WPE [whole-plant cannabis extract] to reduce opioid reward and drug seeking behavior appears quite robust and of great clinical utility,” authors concluded. “Additional systematic research is required to fully evaluate the potential for CBD to serve as an adjunct treatment for opioid use disorder.”
A limited number of clinical trials have previously demonstrated the ability of CBD to mitigate subjects’ cravings for various substances, including heroin, tobacco, and cannabis. Other studies indicate that CBD may also play a role in mitigating symptoms of opioid withdrawal. According to a 2020 review paper, “[E]vidence … demonstrates the potential [of] cannabis to ease opioid withdrawal symptoms, reduce opioid consumption, ameliorate opioid cravings, prevent opioid relapse, improve OUD treatment retention, and reduce overdose deaths.”
Full text of the study, “High-CBD cannabis vapor attenuates opioid reward and partially modulates nociception in female rats,” appears in Addiction Neuroscience.