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Determining the magnitude and duration of acute Δ9-tetrahydrocannabinol (Δ9-THC)-induced driving and cognitive impairment: A systematic and meta-analytic review
Open accessAbstract
The increasing legal availability of cannabis has important implications for road safety. This systematic review characterised the acute effects of Δ9-THC on driving performance and driving-related cognitive skills, with a particular focus on the duration of Δ9-THC-induced impairment. Eighty publications and 1534 outcomes were reviewed. Several measures of driving performance and driving-related cognitive skills (e.g. lateral control, tracking, divided attention) demonstrated impairment in meta-analyses of “peak” Δ9-THC effects (p’s<0.05). Multiple meta-regression analyses further found that regular cannabis users experianced less impairment than ‘other’ (mostly occasional) cannabis users (p = 0.003) and that the magnitude of oral (n = 243 effect estimates [EE]) and inhaled (n = 481 EEs) Δ9-THC-induced impairment depended on various factors (dose, post-treatment time interval, the performance domain (skill) assessed) in other cannabis users (p’s<0.05). The latter model predicted that most driving-related cognitive skills would ‘recover’ (Hedges’ g=–0.25) within ∼5-hs (and almost all within ∼7-hs) of inhaling 20 mg of Δ9-THC; oral Δ9-THC-induced impairment may take longer to subside. These results suggest individuals should wait at least 5 -hs following inhaled cannabis use before performing safety-sensitive tasks.
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“The concurrent use of cannabis and alcohol produces greater driving impairment than cannabis alone [25].”
From Cannabis, cannabinoids and health: a review of evidence on risks and medical benefits (2025) · cites this paper as [25]
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Metadata
- Authors
- McCartney, D., Arkell, T. R., Irwin, C., & McGregor, I. S.
- Affiliations
- The University of Sydney (AU)
- Griffith University (AU)
- Corresponding author
- McCartney, Danielle
- Venue
- Neuroscience & Biobehavioral Reviews
- Publisher
- Elsevier BV
- Published
- 2021-07
- Volume
- 126
- Pages
- 175-193
- ISSN
- 0149-7634 (ISSN-L)
- OpenAlex
- W3121363966
- Cited by
- 170
- References
- 75
- Citations by year
- 2026: 23 · 2025: 30 · 2024: 40 · 2023: 37 · 2022: 26 · 2021: 14
- FWCI
- 3.70
- Type
- journal article
- Language
- en
- Open access
- hybrid
- doi.org
- Licence
- Locations
- Neuroscience & Biobehavioral Reviews (publishedVersion, cc-by-nc-nd)
- PubMed (publishedVersion)
- Griffith Research Online (submittedVersion, cc-by-nc-nd)
- Funders
- University of Sydney
- Griffith University
- Topics
- Health Sciences › Medicine › Pharmacology (medical) › Cannabis and Cannabinoid Research
- Physical Sciences › Engineering › Safety, Risk, Reliability and Quality › Traffic and Road Safety
- Life Sciences › Pharmacology, Toxicology and Pharmaceutics › Toxicology › Forensic Toxicology and Drug Analysis
- Keywords
- delta-9-tetrahydrocannabinol, cannabis, driving performance, cognitive impairment, road safety, inhaled cannabis, divided attention, lateral control, tracking, dosage effect
- MeSH terms
- Attention, Humans, Marijuana Smoking, Psychomotor Performance, Dronabinol, Cognitive Dysfunction
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