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Cited by 72Traffic and Road SafetyCannabis and Cannabinoid ResearchForensic Toxicology and Drug Analysis

Cannabis and Driving

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Pearlson, Godfrey D., Stevens, Michael C., D'Souza, Deepak Cyril·2021·Frontiers in Psychiatry
DOI 10.3389/fpsyt.2021.689444PMC PMC8499672
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Abstract

As more states in the U.S legalize recreational and medicinal cannabis, rates of driving under the influence of this drug are increasing significantly. Aspects of this emerging public health issue potentially pit science against public policy. The authors believe that the legal cart is currently significantly ahead of the scientific horse. Issues such as detection procedures for cannabis-impaired drivers, and use of blood THC levels to gauge impairment, should rely heavily on current scientific knowledge. However, there are many, often unacknowledged research gaps in these and related areas, that need to be addressed in order provide a more coherent basis for public policies. This review focuses especially on those areas. In this article we review in a focused manner, current information linking cannabis to motor vehicle accidents and examine patterns of cannabis-impairment of driving related behaviors, their time courses, relationship to cannabis dose and THC blood levels, and compare cannabis and alcohol-impaired driving patterns directly. This review also delves into questions of alcohol-cannabis combinations and addresses the basis for of per-se limits in cannabis driving convictions. Finally, we distinguish between areas where research has provided clear answers to the above questions, areas that remain unclear, and make recommendations to fill gaps in current knowledge.

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Crossref · 10.3389/fpsyt.2021.689444

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  • Recovery of driving-related skills appears to occur 5-6 hours after cannabis intoxication, but individuals may vary in the amount and duration of impairment.

    “Recovery of driving-related skills appears to occur 5–6 h after cannabis intoxication but individuals may vary in the amount and duration of impairment [24].”

    From Cannabis, cannabinoids and health: a review of evidence on risks and medical benefits (2025) · cites this paper as [24]

    The Introduction section on the duration of driving impairment reports that one on-road study found no significant weaving impairment at 4–5 hours after inhaled THC, and notes that edibles or higher doses could prolong impairment. The section on actual driving behaviors also says individual responses may vary with age, driving experience, and tolerance. The paper does not establish recovery of driving-related skills specifically at 5–6 hours. (LLM, conf=0.87)

    Experimental — accuracy not yet measured

  • Orally administered cannabis produces a protracted increase in blood THC concentration and prolongs impaired driving performance compared to inhaled cannabis.

    “Orally administered cannabis produces a protracted increase in blood THC concentration and prolongs impaired driving performance compared to inhaled cannabis.”

    From Cannabis, cannabinoids and health: a review of evidence on risks and medical benefits (2025) · cites this paper as [24]

    The Pharmacokinetics section says oral THC reaches peak concentration later than inhaled THC, with a more delayed onset and more sustained intoxication. The Duration of Cannabis-Related Driving Impairment section says edibles would *likely* result in a longer period of impairment, but notes that driving studies after oral administration are scarce. The claim overstates that tentative driving comparison as an established finding. (LLM, conf=0.87)

    Experimental — accuracy not yet measured

  • Frequent cannabis users may be less impaired because they may show tolerance to the motor incoordination and cognitive disruptive effects of cannabis.

    “Frequent cannabis users may be less impaired because they may show tolerance to the motor incoordination and cognitive disruptive effects of cannabis.”

    From Cannabis, cannabinoids and health: a review of evidence on risks and medical benefits (2025) · cites this paper as [24]

    In the Introduction section on per se laws (page unavailable), the paper says regular users may develop tolerance to cannabis’s intoxicating and impairing effects. It does not specifically establish tolerance to motor incoordination and cognitive disruption, and it says the implications for driving performance remain unestablished. (LLM, conf=0.82)

    Experimental — accuracy not yet measured

  • Measuring THC-related impairment and fitness to drive is more complicated than for alcohol because THC absorption and bioavailability do not follow a uniform time- and dose-dependent course and cannabis-related behavioral impairments differ from those of alcohol.

    “Measuring THC-related impairment and fitness to drive is more complicated than for alcohol because the absorption and bioavailability of THC does not follow a uniform time- and dose-dependent course and cannabis-related behavioral impairments differ from those of alcohol [24].”

    From Cannabis, cannabinoids and health: a review of evidence on risks and medical benefits (2025) · cites this paper as [24]

  • There are no reliable cut-off values for blood THC levels that indicate when an individual is impaired.

    “Thus, there are no reliable cut-off values for blood THC levels that indicate when an individual is impaired.”

    From Cannabis, cannabinoids and health: a review of evidence on risks and medical benefits (2025) · cites this paper as [24]

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Cited by

Sorted by citations

Authors
Pearlson, G. D., Stevens, M. C., & D'Souza, D. C.
Affiliations
Hartford Hospital (US)
Corresponding author
Pearlson, Godfrey D.
ORCID
Venue
Frontiers in Psychiatry
Publisher
Frontiers Media SA
Published
2021-09-24
Volume
12
Pages
689444-689444
ISSN
1664-0640 (ISSN-L)
DOI
10.3389/fpsyt.2021.689444
PMC
PMC8499672
OpenAlex
W3204204512
Cited by
72
References
4
Citations by year
2026: 13 · 2025: 6 · 2024: 15 · 2023: 26 · 2022: 12
FWCI
2.31
Type
journal article
Language
en
Open access
Licence
Locations
  • Frontiers in Psychiatry (publishedVersion, cc-by)
  • Europe PMC (PubMed Central) (publishedVersion, other-oa)
  • PubMed Central (publishedVersion, cc-by)
  • PubMed (publishedVersion)
  • DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion, cc-by-sa)
Funders
  • National Highway Traffic Safety Administration
  • National Institute on Drug Abuse
Topics
  • Physical Sciences › Engineering › Safety, Risk, Reliability and Quality › Traffic and Road Safety
  • Health Sciences › Medicine › Pharmacology › Cannabis and Cannabinoid Research
  • Life Sciences › Pharmacology, Toxicology and Pharmaceutics › Toxicology › Forensic Toxicology and Drug Analysis
Keywords
cannabis-impaired driving, driving under the influence, motor vehicle accidents, drunk driving, cannabis legalization, dose-response relationship, research gaps, public policy

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