Drivers who test positive for the presence of THC in blood are no more likely to be involved in motor vehicle crashes than are drug-free drivers, according to a federally sponsored case-control study involving some 9,000 participants. The study, published Friday by the United States National Highway Traffic Administration (NHTSA), is the first large-scale case-control study ever conducted in the United States to assess the crash risk associated with both drugs and alcohol use by drivers.
Authors reported that drivers who tested positive for any amount of THC possessed an unadjusted, elevated risk of accident of 25 percent (Odds Ratio=1.25) compared to controls (drivers who tested negative for any drug or alcohol). However, this elevated risk became insignificant (OR=1.05) after investigators adjusted for demographic variables, such as the drivers’ age and gender. After researchers controlled for both demographic variables and the presence of alcohol, THC-positive drivers’ elevated risk of accident was zero (OR=1).
By contrast, researchers reported that drivers who tested positive for low levels of alcohol possessed a statistically significant risk of accident, even after controlling for demographic variables (e.g., Drivers with a BAC of 0.03 possessed a 20 percent greater risk of motor vehicle accident [OR=1.20] compared to controls). Drivers with BAC levels of 0.05 possessed a greater than two-fold risk of accident (OR=2.07) while motorists with BAC levels of 0.08 possessed a nearly four-fold risk of accident (OR=3.93).
Researchers did not analyze drivers’ THC levels to similarly estimate whether higher or lower THC levels may impact crash risk in a dose-dependent manner, as has been previously reported in some separate analyses of fatal crash data.
Authors concluded, “This finding indicates that these other variables (age, gender, ethnicity, and alcohol use) were highly correlated with drug use and account for much of the increased (crash) risk associated with the use of illegal drugs and THC.”
The study’s finding contradict allegations by NIDA and others that “marijuana use more than doubles a driver’s risk of being in an accident,” but are largely consistent with those of a 2013 literature review published in the journal Accident Analysis and Prevention which reported that cannabis-positive drivers did not possess a statistically significant risk of a either fatal accident or a motor vehicle accident causing injury.
See NORML’s white paper on cannabis and psychomotor performance here.
Newly appointed US Surgeon General Vivek Murthy believes that cannabis possesses therapeutic utility — an acknowledgment that contradicts the plant’s present placement as a Schedule I controlled substance under federal law.
Speaking to CBS News, Murthy said: “We have some preliminary data showing that for certain medical conditions and symptoms that marijuana can be helpful.” He added, “I think we have to use that data to drive policy making and I’m very interested to see where that data takes us.”
Dr. Murthy was confirmed as US Surgeon General late last year.
His statements appear to be inconsistent with the Schedule I classification of marijuana under federal law — a scheduling that defines the plant and its organic compounds as possessing “no currently accepted medical use …. in the United States” and lacking “accepted safety … under medical supervision.”
Next week in Sacramento, a federal judge will hear final arguments in a motion challenging the constitutionality of cannabis’ Schedule I classification. In October, defense counsel and experts presented evidence over a five day period arguing that the scientific literature is not supportive of the plant’s present categorization.
Briefs in this ongoing federal case are available online here.
[Update: Perhaps predictably, the Surgeon General has dialed back his initial comments to CBS News. Late last night, The Department of Health and Human Services issued a statement attributed to Murthy stating: “Marijuana policy — and all public health policies — should be driven by science. I believe that marijuana should be subjected to the same, rigorous clinical trials and scientific scrutiny that the Food and Drug Administration (FDA) applies to all new medications. The Federal Government has and continues to fund research on possible health benefits of marijuana and its components. While clinical trials for certain components of marijuana appear promising for some medical conditions, neither the FDA nor the Institute of Medicine have found smoked marijuana to meet the standards for safe and effective medicine for any condition to date.”
Interesting that Dr. Murthy cites the IOM which hasn’t formally commented on the issue of medical marijuana since releasing its report some 15 years ago, long before the results of FDA-approved clinical trials like this had been completed. Also notable that he leans on the FDA for guidance when the agency largely does not review the safety and efficacy of botanical products.]
An updated policy statement issued today by the American Academy of Pediatrics (AAP) calls for the rescheduling of the cannabis plant under federal law to better facilitate clinical trial research and to promote the plant’s eventual pharmaceutical development.
The new position statement resolves: “The AAP strongly supports research and development of pharmaceutical cannabinoids and supports a review of policies promoting research on the medical use of these compounds. The AAP recommends changing marijuana from a Drug Enforcement Administration schedule I (controlled substance) to a Schedule II drug to facilitate this (clinical) research.”
By definition, schedule I controlled substances are defined as possessing no “accepted medical use.” Clinical protocols involving cannabis are strictly controlled and require authorization from various federal agencies, including DEA, FDA, and the National Institute on Drug Abuse (NIDA) – the latter of which is designated under federal law as the sole provider of cannabis and/or organic cannabinoids for research purposes.
“A Schedule 1 listing means there’s no medical use or helpful indications, but we know that’s not true because there has been limited evidence showing [marijuana] may be helpful for certain conditions in adults,” said Dr. Seth Ammerman, who co-authored the new policy statement.
The newly amended AAP resolution also acknowledges that certain types of cannabinoid-therapy may provide benefits to adolescents, particularly those patient populations with treatment-resistant forms of epilepsy and chronic seizures. It states, “The AAP recognizes that marijuana may currently be an option for cannabinoid administration for children with life-limiting or severely debilitating conditions and for whom current therapies are inadequate.”
Last year the Epilepsy Foundation of America issued a similar resolution, citing preclinical data and observational reports of the potential therapeutic benefit of the cannabinoid cannabidiol (CBD) in pediatric patients and calling for “an end to Drug Enforcement Administration (DEA) restrictions that limit clinical trials and research into medical marijuana for epilepsy.”
Separate language in the AAP’s position statement also addresses the social use of the plant, affirming, “AAP strongly supports the decriminalization of marijuana use for both minors and young adults and encourages pediatricians to advocate for laws that prevent harsh criminal penalties for possession or use of marijuana.” By contrast, the statement acknowledges the group’s continued opposition to the legalization of marijuana, a policy change that it alleges poses “potential harm to children.”
Text of the amended AAP position paper is online here. A summary of resolutions issued by other medical and health organizations in regard to patient access to therapeutic cannabis is available on the NORML website here.
District of Columbia city officials this week moved forward with their intentions to implement a voter-approved municipal initiative depenalizing marijuana possession and cultivation offenses.
On Tuesday, city officials confirmed that Initiative 71 was transmitted to Congress for review. Under federal law, all District laws are subject to a 30-day review process by Congress, during which time members may take action to halt the law’s implementation.
Speaking to Roll Call this week, House Oversight and Government Reform Chairman Jason Chaffetz (R-Utah) said that language previously adopted by Congress in a December 2014 spending bill already prohibits DC officials from implementing I-71 and, thus, no further action by Congress is necessary. However, several District officials – including DC Delegate Eleanor Holmes Norton and DC Council Chairman Phil Mendelson – said that the federal provision in question in no way blocks city officials from enacting the new law.
“The District’s examination agrees with our analysis that the initiative was enacted when voters approved it and will take effect at the end of the 30-day congressional review period,” Del. Norton said in a statement.
Chairman Mendelson agreed, saying, “I happen to believe that the initiative was enacted so I think there’s no question that after the 30-day review it will be law.”
The District of Columbia Attorney General’s office has not yet commented in regard to how the District will respond if Congress does not address the initiative during the review process, Roll Call reported.
In November, 70 percent of District voters approved I-71, which removes criminal and civil penalties regarding the adult possession of up to two ounces of cannabis and/or the cultivation of up to six plants.
Separate DC municipal legislation – ‘The Marijuana Legalization and regulation Act’ – which seeks to regulate commercial cannabis production and retail sales, is also pending before the Council. If enacted, this legislation would also go before lawmakers for Congressional review and likely would force a federal challenge.
A poll conducted by the firm Public Policy Polling (PPP) revealed that 60% of Virginia voters would support decriminalizing the adult possession of small amounts of marijuana, indicating strong support for state Senator Adam Ebbin’s marijuana decriminalization measure, Senate Bill 686. Decriminalization had majority support from every age, racial, and gender demographic.
The survey also had support for legalization and regulation of marijuana in the Commonwealth at a record high of 49% support to 44% opposed.
With the legislative session kicking off in Virginia, expect to hear much more about this pending legislation in the coming weeks. If you are a Virginia resident, please CLICK HERE to quickly and easily contact your state Senator and urge their support for SB 686. It is time that our state officials pursued a policy on marijuana that was “Smart on crime and smart for Virginia.”
We strongly encourage you also attend Virginia NORML‘s lobby day in Richmond on January 16th to help put the pressure on state legislators in person. You can click here for more information on lobby day.
If you find yourself traveling in the Richmond area, keep your eyes peeled for Virginia NORML’s billboard in support of SB 686, which should be going on display very soon on Route 360 as you drive over the James River (the billboard image is featured at the top of this post).
This poll was commissioned by MPP and conducted by Public Policy Polling. You can read the full results here.