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Marijuana (cannabis) and road safety.

Many professional drivers will have their own views on Marijuana (cannabis) and its recreation usage. I had previously looked at the effects it had on mental health and the research study found that psychotic behaviour’s indents were more prevalent in young adults using this drug.

Marijuana is the most commonly used illicit drug in the United States. Its use is widespread among young people. In 2015, more than 11 million young adults ages 18 to 25 used marijuana in the past year.

Both hemp and marijuana are from the same genus and species (cannabis sativa). Marijuana is the dried leaves and flowers of the Cannabis sativa or Cannabis plant. tetrahydrocannabinol, known as THC, is responsible for many of the drug’s psychotropic (mind-altering) effects. It’s this chemical that distorts how the mind perceives the world. In other words, it is what makes you high.

  • THC: The cannabinoid that can make you “high”—THC—has some medicinal properties. Two laboratory-made versions of THC, nabilone and dronabinol, have been approved the therapeutic properties found in cannabis to treat nausea, prevent sickness and vomiting from chemotherapy in cancer patients, and increase appetite in some patients with AIDS.
  • CBD: Another chemical in marijuana with potential therapeutic effects is called cannabidiol, or CBD. CBD doesn’t have mind-altering effects and is being studied for its possible uses as medicine. For example, CBD oil has been approved as a possible treatment for seizures in children with some severe forms of epilepsy.
  • THC and CBD: A medication with a combination of THC and CBD is available as a mouth spray for treating pain or the symptoms of multiple sclerosis.

The therapeutic properties of the cannabis are well documented but smoking a marijuana in hand-rolled cigarettes (joints) in a public location could possible land you in jail.  You need to be familiar with the different types of legalisation for medical or recreation use.

Within the UK, recreational cannabis use is still illegal but there is a movement to change this law.  Medicinal / medical use of cannabis is used under licence only.

What effect has it had on road safety?

There are some parts of the USA that cannabis is legalised. It’s been several years since recreational cannabis was made legal in some US states.

It’s not unreasonable to reflect upon this knowledge to see how reducing / removing this legalisation would work within the UK, with regards to road safety and health.

A newspaper report in April 2019, (Guardian) said what almost half of cannabis users believe it’s safe to drive when you’re high, according to a new study by PSB Research and Buzzfeed News. Perhaps unsurprisingly, those who abstain from weed, take a different view – only 14% believe someone who’s stoned can drive safely.

The dangers of driving while intoxicated have been so well established that it’s easy to assume it’s the abstainers who are right and pot-smokers are simply failing to recognize the danger they pose to themselves. But a few studies into the issue have produced a murkier picture.

It’s true that THC, the psychoactive ingredient in cannabis, can impair a person’s levels of attention and their perception of time and speed, important skills you might think for driving a car. One meta-analysis of 60 studies found that marijuana use causes impairment on every measure of safe driving, including motor-coordination, visual function and completion of complex tasks.

But a 2010 analysis published in the American Journal of Addiction found that while “cannabis and alcohol acutely impair several driving-related skills and marijuana smokers tend to compensate effectively while driving by utilizing a variety of behavioural strategies”. The authors concluded that while marijuana should, in theory, make you a worse driver, in tests it doesn’t seem to. “Cognitive studies suggest that cannabis use may lead to unsafe driving, experimental studies have suggested that it can have the opposite effect” .

However, it has been estimated that 22 million Americans (9.4% of the population) have a substance use or dependence problem. As marijuana is the most commonly used drug of abuse, having been tried by 40% of the population, and is also smoked most commonly in the age group that also has the most road traffic accidents, the contribution of marijuana smoking to road traffic accidents is concerning.

A federal report to Congress, conducted by the National Highway Traffic Safety Administration, came to similar conclusions in 2017. In one test, volunteers were given either marijuana, alcohol or both and then used a driving simulator. The researchers found that the stoned drivers were more cautious, exhibiting “reduced mean speeds, increased time driving below the speed limit and increased following distance during a car following task”, although they did find it more difficult to maintain position within a lane.

Both studies come with the caveat that the amount of THC consumed, and the user’s tolerance levels had an impact on results, with heavy smokers likely to be more greatly impaired. Cannabis users are often unaware of how much THC they have consumed – it’s easy to track the difference between one bottle of Budweiser or two, but harder to know how much THC is in each puff of a joint.

For that reason, this kind of research has only limited applicability to the bigger question of whether stoned drivers are likely to cause more accidents in the real world. Perhaps the more pertinent question is whether states where cannabis has been legalised have seen an increase in crashes and collisions.

A 2017 study found that fatal collisions have not risen in states where weed has been legalised, compared with control states where it remained criminalised. However, two further studies have shown that accidents, in general, are more common since weed became legal in certain states.

The Highway Institute found a 12.5% increase in insurance claims on collisions in Colorado following legalisation and a 9.7% increase in Washington. But using the same methodology, they found no observable increase in accidents in Oregon (the authors suggest this may be because legal cannabis use is not continuing to increase in Oregon as it is in the other two states).

Another study by the same organisation found an average increase of 5.2% in police reporting of crashes in states where cannabis is legal compared with control states.

So, it seems that further research is needed to work out the amount of weed that is dangerous and what exact effect it has on driving ability (and don’t those studies sound fun). While most studies suggest that drinking is more dangerous than smoking when it comes to driving ability, there is at least a correlation between increased cannabis use and car crashes.

Roadside Eye-Catchers Drive Motorists To Distraction

UK drivers are putting themselves at risk because they struggle to keep their eyes on the road.

Roadside objects such as billboards, flashing signs and Christmas decorations cause a third of motorists (32 percent) to lose concentration while behind the wheel.

With 41 percent of these drivers confessing to being distracted for up to 5 seconds – which equates to driving 15 car lengths at 30mph – two and a half times, the stopping distance needed at this speed.

At 60mph, this means drivers would find themselves traveling at least the length of a football pitch without their full concentration on the road.

Overall roadside distractions are pulling the attention of 83 per cent of UK drivers away from the roads, Privilege finds.

And its male drivers who are most affected as one in five (22 percent) confess to being captivated by scantily-clad women on adverts, compared to just one in ten female drivers by semi-naked male models (11 percent).

As public spaces become cluttered with illuminating and moving visuals, 26 percent of British drivers have been distracted by huge advertising hoardings, a fifth (21 percent) by the new vehicle activated signs and 17 percent by Christmas lights and decorations.

Dr. Mark Young, an expert in transport ergonomics at Brunel University, said:

“While we currently know a lot of more about in-vehicle distractions such as mobile phones than external distractors, there is a growing body of concern about the lack of any coherent strategy for arranging roadside furniture.

“Drivers’ visual workload varies through the course of a journey, and at crucial times – negotiating a difficult roundabout, for example, there is a small but significant risk of distraction from novel stimuli like advertising. In fact, this risk is probably underestimated, and we need to do more research on the possibility of excluding non-essential information when the driver is already busy dealing with the road.”

Ian Parker, Managing Director of Privilege Insurance, said:“It appears that the development of new technologies, products, and advertising techniques is getting in the way of road safety. The implications of the increase in eye-catching roadside objects such as illuminating signs have not been monitored until today. Privilege is providing motorists with tips on how to concentrate while driving amid the increase in distracting objects.”

To help drivers focus on the roads, relevant signs and drive as safely as possible, Privilege is providing drivers with the following tips and advice:

Try to take notice only of official signs and notices which are crucial for driving. Try saying them out loud as you pass them if it helps make you concentrate on them. If someone asks you what the last sign was, you should be able to tell them.

Constantly scan the road environment for other potential hazards. Don’t let your vision wander off from the beaten track.

When you are stationary try to keep your gaze on the traffic in front – or any road signals. Listen to mid-paced music to relieve boredom, rather than allow your concentration to wander to roadside distractions.

Driven to Distraction

“Each day in the United States, approximately 9 people are killed and more than 1,000 injured in crashes that are reported to involve a distracted driver”.

What Is Distracted Driving?

Distracted driving is any activity that diverts attention from driving, including talking or texting on your phone, eating and drinking, talking to people in your vehicle, fiddling with the stereo, entertainment or navigation system—anything that takes your attention away from the task of safe driving.

Another frequent question is whether talking on the phone is really any more dangerous than putting on mascara, shaving, or reading a map while driving — all things we’ve seen drivers do. I reply that indeed, any activity that distracts a driver visually or cognitively increases the risk of an accident. (And for clinicians, that includes dictating.) It’s just that cell-phone use is far more widespread than these other activities. But none of them is safe.

Texting is the most alarming distraction. Sending or reading a text takes your eyes off the road for 5 seconds. At 55 mph, that’s like driving the length of an entire football field with your eyes closed.

The statistics are chilling. In 2011 (the last year with complete statistics), 3,331 people were killed in motor vehicle crashes involving a distracted driver, and nearly 400,000 were injured within the USA The National Highway Traffic Safety Administration estimates that distracted driving accounts for about one in five crashes in which someone was injured.

You cannot drive safely unless the task of driving has your full attention. Any non-driving activity you engage in is a potential distraction and increases your risk of crashing.

There are three major types of distraction: visual distraction (taking your eyes off the road), manual distraction (taking your hands off the wheel), and cognitive distraction (taking your mind off the complex task of driving).

Imagine the scene: three young women are traveling in a car. It is a sunny morning, traffic is light, and all are wearing their seat belts and are not intoxicated. They are talking about a friend — “You like him, don’t you?”

It is happy, benign teenager chatter. Then the driver decides to include that other friend in the conversation. While steering, she sends him a short text message on her cell phone.

Suddenly, the car swerves into oncoming traffic and metal hits metal at high speed. Bodies are thrown. Glass breaks. Blood splatters. When the car finally comes to a stop, only the driver is conscious. Her screams speak of not only the agony of her injuries but also the realization that she has just killed her two friends — by texting.

This scene appears in a British public service announcement. The video above is horrifying to watch, but although it is obviously staged, the scenario is hardly a fiction: driving while distracted — by talking or texting — increases the likelihood of accident and injury. And some of these accidents kill people.

Although it is difficult to assess the absolute increase in the risk of collision attributable to driver distraction, one study showed that talking on a cell phone while driving posed a risk four times that faced by undistracted drivers and on a par with that of driving while intoxicated.

Another study showed that texting while driving might confer a risk of collision 23 times that of driving while undistracted. Although there are many possible distractions for drivers, more than 275 million Americans own cell phones, and 81% of them talk on those phones while driving. The adverse consequences have reached epidemic proportions.

Current data suggest that each year, at least 1.6 million traffic accidents (28% of all crashes) in the United States are caused by drivers talking on cell phones or texting.  Talking on the phone causes many more accidents than texting, simply because millions of more drivers talk than text; moreover, using a hands-free device does not make talking on the phone any safer.

according to the National Safety Council:

  • Drivers talking on handheld or hands-free cell phones are four times as likely to be involved in a car crash.
  • People talking on cell phones while driving are involved in 21% of all traffic crashes in the U.S.

In addition, hands-free devices do not eliminate the danger of cell phone use during driving.

Acknowledging these risks, all but 11 states have passed laws regarding cell-phone use while driving. And the U.S. government is concerned: in January 2010, the secretary of transportation and the National Safety Council announced the creation of FocusDriven, an organization devoted to reducing the prevalence of distracted driving. The Department of Transportation has also launched a Web site, www.distraction.gov.

At the medical school and academic practice where I teach, students and residents routinely query patients about habits associated with harm, asking about the use of helmets, seat belts, condoms, cigarettes, alcohol, and drugs.

There is little solid evidence that asking these screening questions has any benefit. But we continue to ask them — as I believe we should. And as technology evolves, our questions must be updated in keeping with the risks: it’s time for us to ask patients about driving and distraction.

Although no direct correlation can be made, we know that counselling patients about dangerous behaviours can have powerful consequences. According to the U.S. Preventive Services Task Force, even 3 minutes spent discussing the risks of tobacco use increases the likelihood that a patient will quit smoking.

Context matters. When a doctor raises an issue while providing overall preventive care, the message is different from that conveyed by a public service announcement nestled between ads for chips and beer or a printed warning on a product box.

Recently, I have added a question about driving and distraction to my annual patient review of health and safety. I begin with the customary seat-belt question.

Then I ask, “Do you text while you drive?”

Although I’m concerned about both texting and talking, most people are aware of the risks associated with texting, and many judges it more harshly. If a patient admits to texting while driving, I share my knowledge and concerns. Many patients who do not text while driving voice opinions about its dangers, giving me an opening to note that talking on the phone while driving causes more accidents than texting. 

Although I can share published data and often recommend that patients view the video described above, I find it more powerful simply to say that driving while distracted is roughly equivalent to driving drunk — a statement that captures both the inherent risks and the implied immorality.

Amy N. Ship, M.D. ask patients whether they could reduce or abstain from cell-phone use while driving. As with any plan for behaviour modification, we need to understand the circumstances surrounding the activity.

Many people have become accustomed to the diversion of talking on the phone while driving, and we’re all susceptible to the allure of a new message or call. If patients tell me that occasionally they receive “important” phone calls they don’t want to miss, we discuss what that means in the context of the risks. We talk about alternatives, including pulling over to make or take calls. 

I remind them that we all managed without mobile phones until recently and encourage them to return to the practices of the pre–cell-phone era.

Inattention blindness

Psychology faculty members Jason Watson, Ph.D., and David Strayer, Ph.D., used a video that was created for earlier inattention blindness research featured in the 2010 book The Invisible Gorilla by Christopher Chabris, Ph.D.

The video depicts six actors passing a basketball, and viewers are asked to count the number of passes. Many people are so intent on counting that they fail to see a person in a gorilla suit stroll across the scene, stop briefly to thump its chest and then walk off.

This experiment reveals two things: that we are missing a lot of what goes on around us, and that we have no idea that we are missing so much.

According to previous University of Utah research, only 2.5 percent of individuals can drive and talk on a cell phone without impairment. And Strayer has conducted studies showing that inattention blindness explains why motorists can fail to see something right in front of them – like a stop light turning green – because they are distracted by the conversation, and how motorists using cell phones impede traffic and increase their risk of traffic accidents.

What can drivers do if they want to fill the resulting void?

They can listen to the radio or a CD? 

They can pay attention to what they’re doing and their surroundings, rather than attempt to multitask. We talk about practical solutions. I tell them about a driver who killed a woman while talking on his phone but couldn’t restrain himself even after that horror. He now puts his phone in the trunk of his car before he gets behind the wheel. I talk about creating such a system for eliminating the risk.

Although I’ve encountered less resistance from patients than I’d anticipated, many do have questions. Most commonly, they ask why talking on the phone, even with a hands-free device, is more dangerous than talking to a passenger in their car.

There are several reasons: first is the obvious risk associated with trying to manoeuvre a phone, but cognitive studies have also shown that we are unable to multitask and that neurons are diverted differently depending on whether we are talking on the phone or talking to a passenger. 

When patients aren’t convinced, I ask them,

 “How would you feel if the surgeon removing your appendix talked on the phone — hands free, of course — while operating?”

This hypothetical captures the essence of the problem — the challenge of concentrating fully on the task at hand while engaged in a phone conversation.

In 1959, before seat belts were standard equipment in cars, my father — a surgeon who was an active member of Physicians for Automotive Safety in its infancy and had seen the terrible consequences of motor vehicle accidents — had airplane seat belts installed in our family Studebaker.

Vehicular safety was thus part of my education before I was in grade school. Fifty-plus years later, laws enforce seat-belt use in nearly every state, and deaths from motor vehicle accidents have decreased markedly. 

Just as we’ve moved beyond Studebakers, it’s time for us to update our model of preventive care. Primary care doctors are uniquely positioned to teach and influence patients; we should not squander that power.

A question about driving and distraction is as central to the preventive care we provide as the other questions we ask. Not to ask — and not to educate our patients and reduce their risk — is to place in harm’s way those we hope to heal.

UK Penalties Law

You can get 6 penalty points and a £200 fine if you use a hand-held phone when driving. You’ll also lose your licence if you passed your driving test in the last 2 years.

You can get 3 penalty points if you don’t have a full view of the road and traffic ahead or proper control of the vehicle.

You can also be taken to court where you can:


June 10, 2010N Engl J Med 2010; 362:2145-2147






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