Reference and Bibliography

The views expressed herein do not necessarily express the views of Health Canada


Cannabis and Driving: Key Points of Reference and Bibliography

  1. “Educational and policy initiatives directed at new drivers have failed to adequately inform new drivers about the potential consequences of driving under the influence of cannabis…This speaks to the role of organizations involved in health promotion and education around impaired driving who have, until recently, focused almost exclusively on the issue of drinking and driving and paid less attention to the drug-driving issue.” (7-8)

    “Among the general adolescent population in Atlantic Canada, driving under the influence of cannabis has become a prevalent activity surpassing driving under the influence of alcohol, and it has played an important role in motor vehicle collision risk, independent of drinking and driving, driver experience, and other risk factors.” (8)

    Asbridge et al. (2005) Motor vehicle collision risk and driving under the influence of cannabis: Evidence from adolescents in Atlantic Canada

  2. “The present study presents good evidence that drivers killed in motor vehicle crashes and taking psychoactive drugs, particularly cannabis and strong stimulants, or two or more drugs in combination were more likely to be responsible for the crash than those taking neither drugs nor alcohol. Moreover, the combination of psychoactive drugs with alcohol further increased the likelihood that drivers caused the crash in which they died. We conclude that THC, amphetamines and combinations of psychoactive drugs significantly increase drivers’ risk of a serious road crash.” (247)

    Drummer et al. (2004) The involvement of drugs in drivers of motor vehicles killed in Australian road traffic crashes

  3. “There is considerable evidence that cannabis does impair ability to perform the multiple functions required to drive a car safely. Although the deleterious effects of cannabis are manifestly not as severe as those of alcohol, they are more complex due to its sedative and stimulant properties; nevertheless several countries have proscribed the use of cannabis by drivers and have introduced legislation to that effect. The impetus behind these measures seems to be several fold -- the increasing use of cannabis, especially by younger and therefore more inexperienced drivers; the increasing volume of traffic, dependence on personal vehicles for transport and concomitant increase in accidents; studies highlighting the effects of cannabis on brain function and increased public awareness of the hazards associated with driving and substance abuse; and not least the costs to society and individuals of road traffic casualties.” (330)

    Hadorn. (2004) A review of cannabis and driving skills

  4. “One of the clear messages to emerge from the research reviewed is that there is a need to examine the effects of cannabis in situations where the driver is required to perform several tasks simultaneously or when confronted with a situation that requires a rapid adaptive response. Furthermore, there has been little research examining the effects of cannabis, alone and in combination with alcohol and other drugs, across a range of levels of driving experience.” (xii)

    “As previous researchers have suggested, it is critical to examine the effects of cannabis when the driver in placed in situations involving increased mental load. This represents a shift in the experimental research away from looking simply at the effects of cannabis on traditional measures of driving performance such as lateral placement and speed, and a move towards supplementing traditional measures with investigation of the effects of cannabis when a driver is placed in an unexpected high accident risk situation that requires an immediate decision and response.” (31)

    Lenné et al. (2004) Cannabis and Road Safety: A Review of Recent Epidemiological, Driver Impairment, and Drug Screening Literature

  5. “Surveys that established recent use of cannabis by directly measuring THC in blood showed that THC positives, particularly at higher doses, are about three to seven times more likely to be responsible for their crash as compared to drivers that had not used drugs or alcohol. Together these epidemiological data suggests that recent use of cannabis may increase crash risk, whereas past use of cannabis does not.” (109)

    Ramaekers et al. (2004) Dose related risk of motor vehicle crashes after cannabis use

  6. “In terms of road safety the results show a clear worsening of driver capability following the ingestion of cannabis or the ingestion of cannabis and alcohol together at the doses used, in comparison with placebo (i.e. having taken neither). Within the sample of drivers, the effects of alcohol (at a dose of just more than half of the UK legal limit) and cannabis taken together were slightly greater than with cannabis alone. Given that other research has extensively shown the rapid increase in the risk of accident, particularly fatal accident, with increasing blood alcohol level, the present results show how important it is to avoid any combination of alcohol and cannabis, as well as avoiding alcohol and cannabis taken on their own, before driving or riding.” (2)

    “Drivers under the influence of cannabis seem to attempt to compensate to some extent for the impairment (that they recognise) by driving more slowly, but there are some aspects of the driving task where cannabis-impaired drivers cannot compensate and where their performance deteriorates (e.g. staying in lane on a bend).” (2)

    Sexton et al. (2002) The influence of cannabis and alcohol on driving

  7. “To the extent that drivers compensate for the effect of cannabis, they appear to be able to manage routine and low demand tasks, but the remaining cognitive resources may not sufficient to cope with peak and unexpected demands.”

    Smiley. (1999) Marijuana: On-road and driving simulator studies


Canadian Drug Use Surveys

ADLAF, E. M. and A. Paglia. (2003) Drug Use Among Ontario Students 1977-2003: Ontario Student Drug Use Survey (OSDUS) Highlights. Toronto: Centre for Addiction and Mental Health.

Alberta Youth Experience Survey 2002 Summary Report. (2003) Alberta Alcohol and Drug Abuse Commission.

Alcool et drogues: portrait de la situation en 2002 et principales comparaisons avec 2000. (2002) Enquête québécoise sur le tabagisme chez les élèves du secondaire. Institue de la statistique. Gouvernement du Québec.

Centre for Addiction and Mental Health (2003). Cannabis Use and Driving Among Ontario Adults. CAMH Population Studies eBulletin, May/June, No. 20.

2002 North West Territories Alcohol and Drug Survey. (2003) Northwest Territories Bureau of Statistics.

PATTON, D., D. Brown, B. Brozeit and J. Dhaliwal. (2001) Substance Use among Manitoba High School Students. Addictions Foundation of Manitoba.

POULIN, Christiane. (2002) Nova Scotia Student Drug Use Survey: Highlights Report. Halifax: Nova Scotia Department of Health Addiction Services and Dalhousie University Community Health and Epidemiology. 1-16.

TJEPKEMA, Michael. (2004) Use of Cannabis and Other Illicit Drugs. Health Reports, Vol. 15, No. 4, 43.

World Health Organization. (1997) Cannabis: A Health Perspective and Research Agenda. WHO Division of Mental Health and Prevention of Substance Abuse, Geneva: World Health Organization.


Cannabis and Driving Studies

ADAMS, I. B. and B. R. Martin. (1996) Cannabis: pharmacology and toxicology in animals and humans. Addiction, 91(11), 1585-1614.

ASBRIDGE, Mark, Christiane Poulin and Andrea Donato. (2005) Motor vehicle collision risk and driving under the influence of cannabis: Evidence from adolescents in Atlantic Canada. Accident Analysis and Prevention. (In press)

ASHTON, C. H. (1999) Adverse effects of cannabis and cannabinoids. British Journal of Anaesthesia, 83(4), 637-649.

BIERNESS, Douglas J., Herb M. Simpson and Katharine Desmond. (2003) Drugs and Driving 2002. The Road Safety Monitor. Traffic Injury Research Foundation.

BLOWS, S., R. Q. Ivers, J. Connor, S. Ameratunga, M. Woodward and R. Norton. (2005) Marijuana use and car crash injury. Addiction, 100: 605-611.

CHAIT, L. D. and J. L. Perry. (1994) Acute and residual effects of alcohol and marijuana,

alone and in combination, on mood and performance. Psychopharmacology (Berl), 115(3), 340-349;

CHESHER, G. B. (2003) Cannabis and road safety: An outline of the research studies to examine the effects of cannabis on driving skills and actual driving performance. www.druglibrary.org/schaffer/MISC/driving/driving2.htm.

CHESHER et al. (2002) Cannabis and alcohol in motor vehicle accidents. In Grotenhermen and Russo (Eds). Cannabis and Cannabinoids: Pharmacology, Toxicology, and Therapeutic Potential. New York: Haworth Press, 313-323.

CIMBURA, G., D. M. Lucas, R. C. Bennett, R. A. Warren and H. M. Simpson. (1982) Incidence and toxicological aspects of drugs detected in 484 fatally injured drivers and pedestrians in Ontario. Journal of Forensic Sciences, 27, 855-867.

DOUGHERTY, D. M., D. R. Cherek and J. D. Roache. (1994) The effects of smoked marijuana on progressive-interval schedule performance in humans. Journal of the Experimental Analysis of Behavior, 62 (1), 73-87.

DRUMMER, Olaf H., Jim Gerostamoulos, Helen Batziris, Mark Chu, John Caplehorn, Michael D. Robertson, Philip Swann. (2004) The involvement of drugs in drivers of motor vehicles killed in Australian road traffic crashes. Accident Analysis and Prevention 36: 239--248.

DUSSAULT, C.,M. Brault, M. Brault, J. Bouchard and A. M. Lemire. (2002) The contribution of alcohol and other drugs among fatally injured drivers in Quebec: Some preliminary findings. In Mayhew, D. R., & Dussault, C. (Eds.), Proceedings of the 16th International conference on alcohol, drugs, and traffic safety, 423-430.

European Monitoring Centre for Drugs and Drug Addiction. (1999) Literature Review on the Relation between Drug Use, Impaired Driving and Traffic Accidents. Lisbon: EMCDDA.

GROTENHERMEN, Franjo, Gero Leson, Günter Berghaus, Olaf H. Drummer, Hans-Peter Krüger, Marie Longo, Herbert Moskowitz, Bud Perrine, Jan Ramaekers, Alison Smiley and Rob Tunbridge. (2005) Developing Science-Based Per Se Limits for Driving under the Influence of Cannabis (DUIC). Paper presented at the 17th International Conference on Alcohol, Drugs and Traffic Safety. August 2004.

HADORN, David. (2004) A review of cannabis and driving skills. In The Medicinal Uses of Cannabis and Cannabinoids. Geoffrey Guy, Brian Whittle and Philip Robson Eds., London: Pharmaceutical Press Publications, 329-368.

HARDER, S. and S. Reitbrock. (1997) Concentration-effect relationship of delta-9 tetrahydrocannabinol and prediction of psychotropic effects after smoking marijuana. International Journal of Clinical Pharmacology and Therapeutics, 35(4): 155-159.

JONES, Craig, Karen Freeman and Don Weatherburn. (2003) “Driving Under the Influence of Cannabis in New South Wales rural area.” Crime and Justice Bulletin: Contemporary Issues in Crime and Justice. Number 75 (May 2003), 1-5.

LENNÉ, Michael, Tom Triggs, Michael Regan. (2004) Cannabis and Road Safety: A Review of Recent Epidemiological, Driver Impairment, and Drug Screening Literature. Monash University Accident Research Center.

MANN, Robert, Bruna Brands, Scott Macdonald and Gina Stoduto. (2003) Impacts of cannabis on driving: An analysis of current evidence with an emphasis on Canadian data. Prepared for Road Safety and Motor Vehicle Regulation, Transport Canada.

NEALE, Joanne, Neil McKeganey, Gordon Hay and John Oliver. (2000) Recreational Drug Use and Driving: A Qualitative Study. University of Glasgow, Scottish Executive Central Research Unit.

OHLSSON, A., J. E. Lindgren, A. Wahlen, S. Agurell, L. E. Hollister and H. K. Gillespie. (1980) Plasma delta-9 tetrahydrocannabinol concentrations and clinical effects after oral and intravenous administration and smoking. Clinical Pharmacology Therapy, 28(3), 409-416.

ROBBE, Hindrick. (1998) Marijuana’s impairing effects on driving are moderate when taken alone but severe when combined with alcohol. Psychopharmacol. Clin. Exp., 13: 70-78.

ROBBE, Hindrick and James F. O’Hanlon. (1993) “Marijuana, Alcohol and Actual Driving Performance.” Institute for Human Psychopharmacology University of Limburg, Netherlands.

RAMAEKERS, J.G., G. Berghaus, M. van Laar and O.H. Drummer. (2004) Dose related risk of motor vehicle crashes after cannabis use. Drug and Alcohol Dependence 73: 109--119. Experimental Psychopharmacology Unit, Department of Neurocognition, Faculty of Psychology, Maastricht University.

----,----. (2001) A review of epidemiological and experimental studies on marijuana and driver impairment. Experimental Psychopharmacology Unit. Brain and Behavior Institute. Université de Maastricht.

SEXTON, B.F., P. G. Jackson, R.J. Tunbridge and A. Board, K. Wright, M. Stark, K. Englehart. (2002) The influence of cannabis and alcohol on driving. Prepared for Road Safety Division, Department of the Environment, Transport and the Regions, UK, by Transport Research Laboratory, TRL Report 543.

SEXTON et al. (2000). The influence of cannabis on driving. Prepared for Road Safety Division, Department of the Environment, Transport and the Regions, UK, by Transport Research Laboratory, TRL Report 477.

SMILEY, Alison. (1999) Marijuana: On-road and driving simulator studies. In H. Kalant, W. Corrigall, W. hall and R.G. Smart (Eds). The Health Effects of Cannabis. Centre for Addiction and Mental Health, Toronto, 173-191.

WALSH, G.W. and R.E. Mann. (1999) On the high road: Driving under the influence of cannabis in Ontario. Canadian Journal of Public Health, vol. 90 no. 4, 260-263.

WEEKES, John. (2005) Drugs and Driving FAQs. Canadian Centre on Substance Abuse.

WHEELOCK. Barbara Buston. (2002) Physiological and Psychological Effects of Cannabis: Review of the Research Findings. Prepared for the Senate Committee on Illegal Drugs. Office of Senator Eileen Rossiter.


Cannabis and Piloting Studies

D.S. Janowsky et al. (1976) Marijuana effects on simulated flying ability. American Journal of Psychiatry 133: 384-388 and

----,----. (1976) Simulated flying performance after marijuana intoxication. Aviation, Space, and Environmental Medicine, 47: 124-128.

LEIRER, V.O. et al. (1991) Marijuana carry-over effects on aircraft pilot performance. Aviation, Space, and Environmental Medicine 62: 221-227.

NEWMAN. David G. (2004) Cannabis and its Effects on Pilot Performance and Flight Safety. Australian Transport Safety Bureau, 1-18.



The free Adobe® Reader® allows you to view, navigate, and print PDF files across all major computing platforms. To download Adobe® Reader®, click on the button and follow the instructions to install it.