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Can I drive when taking medicinal cannabis? Is it safe?

  • Written by Tom Arkell, NHMRC Emerging Leadership Fellow, School of Health Sciences, Swinburne University of Technology

Your doctor has just prescribed medicinal cannabis. You think it’s helping. But you rely on your car to get to work and pick up the kids.

Are you allowed to drive? And more importantly, is it safe?

Here’s what the evidence says and what it means for you.

Medicinal cannabis is now widely prescribed in Australia for conditions such as chronic pain, anxiety and sleep disorders.

You can take it in a variety of different ways – for instance, by inhaling it using a vaporiser, or by ingesting an oil. There are many different active compounds. However, the main ones – known as cannabinoids – are delta-9-tetrahydrocannabinol (THC) and cannabidiol (CBD).

THC is also the intoxicating part of cannabis that gets you “stoned”. So this is where things get complicated.

What happens when you take medicinal cannabis?

When cannabis is inhaled, the effects peak in the first hour. They taper off over two to three hours, but can last for up to four to six hours.

When taken orally – for example as an oil – the effects don’t start straight away and can last for up to 8 to 12 hours. That’s because the cannabinoids are absorbed by your gut and metabolised more slowly.

THC negatively impacts cognitive functions, such as attention and memory. It impairs driving in a simulator and in the real world on a highway.

The effects of THC on driving are roughly comparable to low blood alcohol concentrations. But this depends on the dose and how often someone uses cannabis.

Medicinal cannabis used for insomnia does not cause impairment the next day, and regular cannabis users show no driving impairment after 48 hours or more of abstinence.

Can I drive when taking medicinal cannabis? Is it safe?
CC BY-NC Medicinal cannabis prescriptions have skyrocketed in Australia, mostly for legal but unapproved products we don’t even know work or are safe. In this series, experts tease out what’s fuelling the rise of medicinal cannabis, the fallout, and what needs to happen next. Unlike alcohol, THC can make people more cautious behind the wheel. So drivers sometimes try to drive more carefully or leave a larger gap behind the car ahead. However, such strategies may not be enough to offset the impairing effects of THC, and they become less effective under more complex driving conditions. CBD does not impair cognition or driving. Most cannabis and driving studies have used healthy volunteers and deliberately intoxicating doses of THC. So we don’t know whether people are as impaired when using prescribed medicinal cannabis to manage a chronic health condition. In theory, a patient is likely to be less impaired if they use a low dose of THC, if they use the exact same amount of medicinal cannabis on a regular basis, or if medicinal cannabis relieves symptoms that can affect normal functioning, such as chronic pain. Can I legally drive after taking it? In every Australian state and territory, except Tasmania, it is illegal to drive with any detectable amount of THC in your system. Roadside drug testing, which checks for the presence of THC in saliva rather than impairment, cannot distinguish between prescribed medicinal cannabis and illicit cannabis. In Tasmania, you can lawfully drive with THC in your system so long as you are unimpaired and your medicinal cannabis was prescribed and dispensed in Tasmania. Other medications that can impair driving – such as opioids and benzodiazepines – do not carry the same prohibition on driving. You can drive with these medications in your system so long as you are unimpaired and using your medication as prescribed. Driving while impaired (as opposed to driving with the presence of a drug in your system) is a separate offence and applies to both medicinal cannabis and other medications. The discrepancy between how medicinal cannabis and other impairing medications are treated has been the focus of a parliamentary inquiry in New South Wales and broader law reform discussions. Victoria has now amended its road safety act to give magistrates the power to decide whether or not to cancel someone’s licence if they test positive for THC, are unimpaired, and have a valid medicinal cannabis prescription. Nonetheless, it remains illegal to drive in Victoria with THC in your system. You can lawfully drive if you are using a CBD-only medication, so long as you are not impaired. How can I drive safely? If you have been prescribed medicinal cannabis, there are practical steps you can take to reduce your risk when driving. First, speak to your doctor. Let them know you drive, especially if you rely on driving for work or caring responsibilities, or if you work in a safety-sensitive environment, such as construction. Together, you can discuss whether a product containing THC is appropriate, or whether a CBD-only product might be more suitable. Second, don’t just rely on how you feel when determining whether you are safe to drive. Even if you feel completely normal, your driving ability may still be compromised. Even if you are unimpaired, you can still test positive on a roadside drug test for hours after taking medicinal cannabis. The length of time is highly variable and depends on factors such as the dose, route of administration, and how often you take medicinal cannabis. The penalties for driving with THC in your system vary by state and territory. They range from fines to licence disqualifications and potential jail time for repeat offences. A blood test can detect THC days after taking it. So if you are involved in a crash and have THC in your blood, you could face severe legal penalties, and your car insurance may be voided. Roadside drug tests do not check for CBD. What don’t we yet know? Studies are underway to look at how medicinal cannabis impacts driving in people who take it for long-term health conditions, such as chronic pain. Researchers are also testing to see if sensors can detect cannabis impairment in real time while driving. Once these and other studies are complete, we’ll have a clearer picture of how medicinal cannabis affects drivers who take it for long-term medical conditions. To find out more about medicinal cannabis and driving, visit the Therapeutic Goods Administration’s medicinal cannabis hub or ask your health-care practitioner.

Authors: Tom Arkell, NHMRC Emerging Leadership Fellow, School of Health Sciences, Swinburne University of Technology

Read more https://theconversation.com/can-i-drive-when-taking-medicinal-cannabis-is-it-safe-271090

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