The results of a recent study published in JAMA Network Open claim to have found an association between cannabis legalization and an increase in traffic accidents.

The study was conducted by researchers at the University of Ottawa and looked at emergency room visits in Ontario, Canada over a 13-year period (Jan 2010-Dec 2021 which is actually 12 years but they say 13 in the study so what do I know), at the end of which they denoted a 475.3% increase in traffic accidents that resulted in an emergency room visit in which the driver had cannabis in their system at the time of the accident.

“This cross-sectional study found large increases in cannabis involvement in ED visits for traffic injury over time, which may have accelerated following nonmedical cannabis commercialization,” the conclusion of the study said. “Although the frequency of visits was rare, they may reflect broader changes in cannabis-impaired driving. Greater prevention efforts, including targeted education and policy measures, in regions with legal cannabis are indicated.”

At first glance, 475.3% sounds like a big number and suffice it to say many of the anti-cannabis media outlets who repackaged that number for a scary-sounding headline are counting on their readership to look no further and take their word for it that cannabis legalization and car crashes must be associated. I’m a journalist, not a scientist, but I am able to point out some facts about the study that might make that big number seem a bit less scary.

For one thing the study was only conducted in Ontario, Canada. In terms of sample size, that is one city in a country with very specific cannabis laws so to lay the blanket term “legalization” over one very specific set of laws isn’t totally accurate. The study even says so in the introduction:

“Another study also found no increase in total traffic injury hospitalizations in Canada over 2.5 years following legalization. Critically, the slow rollout of the cannabis retail market in Canada and the overlap of the legalization period with the COVID-19 pandemic greatly reduces the ability of these studies to evaluate the impacts of legalization,” the study said.

It’s also important to understand that the total number of injury-causing traffic accidents involving cannabis in the 13-year period came to a grand total of 426 out of 947,604. That number as a percentage is .04%, which is even smaller when compared to the total number of traffic accidents without taking emergency room visits into account. It’s hardly insignificant, but it is, arguably, a much less daunting number at first glance than 475.3%.

One key piece of data the study highlighted was that men appear to be more at risk than women of being involved in such accidents where cannabis intoxication was considered a factor. This stands to reason as a 2016 study by the National Institute of Health found men to use cannabis far more often than women and in greater amounts per use.

“Of the 418 individuals with documented cannabis involvement, 330 (78.9%) were male, 109 (25.6%) were aged 16 to 21 years (mean [SD] age at visit, 30.6 [12.0] years), and 113 (27.0%) had an ED visit or hospitalization for substance use in the 2 years before their traffic injury ED visit,” the study said.

The last and arguably most important question one must ask when dissecting the results of a study is “who paid for this?” Studies cost money, and it goes without saying that people who have money often try to use that money to influence the results of otherwise scientifically sound methods of observation. This is America after all (Or Canada, in this case). However, this study was funded in its entirety by grants from the Canadian Institute of Health and the University of Ottawa, meaning there does not appear to be any private money attempting to sway these results.

Regardless of my nitpicking, this study did point out something important: there is a small but statistically significant chance that a link between cannabis legalization and severe traffic accidents exists, but more context and study is needed to be sure.

“The findings of this repeated cross-sectional study suggest that cannabis-involved severe traffic injuries have increased over time. Legalization of nonmedical cannabis with widespread retail access and increased cannabis product variety may have further increased these visits despite laws specifically aimed at deterring cannabis-impaired driving,” the study said. “Younger adults and males appear to be at particularly increased risk of cannabis-involved traffic injuries. There is a potential need for greater interventions, including education on cannabis-impaired driving, enforcement activities, and policies to regulate access to commercial retail markets.”

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Neither the legalization of adult-use cannabis nor the uptick in retail sales is correlated with an increase in car accidents, NORML reports. The data comes from a study published earlier this month in the Drug and Alcohol Review.

Canadian scientists looked at the number of traffic accidents in Toronto both in the years prior to and then directly after the city legalized adult-use cannabis. 

According to their report: “[N]either the CCA [Canadian Cannabis Act] nor the NCS [number of cannabis stores per capita] is associated with concomitant changes in (traffic safety) outcomes. … During the first year of the CRUL’s [cannabis recreational use laws] implementation in Toronto, no significant changes in crashes, number of road victims and KSI [all road users killed or severely injured] were observed.”

In the U.S., the risk of increased car crashes due to stoned driving is often cited as a reason not to legalize adult-use cannabis. Throughout the years, various studies have reported conflicting information and led to different results depending on whom you ask and what their position on cannabis is. For example, a 2021 U.S. study suggested that auto accident rates rose in California, Colorado, Nevada, Oregon, and Washington, where recreational cannabis use and retail sales are legal, as Newsweek reported. However, if you read the entire article, you notice that at the end, it mentions that the study in question, which used information from injured drivers in emergency rooms in Denver, Colorado; Portland, Oregon; and Sacramento, California, only saw an increase in car accidents when cannabis was paired with alcohol. 

According to the CDC, in 2020, 11,654 people were killed in motor vehicle crashes involving alcohol-impaired drivers, which accounted for 30% of all traffic-related deaths in the U.S. The annual estimated cost of car crash deaths involving alcohol-impaired drivers totaled about $123.3 billion in 2020, including the estimate for lives lost and medical bills. Not only is alcohol legal, but it’s not beholden to the same insane tax laws as cannabis, which, by strangling the legal market, only seem to allow the black market to flourish. The cannabis industry paid over $1.8 billion in additional taxes in 2022 alone. 

The findings of the Toronto Drug and Alcohol Review study are consistent with other Canadian research. For instance, a 2021 study in the journal Drug and Alcohol Dependence “found no evidence that the implementation of the Cannabis Act [which legalized adult-use in Canada] was associated with significant changes in post-legalization patterns of all drivers’ traffic-injury ED [emergency department] visits or, more specifically, youth-driver traffic-injury ED presentations.” As NORML points out, another study published earlier this year similarly concluded, “Overall, there is no clear evidence that RCL [recreational cannabis laws] had any effect on rates of ED visits and hospitalizations for either motor vehicle or pedestrian/cyclist injury across Canada.”

However, in the U.S., insights into the correlation between cannabis legalization and traffic accidents tend to bend to meet Republicans’ regressive and scientifically unsound views. As Benzinga reports, regarding a 2023 bill meant to curb Connecticut’s legal market, State Senator Paul Cicarella (R), a ranking member of the Public Safety and Security Committee, told NBC Connecticut’s Mike Hydeck: “There’s not really a test that can determine when somebody is under the influence of the marijuana,” he said, adding that that the “false positive rate and false negative rate is so high that again, that might be a challenge to be admissible in court as well.” 

The race is indeed on to create a THC breathalyzer. However, anti-cannabis lawmakers fail to grasp that people are already using cannabis, whether it’s legal or not. While cannabis is considered a generally safe substance, like any mind-altering drug, of course, one should consider safety measures such as driving and always using it responsibly. However, if the U.S. truly wants to focus on safety, its priority should be correcting tax laws and legalization on a Federal level because unless that happens, there won’t be a legal market to study. 

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As cannabis legalization continues to sweep states across the country, we’re collectively able to examine trends regarding the potential positive and negative effects of a more widespread, adult-use cannabis market. One notion around cannabis legalization continuously points to the potential for more traffic accidents and increased danger on the road, but one new study, specifically looking at cannabis legalization and truck driving, suggests the opposite could be true.

The study, humorously titled “Marijuana Legalization and Truck Safety: Does the Pineapple Express Damage More Pineapples?” has researchers from the University of Tennessee, University of Arkansas, and Iowa State University honing in on America’s $800 billion truck driving industry. 

Using a state-level panel of heavy truck crash statistics from 2005 to 2019, and a difference-indifference estimation strategy, the researchers tested whether legalization of cannabis has affected the crash rate of heavy trucks. The results show that legalization, in fact, does not increase average crash rates in the states examined.

On the contrary, the research found that recreational cannabis legalization actually reduced the amount of heavy truck accidents by 11%. Specifically, six of the eight states examined, saw a decrease in truck accidents and two saw increases. Vermont and Washington saw the most profound decreases, at -21.5% and -20.1%, respectively, followed by Colorado and Massachusetts, at -18.3% and -18% respectively, and finally Oregon and California, at -3.7% and -3.2%, respectively. The two states reporting increases were Maine at 4.18% and Nevada at 25.6%.

It’s important to note that this is a preprint, meaning that the study has yet to undergo peer review.

Researchers didn’t offer a solid explanation around the reduction in crashes following cannabis legalization, though they offered a couple of theories:

People who might typically drink alcohol could have switched to cannabis. Though it’s still against the law to drive under the influence of cannabis, research suggests that driving high is far less likely to cause a fatal accident than driving under the influence of alcohol. Of course, the safest route is to get behind the wheel fully sober.

They also cite that cannabis is generally consumed at home, rather than at a bar or a restaurant, so even if a trucker partakes, they probably aren’t able to easily access or consume cannabis on the job.

The researchers also wanted to more closely examine the increase in crashes in Nevada by comparing the state to Vermont, which saw the largest decrease by state. They found that Vermont has far less tourism than Nevada, meaning that there are more people traveling who are unfamiliar with the state’s roadways in Nevada. Travelers in Nevada are also more likely to use cannabis outside of the home—like those visiting Las Vegas, for example—indicating a higher likelihood of those folks getting behind the wheel after using cannabis.

Because Vermont is also more densely populated than Nevada, longer stretches of road in the latter state offer more opportunity for crashes.

Some of the findings also contract other recent studies on legal cannabis and driving. One 2021 study from Boston University found that fatal car crashes involving alcohol haven’t decreased over the past two decades, though cannabis-involved fatal accidents doubled, according to the study. Others have suggested that cannabis may increase the overall rates of accidents without necessarily increasing the likelihood of fatal car accidents.

The trucking industry has also faced a number of changes in the wake of cannabis legalization. In January 2020, the Federal Motor Carrier Safety Administration launched its drug and alcohol clearinghouse. It lists all commercial drivers who have failed a drug or alcohol test, though drivers are able to clear their names by following a return-to-duty process.

The clearinghouse is aimed to ensure truck drivers violating drug and alcohol rules aren’t able to quickly secure another trucking job without amending their past behavior and ultimately aims to increase truck safety on the road.

While it’s not fully clear yet how much these aims have increased safety for truckers on the road and other drivers, it has removed a number of drivers. Between January 2020 and April 2022, around 124,000 drivers were removed from their roles as commercial truck drivers because of failed drug tests, and around 31,000 have completed the return-to-duty procedure to return to the road.

Though, the majority of the violations don’t involve drugs like opioids, amphetamines, methamphetamine or cocaine but, you guessed it, cannabis. More than 74,000 truckers who tested positive for cannabis have been removed from commercial truck driving since January 2020.

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