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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A lawmaker in Ohio has introduced a bill that would help marijuana users in the state avoid a costly impaired driving charge. 

News 5 Cleveland reports that the legislation, introduced by a Republican state senator, “would change the standards of the Operating a Vehicle Under the Influence (OVI) law,” and “help update Ohio laws due to the prevalence of medical marijuana licenses.”

The station said that the bill would help drivers avoid “facing charges for driving with THC in their system as long as they can prove they weren’t impaired.”

“Under the current statute for an OVI, it’s testing whether or not it’s in your system. Now that we have legalized it for medical purposes, I think we need to update the statute to where we’re looking at whether or not somebody is impaired,” GOP state Sen. Nathan Manning told News 5 Cleveland. 

“Marijuana in general is a lot different than alcohol, alcohol is lot more black and white,” he added.

Ohio lawmakers passed a bill legalizing medical cannabis in 2016, and sales began in the Buckeye State three years later. 

According to the Ohio Medical Marijuana Control Program, there are more than 330,000 registered medical cannabis patients in the state. The state announced last year that its medical cannabis program had generated nearly $725 million in sales since 2019.

Ohio patients with the following qualifying conditions are eligible for medical cannabis treatment under the state’s law: AIDS, amyotrophic lateral sclerosis, Alzheimer’s disease, cachexia, cancer, chronic traumatic encephalopathy, Crohn’s disease, epilepsy or another seizure disorder, fibromyalgia, glaucoma, hepatitis C, Huntington’s disease, inflammatory bowel disease, multiple sclerosis, pain that is either chronic and severe or intractable, Parkinson’s disease, positive status for HIV, post-traumatic stress disorder, sickle cell anemia, Spasticity, spinal cord disease or injury, terminal illness, Tourette syndrome, traumatic brain injury and ulcerative colitis.

Advocates say the medical cannabis law, and the ubiquity of the treatment statewide, has created a dilemma for law enforcement and patients alike.

“In an OVI, we are charged with being medicated on stuff you bought legally from a dispensary or smoke shop,” Ally Reaves with Midwest CannaWomen told News 5 Cleveland. “That’s not fair.”

The bill introduced by Manning “would allow drivers to have up to 25 nanograms of THC per milliliter in their urine instead of the current 10,” and “would raise the concentration from two to five nanograms of THC per milliliter” for blood, according to the station.

Shifting those standards is crucial, given how long THC can remain in a person’s system. 

“Our policemen and women that are enforcing these traffic laws are doing a great job and very often are not charging anybody unless they are showing signs of impairment, whether that’s through their field sobriety tests or their own observations,” Manning told News 5 Cleveland. “But there are situations where somebody is arrested and has consumed marijuana in the previous few days and technically would be above that ‘per se’ level, even though there’s no impairment whatsoever.”

“The consensus of the scientific community is clear that there is no acceptable limit of marijuana that automatically makes a person impaired,” Manning added. “Impairment must be considered on a case-by-case basis considering all of the available evidence.”

As the number of enrolled medical cannabis patients has grown in Ohio, so too is the number of places where they can legally obtain the product. 

A state medical cannabis regulator said last year that Ohio was aiming to double the number of dispensary licenses in the state by adding more than 70 to the existing 58.

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Individuals enrolled in Massachusetts’ driver’s education program will receive a new lesson starting next year.

According to State House News Service, the Registry of Motor Vehicles, which oversees the program in the Bay State, “indicated Monday that is adopting the AAA curriculum, which is called ‘Shifting Gears: The Blunt Truth About Marijuana and Driving,’ in partnership with members of the Cannabis Control Commission.”

The outlet reports that the Registry of Motor Vehicles “plans a formal announcement on Friday at the Worcester Registry of Motor Vehicles,” and that it “indicated the curriculum will be adopted in January, and will update the driver education module to include research-based information on cannabis and an explanation of how tetrahydrocannabinol (THC), the active chemical in marijuana, affects cognition, vision, reaction time, and perception of time and distance.”

Per local news station WCVB, the program will make Massachusetts “the first state in the nation with legal recreational marijuana to add lessons about cannabis impairment to driver’s education programs.”

“The current driver education module addressing impaired driving will be updated to include research-based information on cannabis, explaining how tetrahydrocannabinol (THC), the active chemical in marijuana, affects cognition, vision, reaction time, and perception of time and distance,” officials with the Massachusetts Department of Transportation said, as quoted by WCVB.

In a statement quoted by State House News Service, the Registry of Motor Vehicles said that next year’s driver’s education enrollees will represent “the first generation of driver education students to be licensed since cannabis became legal in Massachusetts, and AAA research shows that impaired driving crashes may increase and continue to injure and kill motorists and their passengers.”

Such curricula will likely become even more prevalent as more states enter the era of legalization and end prohibition on recreational pot use. 

Last year, Massachusetts Gov. Charlie Baker, a Republican, signaled that he wanted to address the problem of stoned driving in the state, which legalized weed in 2016.

Baker threw his support behind legislation called the “Trooper Thomas Clardy Law,” which bears the name of the late Massachusetts State Trooper Thomas L. Clardy, who died while making a traffic stop in 2016 after his vehicle was hit by a motorist who had THC in his blood.

“This legislation aims to make the Commonwealth’s roads safer and save lives, and we are grateful to the Clardy family for offering their family’s name and support for this legislation, which will help us avoid impaired driving incidents in the future,” Baker said in a statement at the time. “This bill will provide law enforcement officers with more rigorous drug detection training and will strengthen the legal process by authorizing the courts to acknowledge that the active ingredient in marijuana can and does impair motorists. The bill draws on thoughtful recommendations from a broad cross-section of stakeholders, and we look forward to working with our legislative colleagues to pass this bill and make our roads safer.”

But the legislation went up in smoke in the Massachusetts legislature earlier this year after some Democratic lawmakers expressed concern over the reliability of the testing devices.

Officials in Virginia are currently considering their own potential mechanisms to rein in the problem of marijuana-impaired driving, after the Commonwealth legalized recreational cannabis use last year, becoming the first state in the U.S. south to do so.

And in New York, which legalized marijuana last year and is currently preparing to open its regulated weed retailers, officials are said to be “scrambling” to find a reliable marijuana DUI test. 

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The Governors Highway Safety Association (GHSA) commissioned a report about educational campaigns on cannabis and driving on July 26. The GHSA partnered with National Alliance to Stop Impaired Driving to create a playbook written specifically for State Highway Safety Offices (SHSO).

Governors Highway Safety Association’s Executive Director, Jonathan Adkins, explained the need for a playbook that is up to date regarding cannabis legalization, overall acceptance of cannabis by consumers, and more. “As legal cannabis use becomes more widespread in the U.S., motorists need to know the dangers of driving under the influence,” said Adkins. “But that message won’t be heard if it’s outdated, irrelevant or insulting to cannabis consumers. This new report offers a playbook to help states develop messaging that resonates with cannabis users and prompts them to refrain from driving for their own safety and the safety of everyone else on the road.”

The report, called “Cannabis Consumers and Safe Driving: Responsible Use Messaging,” is based on a variety of surveys and interviews, and expands upon an unpublished 2021 Cannabis Regulators Association white paper with “additional strategies and recommendations about promising practices that can enhance safety partnerships and increase the effectiveness of outreach and education on cannabis use and driving.”

The report states that prior to the pandemic, approximately 21% of drivers involved in fatal vehicle crashes had THC in their systems. During the pandemic, this percentage rose to 33% (and for comparison, the percentage of people with alcohol in their systems was only 29%). In a survey conducted by AAA Foundation for Traffic Safety Culture Index, drivers view impairment of alcohol and cannabis differently. When asked about driving while under the influence of alcohol, 95% of people believed it was “very or extremely dangerous.” When asked the same question about cannabis, only 69% responded with the same answer.

The GHSA report writes that further education is key to promoting safe driving and enforcement. It reviewed educational campaigns that have been implemented in Colorado and Washington, which were the first states to legalize cannabis. It also addressed current education efforts that learn from those earlier campaigns, such as the “simple, non-judgmental” messages in Connecticut that have been promoted on social media channels, radio, TV, billboards, bus panels, and printed materials. While cannabis became legal in Connecticut on July 1, 2021, retail sales won’t begin until later this year. However, the report also examines an educational campaign in Wyoming, where cannabis is currently still illegal.

After reviewing the content, the report addresses “promising practices” that the authors view as useful for developing education campaigns, such as partnering with cannabis industry groups, receiving dedicated funding, and using specific wording in campaign messages.

In more detail, the report’s five main recommendations explore campaign success based on the presented examples.

First, it recommends that funding be derived from cannabis sales tax revenue, in partnership with local state legislators. Second, it highly recommends partnering with a variety of cannabis groups with the shared goal of consumer safety. “Working together, collaborative education campaigns can reflect the desires of all partners to help keep cannabis consumers safe,” the report explained.

Third, the report also explained the importance of the campaign messengers. Government leaders and institutions are “generally not good choices,” so it’s essential to choose respected individuals who are a part of the cannabis community to get the point across. The specific words chosen for a campaign can also lend to its success and maintain credibility, such as avoiding archaic terms such as pot or weed, or using “consumer” instead of “user.”

Finally, the report states that a campaign message should be chosen with care and respect. “Insulting or judging the target audience rarely improves message reception and turns people off, resulting in the message getting lost. Not driving after using cannabis should be the primary focus of informational campaigns, not the use of cannabis itself,” the report explains. “Messaging that appeals to the risks versus rewards of driving after consuming cannabis can be effective with the target audience, which tends to be young and male. Because it is not clear what responsible use of cannabis really is or looks like, appeals to moral sensitivity—normative choices that are considered ‘good’ or ‘right’—may have a greater effect on changing behavior than the usual ‘just don’t do it’ messaging.”

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