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Driving under the influence of cannabis: a 10‐year study of age and gender differences in the concentrations of tetrahydrocannabinol in blood
Author(s) -
Jones Alan W.,
Holmgren Anita,
Kugelberg Fredrik C.
Publication year - 2008
Publication title -
addiction
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 2.424
H-Index - 193
eISSN - 1360-0443
pISSN - 0965-2140
DOI - 10.1111/j.1360-0443.2007.02091.x
Subject(s) - driving under the influence , cannabis , tetrahydrocannabinol , dronabinol , poison control , urine , forensic toxicology , medicine , toxicology , injury prevention , chemistry , chromatography , cannabinoid , emergency medicine , psychiatry , biology , receptor
ABSTRACT Background  Δ 9 ‐Tetrahydrocannabinol (THC) is the major psychoactive constituent of cannabis and its various preparations. Increasing use of cannabis for recreational purposes has created a problem for road‐traffic safety. This paper compares age, gender and the concentrations of THC in blood of individuals apprehended for driving under the influence of drugs (DUID) in Sweden, where a zero‐tolerance law operates. Measurements  Specimens of blood or urine were subjected to a broad screening analysis by enzyme immunoassay methods. THC positives were verified by analysis of blood by gas chromatography‐mass spectrometry (GC‐MS) with a deuterium‐labelled internal standard (d 3 ‐THC). All toxicology results were entered into a database (TOXBASE) along with the age and gender of apprehended drivers. Findings  Over a 10‐year period (1995–2004), between 18% and 30% of all DUID suspects had measurable amounts of THC in their blood (> 0.3 ng/ml) either alone or together with other drugs. The mean age [± standard deviation (SD)] of cannabis users was 33 ± 9.4 years (range 15–66 years), with a strong predominance of men (94%, P  < 0.001). The frequency distribution of THC concentrations ( n  = 8794) was skewed markedly to the right with mean, median and highest values of 2.1 ng/ml, 1.0 ng/ml and 67 ng/ml, respectively. The THC concentration was less than 1.0 ng/ml in 43% of cases and below 2.0 ng/ml in 61% of cases. The age of offenders was not correlated with the concentration of THC in blood ( r  = −0.027, P  > 0.05). THC concentrations in blood were higher when this was the only psychoactive substance present ( n  = 1276); mean 3.6 ng/ml, median 2.0 ng/ml compared with multi‐drug users; mean 1.8 ng/ml, median 1.0 ng/ml ( P  < 0.001). In cases with THC as the only drug present the concentration was less than 1.0 ng/ml in 26% and below 2.0 ng/ml in 41% of cases. The high prevalence of men, the average age and the concentrations of THC in blood were similar in users of illicit drugs (non‐traffic cases). Conclusions  The concentration of THC in blood at the time of driving is probably a great deal higher than at the time of sampling (30–90 minutes later). The notion of enacting science‐based concentration limits of THC in blood (e.g. 3–5 ng/ml), as discussed in some quarters, would result in many individuals evading prosecution. Zero‐tolerance or limit of quantitation laws are a much more pragmatic way to enforce DUID legislation.

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