Tuesday, 1 November 2016

Fatal car crashes triple among drivers high on marijuana after legalization in Colorado; double in Washington state

Pamela Fayerman


Prime Minister Justin Trudeau’s plan to legalize marijuana should take into account “sobering” U.S. experiences where the first states to legalize the drug have seen big increases in fatal car crashes among cannabis-impaired drivers, according to a B.C. doctors’ group.

Washington State and Colorado started taxing and regulating cannabis in 2012 and the Council on Health Promotion, a section of Doctors of B.C., said vehicle fatality statistics, post-legalization, are “sobering.”

“In Washington State, fatal crashes among drivers who tested positive for marijuana doubled from eight per cent in 2013 to 17 per cent in 2014. In Colorado, the number of drivers in fatal crashes who tested positive for marijuana without other drugs in their system tripled between 2005 and 2014 from 3.4 per cent to 12.1 per cent,” Nanaimo General Hospital emergency room Dr. Chris Rumball said in an opinion piece in the B.C. Medical Journal, which he wrote on behalf of the council.

Indeed, marijuana is the most frequently detected drug in crash-involved drivers, after alcohol. So while the Canadian government intends to legalize recreational use of marijuana in 2017, studies are indicating that road safety concerns must be considered in the consequences, he said. And various levels of governments must find ways to mitigate the risks of driving while impaired by marijuana.

“Canadian discussions around the legalization of marijuana must include a clear-headed assessment regarding the impact of legalization on road safety. We must create a scientifically sound and fair approach … standards and penalties to enforce any new laws,” Rumball said.

Apart from more deaths related to stoned drivers, Rumball cites the lack of any scientifically proven and practical roadside testing tools for police which means that sobriety testing is left to only the most highly trained officers. When police suspect a driver is drug-impaired, they can demand a Field Sobriety Test. If the driver fails, they can be compelled to go to a police station for further evaluation and ordered to submit a blood, urine or saliva sample.

The cumbersome process has been highlighted by the AAA Foundation for Traffic Safety, which has called the increase in fatal crashes involving marijuana alarming.

“Washington serves as an eye-opening case study for what other states may experience with road safety after legalizing the drug,” said Peter Kissinger, foundation CEO.

Roadside and other testing is problematic because of a lack of scientifically valid tests and lack of consistency tying impairment to levels of marijuana metabolites in the blood. Marijuana affects people differently; frequent users may have persistently high levels of the drug long after use while drug levels can fall rapidly in occasional users. Rumball said while the most common standard used to label drivers as marijuana-impaired is 5 ng/mL, such levels vary significantly among jurisdictions.

THC, the main psychoactive ingredient, is fat soluble, which means it is hard to tie a person’s current state of impairment to a certain blood level.

Dr. Jeffrey Brubacher, a Vancouver General Hospital ER specialist who has done extensive research on impaired driving, said that while some may take issue with the American statistics or study designs, the increase in crashes and fatalities are disconcerting.
“And when marijuana is legalized, there will be an increase in crashes, injuries and fatalities,” Brubacher said.

Brubacher, who was not involved in Rumball’s piece, said there are about 80 specially trained police in B.C. who are drug recognition experts and law enforcement agencies should think about training far more for the post cannabis legalization era because roadside testing will be the greatest deterrent to marijuana-impaired driving.

“We probably need to give police extra authority to do random drug testing because right now, people do not believe they will get caught,” he said.

In research published in the British Medical Journal earlier this year, Brubacher and his co-authors showed the results from crash patients sent to seven trauma hospital centres in B.C. from 2010 to 2012. Study participants were drivers who had a blood test within six hours of a crash. Overall, 40.1 per cent of drivers injured tested positive for alcohol or at least one other drug and 12.7 per cent tested positive for more than one impairing substance.

Brubacher said while alcohol is involved in about a third of serious motor vehicle accidents resulting in severe injuries or deaths “We do know a stoned driver is safer than a drunk driver.”

“But a sober driver is still the safest,” he said.

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