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The road safety impact of cannabis has been a topic of much discussion and debate over the years. These discussions have been revitalized in recent years by initiatives in several jurisdictions to legalize non-medical cannabis. Canada became the second country to legalize non-medical cannabis use in October, 2018, preceded by Uruguay in December 2013. Road safety concerns were key issues in the Canadian government's deliberations on the issue. In this paper, we identify several key questions related to the impact of cannabis on road safety, and provide a consideration of the relevant literature on these questions. These questions cover several perspectives. From an epidemiological perspective, perhaps the central question is whether cannabis use contributes to the chances of being involved in a collision. The answer to this question has evolved in recent years as the ability to conduct the relevant studies has evolved. A related question is the extent to which cannabis plays an important role in road safety, and recent research has made progress in estimating the collisions, injuries, and deaths that may be attributed to cannabis use. Several questions relate to the behavioral and pharmacological effects of cannabis. One central question is whether cannabis affects driving skills in ways that can increase the chances of being involved in a collision. Another important question is whether the effects of the drug on the driving behavior of medical users is similar to, or different from, the effects on non-medical users and whether there are sex differences in the pharmacological and behavioral effects of cannabis. Other important questions are the impact of tolerance to the effects of cannabis on road safety as well as different routes of administration (e.g., edibles, vaped). It remains unclear if there is a dose-response relationship of cannabis to changes in driving. These and other key questions and issues are identified and discussed in this paper.

The objective of this study was to examine the associations of family, school, peer, and attitudinal factors with cannabis use among three immigrant generations of youth. The sample consisted of 3,134 students from the 2009 Ontario Student Drug Use and Health Survey, a provincewide survey of 7th- to 12th-grade students. Results indicate that the odds of using cannabis were lower among first-generation immigrant youth than among second as well as third and later generations. The immigrant generations were more similar than different in the significance of family, school, peers, and attitudinal factors on cannabis use. Parental education, however, was found to differ in its effect on cannabis use across generations. Findings suggest that factors that influence cannabis use may be similar across immigrant generations and that further research is needed on the effects of parental education and the mechanisms through which protection and risk to immigrant generations occur.

Research has shown that tobacco users have an increased risk of collisions compared to nonsmokers. Studies from 1967 through 2013 documented a crude relative risk of collision involvement of about 1.5 among smokers compared to nonsmokers. In January 2009, in response to concerns about the health risks associated with potentially high concentrations of secondhand smoke resulting from smoking in vehicles, the provincial government in Ontario, Canada, introduced legislation restricting smoking in vehicles where children and adolescents are present. We examined the association between reported smoking and involvement in a motor vehicle collision in a large representative sample of adult drivers in Ontario, Canada, from 2002 and 2016, with particular focus on 2002–2008 and 2010–2016, periods before and after the legislation. Data are based on the Centre for Addiction and Mental Health (CAMH) Monitor. Among licensed drivers, prevalence of self-reported collision involvement within the past year for 2002–2008 was 9.39% among those who currently smoked compared to 7.08% of nonsmokers. Following implementation of the legislation, for 2010–2016, the prevalence of collisions for smokers was 7.01% and for nonsmokers was 6.02%. The overall difference for both smokers and nonsmokers between the two time periods was statistically significant; however, the difference between the two groups for the pre-legislation period was significant even after adjusting for potential confounders, while post legislation the difference was not significant. Prior to the legislation, the prevalence of collision was higher among smokers than nonsmokers; following the introduction of the legislation the prevalence was similar for the two groups.

As many jurisdictions consider relaxing cannabis legislation and usage is increasing in North America and other parts of the world, there is a need to explore the possible genetic differences underlying the subjective effects of cannabis. This pilot study investigated specific genetic variations within the cannabinoid receptor 1 (CNR1) gene for association with the subjective effects of smoked cannabis. Data were obtained from a double-blinded, placebo-controlled clinical trial studying the impact of cannabis intoxication on driving performance. Participants randomized to the active cannabis group who consented to secondary genetic analysis (n = 52) were genotyped at the CNR1 rs1049353 and rs2023239 polymorphic areas. Maximum value and area under the curve (AUC) analyses were performed on subjective measures data. Analysis of subjective effects by genotype uncovered a global trend towards greater subjective effects for rs1049353 T-allele- and rs2023239 C-allele-carrying subjects. However, significant differences attributed to allelic identity were only documented for a subset of subjective effects. Our findings suggest that rs1049353 and rs2023239 minor allele carriers experience augmented subjective effects during acute cannabis intoxication.

Justice policy is typically based more on political considerations than on research results. One way to break down barriers between researchers and policy-makers is to encourage partnerships. AUTO21, a member of the Networks of Centres of Excellence program, is designed to facilitate partnerships. The Antisocial Behaviour and the Automobile project focuses on auto theft, driving under the influence of alcohol and cannabis, and road rage/driver aggression. The research areas that have had the greatest policy impact benefited from strong partnerships with organizations that have the visibility, authority, and resources to implement significant changes in program funding and social policy. These areas also have an extensive body of prior research.

Giesbrecht, N., Wettlaufer, A., Simpson, S., April, N., Asbridge, M., Cukier, S., Mann, R., McAllister, J., Murie, A., Pauley, C., Plamondon, L., Stockwell, T., Thomas, G., Thompson, K., & Vallance, K. (2016). Strategies to reduce alcohol-related harms and costs in Canada: A comparison of provincial policies. The International Journal Of Alcohol And Drug Research, 5(2), 33-45. doi:http://dx.doi.org/10.7895/ijadr.v5i2.221Aims: To compare Canadian provinces across 10 research-based alcohol policy and program dimensions.Design and Measures: The 10 Canadian provinces were assessed on the following 10 policy dimensions: alcohol pricing; alcohol control system; physical availability; drinking and driving; marketing and advertising; legal drinking age; screening, brief intervention, and referrals; server training, challenge, and refusal programs; provincial alcohol strategy; warning labels and signs. Data were collected from official documents, including provincial legislation, regulations, and policy, and strategy documents. Three international experts on alcohol policy contributed to refining the protocol. Provincial scores were independently determined by two team members along a 10-point scale for each dimension, and the scores were expressed as a percentage of the ideal. Weighting of dimensions according to scope of impact and effectiveness was applied to obtain the final scores. National and provincial scores were calculated for each dimension and consolidated into overall averages.Findings: Overall, the consolidated national mean is 47.2% of the ideal, with Ontario scoring highest at 55.9%, and Québec lowest at 36.2%. Across dimensions, Legal Drinking Age and Challenge and Refusal Programs scored highest at 75% and 61%, respectively, while Warning Labels and Signs scored lowest at 18% of the ideal. Pricing, rated third highest among dimensions at 57%, should nevertheless remain a priority for improvement, given it is weighted highest in terms of effectiveness and scope.Conclusions and Implications: Policy dimension scores vary among the provinces, with substantial room for improvement in all. Since spring 2013, several provinces have taken steps to implement specific alcohol policies. Concerted action involving multiple stakeholders and alcohol policies is required to reduce the burden of alcohol problems across Canada.

Justice policy is typically based more on political considerations than on research results. One way to break down barriers between researchers and policy-makers is to encourage partnerships. AUTO21, a member of the Networks of Centres of Excellence program, is designed to facilitate partnerships. The Antisocial Behaviour and the Automobile project focuses on auto theft, driving under the influence of alcohol and cannabis, and road rage/driver aggression. The research areas that have had the greatest policy impact benefited from strong partnerships with organizations that have the visibility, authority, and resources to implement significant changes in program funding and social policy. These areas also have an extensive body of prior research.