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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.

O objetivo deste estudo foi determinar as perspectivas dos familiares e pessoas próximas sobre fatores protetores para o uso de drogas ilícitas, em um centro de saúde em Guayaquil. Estudo descritivo, transversal, que utilizou questionário em amostra composta por 100 indivíduos. Os dados foram obtidos a partir das pessoas que têm um familiar ou amigo que usa drogas. Os resultados mostram que dos fatores pessoais e familiares que podem proteger contra o uso de drogas estão: 97% declararam que é possuir sólidos princípios morais, 96% expressar suas emoções, 98% dedicar tempo à família, 95% ter relação de apoio com um dos pais. Na comunidade, estão de acordo com a necessidade de ter um governo que entenda esse problema, 99% apontam para a necessidade da existência de policiais honestos e 99% programas que protejam as pessoas do uso de droga e instituições empenhadas na prevenção. Família, comunidade e a decisão pessoal têm influência e devem ser envolvidos, portanto, mostra-se a importância de se trabalhar para reforçar os fatores protetores e assim reduzir o número de pessoas adictas. ; La finalidad de este estudio fue determinar la perspectiva crítica que los familiares tienen sobre los factores de protección, en el uso de drogas ilícitas en un centro de salud de Guayaquil. Se trata de un estudio descriptivo y transversal, en el que se utilizó un cuestionario para entrevistar a 100 informantes. Se obtuvieron datos de personas que tienen un familiar o amigo que usa drogas ilícitas. Los resultados demostraron que las características personales y familiares que protegen al usuario de drogas ilícitas fueron: 97% tener sólidos principios morales; 96% expresar sentimientos y emociones; 98% tiempo que la familia dedica a estar reunidos, 95% relación de apoyo por parte de uno los padres, 100% existencia de un gobierno que considere a las drogas como prioridad, 99% una fuerza policial más honesta, 99% crear programas e instituciones dedicadas a la prevención. Se concluye que se deben desarrollar estrategias de prevención para el individuo, la familia y la comunidad. ; The objective of this study was to determine the perspectives of drug users' relatives and acquaintances about protective factors for illicit drug use at a health center in Guayaquil. This is a descriptive, cross-sectional study. Data collection was performed through interviews using a questionnaire. Interviews were performed with 100 people who knew a drug user (relative or friend). The results showed that the following personal and family factors could be protective: 97% having solid moral principles, 96% express their feelings, 98% dedicate time for the family, and 95 % have a supportive relationship with one of the parents. Regarding the community, all participants (100%) agree there is a need for a government that understands this issue, 99% refer there should be honest policemen, and 99% state the need for programs that protect people from drug use and institutions that work with prevention. Family, community and personal decisions have effects on becoming involved, hence the need to reinforce protective factors and thus reduce the number of addicted individuals.

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.

ABSTRACT Objective: to investigate the perception of harms and benefits associated with cannabis use among adolescents and how regulatory changes might affect their intention to use marijuana. Method: this multi-centric cross-sectional survey study. participants included 2717 students aged 15-17 from 10 cities in Belize, Brazil, Chile, Colombia, Dominican Republic, Jamaica, Mexico, St. Kitts and Nevis, and Trinidad and Tobago. Results: an average lifetime prevalence of cannabis use of 30.6% (25.8% past year, 15.8% past 30 days). Most participants reported that their closest friends use cannabis (60%); many (55%) stated that they would not use marijuana, even if it were legally available. Conclusion: statistics revealed that a strong perception of benefits, a low perception of risk, and friends' use of cannabis were associated with individual use as well as intention to use within a hypothetical context of regulatory change.