Motor vehicle crash fatalaties and undercompensated care associated with legalization of marijuana

Steinemann, Susan; Galanis, Daniel J; Nguyen, Tiffany; Biffl, Walter L.

doi:10.1097/ta.0000000000001983

Cited by 29 publications

(34 citation statements)

References 20 publications

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“…59 73-77 However, studies assessing the impacts of cannabis regulation on overdose or poisoning by drugs other than cannabis concluded that the effects were either beneficial (four outcome measures 64 76 78 79 ) or mixed/null (three outcome measures [80][81][82] ). Driving with detectable concentrations of THC was most often found to increase following decriminalisation or legal regulation (five of eight outcome measures; [83][84][85][86][87] ), but these studies were of lower average quality (X=12.0).…”

Section: Impacts Of Decriminalisation and Legal Regulationmentioning

confidence: 99%

Impact evaluations of drug decriminalisation and legal regulation on drug use, health and social harms: a systematic review

Scheim

Maghsoudi²,

Marshall

et al. 2020

BMJ Open

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ObjectivesTo review the metrics and findings of studies evaluating effects of drug decriminalisation or legal regulation on drug availability, use or related health and social harms globally.DesignSystematic review with narrative synthesis.Data sourcesWe searched MEDLINE, Embase, PsycINFO, Web of Science and six additional databases for publications from 1 January 1970 through 4 October 2018.Inclusion criteriaPeer-reviewed articles or published abstracts in any language with quantitative data on drug availability, use or related health and social harms collected before and after implementation of de jure drug decriminalisation or legal regulation.Data extraction and synthesisTwo independent reviewers screened titles, abstracts and articles for inclusion. Extraction and quality appraisal (modified Downs and Black checklist) were performed by one reviewer and checked by a second, with discrepancies resolved by a third. We coded study-level outcome measures into metric groupings and categorised the estimated direction of association between the legal change and outcomes of interest.ResultsWe screened 4860 titles and 221 full-texts and included 114 articles. Most (n=104, 91.2%) were from the USA, evaluated cannabis reform (n=109, 95.6%) and focussed on legal regulation (n=96, 84.2%). 224 study outcome measures were categorised into 32 metrics, most commonly prevalence (39.5% of studies), frequency (14.0%) or perceived harmfulness (10.5%) of use of the decriminalised or regulated drug; or use of tobacco, alcohol or other drugs (12.3%). Across all substance use metrics, legal reform was most often not associated with changes in use.ConclusionsStudies evaluating drug decriminalisation and legal regulation are concentrated in the USA and on cannabis legalisation. Despite the range of outcomes potentially impacted by drug law reform, extant research is narrowly focussed, with a particular emphasis on the prevalence of use. Metrics in drug law reform evaluations require improved alignment with relevant health and social outcomes.

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Section: Impacts Of Decriminalisation and Legal Regulationmentioning

confidence: 99%

Impact evaluations of drug decriminalisation and legal regulation on drug use, health and social harms: a systematic review

Scheim

Maghsoudi²,

Marshall

et al. 2020

BMJ Open

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show abstract

“…Fluid and electrolyte disorders may be due to the higher prevalence of hyponatremia and hypokalemia, and dehydration due to intractable hyperemesis in patients with excessive cannabis use . Cannabis impairs coordination and concentration and reduces reaction time that causes driving problems and motor vehicle accidents . The Cambridge Study of Delinquent Development found that cannabis use increases the risk of convictions and violence behavior (OR, 7.1) .…”

Section: Discussionmentioning

confidence: 99%

Cannabis Use Disorder and Epilepsy: A Cross‐National Analysis of 657 072 Hospitalized Patients

2019

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Background and Objectives Recent evidence has suggested that cannabis use precipitates cerebrovascular events. We investigated the relationship between cannabis use disorder (CUD) and hospitalization for epilepsy. Methods Nationwide inpatient sample (NIS) was analyzed from 2010 to 2014 for patients (age 15‐54) with a primary diagnosis of epilepsy (N = 657 072) and comparison was made between patients with ICD‐9 classification of CUD and without CUD. We utilized logistic regression to study the association (odds ratio [OR]) between CUD and epilepsy. Results The incidence of CUD in epilepsy patients was 5.77%, and patients with CUD had a threefold higher likelihood of emergency admissions. Patients with CUD were younger (25‐34 years), male and African American. In regression analysis, adjusted for confounders, cannabis (OR, 1.56), tobacco (OR, 1.20), and alcohol (OR, 1.63) use disorders were found to be associated with higher odds of epilepsy hospitalization, but lower odds with cocaine (OR, 0.953), amphetamine (OR, 0.893), and opioid (OR, 0.828) use disorders. Conclusions and Scientific Significance With the increasing prevalence of medical marijuana legalization, there is increased use of medicinal marijuana. Studies of cannabidiol and marijuana for epilepsy have been highly publicized, leading to its off‐label use for treatment. There is limited evidence to suggest that the cannabinoids may also induce a seizure. This study found that CUD is independently associated with a 56% increased likelihood of epilepsy hospitalization and this association persists even after adjusting for other substance use disorders and confounders. (Am J Addict 2019;28:353–360)

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“…Moreover, users of marijuana, in particular heavy users, are more likely to have problems with use of alcohol and other drugs [53]. It has been demonstrated that acute marijuana smoking impairs driving performance [54], with an increase in motor vehicle fatalities linked to marijuana legalization [55]. Both short-term [56] and long-term [57] use can lead to cognitive performance decline.…”

Section: Discussionmentioning

confidence: 99%

Chronic Marijuana Smoking Does Not Negatively Impact Select Blood Oxidative Stress Biomarkers in Young, Physically Active Men and Women

Butawan¹,

Smith²

2018

Health

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Background: The smoking of Cannabis sativa, the marijuana plant, is increasing in popularity among young adults, even those who may be engaged in regular exercise (i.e., athletes). Research has shown the plant to have antioxidant and analgesic properties, but the effects on oxidative stress are conflicting. The purpose of this study was to measure blood oxidative stress and cardio-metabolic parameters in physically active men and women who regularly smoke marijuana. Methods: A total of 43 marijuana smokers (23 ± 4 years) and 22 non-smokers (24 ± 7 years), who did not smoke tobacco products, participated in this study. Both smokers and non-smokers engaged in regularly exercise, totaling several hours per week (6.4 ± 4.0 and 6.8 ± 4.4, respectively). Smokers reported using marijuana frequently during the week (4.5 ± 2.3 sessions) for a minimum of three consecutive months prior to participating in the study. Blood samples were collected from participants following a 12-hour fast (all food, drink [except water] and smoking) and analyzed for malondialdehyde, advanced oxidation protein products, glucose, cholesterol, and triglycerides. Heart rate and blood pressure was also measured and recorded. Results: No differences of statistical significance were noted for any variable (p > 0.05), with very similar values noted between smokers and non-smokers. Conclusions: In a sample of young, physically active men and women, regular marijuana smoking is not associated with untoward effects on select biomarkers of oxidative stress and cardio-metabolic health. These findings do not suggest that marijuana smoking can be done without harm, as limitations of this study need to be considered.

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Motor vehicle crash fatalaties and undercompensated care associated with legalization of marijuana

Abstract: Prognostic, level III.

Cited by 29 publications

References 20 publications

Impact evaluations of drug decriminalisation and legal regulation on drug use, health and social harms: a systematic review

Impact evaluations of drug decriminalisation and legal regulation on drug use, health and social harms: a systematic review

Cannabis Use Disorder and Epilepsy: A Cross‐National Analysis of 657 072 Hospitalized Patients

Chronic Marijuana Smoking Does Not Negatively Impact Select Blood Oxidative Stress Biomarkers in Young, Physically Active Men and Women

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