Resumen
Background and aims: Cannabis and alcohol are frequently detected in fatal and injury motor vehicle crashes. While epidemiological meta-analyses of cannabis and alcohol have found associations with an increase in crash risk, convergent evidence from driving performance measures is insufficiently quantitatively characterized. Our objectives were to quantify the magnitude of the effect of cannabis and alcohol—alone and in combination—on driving performance and behaviour. Methods: Systematic review and meta-analysis. We systematically searched Academic Search Complete, CINAHL, Embase, Scopus, Google Scholar, MEDLINE, PsycINFO, SPORTDiscus and TRID. Of the 616 studies that underwent full-text review, this meta-analysis represents 57 studies and 1725 participants. We extracted data for hazard response time, lateral position variability, lane deviations or excursions, time out of lane, driving speed, driving speed variability, speed violations, time speeding, headway, headway variability and crashes from experimental driving studies (i.e. driving simulator, closed-course, on-road) involving cannabis and/or alcohol administration. We reported meta-analyses of effect sizes using Hedges’ g and r. Results: Cannabis alone was associated with impaired lateral control [e.g. g = 0.331, 95% confidence interval (CI) = 0.212–0.451 for lateral position variability; g = 0.198, 95% CI = 0.001–0.395 for lane excursions) and decreased driving speed (g = –0.176, 95% CI = –0.298 to –0.053]. The combination of cannabis and alcohol was associated with greater driving performance decrements than either drug in isolation [e.g. g = 0.480, 95% CI = 0.096–0.865 for lateral position variability (combination versus alcohol); g = 0.525, 95% CI = 0.049–1.002 for time out of lane (versus alcohol); g = 0.336, 95% CI = 0.036–0.636 for lateral position variability (combination versus cannabis; g = 0.475, 95% CI = 0.002–0.949 for time out of lane (combination versus cannabis)]. Subgroup analyses indicated that the effects of cannabis on driving performance measures were similar to low blood alcohol concentrations. A scarcity of data and study heterogeneity limited the interpretation of some measures. Conclusions: This meta-analysis indicates that cannabis, like alcohol, impairs driving, and the combination of the two drugs is more detrimental to driving performance than either in isolation.
| Idioma original | English |
|---|---|
| Publicación | Addiction |
| DOI | |
| Estado | Accepted/In press - 2022 |
Nota bibliográfica
Funding Information:Associate Librarian Laura Koltutsky provided guidance related to database selection, electronic search strategy development and study screening. DDS Specialists Lorraine Baker, Kathleen James, Glenda Magallon, Kathy McDonnel, Lana Wong and Judy Zhao processed numerous interlibrary loan requests. The following individuals assisted with abstract screening, full‐text reviews and study quality and risk of bias assessments: Dongzhao Shelley Liu, Gabby Janikian, Louisa Krile and Adam Turner. The following researchers provided missing data: Thomas Arkell, Mark Fillmore, Arne Helland, Danielle McCartney, Nicola Starkey and Mark Vollrath. Finally, we would also like to thank Michael Borenstein for providing technical advice. This research received financial support from a URGC SSH Faculty Seed Grant. The funder did not have a role in the design of the study, its execution, its reported findings or publication.
Publisher Copyright:
© 2021 Society for the Study of Addiction
ASJC Scopus Subject Areas
- Medicine (miscellaneous)
- Psychiatry and Mental health
PubMed: MeSH publication types
- Journal Article
- Meta-Analysis
- Review
- Systematic Review
ODS de las Naciones Unidas
Este resultado contribuye a los siguientes Objetivos de Desarrollo Sostenible
