Impact of Repeated Cannabis Treatments on Driving Abilities

May 18, 2011

A sig­nif­i­cant con­cern in uti­liz­ing cannabis, a known psy­choac­tive drug, in the treat­ment of med­ical con­di­tions is the poten­tial for neg­a­tive cog­ni­tive side effects. Dri­ving is a com­plex activ­ity requir­ing numer­ous cog­ni­tive abil­i­ties, includ­ing con­tin­u­ous track­ing, sequen­tial move­ments, judg­ment, plan­ning, per­cep­tion, atten­tion and speeded infor­ma­tion pro­cess­ing. Pre­vi­ous stud­ies have demon­strated that a sin­gle dose of mar­i­juana results in mild dri­ving impair­ments, the equiv­a­lent of a blood alco­hol con­cen­tra­tion of .03 or greater. The prin­ci­pal aim of the present study is to exam­ine whether rou­tine admin­is­tra­tion of cannabis in the med­ical treat­ment of HIV-related neu­ropa­thy and spas­tic­ity asso­ci­ated with mul­ti­ple scle­ro­sis results in sig­nif­i­cant impair­ment in dri­ving abil­i­ties. In order to achieve this aim, dri­ving sim­u­la­tor assess­ments will be linked to two stud­ies pro­posed by UCSD inves­ti­ga­tors. In Study I (R.J. Ellis, PI), the util­ity of cannabis as a treat­ment for neu­ro­pathic pain in AIDS patients will be assessed using a double-blind, placebo-controlled cross-over design. In Study II (J. Corey-Bloom, PI), the effec­tive­ness of cannabis in reduc­ing spas­tic­ity asso­ci­ated with mul­ti­ple scle­ro­sis will also be eval­u­ated using cannabis. Sub­jects in the present study will fol­low the pro­to­cols out­lined in the Study I and II sub­mis­sions. The pro­to­col and bud­get for each Study are clearly pre­sented in order to facil­i­tate adjust­ments should one of the pro­posed stud­ies not be funded. Sub­jects will be tested on dri­ving sim­u­la­tions that assess stan­dard devi­a­tion of lane posi­tion and coher­ence — mea­sures which have been shown to be sen­si­tive to med­ica­tion effects. Sub­jects will be tested at (1) base­line, fol­low­ing one month of absti­nence from mar­i­juana use, (2) one hour after the final dose in the ini­tial treatment/placebo phase, (3) three hours fol­low­ing the final dose, (4) 18 hours after the final dose; and then a sim­i­lar test­ing sched­ule fol­low­ing the sub­se­quent treatment/placebo arm (assess­ments 5, 6, and 7). As a result of these stud­ies, we will improve our knowl­edge regard­ing the impact of repeated cannabis admin­is­tra­tion on dri­ving abil­i­ties, both acute and fol­low­ing overnight absti­nence. These data will thus pro­vide greater insights regard­ing the real life impact of using “mar­i­juana as medicine.”



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