High Traffic —The Quest for a Reliable Test of Cannabis Impairment

In this issue of JAMA Psychiatry, Marcotte et al report that field sobriety tests (FSTs) as administered by highly trained police officers are insufficient to detect cannabis-induced impairment in a double-blind, placebo-controlled, parallel randomized clinical trial involving a large sample of 184 cannabis users. Although the group receiving active doses of Δ-9-tetrahydrocannabinol (THC), the active ingredient in cannabis, performed worse on the FSTs as compared with the placebo group; about half of the participants in the placebo group were classified as impaired. These findings are in line with previous placebo-controlled studies that also reported high false-positive FST rates under placebo. The legal implication of these findings can be major given that FSTs are currently part of the evaluation protocol in North America to detect drivers who are cannabis impaired. Yet, the lack of sensitivity of FSTs to detect THC-impaired individuals does n ot come as a big surprise, as FSTs have primarily been validated to detect gross alcohol impairment at high (more than 0.10%) blood alcohol concentrations. To add to this problem, there is no cannabis equivalent of a breathalyzer to verify exposure induced impairment, as trace amounts of THC in biom arkers correlate poorly with cannabis-induced behavioral impairment.
Source: JAMA Psychiatry - Category: Psychiatry Source Type: research