Effects of High-Potency Cannabis on Psychomotor Performance in Frequent Cannabis Users

Abstract

Background: Recently increased access to cannabis products in the United States has been associated with increased rates of driving after cannabis use. Although numerous studies indicate that cannabis impairs psychomotor and neurocognitive functions that can affect driving ability, the determination of cannabis-impaired driving risk is complicated by the extent to which frequent cannabis users develop tolerance to THC's subjective, cognitive, and psychomotor effects, and by the fact that there is no validated behavioral or biological marker of recent cannabis use or cannabis-related impairment. This study examined the psychomotor impairment-related effects experienced by frequent cannabis users in Colorado after naturalistic consumption of smoked cannabis, both immediately and 1 h postuse. Results were then validated in a smaller replication sample from Washington state. Methods: In the primary Colorado study, participants (n=70) used the DRUID® mobile app, a brief measure of psychomotor and cognitive domains that are sensitive to the effects of cannabis. First, participants used DRUID to establish a sober baseline impairment score. During a second appointment, they used DRUID at three time points: preuse, immediately after acutely using cannabis, and 1 h postuse. In the Washington replication sample, participants (n=39) used DRUID before acute cannabis consumption and then every half hour for 2.5 h. Results: In both studies, peak DRUID impairment effects were seen immediately after cannabis use, with recovery of performance at 1 h postuse. Specifically, significant quadratic effects of time emerged for both studies (Colorado study: (β=-0.935, SE=0.204, p<0.001); Washington study: β=3.0299, SE=1.3085, p<0.01). Domain-specific effects were tested in the larger Colorado study and were observed for reaction time within a complex divided attention task and a postural-stability balance task. Conclusions: These findings demonstrate that psychomotor impairment emerges immediately after acute cannabis use even in regular users, but decreases significantly 1 h postuse. These results underscore the potential utility of the DRUID app for assessing acute cannabis-related psychomotor impairment. Further research is needed to explore whether the DRUID app and/or the specific psychomotor functions it assesses might serve as a tool for measuring cannabis-related driving impairment. Clinical trials registration number for the Colorado Study: NCT03522103.

Keywords: cannabis; driving; impairment; neurocognitive; psychomotor.

Conflict of interest statement

Dr. DeJong is a shareholder with Impairment Science, Inc. Dr. Milburn is the founder and chief science officer for Impairment Science, Inc.

Figures

FIG. 1.

DRUID® total impairment scores after acute cannabis ingestion across Colorado and Washington samples. The Y-axis represents DRUID total impairment score. On the X-axis, “0” represents the preuse time point. The second time point for the Colorado study was ∼14 min later, as individuals spent an average of 14 min in their homes consuming their cannabis product, and the postuse measurement was taken immediately when they returned to the mobile laboratory. The second time point for the Washington sample took place ∼30 min after subjects initiated consumption. Subjects took an average of 20 min to consume their product. Both studies took a third measurement 60 min after the baseline measurement, and the Washington sample took three more measurements every 30 min.