The effects of cannabis and alcohol on simulated driving: Influences of dose and experience

► Cannabis and alcohol are the most popular drugs amongst recreational users. ► We assessed the effect combining alcohol and cannabis has on simulated driving. ► Addition of alcohol to low (21%) and high (17%) dose of THC produced an additive decrement on driving. Cannabis and alcohol are the most popular drugs amongst recreational users, and most prevalent in injured and deceased drivers. Clarification of the interactive effects of these drugs upon driving behaviour is critical for reducing drug-related road deaths. The current study had two objectives, to examine the effects of cannabis and alcohol on driving performance, and identify if any differences between the effects of cannabis and alcohol on driving performance exist between regular cannabis users and non-regular cannabis users. The project involved 80 participants (49 male, 31 female) who were abstinent recreational users of alcohol and marijuana. They participated in six experimental sessions that involved the consumption of cannabis cigarettes containing no THC, 1.8% THC or 3% THC together with the consumption of alcohol to obtain either 0% BAC, 0.03% BAC or 0.05% BAC. The six sessions were double-blind, counter-balanced, placebo-controlled and medically supervised. Forty participants were allocated to the cannabis with low alcohol (0.03% BAC) group, and 40 participants were allocated to the cannabis with high alcohol (0.05% BAC) group. Driving simulator performance was assessed at 20min post-drug administration and blood samples were taken before and after driving. Driving simulator performance was more impaired in the THC and alcohol combined conditions. Consistent with past research, the level of THC detected in blood is higher when THC is consumed with alcohol, than when cannabis is consumed alone, and regular cannabis users returned higher levels of THC in plasma than non-regular users. Generally, regular cannabis users displayed more driving errors than non-regular cannabis users.