#72
Notable Clinical Interest
Emerging findings or policy developments worth monitoring closely.
Clinicians need to counsel patients about cannabis-impaired driving risks, particularly older adults who may not recognize cognitive and motor changes that increase crash risk. Screening for cannabis use before driving and assessing individual impairment patterns should become part of standard safety discussions, similar to alcohol counseling. Understanding these driving risks helps clinicians provide evidence-based guidance that protects patient safety and public health.
Research led by Professor Carolyn DiGuiseppi examining cannabis use and driving safety in older adults reveals significant impairment risks that clinicians should assess when counseling patients about cannabis use. Cannabis consumption impairs critical driving abilities including reaction time, attention, and motor coordination, with effects varying based on individual factors, dosing, and product type, particularly among older adults who may already have age-related declines in these domains. Given the aging population’s increased cannabis use and potential drug interactions with other medications, clinicians need validated screening tools to identify patients at risk for driving impairment before recommending or approving cannabis therapy. These findings underscore the importance of discussing driving safety explicitly with cannabis-using patients, documenting counseling in the medical record, and considering alternatives for patients with significant driving exposure or occupational safety requirements. For practicing clinicians, a practical approach is to assess driving frequency and responsibilities early in the cannabis discussion and counsel patients to avoid driving for several hours after use, similar to alcohol precautions, while documenting this conversation as part of informed consent.
This topic comes up in consultations often.
Dr. Caplan offers clinical context on evolving cannabis policy and its real-world implications for patients.
Book a consultation →“We’re seeing clear evidence that cannabis impairs reaction time and vehicle control in ways comparable to alcohol, yet most patients don’t treat it with the same caution they would with a drink before driving, and our legal framework hasn’t caught up to the science. As clinicians, we need to have explicit conversations with every patient we recommend cannabis to about driving safety, because the consequences of impairment behind the wheel are the same whether it’s THC or ethanol.”
🚗 Cannabis impairment presents a genuine public health concern for clinicians caring for patients who drive, particularly given emerging evidence that use increases crash risk across age groups and the lack of standardized impairment testing comparable to alcohol screening. Providers should recognize that cannabis effects on reaction time, attention, and coordination are dose- and individual-dependent, making clinical assessment challenging without objective biomarkers, and that concurrent use with medications or alcohol amplifies risk. Older adults warrant special attention given age-related changes in metabolism and potential medication interactions that may increase vulnerability to cannabis-induced driving impairment. While current research continues to define risk thresholds and populations most affected, clinicians should incorporate routine screening about cannabis use patterns into relevant patient encounters (particularly before long drives) and counsel patients about observable impairment signs, the legal liability they face in many jurisdictions, and alternatives to driving when use is anticipated. This represents an important preventive care opportunity similar to
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