title: Relationship between THC concentration in blood and impairment in apprehended drivers.
abstract: OBJECTIVE
  The most important psychoactive ingredient in cannabis, Delta (9)-tetrahydrocannabinol (THC) is one of the most frequently detected substances in blood samples from suspected impaired drivers in Norway. There is growing concern over possible links between the use of cannabis and increased risk of motor-vehicle crashes. Experimental studies have provided useful information on the role of THC and dose-effect relations with respect to psychomotor performance. The main purpose of the present study was to investigate whether a physician's judgment on impairment in a real-life setting among suspected drugged drivers, was related to blood THC concentration.
  
  
  METHODS
  In Norway a police physician performs a clinical test for impairment (CTI) shortly after apprehension. The Norwegian Institute of Public Health analyze blood samples from all drivers suspected of driving under the influence of non-alcoholic drugs. In the present study 589 samples from approximately 30,000 cases of suspected drug impaired driving from the period 1997-99, contained THC as the only drug. In 456 of these cases a conclusion of the CTI was available.
  
  
  RESULTS
  230 (54%) drivers were considered not impaired and 226 (46%) impaired. Impaired drivers had higher blood THC concentration than the drivers who were judged as not impaired (median; 2.5 ng/mL (range; 0.3-45.3 ng/mL) vs 1.9 ng/mL (range; 0.32-24.8 ng/mL), (p < 0.05). Furthermore, drivers with blood THC concentrations above 3 ng/mL had an increased risk for being judged impaired compared to drivers with lower concentration ranges.
  
  
  CONCLUSIONS
  The relationship between the concentration of THC in blood and risk of being assessed impaired found in this cross-sectional study of suspected drugged drivers, supports findings from previous experimental studies of concentration related effects of THC on psychomotor performance and driving skills.
authors.affiliation: Norwegian Institute of Public Health, Division of Forensic Toxicology and Drug Abuse, Nydalen, Oslo, Norway. hassan.khiabani@fhi.no
authors.forename: Hassan Z
authors.initials: HZ
authors.lastname: Khiabani
authors.forename: Jørgen G
authors.initials: JG
authors.lastname: Bramness
authors.forename: Anders
authors.initials: A
authors.lastname: Bjørneboe
authors.forename: Jørg
authors.initials: J
authors.lastname: Mørland
mesh_terms: D000063:Accidents, Traffic; D000328:Adult; D000367:Age Factors; D001334:Automobile Driving; D003627:Data Interpretation, Statistical; D013759:Dronabinol / Q000097:blood*; D005260:Female; D006801:Humans; D007124:Immunoenzyme Techniques; D008297:Male; D002189:Marijuana Abuse / Q000175:diagnosis*; D011597:Psychomotor Performance; D012307:Risk Factors; D012737:Sex Factors; D015813:Substance Abuse Detection
chemical_list: D013759:Dronabinol