Sativex spray for MS spasticity did not impair driving and most patients reported driving improvement
A review of driving studies and real-world registries found no increase in motor vehicle accidents from THC:CBD oromucosal spray (Sativex), with most MS patients reporting improved driving ability after starting treatment.
Quick Facts
What This Study Found
Researchers reviewed all available evidence on whether Sativex, a THC:CBD mouth spray prescribed for MS-related spasticity, affects driving ability. The evidence was reassuring.
Driving studies and real-world registries showed no increase in motor vehicle accidents associated with Sativex use. Most patients actually reported improved driving ability after starting the medication, likely because reduced spasticity and potentially better cognitive function outweighed any mild impairment from the THC component.
An important pharmacological distinction was noted: blood THC levels from Sativex are significantly lower than levels associated with recreational herbal cannabis use. The controlled, metered-dose delivery of the spray produces more stable and modest THC exposure compared to smoking or consuming cannabis.
However, the review cautioned that THC blood measurements after Sativex could exceed legal driving thresholds in some countries, recommending that patients carry a medical certificate and know their country's specific regulations.
Key Numbers
No increase in motor vehicle accidents associated with Sativex use. Majority of patients reported improved driving ability. THC blood levels from Sativex significantly lower than recreational cannabis. Blood THC may still exceed legal thresholds in some countries.
How They Did This
Systematic PubMed search from 2000 to 2017 for articles on THC:CBD oromucosal spray and driving performance, supplemented with relevant references and known articles. Evidence from driving studies and real-world patient registries was synthesized.
Why This Research Matters
For MS patients, losing the ability to drive can mean losing independence. Many patients fear that a THC-containing medication will prevent them from driving. This review provides evidence that at therapeutic doses, Sativex does not impair driving and may actually improve it by reducing the spasticity that was affecting driving performance.
The Bigger Picture
This review highlights the important distinction between medical cannabinoid use at controlled doses and recreational cannabis use for driving safety. The finding that the therapeutic benefit (reduced spasticity) appears to outweigh any cognitive impairment from modest THC exposure supports the concept that the net effect of a medication on driving depends on both its direct effects and the condition it treats.
What This Study Doesn't Tell Us
The review relied on limited driving study data and real-world registries rather than large randomized trials specifically designed to assess driving. Patient self-report of improved driving may be biased. The legal implications of blood THC levels vary by jurisdiction and were not comprehensively mapped. Long-term effects on driving were not assessed.
Questions This Raises
- ?Should drug-driving laws have medical exemptions for patients on prescribed cannabinoid medications?
- ?How do blood THC levels from Sativex compare across different national legal thresholds?
- ?Would objective driving assessments confirm the subjective improvement reported by patients?
Trust & Context
- Key Stat:
- No increase in motor vehicle accidents; most patients reported improved driving
- Evidence Grade:
- This is a review of driving studies and registry data, providing moderate evidence of driving safety with important caveats about legal THC thresholds.
- Study Age:
- Published in 2018 with evidence through mid-2017. Driving regulations for medical cannabis continue to evolve.
- Original Title:
- The influence of THC:CBD oromucosal spray on driving ability in patients with multiple sclerosis-related spasticity.
- Published In:
- Brain and behavior, 8(5), e00962 (2018)
- Authors:
- Celius, Elisabeth G, Vila, Carlos(4)
- Database ID:
- RTHC-01616
Evidence Hierarchy
Summarizes existing research on a topic.
What do these levels mean? →Frequently Asked Questions
Can I drive while using Sativex?
This review found no evidence that Sativex impairs driving in MS patients, and most patients reported improved driving ability. However, blood THC levels may exceed legal driving limits in some countries, so you should check your local regulations and consider carrying a medical certificate.
Is Sativex different from smoking cannabis for driving?
Yes. Blood THC levels from Sativex are significantly lower than those from recreational cannabis use. The controlled, metered spray delivers modest, stable THC levels compared to the high peaks from smoking.
Read More on RethinkTHC
- CBD-oil-quality-guide
- anxiety-medication-after-quitting-weed
- cannabis-chemotherapy-nausea
- cannabis-chronic-pain-research
- cannabis-epilepsy-CBD-Epidiolex
- cbd-anxiety-research-evidence
- cbd-for-weed-withdrawal
- cbd-vs-thc-difference
- medical-benefits-of-cannabis
- quitting-weed-before-surgery
- quitting-weed-medication-interactions
- quitting-weed-pregnancy
- quitting-weed-pregnant
- seniors-older-adults-cannabis-risks-medications
- weed-breastfeeding-THC-breast-milk
Cite This Study
https://rethinkthc.com/research/RTHC-01616APA
Celius, Elisabeth G; Vila, Carlos. (2018). The influence of THC:CBD oromucosal spray on driving ability in patients with multiple sclerosis-related spasticity.. Brain and behavior, 8(5), e00962. https://doi.org/10.1002/brb3.962
MLA
Celius, Elisabeth G, et al. "The influence of THC:CBD oromucosal spray on driving ability in patients with multiple sclerosis-related spasticity.." Brain and behavior, 2018. https://doi.org/10.1002/brb3.962
RethinkTHC
RethinkTHC Research Database. "The influence of THC:CBD oromucosal spray on driving ability..." RTHC-01616. Retrieved from https://rethinkthc.com/research/celius-2018-the-influence-of-thccbd
Access the Original Study
Study data sourced from PubMed, a service of the U.S. National Library of Medicine, National Institutes of Health.
This study breakdown was produced by the RethinkTHC research team. We analyze and report published research findings without making health recommendations. All interpretations are based solely on the published abstract and study data.