One in five cannabis users reported driving under the influence, with older adults as an unexpected risk group
Among US cannabis users, 20.6% reported driving under the influence compared to 8.6% of alcohol users, with substance use disorders, adolescent initiation, and age 65+ predicting cannabis-impaired driving.
Quick Facts
What This Study Found
DUIC prevalence (20.6%) more than double DUIA (8.6%); age 65+ was a DUIC risk factor; substance disorders, early initiation, mental health problems, and criminal justice involvement predicted both; DUIC higher in medical cannabis legal states.
Key Numbers
N=139,524; 20.6% DUIC vs 8.6% DUIA; among DUI reporters: 47.9% DUIA-only, 34.0% DUIC-only, 18.1% both; age 65+ risk factor for DUIC.
How They Did This
Cross-sectional analysis of 2021-2023 NSDUH (N=139,524 adults 18+); binary and multinomial logistic regression for DUIA and DUIC correlates.
Why This Research Matters
Cannabis-impaired driving is far more common than alcohol-impaired driving among respective users, and older adults emerging as a risk group challenges assumptions.
The Bigger Picture
As cannabis legalization expands and older adult use grows, impaired driving prevention must evolve beyond its traditional focus on young alcohol-impaired drivers.
What This Study Doesn't Tell Us
Self-reported DUI likely underestimates; cannot assess impairment level; cannabis impairment detection less established; NSDUH misses driving frequency.
Questions This Raises
- ?Why is cannabis-impaired driving so much more common than alcohol?
- ?Do users perceive less risk?
- ?What accounts for elevated risk among older adults?
Trust & Context
- Key Stat:
- 20.6% of cannabis users reported driving under the influence, more than double the rate for alcohol
- Evidence Grade:
- Large nationally representative dataset with multiple survey years, but self-reported DUI and inability to measure impairment are limitations.
- Study Age:
- Published 2025, data 2021-2023
- Original Title:
- Driving under the influence of alcohol and cannabis: Associations with substance use and behavioral health characteristics.
- Published In:
- Traffic injury prevention, 1-9 (2025)
- Authors:
- Choi, Namkee G(10), Marti, C Nathan(10)
- Database ID:
- RTHC-06216
Evidence Hierarchy
A snapshot of a population at one point in time.
What do these levels mean? →Frequently Asked Questions
How common is driving after using cannabis?
About 1 in 5 cannabis users (20.6%) reported DUI, more than double the rate among alcohol users (8.6%).
Are older adults at risk?
Yes. Adults 65+ who used cannabis were more likely to report driving under the influence than younger users.
Read More on RethinkTHC
Cite This Study
https://rethinkthc.com/research/RTHC-06216APA
Choi, Namkee G; Marti, C Nathan. (2025). Driving under the influence of alcohol and cannabis: Associations with substance use and behavioral health characteristics.. Traffic injury prevention, 1-9. https://doi.org/10.1080/15389588.2025.2587850
MLA
Choi, Namkee G, et al. "Driving under the influence of alcohol and cannabis: Associations with substance use and behavioral health characteristics.." Traffic injury prevention, 2025. https://doi.org/10.1080/15389588.2025.2587850
RethinkTHC
RethinkTHC Research Database. "Driving under the influence of alcohol and cannabis: Associa..." RTHC-06216. Retrieved from https://rethinkthc.com/research/choi-2025-driving-under-the-influence
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.