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.
Traffic safety researchers, public health policymakers, law enforcement
20.6% of cannabis users reported driving under the influence, more than double the rate for alcohol
What the researchers 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.
Why it 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 numbers in context
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 the study worked
Cross-sectional analysis of 2021-2023 NSDUH (N=139,524 adults 18+); binary and multinomial logistic regression for DUIA and DUIC correlates.
What this study cannot tell us
Self-reported DUI likely underestimates; cannot assess impairment level; cannabis impairment detection less established; NSDUH misses driving frequency.
How to read the evidence
Large nationally representative dataset with multiple survey years, but self-reported DUI and inability to measure impairment are limitations.
When this study was published
Published 2025, data 2021-2023
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.
Questions still open
- Why is cannabis-impaired driving so much more common than alcohol? Do users perceive less risk? What accounts for elevated risk among older adults?
Common questions
How common is driving after using cannabis?
Are older adults at risk?
Read the original research
Driving under the influence of alcohol and cannabis: Associations with substance use and behavioral health characteristics.
Traffic injury prevention, 1-9
Citation
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