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Study breakdown

Neither blood tests nor field sobriety tests reliably detect cannabis-impaired driving

ReviewModerate evidence
The takeaway

Both per se blood concentration limits and standard field sobriety tests have fundamental limitations for detecting cannabis-impaired driving, with poor correlation between THC levels and actual impairment and no validated functional test for cannabis.

Cannabis users who drive, law enforcement, policymakers, and anyone interested in the science of impaired driving detection.

Cannabis doubles crash risk, but no reliable detection method exists for cannabis impairment

What the researchers found

Unlike alcohol, THC blood concentrations poorly correspond to amount consumed, crash risk, or degree of impairment. Standard field sobriety tests have not been developed or validated for cannabis, and cannabis impairment is difficult to distinguish from effects of aging or certain medications.

Why it matters

Cannabis use doubles automobile crash risk, yet neither of the two standard approaches for detecting impaired driving works reliably for cannabis. This leaves both cannabis users and law enforcement without clear guidance on driving fitness after use.

The numbers in context

Cannabis associated with approximately 2-fold increase in crash risk. Per se THC limits poorly predict impairment. No validated field sobriety test for cannabis. Cannabis impairment difficult to distinguish from aging or medication effects.

How the study worked

Perspective review examining the strengths and limitations of two cannabis-impaired driving detection approaches: per se blood/breath concentration tests and functional field sobriety tests, compared against their established use for alcohol detection.

What this study cannot tell us

Perspective piece rather than systematic review. The 2-fold crash risk estimate varies across studies. Individual tolerance differences make any per se limit inherently imprecise. Technology may improve faster than this review anticipated.

How to read the evidence

Moderate: well-argued perspective synthesizing existing evidence, though not a systematic review.

When this study was published

Published in 2019.

The bigger picture

The author argues that instead of trying to develop substance-specific detection methods for every possible intoxicant, general impairment detection strategies that work regardless of cause would be more practical and equitable.

Questions still open

  • Could technology-based impairment assessments (reaction time apps, eye tracking) provide substance-agnostic detection? At what point after use is it actually safe to drive? Should legal frameworks shift from substance detection to impairment detection?

Common questions

Why can't police test for cannabis impairment like they do for alcohol?
Alcohol has a clear relationship between blood level and impairment. Cannabis does not. THC levels can be high without impairment or low while still impaired, depending on tolerance, timing, and individual metabolism.
What's the solution for cannabis-impaired driving detection?
The author suggests developing general impairment detection methods that work regardless of what substance caused the impairment, rather than trying to create specific tests for every possible intoxicant.

Read the original research

Strengths and limitations of two cannabis-impaired driving detection methods: a review of the literature.

The American journal of drug and alcohol abuse, 45(6), 610-622

Citation

Ginsburg, Brett C. (2019). Strengths and limitations of two cannabis-impaired driving detection methods: a review of the literature.. The American journal of drug and alcohol abuse, 45(6), 610-622. https://doi.org/10.1080/00952990.2019.1655568

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