Medical Marijuana Use and Driving Performance: A Test of Psychomotor Function in Adults 50 and Older

项目总结 佛罗里达州约有690万人年龄在50岁及以上，据估计，慢性或重度 在这个人群中，非恶性疼痛的比例从35%到52%不等。在拥有法律的33个州中(包括佛罗里达州) 将医用大麻合法化，慢性或严重非恶性疼痛，患病率较高的情况 中老年被认为是医生为其开医用大麻的常见疾病。在 在美国，慢性疼痛是最常被认可的医用大麻使用理由。然而，人们对此知之甚少 关于中后期(50岁-)和老年(65岁及以上)的大麻使用情况。而当 医用大麻可能通过减轻疼痛而造福老年人，持续使用医用大麻对 在现实世界的任务中，如驾驶时的功能没有得到充分的研究。目前，我们没有足够的资金 区分“本身”(大麻数量)和“损害”(行为)的科学证据 在涉及使用大麻的影响下驾驶案件中)。医生、患者和政策 制造商需要数据驱动的指南，说明医用大麻的使用如何影响现实世界中的功能 老年人的驾驶等任务以及使用的潜在不利影响。为此，国家 药物滥用研究所(NIDA)和国家老龄研究所呼吁提供医用大麻的数据 特别是在老年人中，驾驶性能和医用大麻的使用及其不良影响。一个 一项检查老年人预先接触医用大麻并系统跟踪医用大麻的研究 开始、剂量和精神运动功能将为使用量之间的联系提供证据 和损伤。因此，这项拟议的研究将测试医用大麻的使用作为成年人年龄的暴露变量 50及以上的模拟驾驶性能(即响应时间、注意力和执行功能方面的错误 预测道路性能的任务)作为主要结果。进一步，我们将探索两者之间的关联 医用大麻的使用和不良反应。为了实现这一目标，我们提出了以下目标：目标1：测试 医用大麻使用与驾驶失误之间的关系预测道路上的表现，在很高的水平上- Fidelity驾驶模拟器，适用于50岁及以上患有慢性或严重非恶性疼痛的成年人。目标2：检查 医用大麻使用因素(剂量、频率、CBD与THC产品之间的关系，以及 对50岁及以上的成年人有不良影响。这项拟议的研究意义重大，因为它将 前瞻性评估医用大麻的使用，并根据使用与使用之间的关联提供证据基础 以及推动绩效和不良事件。这项研究将通过以下方式获得详细的大麻接触情况 电子病历和抽血，以及驾驶表现和报告的重复测量 带来的不良影响。此外，我们将使用控制组来确保结果不会归因于简单的转换 时间到了。结果将为使用医用大麻对50名成年人的现实世界任务的影响提供证据 而且年纪也更大。

PROJECT SUMMARY Approximately 6.9 million people in the state of Florida are age 50 and older, and estimates of chronic or severe non-malignant pain in this population range from 35-52%. Of the 33 states (including Florida) with laws that legalize marijuana for medical use, chronic or severe non-malignant pain, conditions with greater prevalence in mid to late life, are recognized as common ailments for which physicians prescribe medical marijuana. In the U.S., chronic pain is the most frequently endorsed reason for medical marijuana use. However, little is known about marijuana use during late-middle age (ages 50–64) and older adulthood (ages 65 and older). While medical marijuana may benefit older adults by reducing pain, the impact of sustained medical marijuana use on functioning during real world tasks such as driving is underexamined. Currently, we do not have enough scientific evidence to differentiate “per se” (quantity of marijuana) versus “impairment” (behaviors exhibited) in driving under the influence cases that involve marijuana use. Physicians, patients and policy makers need data driven guidelines regarding how medical marijuana use affects functioning during real world tasks such as driving among older adults and the potential adverse effects of use. To that end, the National Institute on Drug Abuse (NIDA) and the National Institute on Aging have called for data on medical marijuana and driving performance and medical marijuana use and adverse effects among older adults in particular. A study that examines older adults pre-exposure to medical marijuana and systematically tracks medical marijuana initiation, dosage, and psychomotor functioning will provide evidence of the association between quantity of use and impairment. Thus, the proposed study will test medical marijuana use as the exposure variable in adults age 50 and older and simulated driving performance (i.e. errors in response time, attention, and executive functioning tasks that predict on-road performance) as the primary outcome. Further, we will explore the association between medical marijuana use and adverse effects. To accomplish this, we propose the following aims: Aim 1: Test the association between medical marijuana use and driving errors that predict on-road performance, on a high- fidelity driving simulator, in adults 50 and older with chronic or severe non-malignant pain. Aim 2: Examine the association between medical marijuana use factors (dosage, frequency, CBD vs THC products, and route of administration) and adverse effects in adults age 50 and older. The proposed study is significant because it will prospectively evaluate medical marijuana use and provide an evidence base on the association between use and driving performance and adverse events. The study will obtain detailed marijuana exposure through electronic medical records and blood draws together with repeated measures of driving performance and reports of adverse effects. Further, we will use a control group to ensure results are not attributed to simple change over time. Results will provide evidence for the effects of medical marijuana use on real world task among adults 50 and older.