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

医用大麻的使用和驾驶表现：50 岁及以上成年人的精神运动功能测试

• 批准号: 10263908
• 负责人: SHERRILENE CLASSEN
• 金额: $ 15.03万
• 依托单位: FLORIDA STATE UNIVERSITY
• 依托单位国家: 美国
• 财政年份: 2020
• 资助国家: 美国
• 起止时间: 2020-09-30 至 2023-08-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/10263908
• 关键词: Acute; Address; Adult; Adverse effects; Adverse event; Affect; Age; Alcohols; Attention; Automobile Driving; Behavior; Biological; Blood; Cannabidiol; Chronic; Cognition; Computerized Medical Record; Confusion; Consumption; Control Groups; Data; Decision Making; Development; Dizziness; Education; Elderly; Enrollment; Ensure; Exhibits; Exposure to; Feasibility Studies; Fibrinogen; Florida; Frequencies; Future; Goals; Guidelines; Impairment; Laws; Literature; Marijuana; Measures; Medical; Medical Marijuana; Memory; National Institute of Drug Abuse; National Institute on Aging; Non-Malignant; Pain; Patients; Performance; Pharmaceutical Preparations; Physicians; Policy Maker; Population; Prevalence; Psychomotor Impairments; Psychomotor Performance; Race; Reaction Time; Reporting; Research; Risk; Route; Surveys; Task Performances; Testing; Tetrahydrocannabinol; Time; Vaporizer; Work; base; behavioral impairment; chronic pain; dosage; driving behavior; driving under influence; evidence base; executive function; human old age (65+); improved; marijuana legalization; marijuana use; middle age; negative affect; pain reduction; primary outcome; prospective; recruit; sex; sobriety; sociodemographic factors

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.

项目摘要 佛罗里达州约有690万人年龄在50岁及以上， 非恶性疼痛在该人群中的范围为35- 52%。在33个州（包括佛罗里达）中， 大麻合法化用于医疗用途，慢性或严重的非恶性疼痛， 中年到晚年，被认为是医生开医用大麻的常见疾病。在 美国，慢性疼痛是使用医用大麻最常见的原因。然而， 关于中年晚期（50-64岁）和成年晚期（65岁及以上）的大麻使用。而 医用大麻可以通过减少疼痛，持续使用医用大麻对老年人的影响， 在真实的世界任务（如驾驶）中的功能还没有得到充分的研究。目前，我们没有足够的 科学证据来区分“本身”（大麻的数量）与“损害”（行为 展示）在涉及大麻使用的影响下驾驶。医生、患者和政策 制造商需要数据驱动的指导方针，关于医用大麻的使用如何影响真实的世界中的功能 任务，如老年人驾驶和使用的潜在不利影响。为此，国家 药物滥用研究所（NIDA）和国家老龄化研究所呼吁提供医用大麻的数据 以及驾驶表现和医用大麻的使用以及对老年人的不良影响。一 一项研究调查了老年人接触医用大麻之前的情况，并系统地跟踪了医用大麻 启动、剂量和心理功能将提供使用量之间关联的证据 和损伤。因此，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岁及以上和模拟驾驶性能（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。此外，我们还将探讨 医用大麻的使用和副作用。为了实现这一点，我们提出了以下目标：目标1：测试 医用大麻的使用和驾驶错误之间的关联，预测道路上的表现，在一个高- 保真度驾驶模拟器，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 医用大麻使用因素之间的关联（剂量，频率，CBD与THC产品，以及 给药）和50岁及以上成人的不良反应。这项研究之所以重要，是因为它将 前瞻性地评估医用大麻的使用，并提供使用之间的关联的证据基础 以及驾驶性能和不良事件。该研究将通过以下方式获得详细的大麻暴露情况： 电子医疗记录和抽血以及驾驶性能和报告的重复测量 的不利影响。此外，我们将使用一个对照组，以确保结果不归因于简单的改变 时间结果将为成年人使用医用大麻对真实的世界任务的影响提供证据50 年纪也更大了