Paul Armentano, Deputy Director of NORML, discusses the evidence-based science of cannabis, particularly its impact on driving. He emphasizes the importance of evolving the narrative surrounding cannabis to evidence-based policies. Armentano highlights the need to distinguish between THC levels in the body and actual impairment, noting that THC can linger in the system long after impairment has subsided.

Cannabis use, particularly smoking, generally leads to compensatory driving behaviors like reduced speed and lane changes, resulting in a lower accident risk compared to alcohol. However, edibles, with their delayed onset and stronger psychoactive effects, pose a greater risk, and users are advised to utilize a taxi or have a designated driver if they consume edibles. Combining cannabis and alcohol can have synergistic adverse effects on psychomotor performance, making it particularly dangerous.

Rescheduling cannabis from Schedule I to Schedule III would acknowledge its medical utility but wouldn’t address the conflict between federal and state laws. Descheduling cannabis from the Controlled Substances Act is necessary for states to regulate it independently. NORML continues to advocate for cannabis reform, fighting against efforts to undermine existing policies and holding the line to protect the rights of responsible adults and patients.

Cannabis Boomer podcast aims to educate users about cannabis and its effects, emphasizing the importance of informed consumption. The information shared is based on current scientific opinion and should not be considered medical advice.

Primary Keywords: #CannabisAndDriving #MarijuanaLaws #CannabisSafety #THCImpairment #NORMLAdvocacy #MedicalMarijuana #CannabisPolicy #ResponsibleUse #DrivingUnderTheInfluence #CannabisScience

Secondary Keywords: #CannabisReform #MarijuanaLegalization #THCBloodLevels #EdiblesAndDriving #CannabisEducation #WeedSafety #PaulArmentano #CannabisResearch #MarijuanaTesting #DrugPolicyReform

Topical Keywords: #CannabisBoomer #Over50Cannabis #SeniorCannabis #EvidenceBasedPolicy #CannabisAdvocacy #Rescheduling #Schedule3 #CBDSafety #EndocannabinoidSystem #VeteransCannabis

Long-tail Keywords: #HowLongAfterSmokingCanIDrive #CannabisPsychomotorEffects #THCMetabolites #AlcoholAndCannabis #CompensatoryDriving #CannabisVsAlcoholDriving

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On today's Cannabis Boomer Podcast, join Dr. Alex Terrazas as he interviews Paul Armentano, Deputy Director of the National Organization for the Reform of Marijuana Laws. Paul has been involved in the evidence-based science of cannabis since the early 90's and has testified before the US Congress, the DEA and numerous state legislatures. He is an expert on many topics, but today he is here to talk about cannabis and driving. So buckle up and let's get this show on the road. Completely sober, of course.

Paul Armentano, Deputy Director of the National Organization for the Reform of Marijuana Laws and an expert on many aspects of cannabis, especially cannabis and driving. Welcome to the podcast. Thank you for being with me today.

Thank you for having me, Alex. Pleasure to take the time to speak with you.

It is an interesting topic for me because I studied the neuroscience of motor planning. And I know that's a big factor in this topic. But before we get there, tell me how you started with NORML and started studying cannabis. You're quite a pioneer there.

So I've been working in the cannabis advocacy space now for three decades. As you can imagine, I've seen dramatic shifts in both public and cultural opinion, as well as the political landscape over that period of time. And it was my notion when I began this journey, I had the premise that if we could change the way people talk about cannabis, if we evolved the narrative surrounding cannabis, then ultimately we would change the way people thought about cannabis. And if we did that, ultimately we would be able to change the laws and the policies surrounding cannabis. It was very important to me that we emerged from what I would call rhetoric-based cannabis policies to evidence-based cannabis policies, and in order for lawmakers and pundits and the public and everyone else to demand evidence-based marijuana policies, I felt like we needed to present the evidence.

So that's always been my focus in this work.

Very interesting and it's been spectacularly successful, although it did take quite some decades before you were able to get some traction, it sounds like. But really, how many states now have legalized recreational marijuana?

Yeah. Yeah. So when I began doing this work in the mid 1990s, keep in mind there were zero states, where medical cannabis access was regulated. Now there's 40 and there were zero states where the adult use cannabis markets were legal. And today those markets are legal in 24 states and the District of Columbia. That encompasses more than half of the US population.

Getting to driving, which of course is probably one of the obstacles that people had about cannabis. And you know, you read the statistic that cannabis is measurable in 40% of fatal accidents, but I know that's an inflated figure. Tell me a little bit about that.

So you're referring to, I won't even call it a study. You're referring to a paper that received a lot of media attention. This was based on the abstract of a paper that was presented at a conference. Hasn't been peer reviewed. It's referring to toxicological data in a single county in the state of Ohio.

It's certainly not reflective of that we can extrapolate to the state at large or nationwide. And keep in mind this was looking at only instances where individuals were in accidents, where they were suspected to have been under the influence. That's why there was a toxicological examination.

I also really question the data at face value. The researchers talked about have the, the subjects that tested positive for THC on average their THC was about 30 nanograms per milliliter. Off the spectrum. The sort of number we'd expect to see, if somebody had literally smoked marijuana minutes earlier and then was tested. That obviously wasn't the case in, in, in these instances.

These were fatal accidents. These, these toxicological examinations took place hours, if not days after the fact. So I question literally everything about that study, and I don't think it'll ever be published. I don't think it'll pass peer review.

Okay, well I'm gonna take that off my statistics. But you did share a paper with me and one that I had also found that shows that chronic users who stop smoking for three days still show elevated THC levels in their blood. So tell me a little bit about that.

Correct. This is a phenomenon that we have been aware of for many years. THC, and its primary metabolites, are both lipid soluble. So that means they tend to hang around, in the blood, in the urine and bodily fluids for periods of time, and most importantly, periods of time long after the window of impairment has elapsed. So what we see more habitual users of cannabis is essentially their body can only process or metabolize a certain amount of THC and a certain percentage of THC metabolites every day. But, in instances where people are using cannabis on a daily basis, their body is essentially taking in greater amounts of THC and THC metabolites than it can get rid of or process each day.

So these people end up building up kind of a net residual level of THC in the blood, which tends to hang around at fairly low levels, somewhere around four nanograms, five nanograms, six nanograms per milliliter, and we see carboxy THC, the inert cannabis metabolite that hangs around in urine that can build up to very high levels and in, in the hundreds. But because these compounds linger well after reasonable expectation of impairment, we cannot consistently correlate the detection of either THC in blood or carboxy THC in urine with either recency of cannabis use and certainly not with cannabis impairment. And that's simply. Fact NITSA, the National Highway traffic safety Association publicly is on record affirming that AAA is on record affirming that basically any scientific researcher in the field acknowledges you cannot. a person's THC blood levels or carboxy THC, urine levels and in any way try to tie that to impairment of performance or even try to gauge when the person was last exposed to cannabis.

I suppose that would make a good legal defense if one were in trouble for that kind of thing. So of course, and, and when I told some friends that I was gonna do this interview and, and make this topic people said, well, are you advocating that people drive stoned? And, of course, the answer is no.

It does have effects on people's psychomotor function. What do you know about that?

Of course. I wanna make one thing clear. You know NORML, back in the mid 1990s NORML's Board of Directors adopted a memorandum known as the Principles of Responsible Use, where we articulate how we define responsible adult use of cannabis. And one of those core principles is no driving under the influence of cannabis.

So we've been very clear on this, on this position now for decades. Cannabis can impact the way one operates a motor vehicle. It does impact psychomotor skills. Now, there's sort of two parts to this question. One is, you know, how does it impact those skills? And then the second part is, does that change in psychomotor performance?

Is it strongly correlated with an increased risk of accident? Okay, so we know, for instance, with alcohol that alcohol, impacts the way people drive. It tends to make them drive more recklessly. They take more chances. They drive more aggressively. They increase their speed, and those changes in psychomotor performance are strongly linked with increased risk of accident. In fact, individuals who have alcohol in their system, even at legal limits, tend to have a fourfold increase in motor vehicle accident compared to drivers that are sober. So there are about 400 they have a 400% increase in motor vehicle accident risk because again, the skills that are being temporarily altered by alcohol are strongly linked with increased risk of accident.

With cannabis, we tend to see consistent trends in the way people under the influence of THC their driving. Tend to engage in what we define as compensatory driving behavior. Make fewer lane changes. They lower their speed, and they leave more distance between their vehicle and the vehicle in front of them. Those are changes in performance that are typically not linked with an increased risk of accident, which is why we don't see anywhere near a comparable increased or elevated accident risk in individuals who are under the influence of cannabis like we see with individuals under the influence of alcohol. Now, where we do see a change in driving performance that is linked with increased risk of accidents is that people that are acutely under the influence of cannabis tend to weave more often than they do when they are sober. Their driver's side wheel tends to go over the median more often than it does when they're sober. That does lead to a potential increase. Accident risk. And when you sort of crunch the data and you look at studies where culpability has been designated in drivers that test positive for THC we tend to see about on average, a 25% increased accident risk.

Again not zero there, but nowhere near the level we see associated with people under the influence of alcohol, including alcohol at legal limits.

You shared a recent publication about edibles and driving. So I could see that there's some real risk there given how strongly edibles affect people often, and also, you know, take it, an hour later, you might start to feel the effects.

Yeah, so we certainly know with orally ingested THC, there's delayed onset unlike when people inhale cannabis and they tend to feel the effects within minutes. In addition, when TC is taken orally, effects tend to last much longer when, when they do take effect. So there's a very, what we call different pharmacokinetic profile when somebody's smoking THC versus whether they're ingesting it orally. We also know that when people take THC orally, THC is metabolized by the body in a different way than it is when people inhale cannabis. When people orally take THC, the metabolization leads to the creation of a greater quantity of a psychoactive metabolite known as 11 hydroxy THC. That's why people who take edibles tend to feel a stronger effect. After taking edibles, then they feel when they inhale THC, oftentimes that stronger effect is attributed incorrectly to this notion that they just took a large amount. But really it's due to the fact that THC is being processed by their body in a very different way than it is when they inhale THC.

So most of the data we have on cannabis and driving studies from subject who inhaled cannabis. We have much fewer studies looking at oral THC administration. We tend to see fairly similar trends. People who use cannabis habitually tend to be more tolerant to the psychomotor altering effects of cannabis.

Again, we tend to see compensatory behavior. We do, there is one very interesting study, looking at cannabis and edibles where the subjects became so cautious under the influence of edibles that they refused to participate in the study altogether. This was a closed course driving study and essentially a majority of the subjects said they did not feel comfortable operating a motor vehicle in that closed course environment until the effects had begun to wear off. Which again, is a very, sort of different reaction than, than you stereotypically would expect with somebody under the influence of alcohol where you, you hear the stories of struggling to take the car keys from an individual who says they're fine to drive in these instances. Again, under acutely under the influence of cannabis we see individuals refusing to drive altogether.

So if someone goes to a party this holiday season, partakes in some cannabis THC, smoking or other mode of administration, how long do they need to wait before they start driving home?

So the general consensus on this is that if they are smoking cannabis the wait time ought to be three to four hours. Now, arguably, the most acute effects of THC on psychomotor performance occur within about a 20 to 60 minute window. But again, when you look at the literature, generally a three to four hour window is recommended for edibles. It's really much more of a crapshoot, and I would recommend designating someone else to drive that night. The onset of effective edibles could be anywhere from 60 minutes to two hours. When they do take effect, the, the period of intoxication could be anywhere from another three to six hours.

So, you know, essentially in instances like that. It just wouldn't be a good idea to consider driving at all until the following day. The other caution I would give folks that there is quite a bit of, of science in the literature indicating that there can be synergistic adverse effects on psychomotor performance when alcohol and cannabis are used in concert with one another. So, in other words, we tend to see minor changes in psychomotor performance when people use cannabis individually. We tend to see changes in psychomotor performance when people use alcohol individually. But when they use both of those substances together, we see a far more exponential adverse change in psychomotor performance that's greater than, than those two substances individually.

And so that's behavior I think people really need to be aware and be cautioned from engaging in.

Any guesses, neurophysiologically, what's going on with that? A synergistic effect.

That's a really good question, and my guess is we don't know the answer to that. You know, as you probably know, or your audience may know. alcohol is acting on one set of receptors and, and, and cannabinoids are acting on a different set of receptors. So the fact that there is that sort of synergy there is somewhat curious.

Indeed. Leaving driving aside, let's say you take some THC cannabis and you wanna play sports. What's what's happening in your brain and body with that?

Well, we have a pretty good understanding of the way cannabis interacts with the human body. We know that there is a very sophisticated receptor system, not just in the brain, but throughout the body that cannabinoids respond to a lot of attention. I would dare say the majority of attention is, is paid to the way those re mood altering cannabis receptors impact. The receptors in the brain, but we have receptors in our gut and in the reproductive organs in our eyes. You know, again, throughout the body. And the reason there's such an expansive receptor system is because this acts as a regulator or a sort of a modulator for our bodies. The purpose of endogenous cannabinoids interacting with this system is to maintain a state of homeostasis or physiological balance. so that's what these receptors are there to do, and I would dare say the reason we see some people responding therapeutically at a very positive manner to medicinal cannabis are instances where their system may need a boost or their system may not be functioning properly and, and bringing in exogenous cannabinoids and is, is sort of helping the body come back to that state of homeostasis that it's seeking. We certainly know a lot of athletes talk about using cannabinoids to recover from injury or to come down from engaging in strong physical activity. I don't think there's a whole lot of data supporting that cannabis, however, is an actual performance enhancer in the moment when people are in fact engaging in physical activity.

I mean, I try it before I play tennis and I kind of feel that it quiets down some of that crosstalk. And kind of allows you to just be in the moment, but that's just my own personal observation. I've heard other athletes and artists say something to that degree.

Could open to that theory, but I can't say I have any personal experience myself, but anything that would help cut down on the crosstalk in your head when you're playing the game would definitely be beneficial.

So now moving on to the other cannabinoids. CBD, for example, probably has zero effect on driving performance. Is that known?

That is known in fact that there's a number of different studies that have looked at subject's performance after taking CBD on driving simulator as compared to baseline. And we see very little to no change in driving performance, as one would expect.

But what about some of these other cannabinoids such as CBN or CBG? Probably not too much research on that.

I am unaware of any specific driving studies that have looked at the use of those isolated cannabinoids. But keep in mind, the majority of driving studies out there are looking at herbal cannabis. So they're, you're looking at cannabis that would have a mix of all of these different cannabinoid.

So shifting gears again, what do you think about the rescheduling of cannabis? You're a policy wonk on top of being a researcher. What, what are your thoughts on the good and the bad and the ugly of rescheduling?

Yeah, it's a very complicated issue, so. I think it's really important to sort of talk about this issue with respect to what rescheduling would do and what it wouldn't do. Okay. What it would do is for the first time in modern history, it would be an acknowledgement from the federal government that cannabis possesses legitimate medical utility. And I think that acknowledgement is very important. Right now we have sort of are operating under this flat earth policy where we have the majority of scientists and health professionals acknowledging that marijuana is a medicine. We have an overwhelming majority of the public that acknowledges cannabis as a medicine, and we have the majority of states who, through statute recognize cannabis is a me is a medicine, and the federal government says it isn't. simply an untenable position. It's intellectually dishonest, and it's certainly high time that the federal government changes that position and acknowledges again, what the evidence, what the data shows, and that's that cannabis does possess legitimate therapeutic properties and that it's being used safely and effectively by tens of millions of, of Americans right now. So I think that would be an important step for the federal government to take.

What rescheduling cannabis will not do is it won't address the elephant in the room. And that's the fact that right now we have the majority of states, they have passed laws regulating cannabis in a way that is completely contrary and in conflict with federal law. And unfortunately, moving cannabis from Schedule one to Schedule three will not change that reality. Just as the majority of states right now that are regulating cannabis for medical purposes or for adult use purposes in violation. Of federal policy, they would be just as in violation of federal policy if and when cannabis is moved from schedule one to schedule three. The only way we can align state marijuana laws with federal marijuana policy is for the federal government to remove the cannabis plant from the Controlled Substances Act altogether--to deschedule it. This is how the federal government right now treats tobacco, and that's why, particularly with alcohol, we have a patchwork system in the United States with all 50 states regulating alcohol in different unique ways. The way Connecticut regulates alcohol sales is very different than the way California or Texas regulates alcohol sales and states have the freedom and flexibility to set those policies largely as they see fit, because alcohol is not included in the Controlled Substances Act. If it was, states would lack that flexibility because the reason substances are classified in the CSA is for, so the federal government can set uniform rules that says every state needs to treat this drug the same way. That's not happening with cannabis. It's not going to happen with cannabis states are all gone in their separate directions with cannabis, and the federal government needs to reflect that reality. They need to respect that reality. And the only way that's done is by taking cannabis out of the CSA altogether. And that's ultimately what needs to happen. Rescheduling does not get us where we need to go.

So NORML has had this great success we talked about earlier--a really amazing success. I never thought I'd see it in my lifetime. What's next for normal? Where's NORML going now?

So that's a really good question because I think a lot of folks think falsely that marijuana reform is sort of a fait accompli right now, and the reality is political and cultural changes of this type only happen when passionate advocates agitate for them. And I fear that a lot of folks, because the cannabis reform movement has had such success in recent years, has sort of moved on. They've moved on to other issues and they've sort of left the movement to sort of run on autopilot, and that's not how movements, successful political movements operate. That's not how they work. What happens is when the movement gets weaker, opponents are there to try to cash in, to try to fill that void. And the reality is there are a lot of powerful interests that oppose changes in marijuana policy that it shows that oppose the legalization of cannabis. And they haven't gone away. They're still there in many cases. They've regrouped. They've re strategized and they're fighting back since the fact that this is an issue that has public momentum that shifts over time. So right now, far, probably far more than many people recognize we're fighting to hold the line. We're fighting against serious political efforts to roll back in, undermine many of the goals that we've achieved over the last few decades the state level and even at the federal level. We've seen a number of instances in recent months and in recent years where politicians, largely in GOP led states, have engaged in efforts to undermine or nullify voter approved changes in marijuana policy. That's happening right now in Nebraska. It's happening right now in Ohio. It's happening right now in Texas.

We've seen this in Florida at the federal level. Just within the last few weeks, we saw a handful of powerful politicians remove language. From military appropriation, from a military appropriations bill that has now passed that would've allowed for the first time veterans administration doctors to recommend medical cannabis to their patients. Right now, even in legal states, VA doctors can't do that. There was language to allow doctors to finally do this, and it was stripped from the bill and conference committee. Just a few weeks ago, we saw the federal government enact a ban on hemp-derived products.

Again, just within the last few days we see efforts right now in Massachusetts and Maine, there are efforts to place ballot questions and on next year's electoral ballot to repeal legalization in those states. So this is not a battle that's finished. NORML can't just close up shop and go home. We're still here holding the line to make sure that these political victories that we have fought so hard for remain in place 'cause right now they're under assault and that means the freedom of responsible adults and patients who use cannabis is equally under assault.

So tell me about how NORML got the first state to to allow medical marijuana and that must have been a a major victory and a very hard fought win.

California became the first state to legalize the medical use of cannabis. I think it's really important for people to remember that because the reality is, is we have a multi-decade history in this country with states regulating medical marijuana. They know how to do it. They know how to do it successfully. And I only raised that issue because we continue to hear this debate in a handful of states where this remains an issue, like say in Wisconsin. And we often hear political opponents say, well, we don't really know what'll happen if we, if we legalize medical marijuana. The reality is we do. We've been doing it in this country for many, many years. California, again, being the first. The irony is. The only reason California voters decided on legalizing medical marijuana as a ballot question is because the former governor of California in two consecutive years a very limited medical marijuana legalization bill sent to his desk, and both years in a row, he vetoed it. he not done so. That issue would've never gone to the ballot and may have never launched the nationwide medical marijuana initiative. That now again encompasses 40 states in this country.

Well, Paul thank you so much for being with me today and sharing a lot of views, a lot of interesting topics not just related to driving. Thank you so much for joining me and keep up the great work.

In your states and you can directly connect with your lawmakers and tell them how you feel.

You can always find us on social media under at Cannabis Boomer. People who choose to use cannabis need to be aware of what they consume. This podcast is intended to make users better informed about cannabis and its effects. The information shared on this podcast is meant as current opinion in science and should not be considered medical advice.

Primary Keywords:

#CannabisAndDriving #MarijuanaLaws #CannabisSafety #THCImpairment #NORMLAdvocacy #MedicalMarijuana #CannabisPolicy #ResponsibleUse #DrivingUnderTheInfluence #CannabisScience

Secondary Keywords:

#CannabisReform #MarijuanaLegalization #THCBloodLevels #EdiblesAndDriving #CannabisEducation #WeedSafety #PaulArmentano #CannabisResearch #MarijuanaTesting #DrugPolicyReform

Topical Keywords:

#CannabisBoomer #Over50Cannabis #SeniorCannabis #EvidenceBasedPolicy #CannabisAdvocacy #Rescheduling #Schedule3 #CBDSafety #EndocannabinoidSystem #VeteransCannabis

Long-tail Keywords:

#HowLongAfterSmokingCanIDrive #CannabisPsychomotorEffects #THCMetabolites #AlcoholAndCannabis #CompensatoryDriving #CannabisVsAlcoholDriving