The effect of cannabis edibles on driving and blood THC.

BACKGROUND: Cannabis has been shown to impact driving due to changes produced by delta-9-tetrahydrocannabinol (THC), the psychoactive component of cannabis. Current legal thresholds for blood THC while driving are based predominantly on evidence utilizing smoked cannabis. It is known that levels of THC in blood are lower after eating cannabis as compared to smoking yet the impact of edibles on driving and associated blood THC has never been studied. METHODS: Participants drove a driving simulator before and after ingesting their preferred legally purchased cannabis edible. In a counterbalanced control session, participants did not consume any THC or cannabidiol (CBD). Blood was collected for measurement of THC and metabolites as well as CBD. Subjective experience was also assessed. RESULTS: Participants consumed edibles with, on average, 7.3 mg of THC, which is less than the maximum amount available in a single retail package in Ontario, providing an ecologically valid test of cannabis edibles. Compared to control, cannabis edibles produced a decrease in mean speed 2 h after consumption but not at 4 and 6 h. Under dual task conditions in which participants completed a secondary task while driving, changes in speed were not significant after the correction for multiple comparison. No changes in standard deviation of lateral position (SDLP; 'weaving'), maximum speed, standard deviation of speed or reaction time were found at any time point or under either standard or dual task conditions. Mean THC levels were significantly increased, relative to control, after consuming the edible but remained relatively low at approximately 2.8 ng/mL 2 h after consumption. Driving impairment was not correlated with blood THC. Subjective experience was altered for 7 h and participants were less willing/able to drive for up to 6 h, suggesting that the edible was intoxicating. INTERPRETATION: This is the first study of the impact of cannabis edibles on simulated driving. Edibles were intoxicating as revealed by the results of subjective assessments (VAS), and there was some impact on driving. Detection of driving impairment after the use of cannabis edibles may be difficult.

Drug Trafficking; Use; and HIV Risk: The Need for Comprehensive Interventions

The rapid increase in communication and transportation between Africa and other continents as well as the erosion of social fabric attended by poverty; ethnic conflicts; and civil wars has led to increased trafficking and consumption of illicit drugs. Cannabis dominates illicit trade and accounts for as much as 40 of global interdiction. Due to escalating seizures in recent years; the illicit trade in heroin and cocaine has become a concern that has quickly spread from West Africa to include Eastern and Southern Africa in the past 10 years. All regions of Africa are characterized by the use of cannabis; reflecting its entrenched status all over Africa. Most alarming though is the use of heroin; which is now being injected frequently and threatens to reverse the gain made in the prevention of HIV/AIDS. The prevalence of HIV infection and other blood-borne diseases among injection drug users is five to six times that among the general population; calling for urgent intervention among this group. Programs that aim to reduce the drug trafficking in Africa and needle syringe programs as well as medication-assisted treatment (MAT) of heroin dependence while still in their infancy in Africa show promise and need to be scaled up

Smokeless tobacco use among adolescents in Ilala Municipality, Tanzania.

Smokeless tobacco use is a significant part of the overall world tobacco problem. When the habit is introduced early in life, it increases the chance for permanent addiction and primes adolescents for use of harder drugs, exposing them to higher risk of oral cancer and other adverse effects of tobacco. This baseline study aimed at providing descriptive information on smokeless tobacco knowledge and use among adolescents at a time just before the ban on such products was enforced nationally on 1st December 2006. Six out of 101 primary and four out of 11 secondary schools were randomly selected in Ilala Municipality, Tanzania. A total of 1011 students were randomly selected and interviewed; boys (mean age = 14.5 years) accounted for 50.7% and girls (mean age = 13.6 years) 49.3%. The prevalence of tobacco use was 5.9% (boys = 9%; girls = 2.4%). Prevalence of smokeless tobacco use was 3.6%, about half of all who have ever smoked. Most popular brand of smokeless tobacco reported was Kuberi (44.8%) followed by Gutka (6.9%). Twelve (41%) of the smokeless tobacco users were using the products almost everyday. Among the reasons reported for smokeless tobacco use were pleasure (27.6%), smell (17.2%) and taste (6.9%). However, 48.3% of the users did not know why they used the product for the first time. Smokeless tobacco products were branded as nutritional supplements with different tastes and strengths, ideal for enticing the curiosity of adolescents. Given the crafty practice of the tobacco industry and salesmen, there is need for monitoring of availability of these products in circulation and enforcement of the ban nationally and globally to institute measures for effective elimination of this harmful practice.

Smokeless Tobacco Use among Adolescents in Ilala Municipality; Tanzania

Smokeless tobacco use is a significant part of the overall world tobacco problem. When the habit is introduced early in life; it increases the chance for permanent addiction and primes adolescents for use of harder drugs; exposing them to higher risk of oral cancer and other adverse effects of tobacco. This baseline study aimed at providing descriptive information on smokeless tobacco knowledge and use among adolescents at a time just before the ban on such products was enforced nationally on 1st December 2006. Six out of 101 primary and four out of 11 secondary schools were randomly selected in Ilala Municipality; Tanzania. A total of 1011 students were randomly selected and interviewed; boys (mean age= 14.5 years) accounted for 50.7and girls (mean age= 13.6 years) 49.3. The prevalence of tobacco use was 5.9(boys= 9; girls= 2.4). Prevalence of smokeless tobacco use was 3.6; about half of all who have ever smoked. Most popular brand of smokeless tobacco reported was Kuberi (44.8) followed by Gutka (6.9). Twelve (41) of the smokeless tobacco users were using the products almost everyday. Among the reasons reported for smokeless tobacco use were pleasure (27.6); smell (17.2) and taste (6.9). However; 48.3of the users did not know why they used the product for the first time. Smokeless tobacco products were branded as nutritional supplements with different tastes and strengths; ideal for enticing the curiosity of adolescents. Given the crafty practice of the tobacco industry and salesmen; there is need for monitoring of availability of these products in circulation and enforcement of the ban nationally and globally to institute measures for effective elimination of this harmful practice