RT Journal Article
SR Electronic
T1 Association between legalization of recreational cannabis and fatal motor vehicle collisions in the United States: an ecologic study
JF CMAJ Open
JO CMAJ
FD Canadian Medical Association
SP E233
OP E241
DO 10.9778/cmajo.20200155
VO 9
IS 1
A1 Sarah B. Windle
A1 Mark J. Eisenberg
A1 Pauline Reynier
A1 Josselin Cabaussel
A1 Brett D. Thombs
A1 Roland Grad
A1 Carolyn Ells
A1 Crystal Sequeira
A1 Kristian B. Filion
YR 2021
UL http://www.cmajopen.ca/content/9/1/E233.abstract
AB Background: With the recent legalization of recreational cannabis in Canada, cannabis-impaired driving is an important public safety concern. Our aim was to examine the association between recreational cannabis legalization and fatal motor vehicle collisions using data from the United States, which present a timely natural experiment of cannabis legalization.Methods: We conducted an ecologic study using the number of fatal motor vehicle collisions and the associated number of deaths for US jurisdictions with legalized recreational cannabis (2007–2018) retrieved from the US Fatality Analysis Reporting System. We examined jurisdiction-specific rates of fatal motor vehicle collisions and associated deaths before and after recreational cannabis legalization using Poisson regression and meta-analyzed estimates across jurisdictions using DerSimonian and Laird random-effects models.Results: After adjustment for calendar year, legalization was associated with increases in rates of fatal motor vehicle collisions (incidence rate ratio [IRR] 1.15, 95% confidence interval [CI] 1.06–1.26) and associated deaths (IRR 1.16, 95% CI 1.06–1.27). Differences between the first 12 months after legalization relative to subsequent months were inconclusive for rates of fatal motor vehicle collisions (IRR 0.92, 95% CI 0.84–1.02) and associated deaths (IRR 0.92, 95% CI 0.84–1.01).Interpretation: Recreational cannabis legalization in the US was associated with a relative increased risk of fatal motor vehicle collisions of 15% and a relative increase in associated deaths of 16%, with no conclusive difference between the first and subsequent years after legalization. These findings raise concern that there could be a similar increase in fatal motor vehicle collisions and associated deaths in Canada following recreational cannabis legalization.