Cannabidiol (CBD) content in vaporized cannabis does not prevent tetrahydrocannabinol (THC)-induced impairment of driving and cognition

Thomas R Arkell; Nicholas Lintzeris; Richard C Kevin; Johannes G Ramaekers; Ryan Vandrey; Christopher Irwin; Paul S Haber; Iain S McGregor

doi:10.1007/s00213-019-05246-8

Cannabidiol (CBD) content in vaporized cannabis does not prevent tetrahydrocannabinol (THC)-induced impairment of driving and cognition

Thomas R Arkell, Nicholas Lintzeris, Richard C Kevin, Johannes G Ramaekers, Ryan Vandrey, Christopher Irwin, Paul S Haber, Iain S McGregor^*

^*Corresponding author for this work

Research output: Contribution to journal › Article › Academic › peer-review

Abstract

BACKGROUND: The main psychoactive component of cannabis, delta-9-tetrahydrocannabinol (THC), can impair driving performance. Cannabidiol (CBD), a non-intoxicating cannabis component, is thought to mitigate certain adverse effects of THC. It is possible then that cannabis containing equivalent CBD and THC will differentially affect driving and cognition relative to THC-dominant cannabis.

AIMS: The present study investigated and compared the effects of THC-dominant and THC/CBD equivalent cannabis on simulated driving and cognitive performance.

METHODS: In a randomized, double-blind, within-subjects crossover design, healthy volunteers (n = 14) with a history of light cannabis use attended three outpatient experimental test sessions in which simulated driving and cognitive performance were assessed at two timepoints (20-60 min and 200-240 min) following vaporization of 125 mg THC-dominant (11% THC; < 1% CBD), THC/CBD equivalent (11% THC, 11% CBD), or placebo (< 1% THC/CBD) cannabis.

RESULTS/OUTCOMES: Both active cannabis types increased lane weaving during a car-following task but had little effect on other driving performance measures. Active cannabis types impaired performance on the Digit Symbol Substitution Task (DSST), Divided Attention Task (DAT) and Paced Auditory Serial Addition Task (PASAT) with impairment on the latter two tasks worse with THC/CBD equivalent cannabis. Subjective drug effects (e.g., "stoned") and confidence in driving ability did not vary with CBD content. Peak plasma THC concentrations were higher following THC/CBD equivalent cannabis relative to THC-dominant cannabis, suggesting a possible pharmacokinetic interaction.

CONCLUSIONS/INTERPRETATION: Cannabis containing equivalent concentrations of CBD and THC appears no less impairing than THC-dominant cannabis, and in some circumstances, CBD may actually exacerbate THC-induced impairment.

Original language	English
Pages (from-to)	2713-2724
Number of pages	12
Journal	Psychopharmacology
Volume	236
Issue number	9
Early online date	1 May 2019
DOIs	https://doi.org/10.1007/s00213-019-05246-8
Publication status	Published - Sept 2019

Keywords

Cannabis
Tetrahydrocannabinol
Cannabidiol
THC
CBD
Driving
Cognition
ORAL DELTA(9)-TETRAHYDROCANNABINOL
DOUBLE-BLIND
DELTA-9-TETRAHYDROCANNABINOL
ALCOHOL
PERFORMANCE
MARIJUANA
PHARMACOKINETICS
EXTRACT
INTOXICATION

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10.1007/s00213-019-05246-8Licence: CC BY

Cite this

@article{3f09dfd07a834767bd02fecb6705dc7c,

title = "Cannabidiol (CBD) content in vaporized cannabis does not prevent tetrahydrocannabinol (THC)-induced impairment of driving and cognition",

abstract = "BACKGROUND: The main psychoactive component of cannabis, delta-9-tetrahydrocannabinol (THC), can impair driving performance. Cannabidiol (CBD), a non-intoxicating cannabis component, is thought to mitigate certain adverse effects of THC. It is possible then that cannabis containing equivalent CBD and THC will differentially affect driving and cognition relative to THC-dominant cannabis.AIMS: The present study investigated and compared the effects of THC-dominant and THC/CBD equivalent cannabis on simulated driving and cognitive performance.METHODS: In a randomized, double-blind, within-subjects crossover design, healthy volunteers (n = 14) with a history of light cannabis use attended three outpatient experimental test sessions in which simulated driving and cognitive performance were assessed at two timepoints (20-60 min and 200-240 min) following vaporization of 125 mg THC-dominant (11% THC; < 1% CBD), THC/CBD equivalent (11% THC, 11% CBD), or placebo (< 1% THC/CBD) cannabis.RESULTS/OUTCOMES: Both active cannabis types increased lane weaving during a car-following task but had little effect on other driving performance measures. Active cannabis types impaired performance on the Digit Symbol Substitution Task (DSST), Divided Attention Task (DAT) and Paced Auditory Serial Addition Task (PASAT) with impairment on the latter two tasks worse with THC/CBD equivalent cannabis. Subjective drug effects (e.g., {"}stoned{"}) and confidence in driving ability did not vary with CBD content. Peak plasma THC concentrations were higher following THC/CBD equivalent cannabis relative to THC-dominant cannabis, suggesting a possible pharmacokinetic interaction.CONCLUSIONS/INTERPRETATION: Cannabis containing equivalent concentrations of CBD and THC appears no less impairing than THC-dominant cannabis, and in some circumstances, CBD may actually exacerbate THC-induced impairment.",

keywords = "Cannabis, Tetrahydrocannabinol, Cannabidiol, THC, CBD, Driving, Cognition, ORAL DELTA(9)-TETRAHYDROCANNABINOL, DOUBLE-BLIND, DELTA-9-TETRAHYDROCANNABINOL, ALCOHOL, PERFORMANCE, MARIJUANA, PHARMACOKINETICS, EXTRACT, INTOXICATION",

author = "Arkell, {Thomas R} and Nicholas Lintzeris and Kevin, {Richard C} and Ramaekers, {Johannes G} and Ryan Vandrey and Christopher Irwin and Haber, {Paul S} and McGregor, {Iain S}",

note = "Funding Information: We thank Tilray for supplying the cannabis to conduct this study, and Storz and Bickel for supplying the Mighty Medic vaporizers. We thank Dr. Hamish MacDougall, Ms. Zara Mills, Ms. Consuelo Rivas, and Dr. Jordyn Stuart for their invaluable contributions and we wish to sincerely acknowledge the support and contributions of the late Associate Professor David Allsop. Funding Information: Conflict of interest Nicholas Lintzeris has received funding for sponsored research studies from Camurus and has provided consultancies for Indivior and Mundipharma for unrelated work. Ryan Vandrey has received consulting fees from Zynerba Pharmaceuticals, Battelle Memorial Institute, and Canopy Health Innovations Inc. and has received compensation for being on the advisory boards for Insys Therapeutics, Brain Solutions Inc., and The Realm of Caring Foundation. Paul Haber has received research funding from Camurus, and has provided consultancies for Indivior, Abbvie, and Gilead for unrelated work. Iain McGregor acts as a consultant to Kinoxis Therapeutics and is an inventor on several patents relating to novel cannabinoid therapeutics. The other authors have no conflicts of interest to disclose. Funding Information: Funding This study was supported by the Lambert Initiative for Cannabinoid Therapeutics, a philanthropically-funded center for medicinal cannabis research at the University of Sydney. Publisher Copyright: {\textcopyright} 2019, The Author(s).",

year = "2019",

month = sep,

doi = "10.1007/s00213-019-05246-8",

language = "English",

volume = "236",

pages = "2713--2724",

journal = "Psychopharmacology",

issn = "0033-3158",

publisher = "Springer",

number = "9",

}

TY - JOUR

T1 - Cannabidiol (CBD) content in vaporized cannabis does not prevent tetrahydrocannabinol (THC)-induced impairment of driving and cognition

AU - Arkell, Thomas R

AU - Lintzeris, Nicholas

AU - Kevin, Richard C

AU - Ramaekers, Johannes G

AU - Vandrey, Ryan

AU - Irwin, Christopher

AU - Haber, Paul S

AU - McGregor, Iain S

N1 - Funding Information: We thank Tilray for supplying the cannabis to conduct this study, and Storz and Bickel for supplying the Mighty Medic vaporizers. We thank Dr. Hamish MacDougall, Ms. Zara Mills, Ms. Consuelo Rivas, and Dr. Jordyn Stuart for their invaluable contributions and we wish to sincerely acknowledge the support and contributions of the late Associate Professor David Allsop. Funding Information: Conflict of interest Nicholas Lintzeris has received funding for sponsored research studies from Camurus and has provided consultancies for Indivior and Mundipharma for unrelated work. Ryan Vandrey has received consulting fees from Zynerba Pharmaceuticals, Battelle Memorial Institute, and Canopy Health Innovations Inc. and has received compensation for being on the advisory boards for Insys Therapeutics, Brain Solutions Inc., and The Realm of Caring Foundation. Paul Haber has received research funding from Camurus, and has provided consultancies for Indivior, Abbvie, and Gilead for unrelated work. Iain McGregor acts as a consultant to Kinoxis Therapeutics and is an inventor on several patents relating to novel cannabinoid therapeutics. The other authors have no conflicts of interest to disclose. Funding Information: Funding This study was supported by the Lambert Initiative for Cannabinoid Therapeutics, a philanthropically-funded center for medicinal cannabis research at the University of Sydney. Publisher Copyright: © 2019, The Author(s).

PY - 2019/9

Y1 - 2019/9

N2 - BACKGROUND: The main psychoactive component of cannabis, delta-9-tetrahydrocannabinol (THC), can impair driving performance. Cannabidiol (CBD), a non-intoxicating cannabis component, is thought to mitigate certain adverse effects of THC. It is possible then that cannabis containing equivalent CBD and THC will differentially affect driving and cognition relative to THC-dominant cannabis.AIMS: The present study investigated and compared the effects of THC-dominant and THC/CBD equivalent cannabis on simulated driving and cognitive performance.METHODS: In a randomized, double-blind, within-subjects crossover design, healthy volunteers (n = 14) with a history of light cannabis use attended three outpatient experimental test sessions in which simulated driving and cognitive performance were assessed at two timepoints (20-60 min and 200-240 min) following vaporization of 125 mg THC-dominant (11% THC; < 1% CBD), THC/CBD equivalent (11% THC, 11% CBD), or placebo (< 1% THC/CBD) cannabis.RESULTS/OUTCOMES: Both active cannabis types increased lane weaving during a car-following task but had little effect on other driving performance measures. Active cannabis types impaired performance on the Digit Symbol Substitution Task (DSST), Divided Attention Task (DAT) and Paced Auditory Serial Addition Task (PASAT) with impairment on the latter two tasks worse with THC/CBD equivalent cannabis. Subjective drug effects (e.g., "stoned") and confidence in driving ability did not vary with CBD content. Peak plasma THC concentrations were higher following THC/CBD equivalent cannabis relative to THC-dominant cannabis, suggesting a possible pharmacokinetic interaction.CONCLUSIONS/INTERPRETATION: Cannabis containing equivalent concentrations of CBD and THC appears no less impairing than THC-dominant cannabis, and in some circumstances, CBD may actually exacerbate THC-induced impairment.

AB - BACKGROUND: The main psychoactive component of cannabis, delta-9-tetrahydrocannabinol (THC), can impair driving performance. Cannabidiol (CBD), a non-intoxicating cannabis component, is thought to mitigate certain adverse effects of THC. It is possible then that cannabis containing equivalent CBD and THC will differentially affect driving and cognition relative to THC-dominant cannabis.AIMS: The present study investigated and compared the effects of THC-dominant and THC/CBD equivalent cannabis on simulated driving and cognitive performance.METHODS: In a randomized, double-blind, within-subjects crossover design, healthy volunteers (n = 14) with a history of light cannabis use attended three outpatient experimental test sessions in which simulated driving and cognitive performance were assessed at two timepoints (20-60 min and 200-240 min) following vaporization of 125 mg THC-dominant (11% THC; < 1% CBD), THC/CBD equivalent (11% THC, 11% CBD), or placebo (< 1% THC/CBD) cannabis.RESULTS/OUTCOMES: Both active cannabis types increased lane weaving during a car-following task but had little effect on other driving performance measures. Active cannabis types impaired performance on the Digit Symbol Substitution Task (DSST), Divided Attention Task (DAT) and Paced Auditory Serial Addition Task (PASAT) with impairment on the latter two tasks worse with THC/CBD equivalent cannabis. Subjective drug effects (e.g., "stoned") and confidence in driving ability did not vary with CBD content. Peak plasma THC concentrations were higher following THC/CBD equivalent cannabis relative to THC-dominant cannabis, suggesting a possible pharmacokinetic interaction.CONCLUSIONS/INTERPRETATION: Cannabis containing equivalent concentrations of CBD and THC appears no less impairing than THC-dominant cannabis, and in some circumstances, CBD may actually exacerbate THC-induced impairment.

KW - Cannabis

KW - Tetrahydrocannabinol

KW - Cannabidiol

KW - THC

KW - CBD

KW - Driving

KW - Cognition

KW - ORAL DELTA(9)-TETRAHYDROCANNABINOL

KW - DOUBLE-BLIND

KW - DELTA-9-TETRAHYDROCANNABINOL

KW - ALCOHOL

KW - PERFORMANCE

KW - MARIJUANA

KW - PHARMACOKINETICS

KW - EXTRACT

KW - INTOXICATION

U2 - 10.1007/s00213-019-05246-8

DO - 10.1007/s00213-019-05246-8

M3 - Article

C2 - 31044290

SN - 0033-3158

VL - 236

SP - 2713

EP - 2724

JO - Psychopharmacology

JF - Psychopharmacology

IS - 9

ER -