Get Past Executive Dysfunction
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In mathematics, there is a thing called the “travelling salesman problem”, and it is hard. Not just subjectively; it is classified in mathematical terms as an “NP-hard problem”, wherein NP stands for “nondeterministic polynomial”.
The problem is: a travelling salesman must visit a certain list of cities, order undetermined, by the shortest possible route that visits them all.
To work out what the shortest route is involves either very advanced mathematics, or else solving it by brute force, which means measuring every possible combination order (which number gets exponentially larger very quickly after the first few cities) and then selecting the shortest.
Why are we telling you this?
Executive dysfunction’s analysis paralysis
Executive dysfunction is the state of knowing you have things to do, wanting to do them, intending to do them, and then simply not doing them.
Colloquially, this can be called “analysis paralysis” and is considered a problem of planning and organizing, as much as it is a problem of initiating tasks.
Let’s give a simple example:
You wake up in the morning, and you need to go to the bathroom. But the bathroom will be cold, so you’ll want to get dressed first. However, it will be uncomfortable to get dressed while you still need to use the bathroom, so you contemplate doing that first. Those two items are already a closed loop now. You’re thirsty, so you want to have a drink, but the bathroom is calling to you. Sitting up, it’s colder than under the covers, so you think about getting dressed. Maybe you should have just a sip of water first. What else do you need to do today anyway? You grab your phone to check, drink untouched, clothes unselected, bathroom unvisited.
That was a simple example; now apply that to other parts of your day that have much more complex planning possible.
This is like the travelling salesman problem, except that now, some things are better if done before or after certain other things. Sometimes, possibly, they are outright required to be done before or after certain other things.
So you have four options:
- Solve the problem of your travelling-salesman-like tasklist using advanced mathematics (good luck if you don’t have advanced mathematics)
- Solve the problem by brute force, calculating all possible variations and selecting the shortest (good luck getting that done the same day)
- Go with a gut feeling and stick to it (people without executive dysfunction do this)
- Go towards the nearest item, notice another item on the way, go towards that, notice a different item on the way there, and another one, get stuck for a while choosing between those two, head towards one, notice another one, and so on until you’ve done a very long scenic curly route that has narrowly missed all of your targetted items (this is the executive dysfunction approach).
So instead, just pick one, do it, pick another one, do it, and so forth.
That may seem “easier said than done”, but there are tools available…
Task zero
We’ve mentioned this before in the little section at the top of our daily newsletter that we often use for tips.
One of the problems that leads to executive function is a shortage of “working memory”, like the RAM of a computer, so it’s easy to get overwhelmed with lists of things to do.
So instead, hold only two items in your mind:
- Task zero: the thing you are doing right now
- Task one: the thing you plan to do next
When you’ve completed task zero, move on to task one, renaming it task zero, and select a new task one.
With this approach, you will never:
- Think “what did I come into this room for?”
- Get distracted by alluring side-quests
Do not get corrupted by the cursed artefact
In fantasy, and occasionally science fiction, there is a trope: an item that people are drawn towards, but which corrupts them, changes their motivations and behaviors for the worse, as well as making them resistant to giving the item up.
An archetypal example of this would be the One Ring from The Lord of the Rings.
It’s easy to read/watch and think “well I would simply not be corrupted by the cursed artefact”.
And then pick up one’s phone to open the same three apps in a cycle for the next 40 minutes.
This is because technology that is designed to be addictive hijacks our dopamine processing, and takes advantage of executive dysfunction, while worsening it.
There are some ways to mitigate this:
Rebalancing Dopamine (Without “Dopamine Fasting”)
…but one way to avoid it entirely is to mentally narrate your choices. It’s a lot harder to make bad choices with an internal narrator going:
- “She picked up her phone absent-mindedly, certain that this time it really would be only a few seconds”
- “She picked up her phone for the eleventy-third time”
- “Despite her plan to put her shoes on, she headed instead for the kitchen”
This method also helps against other bad choices aside from those pertaining to executive dysfunction, too:
- “Abandoning her plan to eat healthily, she lingered in the confectionary aisle, scanning the shelves for sugary treats”
- “Monday morning will be the best time to start my new exercise regime”, she thought, for the 35th week so far this year
Get pharmaceutical or nutraceutical help
While it’s not for everyone, many people with executive dysfunction benefit from ADHD meds. However, they have their pros and cons (perhaps we’ll do a run-down one of these days).
There are also gentler options that can significantly ameliorate executive dysfunction, for example:
Bacopa Monnieri: A Well-Evidenced Cognitive Enhancer For Focus & More
Enjoy!
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What’s the difference between autism and Asperger’s disorder?
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Swedish climate activist Greta Thunberg describes herself as having Asperger’s while others on the autism spectrum, such as Australian comedian Hannah Gatsby, describe themselves as “autistic”. But what’s the difference?
Today, the previous diagnoses of “Asperger’s disorder” and “autistic disorder” both fall within the diagnosis of autism spectrum disorder, or ASD.
Autism describes a “neurotype” – a person’s thinking and information-processing style. Autism is one of the forms of diversity in human thinking, which comes with strengths and challenges.
When these challenges become overwhelming and impact how a person learns, plays, works or socialises, a diagnosis of autism spectrum disorder is made.
Where do the definitions come from?
The Diagnostic and Statistical Manual of Mental Disorders (DSM) outlines the criteria clinicians use to diagnose mental illnesses and behavioural disorders.
Between 1994 and 2013, autistic disorder and Asperger’s disorder were the two primary diagnoses related to autism in the fourth edition of the manual, the DSM-4.
In 2013, the DSM-5 collapsed both diagnoses into one autism spectrum disorder.
How did we used to think about autism?
The two thinkers behind the DSM-4 diagnostic categories were Baltimore psychiatrist Leo Kanner and Viennese paediatrician Hans Asperger. They described the challenges faced by people who were later diagnosed with autistic disorder and Asperger’s disorder.
Kanner and Asperger observed patterns of behaviour that differed to typical thinkers in the domains of communication, social interaction and flexibility of behaviour and thinking. The variance was associated with challenges in adaptation and distress.
Kanner and Asperger described different thinking patterns in children with autism.
Roman Nerud/ShutterstockBetween the 1940s and 1994, the majority of those diagnosed with autism also had an intellectual disability. Clinicians became focused on the accompanying intellectual disability as a necessary part of autism.
The introduction of Asperger’s disorder shifted this focus and acknowledged the diversity in autism. In the DSM-4 it superficially looked like autistic disorder and Asperger’s disorder were different things, with the Asperger’s criteria stating there could be no intellectual disability or delay in the development of speech.
Today, as a legacy of the recognition of the autism itself, the majority of people diagnosed with autism spectrum disorder – the new term from the DSM-5 – don’t a have an accompanying intellectual disability.
What changed with ‘autism spectrum disorder’?
The move to autism spectrum disorder brought the previously diagnosed autistic disorder and Asperger’s disorder under the one new diagnostic umbrella term.
It made clear that other diagnostic groups – such as intellectual disability – can co-exist with autism, but are separate things.
The other major change was acknowledging communication and social skills are intimately linked and not separable. Rather than separating “impaired communication” and “impaired social skills”, the diagnostic criteria changed to “impaired social communication”.
The introduction of the spectrum in the diagnostic term further clarified that people have varied capabilities in the flexibility of their thinking, behaviour and social communication – and this can change in response to the context the person is in.
Why do some people prefer the old terminology?
Some people feel the clinical label of Asperger’s allowed a much more refined understanding of autism. This included recognising the achievements and great societal contributions of people with known or presumed autism.
The contraction “Aspie” played an enormous part in the shift to positive identity formation. In the time up to the release of the DSM-5, Tony Attwood and Carol Gray, two well known thinkers in the area of autism, highlighted the strengths associated with “being Aspie” as something to be proud of. But they also raised awareness of the challenges.
What about identity-based language?
A more recent shift in language has been the reclamation of what was once viewed as a slur – “autistic”. This was a shift from person-first language to identity-based language, from “person with autism spectrum disorder” to “autistic”.
The neurodiversity rights movement describes its aim to push back against a breach of human rights resulting from the wish to cure, or fundamentally change, people with autism.
Autism is one of the forms of diversity in human thinking, which comes with strengths and challenges.
Alex and Maria photo/ShutterstockThe movement uses a “social model of disability”. This views disability as arising from societies’ response to individuals and the failure to adjust to enable full participation. The inherent challenges in autism are seen as only a problem if not accommodated through reasonable adjustments.
However the social model contrasts itself against a very outdated medical or clinical model.
Current clinical thinking and practice focuses on targeted supports to reduce distress, promote thriving and enable optimum individual participation in school, work, community and social activities. It doesn’t aim to cure or fundamentally change people with autism.
A diagnosis of autism spectrum disorder signals there are challenges beyond what will be solved by adjustments alone; individual supports are also needed. So it’s important to combine the best of the social model and contemporary clinical model.
Andrew Cashin, Professor of Nursing, School of Health and Human Sciences, Southern Cross University
This article is republished from The Conversation under a Creative Commons license. Read the original article.
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Is A Visible Six-Pack Obtainable Regardless Of Genetic Predisposition?
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Have a question or a request? We love to hear from you!
In cases where we’ve already covered something, we might link to what we wrote before, but will always be happy to revisit any of our topics again in the future too—there’s always more to say!
As ever: if the question/request can be answered briefly, we’ll do it here in our Q&A Thursday edition. If not, we’ll make a main feature of it shortly afterwards!
So, no question/request too big or small 😎
❝Is it possible for anyone to get 6-pack abs (even if genetics makes it easier or harder) and how much does it matter for health e.g. waist size etc?❞
Let’s break it down into two parts:
Is it possible for anyone to get 6-pack abs (even if genetics makes it easier or harder)?
Short answer: no
First, a quick anatomy lesson: while “abs” (abdominal muscles) are considered in the plural and indeed they are, what we see as a six-pack is actually only one muscle, the rectus abdominis, which is nestled in between other abdominal muscles that are beyond the scope of our answer here.
The reason that the rectus abdominis looks like six muscles is because there are bands of fascia (connective tissue) lying over it, so we see where it bulges between those bands.
The main difference genes make are as follows:
- Number of fascia bands (and thus the reason that some people get a four-, six-, eight-, or rarely, even ten-pack). Obviously, no amount of training can change this number, any more than doing extra bicep curls will grow you additional arms.
- Density of muscle fibers. Some people have what has been called “superathlete muscle type”, which, while prized by Olympians and other athletes, is on bodybuilding forums less glamorously called being a “hard gainer”. What this means is that muscle fibers are denser, so while training will make muscles stronger, you won’t see as much difference in size. This means that size for size, the person with this muscle type will always be stronger than someone the same size without it, but that may be annoying if you’re trying to build visible definition.
- Twitch type of muscle fibers. Some people have more fast-twitch fibers, some have more slow-twitch fibers. Fast-twitch fibers are better suited for visible abs (and, as the name suggests, quick changes between contracting and relaxing). Slow-twitch fibers are better for endurance, but yield less bulky muscles.
- Inclination to subcutaneous fat storage. This is by no means purely genetic; hormones make the biggest difference, followed by diet. But, genes are an influencing factor, and if your body fat percentage is inclined to be higher than someone else’s, then it’ll take more work to see muscle definition under that fat.
The first of those items is why our simple answer is “no”; because some people are destined to, if muscle is visible, have a four-, eight, or (rarely) ten-pack, making a six-pack unobtainable.
It’s worth noting here that while a bigger number is more highly prized aesthetically, there is literally zero difference healthwise or in terms of performance, because it’s nothing to do with the muscle, and is only about the fascia layout.
The density of muscle fibers is again purely genetic, but it only makes things easier or harder; this part’s not impossible for anyone.
The inclination to subcutaneous fat storage is by far the most modifiable factor, and the thus most readily overcome, if you feel so inclined. That doesn’t mean it will necessarily be easy! But it does mean that it’s relatively less difficult than the others.
How much does it matter for health, e.g. waist size etc?
As you may have gathered from the above, having a six-pack (or indeed a differently-numbered “pack”, if that be your genetic lot) makes no important difference to health:
- The fascia layout is completely irrelevant to health
- The muscle fiber types do make a difference to athletic performance, but not general health when at rest
- The subcutaneous fat storage is a health factor, but probably not how most people think
Healthy body fat percentages are (assuming normal hormones) in the range of 20–25% for women and 15–20% for men.
For most people, having clearly visible abs requires going below those healthy levels. For most people, that’s not optimally healthy. And those you see on magazine covers or in bodybuilding competitions are usually acutely dehydrated for the photo, which is of course not good. They will rehydrate after the shoot.
However, waist size (especially as a ratio, compared to hip size) is very important to health. This has less to do with subcutaneous fat, though, and is more to do with visceral belly fat, which goes under the muscles and thus does not obscure them:
Visceral Belly Fat & How To Lose It
One final note: fat notwithstanding, and aesthetics notwithstanding, having a strong core is very good for general health; it helps keeps one’s internal organs in place and well-protected, and improves stability, making falls less likely as we get older. Additionally, having muscle improves our metabolic base rate, which is good for our heart. Abs are just one part of core strength (the back being important too, for example), but should not be neglected.
Top-tier exercises to do include planks, and hanging leg raises (i.e. hang from some support, such as a chin-up bar, and raise your legs, which counterintuitively works your abs a lot more than your legs).
Take care!
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Driving under the influence of marijuana: An explainer and research roundup
10almonds is reader-supported. We may, at no cost to you, receive a portion of sales if you purchase a product through a link in this article.
Update 1: On May 16, 2024, the U.S. Department of Justice sent a proposed rule to the Federal Register to downgrade marijuana from a Schedule I to a Schedule III drug. This is the first step in a lengthy approval process that starts with a 60-day comment period.
Update 2: Two recent research studies were added to the “Studies on marijuana and driving” section of this piece on July 18, 2024.
As marijuana use continues to rise and state-level marijuana legalization sweeps the U.S., researchers and policymakers are grappling with a growing public safety concern: marijuana-impaired driving.
As of April 2023, 38 U.S. states had legalized medical marijuana and 23 had legalized its recreational use, according to the National Conference of State Legislatures. Recreational or medical marijuana measures are on the ballot in seven states this year.
The issue of marijuana-impaired driving has not been an easy one to tackle because, unlike alcohol, which has well-established thresholds of impairment, the metrics for marijuana’s effects on driving remain rather elusive.
“We don’t have that kind of deep knowledge right now and it’s not because of lack of trying,” says Dr. Guohua Li, professor of epidemiology and the founding director of the Center for Injury Science and Prevention at Columbia University.
“Marijuana is very different from alcohol in important ways,” says Li, who has published several studies on marijuana and driving. “And one of them is that the effect of marijuana on cognitive functions and behaviors is much more unpredictable than alcohol. In general, alcohol is a depressant drug. But marijuana could act on the central nervous system as a depressant, a stimulant, and a hallucinogenic substance.”
Efforts to create a breathalyzer to measure the level of THC, the main psychoactive compound found in the marijuana plant, have largely failed, because “the THC molecule is much bigger than ethanol and its behavior after ingestion is very different from alcohol,” Li says.
Currently, the two most common methods used to measure THC concentration to identify impaired drivers are blood and saliva tests, although there’s ongoing debate about their reliability.
Marijuana, a term interchangeably used with cannabis, is the most commonly used federally illegal drug in the U.S.: 48.2 million people, or about 18% of Americans reported using it at least once in 2019, according to the latest available data from the Centers for Disease Control and Prevention. Worldwide, 2.5% of the population consumes marijuana, according to the World Health Organization.
Marijuana is legal in several countries, including Canada, where it was legalized in 2018. Despite state laws legalizing cannabis, it remains illegal at the federal level in the U.S.
As states grapple with the contentious issue of marijuana legalization, the debate is not just about public health, potential tax revenues and economic interests. At the heart of the discussion is also the U.S. criminal justice system.
Marijuana is shown to have medicinal qualities and, compared with substances like alcohol, tobacco, and opioids, it has relatively milder health risks. However, it’s not risk-free, a large body of research has shown.
Marijuana consumption can lead to immediate effects such as impaired muscle coordination and paranoia, as well as longer-term effects on mental health and cognitive functions — and addiction. As its use becomes more widespread, researchers are trying to better understand the potential hazards of marijuana, particularly for younger users whose brains are in critical stages of development.
Marijuana and driving
The use of marijuana among drivers, passengers and pedestrians has increased steadily over the past two decades, Li says.
Compared with the year 2000, the proportion of U.S. drivers on the road who are under the influence of marijuana has increased by several folds, between five to 10 times, based on toxicology testing of people who died in car crashes, Li says.
A 2022 report from the National Transportation Safety Board finds alcohol and cannabis are the two most commonly detected drugs among drivers arrested for impaired driving and fatally injured drivers. Most drivers who tested positive for cannabis also tested positive for another potentially impairing drug.
“Although cannabis and many other drugs have been shown to impair driving performance and are associated with increased crash risk, there is evidence that, relative to alcohol, awareness about the potential dangers of driving after using other drugs is lower,” according to the report.
Indeed, many U.S. adults perceive daily marijuana use or exposure to its smoke safer than tobacco, even though research finds otherwise.
Several studies have demonstrated marijuana’s impact on driving.
Marijuana use can reduce the drivers’ ability to pay attention, particularly when they are performing multiple tasks, research finds. It also slows reaction time and can impair coordination.
“The combination is that you potentially have people who are noticing hazards later, braking slower and potentially not even noticing hazards because of their inability to focus on competing things on the road,” says Dr. Daniel Myran, an assistant professor at the Department of Family Medicine and health services researcher at the University of Ottawa.
In a study published in September in JAMA Network Open, Myran and colleagues find that from 2010 to 2021 the rate of cannabis-involved traffic injuries that led to emergency department visits in Ontario, Canada, increased by 475%, from 0.18 per 1,000 traffic injury emergency department visits in 2010 to 1.01 visits in 2021.
To be sure, cannabis-involved traffic injuries made up a small fraction of all traffic injury-related visits to hospital emergency departments. Out of 947,604 traffic injury emergency department visits, 426 had documented cannabis involvement.
Myran cautions the increase shouldn’t be solely attributed to marijuana legalization. It captures changing societal attitudes toward marijuana and acceptance of cannabis use over time in the lead-up to legalization. In addition, it may reflect an increasing awareness among health care providers about cannabis-impaired driving, and they may be more likely to ask about cannabis use and document it in medical charts, he says.
“When you look at the 475% increase in cannabis involvement in traffic injuries, rather than saying legalizing cannabis has caused the roads to be unsafe and is a public health disaster, it’s that cannabis use appears to be growing as a risk for road traffic injuries and that there seem to be more cannabis impaired drivers on the road,” Myran says. “Legalization may have accelerated this trend. Faced with this increase, we need to think about what are public health measures and different policy interventions to reduce harms from cannabis-impaired driving.”
Setting a legal limit for marijuana-impaired driving
Setting a legal limit for marijuana-impaired driving has not been easy. Countries like Canada and some U.S. states have agreed upon a certain level of THC in blood, usually between 1 to 5 nanograms per milliliter. Still, some studies have found those limits to be weak indicators of cannabis-impaired driving.
When Canada legalized recreational marijuana in 2018, it also passed a law that made it illegal to drive with blood THC levels of more than 2 nanograms. The penalties are more severe for blood THC levels above 5 nanograms. The blood test is done at the police station for people who are pulled over and are deemed to be drug impaired.
In the U.S., five states — Ohio, Illinois, Montana, Washington and Nevada — have “per se laws,” which set a specific amount of THC in the driver’s blood as evidence of impaired driving, according to the National Conference of State Legislatures. That limit ranges between 2 and 5 nanograms of THC per milliliter of blood.
Colorado, meanwhile, has a “permissible inference law,” which states that it’s permissible to assume the driver was under the influence if their blood THC level is 5 nanograms per milliliter or higher, according to NCSL.
Twelve states, most which have legalized some form of marijuana of use, have zero tolerance laws for any amount of certain drugs, including THC, in the body.
The remaining states have “driving under the influence of drugs” laws. Among those states, Alabama and Michigan, have oral fluid roadside testing program to screen drivers for marijuana and other drugs, according to NCSL.
In May this year, the U.S. Department of Transportation published a final rule that allows employers to use saliva testing for commercially licensed drivers, including truck drivers. The rule, which went into effect in June, sets the THC limit in saliva at 4 nanograms.
Saliva tests can detect THC for 8 to 24 hours after use, but the tests are not perfect and can results in false positives, leading some scientists to argue against using them in randomly-selected drivers.
In a 2021 report, the U.S. National Institute of Justice, the research and development arm of the Department of Justice, concluded that THC levels in bodily fluids, including blood and saliva “were not reliable indicators of marijuana intoxication.”
Studies on marijuana and driving
Over the past two decades, many studies have shown marijuana use can impair driving. However, discussions about what’s the best way to measure the level of THC in blood or saliva are ongoing. Below, we highlight and summarize several recent studies that address the issue. The studies are listed in order of publication date. We also include a list of related studies and resources to inform your audiences.
State Driving Under the Influence of Drugs Laws
Alexandra N. Origenes, Sarah A. White, Emma E. McGinty and Jon S. Vernick. Journal of Law, Medicine & Ethics, July 2024.Summary: As of January 2023, 33 states and D.C. had a driving under the influence of drugs law for at least one drug other than cannabis. Of those, 29 states and D.C. had a law specifically for driving under the influence of cannabis, in addition to a law for driving under the influence of other drugs. Four states had a driving under the influence of drug laws, excluding cannabis. Meanwhile, 17 states had no law for driving under the influence of drugs, including cannabis. “The 17 states lacking a DUID law that names specific drugs should consider enacting such a law. These states already have expressed their concern — through legislation — with drug-impaired driving. However, failure to name specific drugs is likely to make the laws more difficult to enforce. These laws may force courts and/or law enforcement to rely on potentially subjective indicators of impairment,” the authors write.
Associations between Adolescent Marijuana Use, Driving After Marijuana Use and Recreational Retail Sale in Colorado, USA
Lucas M. Neuroth, et al. Substance Use & Misuse, October 2023.Summary: Researchers use data from four waves (2013, 2015, 2017 and 2019) of the Healthy Kids Colorado Survey, including 47,518 students 15 and older who indicated that they drove. They find 20.3% of students said that they had used marijuana in the past month and 10.5% said they had driven under the influence of marijuana. They find that the availability of recreational marijuana in stores was associated with an increased prevalence of using marijuana one to two times in the past month and driving under the influence of marijuana at least once. “Over the study period, one in ten high school age drivers engaged in [driving after marijuana use], which is concerning given the high risk of motor vehicle-related injury and death arising from impaired driving among adolescents,” the authors write.
Are Blood and Oral Fluid Δ9-tetrahydrocannabinol (THC) and Metabolite Concentrations Related to Impairment? A Meta-Regression Analysis
Danielle McCartney, et al. Neuroscience & Biobehavioral Reviews, March 2022.Summary: Commonly used THC measurements may not be strong indicators of driving impairment. While there is a relationship between certain biomarkers like blood THC concentrations and impaired driving, this correlation is often weak. The study underscores the need for more nuanced and comprehensive research on this topic, especially as cannabis usage becomes more widespread and legally accepted.
The Effects of Cannabis and Alcohol on Driving Performance and Driver Behaviour: A Systematic Review and Meta-Analysis
Sarah M. Simmons, Jeff K. Caird, Frances Sterzer and Mark Asbridge. Addiction, January 2022.Summary: This meta-analysis of experimental driving studies, including driving simulations, confirms that cannabis impairs driving performance, contrary to some beliefs that it might enhance driving abilities. Cannabis affects lateral control and speed — typically increasing lane excursions while reducing speed. The combination of alcohol and marijuana appears worse than either alone, challenging the idea that they cancel each other out.
Cannabis Legalization and Detection of Tetrahydrocannabinol in Injured Drivers
Jeffrey R. Brubacher, et al. The New England Journal of Medicine, January 2022.Summary: Following the legalization of recreational marijuana in Canada, there was a notable increase in injured drivers testing positive for THC, especially among those 50 years of age or older. This rise in cannabis-related driving incidents occurred even with new traffic laws aiming to deter cannabis-impaired driving. This uptick began before legalization became official, possibly due to perceptions that cannabis use was soon-to-be legal or illegal but not enforced. The data suggests that while legalization has broad societal impacts, more comprehensive strategies are needed to deter driving under the influence of cannabis and raise public awareness about its risks.
Cannabis and Driving
Godfrey D. Pearlson, Michael C. Stevens and Deepak Cyril D’Souza. Frontiers in Psychiatry, September 2021.Summary: Cannabis-impaired driving is a growing public health concern, and studies show that such drivers are more likely to be involved in car crashes, according to this review paper. Drivers are less affected by cannabis than they are by alcohol or cocaine, but the problem is expected to escalate with increasing cannabis legalization and use. Unlike alcohol, THC’s properties make it challenging to determine direct impairment levels from testing results. Current roadside tests lack precision in detecting genuine cannabis-impaired drivers, leading to potential wrongful convictions. Moreover, there is a pressing need for research on the combined effects of alcohol and cannabis on driving, as well as the impact of emerging popular forms of cannabis, like concentrates and edibles. The authors recommend public awareness campaigns about the dangers of driving under the influence of cannabis, similar to those against drunk driving, to address misconceptions. Policymakers should prioritize science-based decisions and encourage further research in this domain.
Demographic And Policy-Based Differences in Behaviors And Attitudes Towards Driving After Marijuana Use: An Analysis of the 2013–2017 Traffic Safety Culture Index
Marco H. Benedetti, et al. BMC Research Notes, June 2021.Summary: The study, based on a U.S. survey, finds younger, low-income, low-education and male participants were more tolerant of driving after marijuana consumption. Notably, those in states that legalized medical marijuana reported driving after use more frequently, aligning with studies indicating a higher prevalence of THC detection in drivers from these states. Overall, while the majority perceive driving after marijuana use as dangerous, not all research agrees on its impairment effects. Existing studies highlight that marijuana impacts motor skills and executive functions, yet its direct correlation with crash risk remains debated, given the variations in individual tolerance and how long THC remains in the system.
Driving Under the Influence of Cannabis: A Framework for Future Policy
Robert M. Chow, et al.Anesthesia & Analgesia, June 2019.Summary: The study presents a conceptual framework focusing on four main domains: legalization, driving under the influence of cannabis, driver impairment, and motor vehicle accidents. With the growing legalization of cannabis, there’s an anticipated rise in cannabis-impaired driving cases. The authors group marijuana users into infrequent users who show significant impairment with increased THC blood levels, chronic users with minimal impairment despite high THC levels, and those with consistent psychomotor deficits. Current challenges lie in the lack of standardized regulation for drivers influenced by cannabis, primarily because of state-to-state variability and the absence of a federal statutory limit for blood THC levels. European nations, however, have established thresholds for blood THC levels, ranging from 0.5 to 50.0 micrograms per liter depending on whether blood or blood serum are tested. The authors suggest the combined use of alcohol and THC blood tests with a psychomotor evaluation by a trained professional to determine impairment levels. The paper stresses the importance of creating a structured policy framework, given the rising acceptance and use of marijuana in society.
Additional research
Cannabis-Involved Traffic Injury Emergency Department Visits After Cannabis Legalization and Commercialization
Daniel T. Myran, et al. JAMA Network Open, September 2023.Driving Performance and Cannabis Users’ Perception of Safety: A Randomized Clinical Trial
Thomas D. Marcotte, et al. JAMA Psychiatry, January 2022.Medicinal Cannabis and Driving: The Intersection of Health and Road Safety Policy
Daniel Perkins, et al. International Journal of Drug Policy, November 2021.Prevalence of Marijuana Use Among Trauma Patients Before and After Legalization of Medical Marijuana: The Arizona Experience
Michael Levine, et al. Substance Abuse, July 2021.Self-Reported Driving After Marijuana Use in Association With Medical And Recreational Marijuana Policies
Marco H. Benedetti, et al. International Journal of Drug Policy, June 2021.Cannabis and Driving Ability
Eric L. Sevigny. Current Opinion in Psychology, April 2021.The Failings of per se Limits to Detect Cannabis-Induced Driving Impairment: Results from a Simulated Driving Study
Thomas R. Arkell, et al. Traffic Injury Prevention, February 2021.Risky Driving Behaviors of Drivers Who Use Alcohol and Cannabis
Tara Kelley-Baker, et al. Transportation Research Record, January 2021.Direct and Indirect Effects of Marijuana Use on the Risk of Fatal 2-Vehicle Crash Initiation
Stanford Chihuri and Guohua Li. Injury Epidemiology, September 2020Cannabis-Impaired Driving: Evidence and the Role of Toxicology Testing
Edward C. Wood and Robert L. Dupont. Cannabis in Medicine, July 2020.Association of Recreational Cannabis Laws in Colorado and Washington State With Changes in Traffic Fatalities, 2005-2017
Julian Santaella-Tenorio, et al. JAMA Internal Medicine, June 2020.Marijuana Decriminalization, Medical Marijuana Laws, and Fatal Traffic Crashes in US Cities, 2010–2017
Amanda Cook, Gregory Leung and Rhet A. Smith. American Journal of Public Health, February 2020.Cannabis Use in Older Drivers in Colorado: The LongROAD Study
Carolyn G. DiGuiseppi, et al. Accident Analysis & Prevention, November 2019.Crash Fatality Rates After Recreational Marijuana Legalization in Washington and Colorado
Jayson D. Aydelotte, et al. American Journal of Public Health, August 2017.Marijuana-Impaired Driving: A Report to Congress
National Highway Traffic Safety Administration, July 2017Interaction of Marijuana And Alcohol on Fatal Motor Vehicle Crash Risk: A Case–Control Study
Stanford Chihuri, Guohua Li and Qixuan Chen. Injury Epidemiology, March 2017.US Traffic Fatalities, 1985–2014, and Their Relationship to Medical Marijuana Laws
Julian Santaella-Tenorio, et al. American Journal of Public Health, February 2017.Delays in DUI Blood Testing: Impact on Cannabis DUI Assessments
Ed Wood, Ashley Brooks-Russell and Phillip Drum. Traffic Injury Prevention, June 2015.Establishing Legal Limits for Driving Under the Influence of Marijuana
Kristin Wong, Joanne E. Brady and Guohua Li. Injury Epidemiology, October 2014.Cannabis Effects on Driving Skills
Rebecca L. Hartman and Marilyn A. Huestis. Clinical Chemistry, March 2014.Acute Cannabis Consumption And Motor Vehicle Collision Risk: Systematic Review of Observational Studies and Meta-Analysis
Mark Asbridge, Jill A. Hayden and Jennifer L. Cartwright. The BMJ, February 2012.Resources for your audiences
The following resources include explainers from federal agencies and national organizations. You’re free to use images and graphics from federal agencies.
- CDC’s main marijuana page.
- CDC’s marijuana data and statistics.
- Marijuana Drug Facts from the National Institute on Drug Abuse.
- Health Effects of Marijuana from the CDC.
- Learn About Marijuana Risks from the Substance Abuse and Mental Health Services Administration.
- Marijuana and Lung Health from the American Lung Association.
- Substance Use Disorder 101 from the U.S. Department of Health & Human Services.
- What You Need To Know About Marijuana Use and Driving from the CDC.
- Does marijuana use affect driving? from the National Institute on Drug Abuse.
- Drug-Impaired Driving from the National Highway Traffic Safety Administration.
This article first appeared on The Journalist’s Resource and is republished here under a Creative Commons license.
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This is not the most cheery book we’ve reviewed, but it is an important one. From its first chapter, with “a tale of two deaths”, one that went as well as can be reasonably expected, and the other one not so much, it presents a lot of choices.
The book is not prescriptive in its advice regarding how to deal with these choices, but rather, investigative. It’s thought-provoking, and asks questions—tacitly and overtly.
While the subtitle says “for families and caregivers”, it’s as much worth when it comes to managing one’s own mortality, too, by the way.
As for the scope of the book, it covers everything from terminal diagnosis, through the last part of life, to the death itself, to all that goes on shortly afterwards.
Stylewise, it’s… We’d call it “easy-reading” for style, but obviously the content is very heavy, so you might want to read it a bit at a time anyway, depending on how sensitive to such topics you are.
Bottom line: this book is not exactly a fun read, but it’s a very worthwhile one, and a good way to avoid regrets later.
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The Art and Science of Connection – by Kasley Killam, MPH
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We can eat well, exercise well, and even sleep well, and we’ll still have a +53% increased all-cause mortality if we lack social connection—even if we technically have support and access to social resources, just not the real human connection itself. And as we get older, it gets increasingly easy to find ourselves isolated.
The author is a social scientist by profession, and it shows. None of what she shares in the book is wishy-washy; it has abundant scientific references coming thick and fast, and a great deal of clarity with regard to terms, something often not found in books of this genre that lean more towards the art than the science.
On which note, for the reader who may be thinking “I am indeed quite alone”, she also offers proven techniques for remedying that; not in the way that many books use the word “proven” to mean “we got some testimonials”, but rather, proven in the sense of “we did science to it and based on these 17 large population-based retrospective cohort studies, we can say with 99% confidence that this is an effective tool to mediate improved social bonds and social health outcomes”.
To this end, it’s a very practical book also, and should bestow upon any isolated reader a sense of confidence that in fact, things can be better. A particular strength is that it also looks at many different scenarios, so for the “what if I…” people with clear reasons why social connection is not abundantly available, yes, she has such cases covered too.
Bottom line: if you’d like to live more healthily for longer, social health is an underrated and oft-forgotten way of greatly increasing those things, by science.
Click here to check out The Art And Science Of Social Connection, and get connected!
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Dr. Patrick Walsh’s Guide to Surviving Prostate Cancer – by Dr. Patrick Walsh & Janet Farrar Worthington
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Prostate cancer is not glamorous or fun, and neither is this book.
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Like many cancers, prostate cancer is easy to treat if caught very early, becomes harder to treat as it goes, and almost impossible to cure if it gets as far as metastasis (i.e., it spread). Like all cancers, it’s better off avoided entirely if possible.
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It’s asking whenever possible “is there another option?” and exploring all options, with information and without judgment, at each stage.
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Click here to check out Dr. Patrick Walsh’s Guide To Surviving Prostate Cancer, and be prepared!
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