Driving under the influence of marijuana: An explainer and research roundup
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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 2020
Cannabis-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 2017
Interaction 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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The 5 Resets – by Dr. Aditi Nerurkar
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.
What this book isn’t: an advice to go on a relaxing meditation retreat, or something like that.
What this is: a science-based guide to what actually works.
There’s no need to be mysterious, so we’ll mention that the titular “5 resets” are:
- What matters most
- Quiet in a noisy world
- Leveraging the brain-body connection
- Coming up for air (regaining perspective)
- Bringing your best self forward
All of these are things we can easily lose sight of in the hustle and bustle of daily life, so having a system for keeping them on track can make a huge difference!
The style is personable and accessible, while providing a lot of strongly science-backed tips and tricks along the way.
Bottom line: if life gets away from you a little too often for comfort, this book can help you keep on top of things with a lot less stress.
Click here to check out “The 5 Resets”, and take control with conscious calm!
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You Are Not a Before Picture – by Alex Light
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It’s that time of year, and many of us are looking at what we’ll do in the coming days, weeks, and months to level-up our health. So… Is this a demotivational book?
Quite the opposite! It’s rather a case of an often much-needed reminder to ensure that our plans are really our own, and really are what’s best for us. Why wouldn’t they be, you ask?
Much of diet culture (ubiquitous! From magazine covers to movie stars to the models advertising anything from health insurance to water filters) has us reaching for “body goals” that are not possible without a different skeleton and genes and compromises and post-production edits.
Alex Light—herself having moved from the fashion and beauty industry into health education—sets out in a clear, easy-reading manner, how we can look after ourselves, not be neglectful of our bodies, and/but also not get distracted into unhelpful, impossible, castles-in-the-air.
Bottom line: you cannot self-hate your way into good health, and good health will always be much more attainable than a body that’s just not yours. This book can help you sort out which is which.
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Potatoes & Anxiety
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It’s Q&A Day at 10almonds!
Have a question or a request? You can always hit “reply” to any of our emails, or use the feedback widget at the bottom!
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
❝My other half considers potatoes a wonder food, except when fried. I don’t. I find, when I am eating potatoes I put on weight; and, when I’m not eating them, I lose it. Also, although I can’t swear to it, potatoes also make me feel a little anxious (someone once told me it could have something to do with where they are on the “glycemic index”). What does the science say?❞
The glycemic index of potatoes depends on the kind of potato (obviously) and also, less obviously, how it’s prepared. For a given white potato, boiling (which removes a lot of starch) might produce a GI of around 60, while instant mash (basically: potato starch) can be more like 80. For reference, pure glucose is 100. And you probably wouldn’t take that in the same quantity you’d take potato, and expect to feel good!
So: as for anxiety, it could be, since spiked blood sugars can cause mood swings, including anxiety.
Outside of the matter of blood sugars, the only reference we could find for potatoes causing anxiety was fried potatoes specifically:
❝frequent fried food consumption, especially fried potato consumption, is strongly associated with 12% and 7% higher risk of anxiety and depression, respectively❞
…which heavily puts the blame not on the potatoes themselves, but on acrylamide (the orange/brown stuff that is made by the Maillard reaction of cooking starches in the absence of water, e.g. by frying, roasting, etc).
Here’s a very good overview of that, by the way:
A Review on Acrylamide in Food: Occurrence, Toxicity, and Mitigation Strategies
Back on the core topic of potatoes and GI and blood sugar spikes and anxiety, you might benefit from a few tweaks that will allow you to enjoy potatoes without spiking blood sugars:
10 Ways To Balance Blood Sugars
Enjoy!
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What Most People Don’t Know About HIV
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What To Know About HIV This World AIDS Day
Yesterday, we asked you to engage in a hypothetical thought experiment with us, and putting aside for a moment any reason you might feel the scenario wouldn’t apply for you, asked:
❝You have unprotected sex with someone who, afterwards, conversationally mentions their HIV+ status. Do you…❞
…and got the above-depicted, below-described, set of responses. Of those who responded…
- Just over 60% said “rush to hospital; maybe a treatment is available”
- Just under 20% said “ask them what meds they’re taking (and perhaps whether they’d like a snack)”
- Just over 10% said “despair; life is over”
- Two people said “do the most rigorous washing down there you’ve ever done in your life”
So, what does science say about it?
First, a quick note on terms
- HIV is the Human Immunodeficiency Virus. It does what it says on the tin; it gives humans immunodeficiency. Like many viruses that have become epidemic in humans, it started off in animals (called SIV, because there was no “H” involved yet), which were then eaten by humans, passing the virus to us when it one day mutated to allow that.
- It’s technically two viruses, but that’s beyond the scope of today’s article; for our purposes they are the same. HIV-1 is more virulent and infectious than HIV-2, and is the kind more commonly found in most of the world.
- AIDS is Acquired Immunodeficiency Syndrome, and again, is what it sounds like. When a person is infected with HIV, then without treatment, they will often develop AIDS.
- Technically AIDS itself doesn’t kill people; it just renders people near-defenseless to opportunistic infections (and immune-related diseases such as cancer), since one no longer has a properly working immune system. Common causes of death in AIDS patients include cancer, influenza, pneumonia, and tuberculosis.
People who contract HIV will usually develop AIDS if untreated. Untreated life expectancy is about 11 years.
HIV/AIDS are only a problem for gay people: True or False?
False, unequivocally. Anyone can get HIV and develop AIDS.
The reason it’s more associated with gay men, aside from homophobia, is that since penetrative sex is more likely to pass it on…
- If a man penetrates a woman and passes on HIV, that woman will probably not go on to penetrate someone else
- If a man penetrates a man and passes on HIV, that man could go on to penetrate someone else—and so on
- This means that without any difference in safety practices or promiscuity, it’s going to spread more between men on average, by simple mathematics.
- This is why “men who have sex with men” is the generally-designated higher-risk category.
There is medication to cure HIV/AIDS: True or False?
False (though there have been individual case studies of gene treatments that may have cured people—time will tell).
But! There are medications that can prevent HIV from being a life-threatening problem:
- PrEP (Pre-Exposure Prophylaxis) is a medication that one can take in advance of potential exposure to HIV, to guard against it.
- This is a common choice for people aren’t sure about their partners’ statuses, or people working in risky environments.
- PEP (Post-Exposure Prophylaxis) is a medication that one can take after potential exposure to HIV, to “nip it in the bud”.
- Those of you who were rushing to hospital in our poll, this is what you’re rushing there for.
- ARVs (Anti-RetroVirals) are a class of medications (there are different options; we don’t have room to distinguish them) that reduce an HIV+ person’s viral load to undetectable levels.
- Those of you who were asking what meds your partner was taking, these will be those meds. Also, most of them are to be taken in the morning with food, so that’s what the snack was for.
If someone is HIV+, the risk of transmission in unprotected sex is high: True or False?
True or False, with false being the far more likely. It depends on their medications, and this is why you were asking. If someone is on ARVs and their viral load is undetectable (as is usual once someone has been on ARVs for 6 months), they cannot transmit HIV to you.
U=U is not a fancy new emoticon, it means “undetectable = untransmittable”, which is a mathematically true statement in the case of HIV viral loads.
See: NIH | HIV Undetectable=Untransmittable (U=U)
If you’re thinking “still sounds risky to me”, then consider this:
You are safer having unprotected sex with someone who is HIV+ and on ARVs with an undetectable viral load, than you are with someone you are merely assuming is HIV- (perhaps you assume it because “surely this polite blushing young virgin of a straight man won’t give me cooties” etc)
Note that even your monogamous partner of many decades could accidentally contract HIV due to blood contamination in a hospital or an accident at work etc, so it’s good practice to also get tested after things that involve getting stabbed with needles, cut in a risky environment, etc.
If you’re concerned about potential stigma associated with HIV testing, you can get kits online:
CDC | How do I find an HIV self-test?
(these are usually fingerprick blood tests, and you can either see the results yourself at home immediately, or send it in for analysis, depending on the kit)
If I get HIV, I will get AIDS and die: True or False?
False, assuming you get treatment promptly and keep taking it. So those of you who were at “despair; life is over” can breathe a sigh of relief now.
However, if you get HIV, it does mean you will have to take those meds every day for the rest of your (no reason it shouldn’t be long and happy) life.
So, HIV is definitely still something to avoid, because it’s not great to have to take a life-saving medication every day. For a little insight as to what that might be like:
HIV.gov | Taking HIV Medication Every Day: Tips & Challenges
(as you’ll see there, there are also longer-lasting injections available instead of daily pulls, but those are much less widely available)
Summary
Some quick take-away notes-in-a-nutshell:
- Getting HIV may have been a death sentence in the 1980s, but nowadays it’s been relegated to the level of “serious inconvenience”.
- Happily, it is very preventable, with PrEP, PEP, and viral loads so low that they can’t transmit HIV, thanks to ARVs.
- Washing will not help, by the way. Safe sex will, though!
- As will celibacy and/or monogamy in seroconcordant relationships, e.g. you both have the same (known! That means actually tested recently! Not just assumed!) HIV status.
- If you do get it, it is very manageable with ARVs, but prevention is better than treatment
- There is no certain cure—yet. Some people (small number of case studies) may have been cured already with gene therapy, but we can’t know for sure yet.
Want to know more? Check out:
Take care!
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Hormone Replacement
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.
It’s Q&A Day at 10almonds!
Have a question or a request? You can always hit “reply” to any of our emails, or use the feedback widget at the bottom!
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
❝I cant believe 10 Almonds addresses questions. Thanks. I see the word symptoms for menopause. I don’t know what word should replace it but maybe one should be used or is symptom accurate? And I recently read that there was a great disservice for women in my era as they were denied/scared of hormones replacement. Unnecessarily❞
You’d better believe it! In fact we love questions; they give us things to research and write about.
“Symptom” is indeed an entirely justified word to use, being:
- General: any phenomenon or circumstance accompanying something and serving as evidence of it.
- Medical: any phenomenon that arises from and accompanies a particular disease or disorder and serves as an indication of it.
If the question is more whether the menopause can be considered a disease/disorder, well, it’s a naturally occurring and ultimately inevitable change, yes, but then, so is cancer (it’s in the simple mathematics of DNA replication and mutation that, unless a cure for cancer is found, we will always eventually get cancer, if nothing else kills us first).
So, something being natural/inevitable isn’t a reason to not consider it a disease/disorder, nor a reason to not treat it as appropriate if it is causing us harm/discomfort that can be safely alleviated.
Moreover, and semantics aside, it is medical convention to consider menopause to be a medical condition, that has symptoms. Indeed, for example, the US’s NIH (and its constituent NIA, the National Institute of Aging) and the UK’s NHS, both list the menopause’s symptoms, using that word:
- NIA (NIH): What are the signs and symptoms of menopause?
- NHS: Common symptoms of menopause and perimenopause
With regard to fearmongering around HRT, certainly that has been rife, and there were some very flawed (and later soundly refuted) studies a while back that prompted this—and even those flawed studies were not about the same (bioidentical) hormones available today, in any case. So even if they had been correct (they weren’t), it still wouldn’t be a reason to not get treatment nowadays, if appropriate!
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Healing Arthritis – by Dr. Susan Blum
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We previously reviewed another book by this author, her Immune System Recovery Plan, and today it’s more specific: healing arthritis
Of course, not all arthritis is rooted in immune dysfunction, but a) all of it is made worse by immune dysfunction and b) rheumatoid arthritis, which is an autoimmune disease, affects 1% of the population.
This book tackles all kinds of arthritis, by focusing on addressing the underlying causes and treating those, and (whether it was the cause or not) reducing inflammation without medication, because that will always help.
The “3 steps” mentioned in the subtitle are three stages of a plan to improve the gut microbiome in such a way that it not only stops worsening your arthritis, but starts making it better.
The style here is on the hard end of pop-science, so if you want something more conversational/personable, then this won’t be so much for you, but if you just want the information and explanation, then this does it just fine, and it has frequent references to the science to back it up, with a reassuringly extensive bibliography.
Bottom line: if you have arthritis and want a book that will help you to get either symptom-free or as close to that as is possible from your current condition (bearing in mind that arthritis is generally degenerative), then this is a great book for that.
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