Recreational cannabis legalization has resulted in concerns about more episodes of impaired driving.1 Primary care physicians grapple with how to address this with their patients. “There are many unknowns about cannabis impairment and driving,” notes Carolyn Ells, PhD, former associate professor in the faculty of medicine and health sciences at McGill University in Montreal.
Ells and colleagues developed an ethical guidance for primary care practitioners who are concerned about cannabis-impaired driving.2 Their goal was to address how to ethically care for patients who report driving frequently, and also report using cannabis. “Primary care providers have certain duties vis-á-vis their relationship with patients — to foster a therapeutic relationship; and duties to inform, to provide care, and, in some circumstances, to report potentially harmful situations,” Ells notes.
Primary care providers should discuss frequency of use, dosage, tolerance levels, and withdrawal symptoms. Inform patients of the harms, risks, and legal consequences of cannabis-impaired driving. Notably, providers and patients should understand physicians may be obligated to report cannabis-impaired driving to legal authorities when the user engages in harmful behavior to themselves or others.
Ells and colleagues stressed the importance of tailoring approaches to various populations. “For example, informing and counseling youth who are new to cannabis use, and to driving, calls for a different approach than those with persistent long-term use arising from chronic disability,” Ells explains.
REFERENCES
1. Windle SB, Sequeira C, Filion KB, et al. Impaired driving and legalization of recreational cannabis. CMAJ 2021;193:E481-E485.
2. Huerne K, Ells C, Grad R, et al. Cannabis-impaired driving: Ethical considerations for the primary care practitioner. Ann Med 2023;55:24-33.
Primary care providers should discuss frequency of use, dosage, tolerance levels, and withdrawal symptoms. Also, inform patients of the harms, risks, and legal consequences of cannabis-impaired driving.
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