Separate and combined effects of marijuana and alcohol on mood, equilibrium and simulated driving

Rationale: Marijuana and alcohol, when used separately and in combination, contribute to automobile accidents and failed sobriety tests of standing balance. However, the extent to which the drugs have additive effects on both of these measures is unknown. Objectives: This study was designed to compare directly the separate and combined effects of marijuana and alcohol on simulated emergency braking and dynamic posturography. Methods: Twelve healthy subjects who regularly used both marijuana and alcohol completed nine test sessions in a counterbalanced within-subject design. Subjects drank a beverage (0, 0.25, or 0.5 g/kg alcohol) then smoked a cigarette (0, 1.75, or 3.33% THC). Testing began 2 min after smoking and was conducted within the ascending limb of the blood alcohol curve. Results: The 0.5 g/kg alcohol dose significantly increased brake latency without affecting body sway. In contrast, the 3.3% THC dose increased body sway but did not affect brake latency. There were no additive drug effects on mood or behavior. Conclusions: Although field sobriety tests are often used to determine driving impairment, these results suggest that impaired balance following marijuana use may not coincide with slowed reaction time. Conversely, braking impairment from low doses of alcohol may not be revealed by tests of balance.