An open road driving performance task to examine long-term medical marijuana use and prescription opioid positivity in adults 50 and older - PROJECT SUMMARY Medical marijuana is legal in 37 states and the District of Columbia, and use among adults 50 and older has more than doubled in the past decade, with exponential increases projected by 2050. Adults 50 and older are among the largest consumers of medical marijuana, with chronic pain as their most frequently endorsed reason for use. In addition, the use of prescription opioids, one of the most common treatments for pain management in this population, is a factor complicating chronic pain management as those 50 and older are three times more likely to be prescribed opioids than younger adults. The primary goal of the current proposal is to identify the effects of daily long-term (i.e., use >12 months daily or most days of the week) medical marijuana use on driving performance outcomes using an open road test under real world conditions in adults 50 and older who endorse chronic or severe non-malignant pain; and examine the combined effect of daily long-term medical marijuana use and prescription opioid use on driving outcomes. A secondary goal is to qualitatively explore self-regulation of medical marijuana and prescription opioid use in this population. These goals are of the utmost significance given that THC is associated with a 50% increased risk for traffic crash, and the risk of motor vehicle collision while driving under the influence of marijuana is two times higher than when driving unimpaired. Further, opioid use is associated with a 47% increased risk of crash initiation and aging itself is associated with increased crash risk and declines in driving performance. Thus, the proposed study will test medical marijuana use as the exposure variable in adults age 50 and older and an open-road driving task performance as the primary outcome. The study will detail THC exposure through electronic medical records, urinalysis, and data extracted from RYAH Smart Inhaler devices, in conjunction with measures of open-road driving task. Further, we will use a race-sex matched group of non-marijuana users, and age variability will be balanced in both groups. Results will provide evidence for the effects of medical marijuana use and opioid positivity on a real-world driving task among adults 50 and older. To accomplish this, we propose the following aims: Aim 1: Identify the effects of daily long-term medical marijuana use on driving performance using an open-road driving task in adults 50 and older. Aim 2: Examine the combined effect of medical marijuana use and prescribed opioid use on driving outcomes via an open road driving performance task. Exploratory Aim: Identify intervention targets to improve self-regulation of medical marijuana use, prescribed opioid use, and driving performance in adults 50 and older. Given the proliferation of medical marijuana use and prescription opioid use in adults 50 and older, it is imperative that we understand the long-term effects of daily medical marijuana use and how co-occurring use with prescription opioids affects real-world driving outcomes. With our interdisciplinary team’s expertise and our current research infrastructure throughout the state of Florida, including our research partners, we are uniquely poised to execute this relevant and timely work.
