Driving high study may boost critics of marijuana legalization

By HPN Staff

The rate of driving deaths linked to marijuana use has remained steady — even slightly increased — after the legalization of the drug in one state, according to the American College of Surgeons (ACS) — a finding that could complicate efforts to relax federal restrictions on cannabis.

In 2023, Ohio voters passed a citizen-led initiative, Issue 2, that was backed by the Campaign to Regulate Cannabis Like Alcohol, an affiliate of the Marijuana Policy Project. The passage of the ballot initiative legalized recreational marijuana use in that state.

The new research, presented to the ACS Clinical Congress in October, examined driver fatalities in the Dayton area over six years (2019-2024), both before and after the state’s 2023 legalization.

Before recreational marijuana was made legal, 42.1% of drivers killed tested positive for active delta-9-tetrahydrocannabinol (THC) in their bloodstream. After legalization, this rate climbed to 45.2%. The average rates detected “far exceeded” legal limits for THC intoxication, ACS said in a statement on the study.

“The research highlights a significant and persistent public health risk that is unchanged by the legalization of recreational cannabis,” ACS said. The study said, “The research highlights a significant and persistent public health risk,” but noted that statistically demonstrated the risk was unchanged by the legalization of cannabis. 

Why it matters

Last year, officials in the Biden Administration proposed reclassifying marijuana from Schedule I to Schedule III under the Controlled Substances Act, following more than a decade of state-level legalization. But the proposal wasn’t finalized before former President Joe Biden left office in January.

In August, the Trump administration confirmed it was considering the proposal, but during a White House briefing in August, President Trump said it was a “very complicated subject.”

“I've heard great things having to do with medical, and I've had bad things having to do with just about everything else,” he told reporters. 

Reclassification would not legalize recreational marijuana at the national level, but it would acknowledge that the drug has some medical uses and allow for further testing and development of marijuana-based treatments.

Trump supporters are conflicted on the question of loosening federal restrictions on marijuana, and research that challenges the public health benefits of state-level legalization could strengthen the hand of cannabis critics.

Those critics include a group of nine U.S. House Republicans, who wrote to Attorney General Pam Bondi in August to signal their fierce opposition to reclassification. 

“We should aim to reduce exposure to addictive, impairing substances, not reclassify them in ways that expand access and downplay risks,” said Arizona Congressman Paul Gosar, one of the co-authors of the letter.

Last month, the U.S. House Appropriations Committee advanced a funding bill that would effectively block the Justice Department from reclassifying marijuana, although it is uncertain whether this so-called budget rider will actually become law.

The bigger picture

The federal debate over marijuana reclassification follows the legalization of marijuana for recreational use across almost half the country — 24 states and the District of Columbia, according to the National Conference of State Legislatures (NCSL).

Another 16 states allow medical use. Eight states only allow cannabidiol (CBD) products with low THC content that do not give the user a “high.” Two states, Idaho and Kansas, prohibit THC and CBD, according to NCSL.

The wave of legalization for recreational use started in 2012 with Colorado and Washington state. However, there are signs that the wave may have crested. Last year, voters in Florida, North Dakota and South Dakota blocked the expansion of medical marijuana to recreational use.

Additional context

In the wake of recreational legalization, the cannabis industry has developed increasingly potent THC products, challenging efforts to reduce impaired driving, addiction, mental health disorders, and underage use, according to Jonathan Samet, the former dean of the Colorado School of Public Health.