Journal Article

Controlled Cannabis Vaporizer Administration: Blood and Plasma Cannabinoids with and without Alcohol

Huestis, Marilyn A, Spurgin, Andrew, Brown, Timothy L, Milavetz, Gary, Gorelick, David A, Gaffney, Gary, Hartman, Rebecca L

2015

Overview

Increased medical and legal cannabis intake is accompanied by greater use of cannabis vaporization and more cases of driving under the influence of cannabis. Although simultaneous Δ(9)-tetrahydrocannabinol (THC) and alcohol use is frequent, potential pharmacokinetic interactions are poorly understood. Here we studied blood and plasma vaporized cannabinoid disposition, with and without simultaneous oral low-dose alcohol. Thirty-two adult cannabis smokers (≥1 time/3 months, ≤3 days/week) drank placebo or low-dose alcohol (target approximately 0.065% peak breath-alcohol concentration) 10 min before inhaling 500 mg placebo, low-dose (2.9%) THC, or high-dose (6.7%) THC vaporized cannabis (6 within-individual alcohol-cannabis combinations). Blood and plasma were obtained before and up to 8.3 h after ingestion. Nineteen participants completed all sessions. Median (range) maximum blood concentrations (Cmax) for low and high THC doses (no alcohol) were 32.7 (11.4-66.2) and 42.2 (15.2-137) μg/L THC, respectively, and 2.8 (0-9.1) and 5.0 (0-14.2) μg/L 11-OH-THC. With alcohol, low and high dose Cmax values were 35.3 (13.0-71.4) and 67.5 (18.1-210) μg/L THC and 3.7 (1.4-6.0) and 6.0 (0-23.3) μg/L 11-OH-THC, significantly higher than without alcohol. With a THC detection cutoff of ≥1 μg/L, ≥16.7% of participants remained positive 8.3 h postdose, whereas ≤21.1% were positive by 2.3 h with a cutoff of ≥5 μg/L. Vaporization is an effective THC delivery route. The significantly higher blood THC and 11-OH-THC Cmax values with alcohol possibly explain increased performance impairment observed from cannabis-alcohol combinations. Chosen driving-related THC cutoffs should be considered carefully to best reflect performance impairment windows. Our results will help facilitate forensic interpretation and inform the debate on drugged driving legislation.

• Publisher: Oxford University Press
• Subject: Administration, Oral / Adult / Agreements / Alcohol / Alcoholic beverages / Alcohols / Blood / Blood & organ donations / Cannabinoids - blood / Cannabinoids - pharmacokinetics / Colleges & universities / Driving ability / Dronabinol - administration & dosage / Dronabinol - analogs & derivatives / Dronabinol - blood / Drug abuse / Drug dosages / Ethanol / Ethanol - administration & dosage / Female / Humans / Ingestion / Legislation / Male / Marijuana Smoking - blood / Medical Marijuana - administration & dosage / Medical Marijuana - blood / Nebulizers and Vaporizers / Pharmacokinetics / Plasma / Vaporization / Young Adult