https://www.drugabuse.gov/publications/research-reports/marijuana/does-marijuana-use-affect-driving
Marijuana is the illicit drug most frequently found in the blood of drivers who have been involved in vehicle crashes, including fatal ones.10 Two large European studies found that drivers with THC in their blood were roughly twice as likely to be culpable for a fatal crash than drivers who had not used drugs or alcohol.11,12 However, the role played by marijuana in crashes is often unclear because it can be detected in body fluids for days or even weeks after intoxication and because people frequently combine it with alcohol. Those involved in vehicle crashes with THC in their blood, particularly higher levels, are three to seven times more likely to be responsible for the incident than drivers who had not used drugs or alcohol. The risk associated with marijuana in combination with alcohol appears to be greater than that for either drug by itself.8
Several meta-analyses of multiple studies found that the risk of being involved in a crash significantly increased after marijuana use13—in a few cases, the risk doubled or more than doubled.14–16 However, a large case-control study conducted by the National Highway Traffic Safety Administration found no significant increased crash risk attributable to cannabis after controlling for drivers’ age, gender, race, and presence of alcohol.
Endogenous cannabinoids such as anandamide (see figure) function as
neurotransmitters because they send chemical messages between nerve cells (
neurons) throughout the nervous system. They affect brain areas that influence pleasure, memory, thinking, concentration, movement, coordination, and sensory and time perception. Because of this similarity, THC is able to attach to molecules called
cannabinoid receptors on neurons in these brain areas and activate them, disrupting various mental and physical functions and causing the effects described earlier. The neural communication network that uses these cannabinoid neurotransmitters, known as the
endocannabinoid system, plays a critical role in the nervous system’s normal functioning, so interfering with it can have profound effects.
For example, THC is able to alter the functioning of the hippocampus (see "
Marijuana, Memory, and the Hippocampus") and orbitofrontal cortex, brain areas that enable a person to form new memories and shift his or her attentional focus. As a result, using marijuana causes impaired thinking and interferes with a person’s ability to learn and perform complicated tasks. THC also disrupts functioning of the cerebellum and basal ganglia, brain areas that regulate balance, posture, coordination, and reaction time. This is the reason people who have used marijuana may not be able to drive safely (see "
Does marijuana use affect driving?") and may have problems playing sports or engaging in other physical activities.