1. Marijuana Involvement in Fatal Crashes Staci Hoff, PhD Research Director shoff@wtsc.wa.gov (360) 349-4849

2. Background  Legalized marijuana for recreational use through the passage of I-502 in Nov. 2012  Recreational stores began opening in July 2014  Portion of taxes from sales allocated to education and prevention  No prevention funds prior to sales  No funds allocated to traffic safety specifically  I-502 set a 5ng/ml blood per se marijuana limit

3. The Requests Poured In…

4. The Problem with Data Delta 9 Hashish Oil Hashish Marijuana/Marihuana Marinol Tetrahydrocannabinols (THC) Cannabinoid (Type Unk)

5. Marijuana Has Always Been the Dominate Drug in Fatal Crashes

6. Does Marijuana Use Increase Crash Risk??

7. Toxicology Testing Among Persons Involved in Fatal Crashes  RCW 46.52.065 – blood samples from all drivers/pedestrians killed in any traffic crash where death occurred within 4 hrs  Centralized Toxicology – all blood samples sent to the State Toxicologist at the Washington State Patrol Toxicology Lab

8. WTSC -RADD Reviewed all toxicology paper reports (deceased) and manually entered full toxicology outcomes into spreadsheet Worked with the Toxicology Lab to abstract the information for surviving drivers Abstracted full toxicology for everyone in fatal crashes who had toxicology testing (drivers, occupants, non-motorists) Married to the original FARS record for in-depth fatal crash analysis – state case number, MDE vehicle and person numbers Initial report focused on data years 2010-2014, DRIVERS (http://wtsc.wa.gov/research-data/traffic-safety-studies/)http://wtsc.wa.gov/research-data/traffic-safety-studies/

10. +24 in 2015 = 80 total drivers with THC ONLY

11. Toxicology Outcomes20102011201220132014 *2015pre Not Tested 219226224212272375 No Drugs, No Alcohol 147151 147116155 Alcohol Only <.079 1586710 Alcohol Only >.080 67 606951 47 THC Only 971372024 Carboxy-THC Only 11107364 THC + Alcohol <.079 310365 THC + Alcohol >.080 16 12162326 Carboxy-THC + Alcohol 12611931 THC + Drugs + Alcohol <.079 00123 5 THC + Drugs + Alcohol >.080 2523610 Carboxy-THC + Drugs + Alcohol 1025201 THC + Drugs 63851712 Carboxy-THC + Drugs 1053754 Other Drugs Only 474246715277 Other Drugs + Alcohol Only 201819202418

13. Number of Units Involved

14. Day versus Night Crashes

15. Co-Occurring High Risk Factors

16. Unrestrained Drivers

17. THC versus Carboxy-THC and per se Marijuana Result201020112012201320142015 Any Cannabinoid8156635989 94 THC >5 ng/ml 2419231938 43 29.6%33.9%36.5%32.2%42.7% 45.7% THC <5 ng/ml 1213121837 36 14.8%23.2%19.0%30.5%41.6% 38.3% THC Result Unk 00110 6 Any Delta-9 THC 3632363875 85 44.4%57.1% 64.4%84.3% 90.4% Carboxy-THC 4524272114 9 55.6%42.9% 35.6%15.7%9.6%

18. What’s Next?  Continue to manually extract results and levels for fatal crashes  Integrated Traffic Records (TRCC)  Agreement between WTSC-WSP for electronic toxicology data files for record linkage – in process  Link drug testing outcomes to all crash severities  Data Governance is Important!  Data Users – AAA, IIHS, WSU, WSIPP  Challenges remain  Route/type of marijuana consumption  Blood level ^= Impairment  Chronic vs Acute Users

19. What can you do to prepare?  Are drivers being tested?  State law? Alcohol only?  WHO is testing them?  DUI/DRE database?  Blood warrants?  Hospital records?  WHICH labs are processing the samples?  Data Sharing Agreements!  Marijuana is NOT Alcohol, but Marijuana+Alcohol= REALLY SCARY!

20. Questions?