Alcohol Intoxication, Cannabis Intoxication
Conditions
Brief summary
This study will evaluate the individual and interactive effects of oral cannabis and alcohol on subjective and behavioral measures of impairment.
Detailed description
This clinical laboratory study will be double-blind, placebo-controlled and will utilize a within-subjects experimental design. Participants will complete 7 outpatient drug administration sessions that will consist of self-administration of oral cannabis (0, 10 or 25mg THC) and alcohol (either placebo or active; BAC of 0.05 percent); participants will always receive both an alcohol drink (active or placebo) and dose of cannabis (active or placebo). Participants will also complete a condition in which they administer alcohol (BAC: 0.08 percent) with placebo cannabis, as a positive control. Primary outcomes include performance on field sobriety tests, cognitive and psychomotor impairment, subjective drug effects, and simulated driving performance. Blood concentrations of THC and THC metabolites will also be determined.
Interventions
DRUGCannabis
Cannabis will be orally ingested via a brownie
DRUGAlcohol
Alcohol will be orally ingested via a flavored drink
Sponsors
Johns Hopkins University
National Institute on Drug Abuse (NIDA)
Study design
Allocation
RANDOMIZED
Intervention model
CROSSOVER
Primary purpose
BASIC_SCIENCE
Masking
DOUBLE (Subject, Outcomes Assessor)
Masking description
Double-blind (Participant, Outcomes Assessor), placebo controlled, and double-dummy
Intervention model description
All participants will complete all dose conditions (study arms) in a randomized order
Eligibility
Sex/Gender
ALL
Age
21 Years to 55 Years
Healthy volunteers
Yes
Inclusion criteria
1. Have provided written informed consent 2. Be between the ages of 21 and 55 3. Be in good general health based on a physical examination, medical history, vital signs, and screening urine and blood tests 4. Not be pregnant or nursing (if female). All females must have a negative serum pregnancy test at the screening visit and a negative urine pregnancy test at each study visit. 5. Have a body mass index (BMI) in the range of 19 to 36 kg/m2 6. Blood pressure at Screening Visit does not exceed a systolic blood pressure (SBP) of 150 mmHg or a diastolic blood pressure (DBP) of 90 mmHg 7. Have not donated blood in the prior 30 days. 8. Report at least 2 days of binge drinking in the past 90 days (greater than 4 or 5 drinks on a single occasion for women and men, respectively) 9. Report ≥ 1 use of cannabis in the past year 10. Provide negative urine test for illicit drug use (excluding THC) and negative breath alcohol test (0% BAC) at screening and before study sessions 11. Report at least 1 instance of simultaneous alcohol and use in the past year.
Exclusion criteria
1. Psychoactive drug use (aside from cannabis, nicotine, alcohol, or caffeine) in past month 2. Current use of over-the-counter (OTC) drugs, supplements/vitamins, or prescription medications that, in the opinion of the investigator or medical staff, will impact the participant's safety 3. History of or current evidence of significant medical condition 4. Evidence of current psychiatric condition \[(MINI for Diagnostic and Statistical Manual (DSM)-V)\] 5. Meet criteria for severe alcohol use disorder (MINI for DSM-V) 6. Clinical Institute Withdrawal Assessment for Alcohol scale (CIWA-Ar) score \> 9 7. Been in treatment previously for alcohol or cannabis use disorder 8. Use of cannabis, on average, more than 2 times/week over past 3 months 9. Liver function tests more than 2x normal range 10. Enrollment in another clinical trial or receiving of any drug as part of research within past 30 days 11. Shipley vocabulary score \<18 (corresponds to 5th grade reading level).
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Mean Peak Change From Baseline DRUID Application Global Impairment Score | 7.5 hours, assessed at baseline (prior to drug administration) and again 1, 1.5, 2.5, 3.5, 4.5, 5.5, 6.5, and 7.5 hours after oral cannabis ingestion. | Acute cognitive and behavioral impairment will be assessed with global impairment score (range 0-100) on the DRUID app (higher scores indicate greater impairment). Results are mean change from baseline. |
| Cumulative Score on Field Sobriety Tests | 7.5 hours | Impairment will be assessed using a battery of standard field sobriety tests including: the Horizontal Gaze Nystagmus Test (HGN), the Walk and Turn, the One Leg Stand, and the Modified Romberg Balance. We will report the cumulative amount of clues observed across these tasks (out of a possible 0-22 clues). Higher scores indicate greater/worse impairment. These assessments were completed once after 7.5 hours. |
| Mean Peak Change From Baseline Scores on the Drug Effect Questionnaire (DEQ) - Feel Drug Effect | 7.5 hours, assessed at baseline (prior to drug administration) and again 0.5, 1, 1.25, 1.5, 2.5, 3.5, 4.5, 5.5, 6.5, and 7.5 hours after oral cannabis ingestion | The DEQ will be used to obtain subjective ratings of "feel drug effects". Score range from 0 (none) to 100 (extreme) using a 100mm line anchored with none/extreme designation. Results are mean change from baseline and a higher score indicates a more extreme/worse drug effect. |
| Drug Effect Questionnaire - Feel High | 7.5 hours | The DEQ will be used to obtain subjective ratings of "feel high". Score range from 0 (none) to 100 (extreme) using a 100mm line anchored with none/extreme designation. Higher score greater "feel high" rating. |
| Drug Effect Questionnaire - Confidence to Drive (Change From Baseline) | 7.5 hours | The DEQ will be used to obtain subjective ratings of "confidence to drive". Score range from 0 (none) to 100 (extreme) using a 100mm line anchored with none/extreme designation. Higher scores indicate higher confidence to drive. Results expressed as change from baseline |
| Drug Effect Questionnaire - Willingness to Drive | 7.5 hours | The DEQ will be used to obtain subjective ratings of "willingness to drive". Score range from 0 (none) to 100 (extreme) using a 100mm line anchored with none/extreme designation. Higher score indicates higher willingness to drive. |
| Biphasic Alcohol Effects Scale (BAES) - Sedative Score | Baseline, 7.5 hours | The BAES is used to assess sedative and stimulant subjective effects of alcohol. There are 7 sedative-related questionnaire items, each presented on a scale of 0 (not at all) to 10 (extremely), which are integrated to produce an overall sedative score (0-70). Higher scores indicating greater sedative effects of alcohol. Scores presented show the change from baseline to 7.5 hours. |
| Biphasic Alcohol Effects Scale (BAES) - Stimulant Score | 7.5 hours | The BAES is used to assess sedative and stimulant subjective effects of alcohol. There are 7 stimulant-related questionnaire items, each presented on a scale of 0 (not at all) to 10 (extremely), which are integrated to produce an overall stimulant score (0-70). Higher scores indicating greater stimulant effects of alcohol. |
| Subjective High Assessment Scale (SHAS) | 7.5 hours | For the SHAS, participants are presented with 13 questionnaire items, displayed on a visual analog scale anchored from 0 (normal) to 10 (extremely), which assess subjective effects of alcohol. These items are integrated to produce an overall SHAS score (0-130). Higher score indicates greater effects of alcohol. |
| Driving Performance as Assessed by Standard Deviation of Lateral Position (SDLP) | Baseline, 1, 1.5, 2.5, 3.5, 4.5, 5.5, 6.5, and 7.5 hours | The STISIM Drive® M4000-R Console system will be used to assess driving performance, a state-of-the-art technology that has been independently validated to reflect real-world driving conditions. SDLP (measured in cm) was calculated across all drives to get a composite index of lateral control and reported as peak change from baseline. SDLP is the gold standard of quantifying the magnitude of driving impairment from drugs and alcohol and has excellent predictive validity to actual driving. Scores range from 0 to no upper limit. Higher scores represent higher magnitude of driving impairment. |
| Driving Performance as Assessed by Composite Drive Score | Baseline, 1, 1.5, 2.5, 3.5, 4.5, 5.5, 6.5, and 7.5 hours | Driving impairment will be assessed via a composite drive score. The composite drive score is derived by integrating various driving outcomes (see primary and secondary driving outcomes). Higher z-score indicates worse performance. The score is on a z-score scale, meaning a score of 1 equates to 1 standard deviation outside of the participants' mean baseline performance and a Z-score of 0 represents the mean baseline performance. This was calculated across all drives and reported as peak change from baseline. |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Driving Performance as Assessed by Standard Deviation of Speed (SDSP) | Baseline, 1, 1.5, 2.5, 3.5, 4.5, 5.5, 6.5, and 7.5 hours | The STISIM Drive® M4000-R Console system will be used to assess driving performance, a state-of-the-art technology that has been independently validated to reflect real-world driving conditions. SDSP will be calculated across all drives to get a composite index of the variability in speed (measured in MPH) and is reported as peak change from baseline. Scores range from 0 to no upper limit. Higher scores represent higher magnitude of driving impairment. |
| Total Run Length | Baseline, 1, 1.5, 2.5, 3.5, 4.5, 5.5, 6.5, and 7.5 hours | The STISIM Drive® M4000-R Console system will be used to assess driving performance, a state-of-the-art technology that has been independently validated to reflect real-world driving conditions. Total run length will be calculated across all drives and measured as peak change from baseline score (in seconds). Higher scores represent higher magnitude of driving impairment. |
| Driving Performance (Number of Speed Exceedances) | Baseline, 1, 1.5, 2.5, 3.5, 4.5, 5.5, 6.5, and 7.5 hours | The STISIM Drive® M4000-R Console system will be used to assess driving performance, a state-of-the-art technology that has been independently validated to reflect real-world driving conditions. Driving performance will be calculated across all drives to get a cumulative number of times participants exceed the allowable speed limit and reported as peak change from baseline. Scores range from 0 to no upper limit. Higher scores represent higher numbers of speed exceedances. |
| Driving Performance (Number of Accidents) | Baseline, 1, 1.5, 2.5, 3.5, 4.5, 5.5, 6.5, and 7.5 hours | The STISIM Drive® M4000-R Console system will be used to assess driving performance, a state-of-the-art technology that has been independently validated to reflect real-world driving conditions. Driving performance will be calculated across all drives to get a cumulative number of accidents (including car collisions, pedestrians hit, etc.) and reported as peak change from baseline. Scores range from 0 to no upper limit. Higher scores represent higher numbers of accidents. |
| Driving Performance (Total Rule Violations) | Baseline, 1, 1.5, 2.5, 3.5, 4.5, 5.5, 6.5, and 7.5 hours | The STISIM Drive® M4000-R Console system will be used to assess driving performance, a state-of-the-art technology that has been independently validated to reflect real-world driving conditions. Driving performance will be calculated across all drives to get a cumulative number of total rule violations (including number of missed stop signs, illegal turns, speed exceedances, etc.) and reported as peak change from baseline. Scores range from 0 to no upper limit. Higher scores represent higher numbers of rule violations. All scores reported are relative to baseline, thus negative values represent a lower number of rule violations than at baseline. |
| Driving Performance (Distance to Lead Vehicles) | Baseline, 1, 1.5, 2.5, 3.5, 4.5, 5.5, 6.5, and 7.5 hours | The STISIM Drive® M4000-R Console system will be used to assess driving performance, a state-of-the-art technology that has been independently validated to reflect real-world driving conditions. Driving performance will be calculated across all drives to get the mean distance (in meters) maintained to lead vehicles during car-following segments and reported as peak change from baseline. Scores range from 0 to no upper limit. Higher scores represent greater distance maintained to lead vehicles. All scores reported are relative to baseline, thus negative values represent a shorter distance maintained than at baseline. |
| Change in Field Sobriety Test - Score on Horizontal Gaze Nystagmus Test | Baseline, 7.5 hours | Impairment will be assessed using performance on the Horizontal Gaze Nystagmus Test (HGN). Total score will be recorded (out of possible 0-6 clues) with higher scores indicating higher impairment. Assessed at baseline and 7.5 hours, change from baseline to 7.5 hours reported |
| Change in Field Sobriety Test - Score on Walk and Turn Test | Baseline, 7.5 hours | Impairment will be assessed using performance on the the Walk and Turn. Total score will be recorded (out of a possible 0-8 clues) with higher scores indicating higher impairment. Assessed at baseline and 7.5 hours, change from baseline to 7.5 hours reported |
| Change in Field Sobriety Test - Score on One Leg Stand | Baseline, 7.5 hours | Impairment will be assessed using performance on the One Leg Stand test. Total score will be recorded (out of a possible 0-4 clues) with higher scores indicating higher impairment. Assessed at baseline and 7.5 hours, change from baseline to 7.5 hours reported |
| Change in Field Sobriety Test - Score on Modified Romberg Balance | Baseline, 7.5 hours | Impairment will be assessed using performance on the Modified Romberg Balance test. Total score will be recorded (out of a possible 0-4 clues) with higher scores indicating higher impairment. Assessed at baseline and 7.5 hours, change from baseline to 7.5 hours reported |
| Drug Effect Questionnaire - Like Drug Effect | 7.5 hours | The DEQ will be used to obtain subjective ratings of "like drug effect". Score range from 0 (none) to 100 (extreme) using a 100mm line anchored with none/extreme designation. Higher score indicating greater "liked drug effect" rating. |
| Drug Effect Questionnaire - Dislike Drug Effect | 7.5 hours | The DEQ will be used to obtain subjective ratings of "dislike drug effect". Score range from 0 (none) to 100 (extreme) using a 100mm line anchored with none/extreme designation. Higher score indicating greater "dislike drug effect" rating. |
| Pharmacokinetics - CMax for THC and THC Metabolites | Baseline, 1, 1.5, 2.5, 3.5, 4.5, 5.5, 6.5, and 7.5 hours | Whole blood concentrations of THC, 11-OH-THC, and THCCOOH will be measured using quantitative liquid chromatography-tandem mass spectrometry (LC-MS-MS) analysis. The maximum concentration (Cmax) is determined as the highest concentration reached for each individual (ng/mL) across all timepoints. |
| Pharmacokinetics - AUC for THC and THC Metabolites | Baseline, 1, 1.5, 2.5, 3.5, 4.5, 5.5, 6.5, and 7.5 hours | Whole blood concentrations of THC, 11-OH-THC, and THCCOOH will be measured using quantitative liquid chromatography-tandem mass spectrometry (LC-MS-MS) analysis. The area under the curve (AUC) is calculated cumulative across all timepoints. |
| Pharmacokinetics - CMax for Alcohol | Baseline, 1, 1.5, 2.5, 3.5, 4.5, 5.5, 6.5, and 7.5 hours | BAC will be measured using the Alco-Sensor IV. Measuring BAC is needed to confirm that participants reached the targeted BAC for a given session and to confirm adherence to pre-session alcohol abstinence requirements (g/210L). The maximum concentration (Cmax) is determined as the highest concentration reached for each individual (ng/mL) across all timepoints. |
| Pharmacokinetics - AUC for Alcohol | Baseline, 1, 1.5, 2.5, 3.5, 4.5, 5.5, 6.5, and 7.5 hours | Whole blood concentrations of Alcohol will be measured using quantitative liquid chromatography-tandem mass spectrometry (LC-MS-MS) analysis. The area under the curve (AUC) is calculated cumulative across all timepoints. |
Countries
United States
Contacts
PRINCIPAL_INVESTIGATORTory Spindle, PhD
Johns Hopkins University
Participant flow
Pre-assignment details
70 participants were enrolled (consented) and 25 were considered eligible and went on to complete all study procedures.
Baseline characteristics
| Characteristic | — |
|---|---|
| Age, Categorical <=18 years | 0 Participants |
| Age, Categorical >=65 years | 0 Participants |
| Age, Categorical Between 18 and 65 years | 25 Participants |
| Age, Continuous | 25.6 years STANDARD_DEVIATION 4.9 |
| Ethnicity (NIH/OMB) Hispanic or Latino | 4 Participants |
| Ethnicity (NIH/OMB) Not Hispanic or Latino | 21 Participants |
| Ethnicity (NIH/OMB) Unknown or Not Reported | 0 Participants |
| Race (NIH/OMB) American Indian or Alaska Native | 0 Participants |
| Race (NIH/OMB) Asian | 1 Participants |
| Race (NIH/OMB) Black or African American | 2 Participants |
| Race (NIH/OMB) More than one race | 2 Participants |
| Race (NIH/OMB) Native Hawaiian or Other Pacific Islander | 0 Participants |
| Race (NIH/OMB) Unknown or Not Reported | 0 Participants |
| Race (NIH/OMB) White | 20 Participants |
| Region of Enrollment United States | 25 Participants |
| Sex: Female, Male Female | 10 Participants |
| Sex: Female, Male Male | 15 Participants |
Adverse events
| Event type | EG000 affected / at risk | EG001 affected / at risk | EG002 affected / at risk | EG003 affected / at risk | EG004 affected / at risk | EG005 affected / at risk | EG006 affected / at risk |
|---|---|---|---|---|---|---|---|
| deaths Total, all-cause mortality | 0 / 25 | 0 / 25 | 0 / 25 | 0 / 25 | 0 / 25 | 0 / 25 | 0 / 25 |
| other Total, other adverse events | 2 / 25 | 0 / 25 | 3 / 25 | 0 / 25 | 4 / 25 | 0 / 25 | 0 / 25 |
| serious Total, serious adverse events | 0 / 25 | 0 / 25 | 0 / 25 | 0 / 25 | 0 / 25 | 0 / 25 | 0 / 25 |
Outcome results
None listed