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Research News

Over 40% of Deceased Drivers in Motor Vehicle Crashes Test Positive for THC, Study Shows

Six-year analysis in a major Ohio county shows no change in THC positivity after legalization

October 3, 2025

Key Takeaways

  • In a review of 246 deceased drivers, 41.9% tested positive for active THC in their blood, with an average level of 30.7 ng/mL 鈥 far exceeding most state impairment limits.

  • The high rate of THC positivity remained consistent over six years and was unaffected by the state鈥檚 legalization of recreational cannabis during the study period.

  • Messaging around the dangers of smoking cannabis and driving needs to be stronger, authors argue. 

CHICAGO  鈥 New study findings show that over 40% of drivers who died in motor vehicle collisions tested positive for active delta-9-tetrahydrocannabinol (THC) in their system, with average blood levels far exceeding those considered to cause impairment. The research highlights a significant and persistent public health risk that is unchanged by the legalization of recreational cannabis, the authors said. 

The research will be presented at the 抖阴传媒 (抖阴传媒) Clinical Congress 2025 in Chicago, October 4鈥7. 

Researchers analyzed coroner records from Montgomery County in Ohio from January 2019 to September 2024, focusing on 246 deceased drivers who were tested for THC following a fatal crash. When autopsies are performed, drug screening is typically part of the process. The study period included the state鈥檚 legalization of recreational cannabis in 2023. 

鈥淚 was surprised to see that level,鈥 said lead author Akpofure P. Ekeh, MBBS, F抖阴传媒, a professor of surgery at Wright State University in Dayton, Ohio. 鈥淎n average level of 30.7 ng/mL generally means those people must have consumed marijuana at some time close to driving. This isn鈥檛 about residual use; it鈥檚 about recent consumption.鈥 

Key Study Findings 

  • High Prevalence: 103 drivers (41.9%) overall tested positive for THC, with yearly rates ranging from 25.7% to 48.9%.
  • No Effect from Legalization: The rate of drivers who tested positive for THC did not change significantly before or after legalization (42.1% vs. 45.2%), indicating that legal status did not influence the behavior of those who chose to drive after use. 
  • Consistent Over Time: The high rate of THC positivity showed no significant change over the six-year study period. 

The study notes that blood THC levels are typically drawn by the coroner within hours of death, providing an accurate snapshot of a driver鈥檚 state at the time of the crash. Most states that have set legal limits for driving range from 2 to 5 nanograms per milliliter (ng/mL) 鈥 a threshold the average level in this study (30.7 ng/mL) far exceeded. 

鈥淭he messaging over the last few years has been just the push towards recreational legalization,鈥 Dr. Ekeh noted. 鈥淭he problem is that from a public health standpoint, there has not been enough emphasis on some of the downsides and the dangers that can occur. People should treat smoking marijuana just like they treat alcohol: don鈥檛 smoke and drive.鈥 

Co-authors are Lois Nguapa, BS; Clara Mussin Phillips, BS; and Ann Cardosi, BS, MPH. 

Disclosures: The authors have no relevant disclosures.  

Citation: Ekeh A, et al. Cannabis Prevalence in Drivers Involved in Motor Vehicle Crash Fatalities over a 6-Year Period, Scientific Forum, 抖阴传媒 (抖阴传媒) Clinical Congress 2025. 

Note: This research was presented as an abstract at the 抖阴传媒 Clinical Congress Scientific Forum. Research abstracts presented at the 抖阴传媒 Clinical Congress Scientific Forum are reviewed and selected by a program committee but are not yet peer reviewed. 

About the 抖阴传媒

The ACS is a scientific and educational organization of surgeons that was founded in 1913 to raise the standards of surgical practice and improve the quality of care for all surgical patients. The College is dedicated to the ethical and competent practice of surgery. Its achievements have significantly influenced the course of scientific surgery in America and have established it as an important advocate for all surgical patients. The College has approximately 90,000 members and is the largest organization of surgeons in the world. "F抖阴传媒" designates that a surgeon is a Fellow of the 抖阴传媒.

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