I have held a man’s ruptured spleen in my hands at 3am. I have told a woman that her son did not survive surgery. I have watched nurses who see this every night still find the composure to do their jobs.
So when a government announces it is prepared to make it easier for impaired drivers to be on the roads where these patients come from, I am not going to use diplomatic language. I am going to say what this is: a failure of political courage that will cost lives.
NSW Premier Chris Minns has thrown his support behind a proposal allowing “medicinal” cannabis users to drive on a valid prescription, with a “three strikes” system that merely fines – rather than convicts – a driver who returns a positive THC reading on their first offence. The NSW treasurer has called it “common sense”. It is not common sense. It is populist politics dressed up in the language of fairness, and it will end with more broken bodies on my operating table.
Let me be direct: the politicians making these announcements are clearly not reading the literature.
A major 2026 review published in Current Addiction Reports by Metrik, Bush, Gunn and McCarthy found that THC impairs all eight executive function domains critical to safe driving – and this effect rises the higher the dose. Every one of them. Not some. All eight.
Inhaled cannabis causes measurable driving impairment for four to five hours after inhalation. The same review contains a finding that should stop every politician in this state cold: cannabis is now the No. 1 substance found in the blood of seriously or fatally injured road users in American states that have liberalised its use – appearing in 25.1 per cent of cases, ahead of alcohol at 23.1 per cent. Cannabis-involved crashes more than doubled between 2000 and 2018. This is a worsening problem, and our government wants to loosen the rules.
Teresa Nicoletti, of the Australian Medicinal Cannabis Association, stated this week that there is “no accepted amount of THC that will cause impairment”. What she means is that no legal threshold has been agreed upon. What the science shows is the opposite of reassuring.
Research published in the BMJ by Asbridge and colleagues found acute cannabis use nearly doubles crash risk. Separate controlled studies found significant driving impairment at THC blood concentrations below most existing legal thresholds. In those same trials, THC-induced lane deviation was comparable to or greater than alcohol at 0.05 per cent – and the impaired drivers were willing and ready to get behind the wheel regardless.
When the NSW parliament’s own 2024 inquiry found “no scientific consensus” on safe THC levels, the appropriate response was not to shrug and wave people through. It was to hold the line.
While this political debate proceeds, people are dying on NSW roads at an accelerating rate. In the 12 months to April 2026, 351 people were killed – up 5.1 per cent on the previous year. In 2025, 11,667 people were hospitalised with serious injuries, up from 11,120 the year before. These are not abstract figures. Each one is a trauma team, a resuscitation bay, a conversation with a family in a waiting room.
And into this environment, the NSW government is preparing to tell cannabis users that driving after medicating is acceptable, provided they have a piece of paper from a doctor.
NRMA data covering NSW fatal crashes between 2019 and 2023 found cannabis was the most frequently detected illicit substance, present in 69 per cent of drug-positive cases – well ahead of methamphetamine at 43 per cent. Cannabis is already the dominant drug in our fatal crash data. The proposed policy response is to extend greater tolerance to cannabis-positive drivers. That is not reform. That is negligence with paperwork.
There is no mystery about what is happening here. The “medicinal” cannabis industry has lobbied hard, framing this as a patient-rights issue, and the Minns government has decided the electoral cost of offending cannabis users outweighs whatever it costs in road deaths. I am asking that calculation be made openly, because the public deserves to hear it said plainly.
We do not have a rapid, validated roadside test for cannabis impairment. What we have is a drug-wipe that detects presence, not impairment. Under this proposal, presence on a first offence attracts nothing more than a fine. That is not a deterrent. That is a licence fee.
Premier Minns has the power to reject this proposal. I am calling on him to do so – and to keep it withdrawn until a validated roadside impairment test exists, until prescribers are held to account for counselling patients on driving risk, and until this government takes the rising road toll with the urgency it deserves.
I have been a trauma surgeon for over 20 years. The physics of a vehicle collision does not care about prescriptions.
John Crozier is a trauma surgeon and road safety advocate.
Dr John Crozier is chair of the National Trauma Committee of the Royal Australasian College of Surgeons.