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BMJ Open. 2016 Mar 10;6(3):e009278. doi: 10.1136/bmjopen-2015-009278.

Prevalence of alcohol and drug use in injured British Columbia drivers.

Author information

1
Department of Emergency Medicine, University of British Columbia, Vancouver, British Columbia, Canada.
2
Provincial Toxicology Centre, Vancouver, British Columbia, Canada.
3
Provincial Toxicology Centre, Vancouver, British Columbia, Canada Department of Pathology and Laboratory Medicine, The University of British Columbia, Vancouver, British Columbia, Canada.
4
Department of Community Health and Epidemiology, Dalhousie University, Halifax, Nova Scotia, Canada.
5
University of Victoria, Centre for Addiction Research of British Columbia, Vancouver, British Columbia, Canada.
6
Department of Forensic Medicine, Monash University, Melbourne, Victoria, Australia.
7
Department of Emergency Medicine, University of British Columbia, Vancouver, British Columbia, Canada Provincial Health Services Authority, British Columbia Centre for Disease Control, Vancouver, British Columbia, Canada.
8
Provincial Health Services Authority, British Columbia Centre for Disease Control, Vancouver, British Columbia, Canada.
9
Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada.

Abstract

OBJECTIVES:

Determine the prevalence of drug use in injured drivers and identify associated demographic factors and crash characteristics.

DESIGN:

Prospective cross-sectional study.

SETTING:

Seven trauma centres in British Columbia, Canada (2010-2012).

PARTICIPANTS:

Automobile drivers who had blood obtained within 6 h of a crash.

MAIN OUTCOME MEASURES:

We analysed blood for cannabis, alcohol and other impairing drugs using liquid chromatography/mass spectrometry (LCMS).

RESULTS:

1097 drivers met inclusion criteria. 60% were aged 20-50 years, 63.2% were male and 29.0% were admitted to hospital. We found alcohol in 17.8% (15.6% to 20.1%) of drivers. Cannabis was the second most common recreational drug: cannabis metabolites were present in 12.6% (10.7% to 14.7%) of drivers and we detected Δ-9-tetrahydrocannabinol (Δ-9-THC) in 7.3% (5.9% to 9.0%), indicating recent use. Males and drivers aged under 30 years were most likely to use cannabis. We detected cocaine in 2.8% (2.0% to 4.0%) of drivers and amphetamines in 1.2% (0.7% to 2.0%). We also found medications including benzodiazepines (4.0% (2.9% to 5.3%)), antidepressants (6.5% (5.2% to 8.1%)) and diphenhydramine (4.7% (3.5% to 6.2%)). Drivers aged over 50 years and those requiring hospital admission were most likely to have used medications. Overall, 40.1% (37.2% to 43.0%) of drivers tested positive for alcohol or at least one impairing drug and 12.7% (10.7% to 14.7%) tested positive for more than one substance.

CONCLUSIONS:

Alcohol, cannabis and a broad range of other impairing drugs are commonly detected in injured drivers. Alcohol is well known to cause crashes, but further research is needed to determine the impact of other drug use, including drug-alcohol and drug-drug combinations, on crash risk. In particular, more work is needed to understand the role of medications in causing crashes to guide driver education programmes and improve public safety.

KEYWORDS:

ACCIDENT & EMERGENCY MEDICINE; EPIDEMIOLOGY; PUBLIC HEALTH; TOXICOLOGY; accidents, traffic

PMID:
26966054
PMCID:
PMC4800149
DOI:
10.1136/bmjopen-2015-009278
[Indexed for MEDLINE]
Free PMC Article

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