Drug use and fatal motor vehicle crashes: a case-control study.

Drugged driving is a serious safety concern, but its role in motor vehicle crashes has not been adequately studied. Using a case-control design, the authors assessed the association between drug use and fatal crash risk. Cases (n=737) were drivers who were involved in fatal motor vehicle crashes in the continental United States during specific time periods in 2007, and controls (n=7719) were participants of the 2007 National Roadside Survey of Alcohol and Drug Use by Drivers. Overall, 31.9% of the cases and 13.7% of the controls tested positive for at least one non-alcohol drug. The estimated odds ratios of fatal crash involvement associated with specific drug categories were 1.83 [95% confidence interval (CI): 1.39, 2.39] for marijuana, 3.03 (95% CI: 2.00, 4.48) for narcotics, 3.57 (95% CI: 2.63, 4.76) for stimulants, and 4.83 (95% CI: 3.18, 7.21) for depressants. Drivers who tested positive for both alcohol and drugs were at substantially heightened risk relative to those using neither alcohol nor drugs (Odds Ratio=23.24; 95% CI: 17.79, 30.28). These results indicate that drug use is associated with a significantly increased risk of fatal crash involvement, particularly when used in combination with alcohol.

[1]  E. Kelly,et al.  A review of drug use and driving: epidemiology, impairment, risk factors and risk perceptions. , 2004, Drug and alcohol review.

[2]  A. Egberts,et al.  Psychoactive substance use and the risk of motor vehicle accidents. , 2004, Accident; analysis and prevention.

[3]  T. Blakely,et al.  Role of cannabis in motor vehicle crashes. , 1999, Epidemiologic reviews.

[4]  P. Michie,et al.  Effects of Benzodiazepines, Antidepressants and Opioids on Driving , 2011, Drug safety.

[5]  P. Zador Alcohol-related relative risk of fatal driver injuries in relation to driver age and sex. , 1991, Journal of studies on alcohol.

[6]  T Parran,et al.  Prescription drug abuse: A question of balance , 1997 .

[7]  David L Streiner,et al.  Benzodiazepine use and driving: a meta-analysis. , 2009, The Journal of clinical psychiatry.

[8]  M. Asbridge,et al.  Acute cannabis consumption and motor vehicle collision risk: systematic review of observational studies and meta-analysis , 2012, BMJ : British Medical Journal.

[9]  James A. Kaplan,et al.  Alcohol and other drug use among victims of motor-vehicle crashes--West Virginia, 2004-2005. , 2006, MMWR. Morbidity and mortality weekly report.

[10]  B Ludes,et al.  Comparison of the prevalence of alcohol, cannabis and other drugs between 900 injured drivers and 900 control subjects: results of a French collaborative study. , 2003, Forensic science international.

[11]  Stefanie Y Leung,et al.  Benzodiazepines, opioids and driving: an overview of the experimental research. , 2011, Drug and alcohol review.

[12]  A. Egberts,et al.  The Relationship between Benzodiazepine Use and Traffic Accidents , 2010, CNS drugs.

[13]  A. Engeland,et al.  An increased risk of motor vehicle accidents after prescription of methadone. , 2012, Addiction.

[14]  R. Voas,et al.  Prescription drugs, drugged driving and per se laws , 2012, Injury Prevention.

[15]  Jean-Louis Martin,et al.  Cannabis intoxication and fatal road crashes in France: population based case-control study , 2005, BMJ : British Medical Journal.

[16]  J. Ramaekers,et al.  Pitfalls in estimating drug-related crash risk. , 2003, Trends in pharmacological sciences.

[17]  Marilyn A Huestis,et al.  Cannabis effects on driving skills. , 2013, Clinical chemistry.

[18]  Anders Engeland,et al.  Risk of road traffic accidents associated with the prescription of drugs: a registry-based cohort study. , 2007, Annals of epidemiology.

[19]  Martin Boorman,et al.  The effects of cannabis and alcohol on simulated driving: Influences of dose and experience. , 2013, Accident; analysis and prevention.

[20]  M. Gold,et al.  The mirage of impairing drug concentration thresholds: a rationale for zero tolerance per se driving under the influence of drugs laws. , 2012, Journal of analytical toxicology.

[21]  I. M. Bernhoft,et al.  Alcohol and drugs in seriously injured drivers in six European countries. , 2013, Drug testing and analysis.

[22]  Nicholas Moore,et al.  Risk of injurious road traffic crash after prescription of antidepressants , 2012, Injury Prevention.

[23]  Guohua Li,et al.  Trends and Pattern of Drug Abuse Deaths in Maryland Teenagers , 2011, Journal of forensic sciences.

[24]  Randolph Atkins,et al.  Epidemiology of Alcohol and Other Drug Use Among Motor Vehicle Crash Victims Admitted to a Trauma Center , 2004, Traffic injury prevention.

[25]  Marjan Hagenzieker,et al.  Risk of injury by driving with alcohol and other drugs , 2011 .

[26]  Emmanuelle Amoros,et al.  Responsibility study: main illicit psychoactive substances among car drivers involved in fatal road crashes. , 2011, Annals of advances in automotive medicine. Association for the Advancement of Automotive Medicine. Annual Scientific Conference.

[27]  W. M. Bosker,et al.  Effects of stimulant drugs on actual and simulated driving: perspectives from four experimental studies conducted as part of the DRUID research consortium , 2012, Psychopharmacology.

[28]  H. Gjerde,et al.  Impairment in drivers due to cannabis in combination with other drugs. , 1991, Forensic science international.

[29]  S. Baker,et al.  Injury research: Theories, methods, and approaches , 2012 .

[30]  R. Voas,et al.  Drug and alcohol involvement in four types of fatal crashes. , 2011, Journal of studies on alcohol and drugs.

[31]  A. Verstraete,et al.  A Case-Control Study Estimating Accident Risk for Alcohol, Medicines and Illegal Drugs , 2012, PloS one.

[32]  F. Musshoff,et al.  Driving Under the Influence of Amphetamine‐Like Drugs , 2012, Journal of forensic sciences.

[33]  M. Bédard,et al.  The Impact of Benzodiazepines on Safe Driving , 2008, Traffic injury prevention.

[34]  A. Verstraete,et al.  Drugs and Driving , 2004, Traffic injury prevention.

[35]  Guohua Li,et al.  Validity of suspected alcohol and drug violations in aviation employees. , 2010, Addiction.

[36]  D. Rubin Multiple imputation for nonresponse in surveys , 1989 .

[37]  A. S. Tippetts,et al.  2007 National Roadside Survey of Alcohol and Drug Use by Drivers: Methodology , 2009 .

[38]  Sven Ove Samuelsen,et al.  Alcohol, psychoactive drugs and fatal road traffic accidents in Norway: a case-control study. , 2011, Accident; analysis and prevention.

[39]  Anders Engeland,et al.  Road traffic accident risk related to prescriptions of the hypnotics zopiclone, zolpidem, flunitrazepam and nitrazepam. , 2008, Sleep medicine.

[40]  M. Bédard,et al.  The Impact of Cannabis on Driving , 2007 .

[41]  Randolph Atkins,et al.  Drug and alcohol use among drivers admitted to a Level-1 trauma center. , 2005, Accident; analysis and prevention.

[42]  Charles J DiMaggio,et al.  Marijuana use and motor vehicle crashes. , 2012, Epidemiologic reviews.

[43]  John Van Hoewyk,et al.  A multivariate technique for multiply imputing missing values using a sequence of regression models , 2001 .

[44]  Robert B Voas,et al.  The Need for Drugged Driving Per Se Laws: A Commentary , 2012, Traffic injury prevention.

[45]  D. Taylor,et al.  Circadian variation in plasma theophylline concentrations during maintenance therapy with a sustained-release preparation in patients with obstructive airways disease. , 1984, British journal of clinical pharmacology.

[46]  Robert B. Voas,et al.  2007 National Roadside Survey of Alcohol and Drug Use by Drivers: Alcohol Results , 2009 .

[47]  K. O’grady,et al.  Substance-related traffic-risk behaviors among college students. , 2011, Drug and alcohol dependence.

[48]  D Shinar,et al.  STATE OF KNOWLEDGE OF DRUG-IMPAIRED DRIVING , 2003 .

[49]  P. Philip,et al.  The impact of medicinal drugs on traffic safety: a systematic review of epidemiological studies , 2009, Pharmacoepidemiology and Drug Safety.

[50]  H. Gjerde,et al.  Alcohol, psychoactive substances and non-fatal road traffic accidents - a case-control study , 2012, BMC Public Health.

[51]  W. Haddon,et al.  A controlled study of fatal automobile accidents in New York City , 1962 .

[52]  K. Bird,et al.  Investigating drug--ethanol interactions. , 1984, British journal of clinical pharmacology.

[53]  Joanne E Brady,et al.  Prevalence of alcohol and other drugs in fatally injured drivers. , 2013, Addiction.

[54]  Jean-Marie Annoni,et al.  Weed or Wheel! fMRI, Behavioural, and Toxicological Investigations of How Cannabis Smoking Affects Skills Necessary for Driving , 2013, PloS one.

[55]  R. Voas,et al.  Alcohol- and Drug-Involved Driving in the United States , 2011, Evaluation review.