RT Journal Article
SR Electronic
T1 Prevalence of alcohol and drug use in injured British Columbia drivers
JF BMJ Open
JO BMJ Open
FD British Medical Journal Publishing Group
SP e009278
DO 10.1136/bmjopen-2015-009278
VO 6
IS 3
A1 Jeffrey R Brubacher
A1 Herbert Chan
A1 Walter Martz
A1 William Schreiber
A1 Mark Asbridge
A1 Jeffrey Eppler
A1 Adam Lund
A1 Scott Macdonald
A1 Olaf Drummer
A1 Roy Purssell
A1 Gary Andolfatto
A1 Robert Mann
A1 Rollin Brant
YR 2016
UL http://bmjopen.bmj.com/content/6/3/e009278.abstract
AB 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.