The prevalence of alcohol, cannabinoids, benzodiazepines and stimulants amongst injured drivers and their role in driver culpability Part I: the prevalence of drug use in drivers, and characteristics of the drug-positive group

doi:10.1016/S0001-4575(99)00111-6

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The prevalence of alcohol, cannabinoids, benzodiazepines and stimulants amongst injured drivers and their role in driver culpability Part I: the prevalence of drug use in drivers, and characteristics of the drug-positive group

Journal Article•DOI•

The prevalence of alcohol, cannabinoids, benzodiazepines and stimulants amongst injured drivers and their role in driver culpability Part I: the prevalence of drug use in drivers, and characteristics of the drug-positive group

Marie C. Longo¹, Christine E. Hunter, Robert J. Lokan, Jason M. White¹, Michael T. White - Show less +1 more•Institutions (1)

University of Adelaide¹

01 Sep 2000-Accident Analysis & Prevention (Pergamon)-Vol. 32, Iss: 5, pp 613-622

TL;DR: Blood samples from 2,500 injured drivers were analysed for alcohol, cannabinnoids, benzodiazepines and stimulants, and a similar proportion of car drivers and motorcycle riders tested positive for drugs, although riders were more likely to test positive for THC.

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About: This article is published in Accident Analysis & Prevention.The article was published on 2000-09-01. It has received 129 citations till now. The article focuses on the topics: Blood alcohol content.

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Journal Article•DOI•

Acute cannabis consumption and motor vehicle collision risk: systematic review of observational studies and meta-analysis

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Mark Asbridge¹, Jill A. Hayden, Jennifer Cartwright•Institutions (1)

Dalhousie University¹

09 Feb 2012-BMJ

TL;DR: Acute cannabis consumption is associated with an increased risk of a motor vehicle crash, especially for fatal collisions, and could be used as the basis for campaigns against drug impaired driving, developing regional or national policies to control acute drug use while driving, and raising public awareness.

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Abstract: Objective To determine whether the acute consumption of cannabis (cannabinoids) by drivers increases the risk of a motor vehicle collision. Design Systematic review of observational studies, with meta-analysis. Data sources We did electronic searches in 19 databases, unrestricted by year or language of publication. We also did manual searches of reference lists, conducted a search for unpublished studies, and reviewed the personal libraries of the research team. Review methods We included observational epidemiology studies of motor vehicle collisions with an appropriate control group, and selected studies that measured recent cannabis use in drivers by toxicological analysis of whole blood or self report. We excluded experimental or simulator studies. Two independent reviewers assessed risk of bias in each selected study, with consensus, using the Newcastle-Ottawa scale. Risk estimates were combined using random effects models.

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637 citations

Journal Article•DOI•

A review of drug use and driving: epidemiology, impairment, risk factors and risk perceptions

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Erin Kelly¹, Shane Darke¹, Joanne Ross¹•Institutions (1)

National Drug and Alcohol Research Centre¹

01 Sep 2004-Drug and Alcohol Review

TL;DR: It is concluded that drug driving is a significant problem, both in terms of a general public health issue and as a specific concern for drug users.

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Abstract: The existing literature on the prevalence of drug driving, the effects of drugs on driving performance, risk factors and risk perceptions associated with drug driving was reviewed. The 12-month pre...

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425 citations

Cites background from "The prevalence of alcohol, cannabin..."

...[25] Australia 1995 – 1996 Blood; drivers injured in MVAs 2500 Cannabis: younger; benzodiazepines: older; alcohol: males, younger Macdonald & Dooley [177] Canada 1988 Household survey; individuals with convictions for DUIA matched with controls Total sample: 9943; DUIA cases: 78; controls: 78 Cases more likely than controls to have other driving convictions...
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...While, in the majority of studies, males are more likely to report drug driving [151 – 153,156,158] and to be found positive for drugs due to suspicion of impaired driving [10,44,58,67] or after accident-involvement [16,17,24,25,27,159], a number of studies have failed to find evidence of sex differences in drug driving prevalence [19,68,69,160 – 162]....
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...[25] Australia 1995 – 1996 Drivers injured in MVAs; blood 2500 DUIA 10%, drugs 10% Longo et al....
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...middle-aged to older drivers [24,25,64], due presum-...
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Journal Article•DOI•

Cannabis intoxication and fatal road crashes in France: population based case-control study

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Bernard Laumon, Blandine Gadegbeku, Jean-Louis Martin, Marie-Berthe Biecheler

08 Dec 2005-BMJ

TL;DR: Driving under the influence of cannabis increases the risk of involvement in a crash in France, however, in France its share in fatal crashes is significantly lower than that associated with positive blood alcohol concentration.

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Abstract: Objectives To evaluate the relative risk of being responsible for a fatal crash while driving under the influence of cannabis, the prevalence of such drivers within the driving population, and the corresponding share of fatal crashes. Design Population based case-control study. Participants 10 748 drivers, with known drug and alcohol concentrations, who were involved in fatal crashes in France from October 2001 to September 2003. Main outcome measures The cases were the 6766 drivers considered at fault in their crash; the controls were 3006 drivers selected from the 3982 other drivers. Positive detection of cannabis was defined as a blood concentration of Δ 9 tetrahydrocannabinol of over 1 ng/ml. The prevalence of positive drivers in the driving population was estimated by standardising controls on drivers not at fault who were involved in crashes resulting in slight injuries. Results 681 drivers were positive for cannabis (cases 8.8%, controls 2.8%), including 285 with an illegal blood alcohol concentration (0.5 g/l). Positive cannabis detection was associated with increased risk of responsibility (odds ratio 3.32, 95% confidence interval 2.63 to 4.18). A significant dose effect was identified; the odds ratio increased from 2.18 (1.22 to 3.89) if 0 9 tetrahydrocannabinol 9 tetrahydrocannabinol 5 ng/ml. The effect of cannabis remains significant after adjustment for different cofactors, including alcohol, with which no statistical interaction was observed. The prevalence of cannabis (2.9%) estimated for the driving population is similar to that for alcohol (2.7%). At least 2.5% (1.5% to 3.5%) of fatal crashes were estimated as being attributable to cannabis, compared with 28.6% for alcohol (26.8% to 30.5%). Conclusions Driving under the influence of cannabis increases the risk of involvement in a crash. However, in France its share in fatal crashes is significantly lower than that associated with positive blood alcohol concentration.

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324 citations

Journal Article•DOI•

Residual effects of hypnotics: epidemiology and clinical implications.

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Annemiek Vermeeren¹•Institutions (1)

Maastricht University¹

01 Jan 2004-CNS Drugs

TL;DR: In this paper, epidemiological evidence on the effect of hypnotics on patients' risk for accidents such as traffic accidents, falls and hip fractures (i.e. end-points for residual effects).

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Abstract: The risk of ‘hangover’ effects, e.g. residual daytime sleepiness and impairment of psychomotor and cognitive functioning the day after bedtime administration, is one of the main problems associated with the use of hypnotics. However, the severity and duration of these effects varies considerably between hypnotics and is strongly dependent on the dose administered. This article reviews epidemiological evidence on the effect of hypnotics on patients’ risk for accidents such as traffic accidents, falls and hip fractures (i.e. end-points for residual effects). Information on the duration and severity of residual effects of 11 hypnotics (flunitrazepam, flurazepam, loprazolam, lormetazepam, midazolam, nitrazepam, temazepam, triazolam, zaleplon, zolpidem and zopiclone) was derived from expert ratings, a meta-analysis and actual driving studies. Epidemiological studies show that the risks of an accident increase with increasing half-life of the hypnotic, but that the use of hypnotics with a short half-life, such as triazolam, zopiclone and zolpidem, can also be associated with increased risks. A summary of results from experimental studies should enable prescribing clinicians to compare residual effects of the various hypnotics at different doses and select the one considered most favourable in this respect for the individual patient. This information should also enable them to inform patients more adequately about the likelihood and duration of residual effects of a specific hypnotic dose.

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255 citations

Journal Article•DOI•

The prevalence of alcohol, cannabinoids, benzodiazepines and stimulants amongst injured drivers and their role in driver culpability: part ii: the relationship between drug prevalence and drug concentration, and driver culpability.

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Marie C. Longo¹, Christine E. Hunter, Robert J. Lokan, Jason M. White¹, Michael T. White - Show less +1 more•Institutions (1)

University of Adelaide¹

01 Sep 2000-Accident Analysis & Prevention

TL;DR: In this article, the authors examined the relationship between the prevalence and concentration of drugs and the culpability of the driver using an objective method for assessing culpability, and found a significant concentration-dependent relationship between alcohol and culpability: as blood alcohol concentration increased, so did the percentage of culpable drivers.

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223 citations

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Journal Article•DOI•

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Marie C. Longo¹, Christine E. Hunter, Robert J. Lokan, Jason M. White¹, Michael T. White - Show less +1 more•Institutions (1)

University of Adelaide¹

01 Sep 2000-Accident Analysis & Prevention

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223 citations

Journal Article•DOI•

Role of drugs in traffic accidents.

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R. Honkanen, L. Ertama, M Linnoila, Antti Alha, I. Lukkari, M. Karlsson, O. Kiviluoto, M. Puro - Show less +4 more

15 Nov 1980-BMJ

TL;DR: Drug use appeared to be somewhat lower in Finland than in other Western countries, and illness to be a more important traffic hazard than drugs in general.

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Abstract: Serum samples from 201 drivers who presented at emergency departments within six hours after being injured in a road accident and 325 control drivers selected randomly at petrol stations were screened for drugs by combined thin-layer and gas chromatography. Blood alcohol concentrations were also measured, and a questionnaire on the subjects9 state of health and use of drugs administered. At interview 30 patients (15%) and 44 controls (13%) said that they had taken drugs in the previous 24 hours. Four patients (2%) and six controls (2%) said that they had taken psychotropic drugs, but serum analysis detected psychotropic drugs in 10 patients (5%) and eight controls (2.5%). Diazepam was found in 16 of the 18 subjects in whom psychotropic drugs were detected. Alcohol was detected in 30 patients (15%) and three controls (1%). Drug use appeared to be somewhat lower in Finland than in other Western countries, and illness to be a more important traffic hazard than drugs in general. Interview was not a reliable method of establishing whether drivers had taken psychotropic drugs. Taking diazepam may increase the risk of being involved in a traffic accident, but alcohol was the most powerful risk factor.

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145 citations

"The prevalence of alcohol, cannabin..." refers result in this paper

...Moreover, the prevalence of alcohol was still much higher than those found in studies using non-crash involved drivers (Bo et al., 1975; Honkanen et al., 1980; Ferrara and Rozza, 1985; Ferrara et al., 1990)....
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Journal Article•DOI•

Alcohol and drug use among motor vehicle collision victims admitted to a regional trauma unit: demographic, injury, and crash characteristics

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Gina Stoduto, Evelyn Vingilis, Bhushan M. Kapur, Wen-Jenn Sheu, Barry A. McLellan, Carolyn B. Liban¹ - Show less +2 more•Institutions (1)

Sunnybrook Health Sciences Centre¹

01 Aug 1993-Accident Analysis & Prevention

TL;DR: It was found that BAC-positive drug-screened drivers were significantly more likely to be male, involved in a single-vehicle collision, not wearing a seat belt, ejected from the vehicle, and travelling at higher speeds than BAC negative drivers.

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137 citations

"The prevalence of alcohol, cannabin..." refers background or result in this paper

..., 1995) typically report lower rates of benzodiazepine and stimulant positive drivers than studies using non-fatally injured drivers (Stoduto et al., 1993; Christophersen et al., 1995)....
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...The results found for alcohol and THC are consistent with previous studies using non-fatally injured drivers (Stoduto et al., 1993; Waller et al., 1997)....
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...However, some studies that examined non-fatally injured drivers reported percentages as high as 12% (Christophersen et al., 1995 in Norway; Stoduto et al., 1993 in Canada)....
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...Those studies using fatally injured drivers (Everest and Tunbridge, 1990; Drummer, 1994; Jeffrey et al., 1995) typically report lower rates of benzodiazepine and stimulant positive drivers than studies using non-fatally injured drivers (Stoduto et al., 1993; Christophersen et al., 1995)....
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...Cannabinoids have been the most frequently detected drugs in injured drivers after alcohol, with the percentage of drivers testing positive ranging from 7 to 15% (Stoduto et al., 1993 in Canada and Waller et al., 1997 in the USA)....
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Journal Article•DOI•

Marijuana and alcohol use among 1023 trauma patients. A prospective study.

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Carl A. Soderstrom, Anna L. Trifillis, Belavadi S. Shankar, William E. Clark, R. Adams Cowley - Show less +1 more

01 Jun 1988-Archives of Surgery

TL;DR: Marijuana use prior to injury was determined prospectively in 1023 patients injured as the result of vehicular and nonvehicular trauma and was higher among those 30 years of age or younger and among men.

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Abstract: • Marijuana use prior to injury was determined prospectively in 1023 patients injured as the result of vehicular (67.6%) and nonvehicular (32.4%) trauma. Most were men (72.8%); most were 30 years of age or younger (58.4%). All were admitted directly from the scene of injury. Serum δ-9-tetrahydrocannabinol activity was ascertained using a radioimmunoassay. Activity of 2 ng/mL or more was detected in 34.7% of subjects. Blood alcohol determinations were made in 1006 patients; 33.5% were positive. Marijuana use among vehicular and nonvehicular trauma victims was not significantly different. Marijuana use was higher among those 30 years of age or younger and among men. Vehicular crash victims consumed alcohol more frequently. Use of marijuana and alcohol in combination (16.5%) was highly significant compared with marijuana alone (18.3%), alcohol alone (16.1 %), or neither drug (49.1%). Arch Surg 1988;123:733-737)

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121 citations

"The prevalence of alcohol, cannabin..." refers result in this paper

...These results accurately reflect patterns of drug use in Australian society, and are also consistent with past studies of non-fatally injured drivers (Soderstrom et al., 1988; Holubowycz, 1989; McLellan et al., 1995)....
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Journal Article•DOI•

Incidence and toxicological aspects of drugs detected in 484 fatally injured drivers and pedestrians in ontario

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G Cimbura, Douglas M. Lucas, R C Bennett, R. A. Warren, Herb M. Simpson - Show less +1 more

01 Oct 1982-Journal of Forensic Sciences

TL;DR: Results are presented of a comprehensive drug study carried out on specimens from drivers and pedestrians fatally injured in Ontario, finding that alcohol was found in 57% of the study sample and drugs other than alcohol, in 26%.

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Abstract: Results are presented of a comprehensive drug study carried out on specimens from drivers and pedestrians fatally injured in Ontario. Toxicological analyses were regularly performed on blood and urine and occasionally on vitreous humor, stomach contents, and liver. The analytical procedures could detect and quantitate a wide variety of drugs including such illicit drugs as Cannabis. With respect to drivers, alcohol was found in 57% of the study sample and drugs other than alcohol, in 26%. However, in only 9.5% of the drivers were psychoactive drugs (other than alcohol) detected in the blood in concentrations that may adversely affect driving skills. Delta-9-Tetrahydrocannabinol and diazepam accounted for a majority of the findings in this category.

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101 citations

"The prevalence of alcohol, cannabin..." refers result in this paper

...The relationship between the prevalence of drugs and driver age was also consistent with previous studies, with significant differences found in age depending on the type of drug being used (Warren et al., 1981; Cimbura et al., 1982; Holubowycz et al., 1994; Haworth et al., 1997a,b,c)....
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