Prevalence of alcohol and drug use in injured British Columbia drivers
posted 10/03/2016
publication BMJ Open
Jeffrey R Brubacher1,
Herbert Chan1,
Walter Martz2,
William Schreiber2,3,
Mark Asbridge4,
Jeffrey Eppler1,
Adam Lund1,
Scott Macdonald5,
Olaf Drummer6,
Roy Purssell1,7,
Gary Andolfatto1,
Robert Mann7,
Rollin Brant8
+Author Affiliations
1Department of Emergency Medicine, University of British Columbia, Vancouver, British Columbia, Canada
2Provincial Toxicology Centre, Vancouver, British Columbia, Canada
3Department of Pathology and Laboratory Medicine, The University of British Columbia, Vancouver, British Columbia, Canada
4Department of Community Health and Epidemiology, Dalhousie University, Halifax, Nova Scotia, Canada
5University of Victoria, Centre for Addiction Research of British Columbia, Vancouver, British Columbia, Canada
6Department of Forensic Medicine, Monash University, Melbourne, Victoria, Australia
7Provincial Health Services Authority, British Columbia Centre for Disease Control, Vancouver, British Columbia, Canada
7Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada
8Department of Statistics, University of British Columbia, Vancouver, British Columbia, Canada
Correspondence toDr Jeffrey R Brubacher; jbrubacher@shaw.ca
Received 1 July 2015
Revised 4 December 2015
Accepted 4 December 2015
Published 10 March 2016
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.
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