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Driving under the influence of alcohol or drugs is one of the main contributing causes of serious road traffic crashes (RTCs). This study aimed to investigate the involvement of alcohol and drugs in driver fatalities in Norway during 2011–2020 and compare the findings with data from the previous decade. We linked the results of forensic toxicology testing for alcohol and the 17 most commonly used drugs assigned with legal limits with data on fatal road traffic crashes obtained from Statistics Norway and the Norwegian Public Roads Administration. The number of fatalities had decreased significantly since the previous decade, while the proportion of drivers and riders tested for alcohol and drug use increased. Blood alcohol concentrations at the legal limit or higher were found in 14.4% and psychoactive drugs were detected in 15.8% of the cases; 10.7% tested positive for illicit drugs, and 10.1% for medicinal drugs. The most prevalent illicit drugs were tetrahydrocannabinol (7.9%) and amphetamine/methamphetamine (4.7%), whereas the most prevalent medicinal drugs were clonazepam (3.7%) and diazepam (2.2%). There was a marked reduction in the number of motor vehicle drivers killed in RTCs compared with the previous decade, and also a reduction in the prevalence of alcohol. For other substances, there were no marked changes in the prevalence. [ABSTRACT FROM AUTHOR]

Objective:To investigate whether the use of the stimulants amphetamines and cocaine by truck drivers in Brazil was related to travel length. Methods:Truck drivers were randomly stopped by the Federal Highway Police on interstate roads in Sao Paulo State during morning hours from 2008 to 2011 and invited to participate in the project “Comandos de Saúde nas Rodovias” (Health Commands on the Roads). Participants were asked about the use of drugs, travel distance, and age, and gender was recorded. Samples of urine were collected and analyzed for amphetamine, benzoylecgonine (a metabolite of cocaine), and carboxytetrahydrocannabinol (THC-COOH; a metabolite of cannabis) by immunological screening and quantification by gas chromatography–mass spectroscopy. Results:Current use of amphetamine, cocaine, and cannabis was reported by 5.7%, 0.7%, and 0.3% of the truck drivers, respectively. Amphetamine, benzoylecgonine, and THC-COOH were found in urine samples from 5.4%, 2.6,% and in 1.0% of the drivers, respectively. There was a significant association between the positive cases for amphetamine and reported travel length; 9.9% of urine samples from drivers who reported travel length of more than 270 km were positive for amphetamine, and 10.9% of those drivers reported current use of amphetamines. In most cases, appetite suppressants containing amphetamines had been used, but the purpose was most often to stay awake and alert while driving. Truck drivers with travel length of more than 270 km had significantly higher odds ratio (OR) for having a urine sample that was positive for amphetamine when adjusted for age as confounding factor (OR = 9.41, 95% confidence interval [CI], 3.97–22.26). No significant association was found between the use of cocaine or cannabis and travel length. Conclusion:Truck drivers who reported driving more than 270 km had significantly higher frequencies of urine samples positive for amphetamine and reported significantly more frequent current use of amphetamines than those who reported shorter driving distances. [ABSTRACT FROM PUBLISHER]

Objective:Recent Norwegian and Finnish studies have found high odds ratios for serious or fatal injury in road traffic accidents among drivers after drinking alcohol. In this report we have compared the odds ratios with results from studies in other countries. Methods:A literature review was conducted. Results:The odds ratios were significantly higher than in countries where drunk driving is more common. Conclusion:The calculated odds ratios are not only related to alcohol use or blood alcohol concentration per se but also related to the study design—for example, the inclusion of nonculpable drivers among cases—and confounding factors not included in statistical analysis; for example, risk-taking behavior. Those two issues may contribute to explaining why the reported odds ratios are higher for Norway and Finland. [ABSTRACT FROM AUTHOR]

Objective: India reported the highest number of road traffic crashes, related injuries, and deaths among all countries in the world, with 105,725 road traffic fatalities and 452,922 nonfatal road traffic injuries in 2007. In this report we present a systematic review of available literature on the use of psychoactive substances (alcohol and drugs) among road users, particularly those involved in road traffic crashes (RTCs). Methods: MEDLINE, EMBASE, Ind Medica, and several other databases were searched for reports published between 1980 and 2011 that present data on the prevalence or extent of substance use among road users in India. Results: Among the 23 studies eligible for the review, alcohol was reported by all, but only 2 mentioned the use of drugs. Most of the studies were hospital based, included injured or killed road users, and belonged to southern parts of India. Seven studies did not report any method for detecting alcohol use, whereas 7 used analytical testing, 7 used self-reporting, and 2 used observation. Utilizing the various means of verification, the studies reported that 2 to 33 percent of injured and 6 to 48 percent of killed RTC victims had consumed alcohol or drugs; only 2 mentioned drugs without specifying which types. Most studies did not distinguish between drivers, passengers, bicyclists, and pedestrians, and none investigated alcohol or drug use among those responsible for the accident. Conclusion: A significant proportion of injured or killed road users in India had used alcohol before the accident. However, the existing studies cannot be used to estimate the risk of accident involvement among drunk drivers. There is a need for more rigorous research and capacity building on substance use vis-à-vis road traffic crashes. [ABSTRACT FROM PUBLISHER]

Objective: Using alcohol or psychoactive drugs before driving a motor vehicle may increase the risk of crash involvement, injury, and death. This is better documented for alcohol than for drugs. The aim of this study was to expand a previous case-control study on substance use and driver fatality by doubling the number of cases and controls, and hence improve the statistical power and enable the analysis of combined substance use., Methods: We collected data on alcohol and drug use from all 1197 drivers of cars and vans who were fatally injured in road traffic crashes in Norway between 2005 and 2020 ('cases') by analyzing blood samples or reviewing other information on substance use. We also collected data on alcohol and drug use among 17,219 drivers in random road traffic ('controls') by analyzing oral fluid samples. Substance use was converted to dichotomous variables (no use/use). We used unconditional logistic regression to estimate adjusted odds ratios (aORs) with 95% confidence intervals (CIs) of driver fatality for mutually exclusive substance groups, adjusted for sex, age, geographic region, urban centrality class, and time interval of the week., Results: Compared to no substance use, the aOR (95% CI) for driver fatality was for alcohol 91 (61-137), stimulants (primarily amphetamines) aOR 22 (9-56), benzodiazepines and z-hypnotics (BZDs) aOR 4.0 (2.7-5.9), tetrahydrocannabinol (THC) aOR 3.4 (1.7-6.7), and opioids aOR 1.4 (0.4-4.9). The aOR for any polysubstance use was 168 (96-297). The combinations of BZDs with stimulants or THC were associated with markedly higher aORs for driver fatality than the use of single substance groups., Conclusions: Alcohol and polysubstance use are the most important predictors of fatal injury, followed by stimulants.