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The UC Berkeley Safe Transportation Research and Education Center (SafeTREC) has released the California Traffic Safety Survey 2024. The study was led by Ewald & Wasserman Research Consultants (E&W) and conducted on behalf of the California Office of Traffic Safety (OTS) and SafeTREC.The California Traffic Safety Survey has been conducted annually since 2010 to gain a better understanding of a range of traffic safety behaviors, and to help inform traffic safety programs and public education campaigns. This year’s survey was conducted with an online panel of California drivers in all California counties for a total of 2,507 respondents, with the majority of those surveyed (57.9% weighted) coming from Southern California and falling within the 18-44 age range.

A multi‐analyte liquid chromatography‐tandem mass spectrometry (LC‐MS/MS) method is described, involving the separation of delta‐9‐tetrahydrocannabinol (delta‐9‐THC) and delta‐8‐THC in addition to other commonly encountered drugs and metabolites. Briefly, sample preparation involved an alkaline liquid–liquid extraction (methyl tert‐butyl ether) of blood (100 μl). The solvent layer was transferred, evaporated to dryness, reconstituted, and samples then separated on an Agilent Poroshell 120 EC‐C18 100 Å (50 mm × 3.0 mm, 2.7 μm) analytical column using a multi‐step gradient elution of 50 mM ammonium formate in water (pH 3.5) and 0.1% formic acid in methanol over 14 min. A SCIEX Triple Quad 6500+ system operating in scheduled multiple reaction monitoring and positive electrospray ionization was used for detection. There were no interferences, and matrix effects were generally acceptable (±20% of neat response). Linearity was achieved within the calibration range, including methylamphetamine (MA) (10–1000 ng/ml), 3,4‐methylenedioxy‐N‐methylamphetamine (MDMA) (10–1,000 ng/ml), cocaine (10–1000 ng/ml), and two THC isomers (1–100 ng/ml). Accuracies of MA, MDMA, cocaine, and two THC isomers were 3.6 to 8.9%, −1.2 to 4%, −5.3 to 5.8%, and −11 to 14%, respectively; while precision estimates of the same were 1.6 to 5.4%, 1.7 to 5.3%, 1.2 to 4.5%, and 2 to 10%, respectively. Autosampler stability and dilution integrity were within acceptable limits, and no carryover was detected at the limit of detection. This validated LC‐MS/MS method made the routine identification of both delta‐9‐THC and delta‐8‐THC in blood possible. [ABSTRACT FROM AUTHOR]

Many studies have compared individuals who use cannabis for recreational versus medical purposes, but little is known about the moral norms and risk perceptions toward recreational versus medical cannabis while driving. This study aims to examine young Israeli adults’ behaviors, perceived moral norms, and perceived risk regarding driving under the influence of recreational versus medical cannabis. Methods: The study was conducted using quantitative questionnaires. Participants were 504 young adults, aged 18–30 (M = 25.26; SD = 5.40), of whom 314 (62.3%) were women. Results: Driving under the influence of medical cannabis was perceived as more moral and less risky than driving under the influence of recreational cannabis. Significant positive correlations were observed between perceived risk and perceived moral norms for both types of cannabis. Significant negative correlations were found between the frequency of driving under the influence of recreational cannabis and the perceived risk and perceived moral norms associated with both types of cannabis. Conclusion: Policymakers should promote prevention, harm reduction, and enforcement interventions to address the issue of driving under the influence of both recreational and medical cannabis. [ABSTRACT FROM AUTHOR]

Motor vehicle crashes are a leading cause of death for young adults (YA) in the USA, and driving under the influence of alcohol (DUIA), cannabis (DUIC), and simultaneous use of both substances (DUIAC) are prominent risk factors. Trends in YA impaired driving behaviors after opening of cannabis retail stores have been understudied. We examined YA trends in DUIA, DUIC, and DUIAC from immediately prior through 5 years following the opening of cannabis retail outlets in Washington State (2014–2019). Differences in trends were assessed across age, sex, and urbanicity. Weighted logistic regressions assessed yearly change in prevalence of DUIA, DUIC, and DUIAC from 2014 to 2019, using annual statewide data from the Washington Young Adult Health Survey (n = 12,963; ages 18–25). Moderation of trends by age, sex, and urbanicity was assessed. Prevalence of DUIA decreased overall (AOR = 0.93, 95% CI 0.90, 0.97) and among drinkers (AOR = 0.95, 95% CI 0.91, 0.99) but remained at concerning levels in 2019 (10% overall; 16% among drinkers). Overall DUIC did not change significantly (AOR = 0.99, 95% CI 0.96, 1.03; 11% by 2019) but decreased among those who used cannabis (AOR = 0.91, 95% CI 0.86, 0.96; 33% by 2019). DUIAC decreased but not significantly (overall: AOR = 0.89, 95% CI 0.78, 1.01; those who used alcohol and cannabis: AOR = 0.84, 95% CI 0.74, 1.04). Prevalence of YA DUI remained concerning. Trends may reflect some success in reducing DUI, but additional detection and prevention are needed. [ABSTRACT FROM AUTHOR]

Existing literature on driving under the influence during adolescence is sparse, especially for driving after the use of non-medical prescription drugs (DAP). This study examines the prevalence of driving after use of alcohol (DAA), cannabis (DAC), and DAP, and examines the role of several potential risk and protective factors. This was a secondary analysis of the 2022 Rhode Island Study Survey, a cross-sectional survey of middle and high school students. Separate multivariable regressions were conducted for each outcome among lifetime users for each substance, controlling for current substance use, individual-, perceived parental-, and perceived friend-substance use risk perception, age, sexual/gender minority (SGM) status, race, ethnicity, school level, and town poverty level. Among lifetime users of alcohol (n = 3849), cannabis (n = 2289), and non-medical prescription drugs (n = 611), the prevalence of DAA, DAC, and DAP was 4.9, 14.3, and 16.9%, respectively. Current substance use, high individual risk perception, being nonwhite, and being Hispanic were risk factors for DAA while perceiving parent's risk perception as negative and being heterosexual cisgender-female were protective. Current substance use, negative individual risk perception, and being nonwhite were risk factors for DAC while perceiving parent's risk perception as negative and being in high school were protective. Current substance use and older age were risk factors for DAP while perceiving parent's risk perception as negative and perceiving friend's risk perception as negative were protective. Driving under the influence is a concern among adolescent substance users. Current substance use and perceived parental risk perception as negative are common risks and protective factors, respectively. Findings suggest substance-specific, heterogeneous interventions are needed. For example, interventions focusing on peer perceptions are most relevant for DAP, while shifting personal perceptions of harm are most relevant for DAC. [ABSTRACT FROM AUTHOR]

The first aim of the study was to identify sex differences in the use of psychoactive substances among subjects with a previous driving under the influence (DUI) episode. The secondary objective was to propose specific strategies for medico-legal improvements. This was a retrospective observational study that took place between June 1, 2019, and August 31, 2023. It was conducted on DUI subjects examined for reinstatement of their driver's license using an integrated medico-legal and toxicological approach. Ethyl glucuronide (EtG) and illicit psychoactive substances were determined from hair samples. We performed descriptive statistical analyses for the entire sample as well as separately by sex. Additionally, we conducted binary logistic regression analyses separately for males and females to identify protective/risk factors associated with previous road accidents and judgments of unfitness to drive due to excessive alcohol consumption (EtG ≥ 30 pg/mg). The study included 2,221 subjects, comprising 1,970 men and 251 women. Men exhibited a higher prevalence of tobacco, alcohol, and illicit psychoactive substance use. Women were more frequently co-users of alcohol and psychoactive substances and involved in road accidents at the time of DUI. Among the men, being married or having a partner was found to be a protective factor concerning past traffic accidents. For both sexes, a DUI episode with a blood alcohol concentration (BAC) exceeding 1.5 g/L or the co-ingestion of alcohol and drugs was identified as a risk factor for road accident involvement. For men, smoking more than 20 cigarettes per day and, for women, having a DUI episode with a BAC over 1.5 g/L were the main factors indicating unfitness to drive, as determined through high hair EtG levels (> 30 pg/mg). Women with a previous history of road accidents were less likely to have EtG levels of 30 pg/mg or more. The study confirmed sex differences in subjects with a previous DUI episode. A BAC exceeding 1.5 g/L or the simultaneous use of alcohol and drugs at the time of DUI necessitate careful assessment of both men and women seeking driver's license reinstatement. In women, a BAC exceeding 1.5 g/L is considered a risk factor for a subsequent judgment of unfitness to drive. The medico-legal assessment should also involve a thorough investigation of smoking habits in men, as these habits could be related to an increased risk of excessive alcohol consumption. [ABSTRACT FROM AUTHOR]

BackgroundCannabis is increasingly used both medically and recreationally. With widespread use, there is growing concern about how to identify cannabis-impaired drivers.MethodsA placebo-controlled randomized double-blinded protocol was conducted to study the effects of cannabis on driving performance. One hundred ninety-one participants were randomized to smoke ad libitum a cannabis cigarette containing placebo or delta-9-tetrahydrocannabinol (THC) (5.9% or 13.4%). Blood, oral fluid (OF), and breath samples were collected along with longitudinal driving performance on a simulator (standard deviation of lateral position [SDLP] and car following [coherence]) over a 5-hour period. Law enforcement officers performed field sobriety tests (FSTs) to determine if participants were impaired.ResultsThere was no relationship between THC concentrations measured in blood, OF, or breath and SDLP or coherence at any of the timepoints studied (P > 0.05). FSTs were significant (P < 0.05) for classifying participants into the THC group vs the placebo group up to 188 minutes after smoking. Seventy-one minutes after smoking, FSTs classified 81% of the participants who received active drug as being impaired. However, 49% of participants who smoked placebo (controls) were also deemed impaired at this same timepoint. Combining a 2 ng/mL THC cutoff in OF with positive findings on FSTs reduced the number of controls classified as impaired to zero, 86 minutes after smoking the placebo.ConclusionsRequiring a positive toxicology result in addition to the FST observations substantially improved the classification accuracy regarding possible driving under the influence of THC by decreasing the percentage of controls classified as impaired.

ISSUES: Policy enforcement is crucial to achieve impacts on alcohol-related harm. It is not clear what level of enforcement intensity or dosage is necessary for addressing drink driving and related harms. Given competing enforcement demands and agencies resource constraints, understanding how much enforcement is sufficient to deter drink driving is critical. APPROACH: This systematic literature review followed Preferred Reporting Items for Systematic Review and Meta-Analysis Protocols (PRISMA) guidelines to examine research about dosage effects of enforcement and related visibility on drink-driving outcomes, including motor vehicle crashes and fatalities. Risk of bias was assessed using the Cochrane Collaboration Effective Practice and Organization of Care tool and the JBI checklist. KEY FINDINGS: The 21 studies that met the inclusion criteria for this review differed in measures of enforcement dosage and outcomes, making it difficult to synthesise results across studies and draw conclusions about a threshold or optimal level of enforcement. Although most included studies found that sustained enforcement was associated with reductions in drink driving or related harms, only two studies tested an optimal dosage. Due to study design limitations, a substantial percentage of these studies must be considered with caution. IMPLICATIONS: Additional research with rigorous study designs with appropriate controls is needed to determine an optimal high visibility enforcement dosage level to help law enforcement agencies make realistic decisions about allocating enforcement resources to address drink driving. CONCLUSION: Consistent evidence about a drink-driving enforcement dosage threshold is lacking, partly due to an insufficient number of well-designed studies. Addressing challenges of conducting rigorous studies in community settings is crucial.

Driving under the influence (DUI) of alcohol or cannabis poses public health risks. Little is known about DUI of Delta-8 THC, a newer cannabis product. Using 2022 survey data among 189 U.S. adults ages 18–25 (58.73% male, 59.26% non-Hispanic White), multivariable logistic regression examined substance-specific (alcohol, cannabis, Delta-8) DUI perceived likelihood and risk in relation to past-year DUI among those with past-year use of each. Overall, 72.49% reported past-year alcohol use, 50.53% cannabis, and 22.46% Delta-8. Among those reporting past-year use of each respective substance, 33.58% reported DUI of alcohol, 32.63% cannabis, and 57.14% Delta-8. On average, participants had the same DUI perceived likelihood (“somewhat unlikely”) across substances and perceived alcohol DUI as riskiest. Higher alcohol DUI perceived likelihood and lower perceived risk were associated with alcohol-related DUI. Greater cannabis-related perceived likelihood (but not risk) was associated with cannabis-related DUI. Neither Delta-8 DUI perceived likelihood nor risk were associated with Delta-8 DUI. In sum, perceived DUI likelihood for alcohol, cannabis, or Delta-8 tended to be similar. Among those with past-year use of each, the proportion of DUI was highest for Delta-8. Interventions should target DUI-related perceived likelihood and promote protective behavioral strategies that reduce substance-specific DUI risk. [ABSTRACT FROM AUTHOR]

To estimate the prevalence and factors associated with Driving Under the Influence of Alcohol (DUIA) among car drivers and motorcyclists in Brazil and to evaluate the association between DUIA and self-reported Road Traffic Injuries (RTIs) in these groups. A cross-sectional study was conducted using data from adults aged 18 or older who participated in the 2019 National Health Survey. Probability sampling was used to recruit participants, and data collection was carried out through home visits. Data from 31,246 car drivers and 21,896 motorcyclists were analyzed. Key indicators included the proportion (%) of car drivers who consumed alcohol and then drove in the past 12 months and the proportion (%) of motorcyclists who consumed alcohol and then drove in the past 12 months. Multiple Poisson regression was used to determine factors associated with DUIA and the association of this variable with RTIs in both groups. DUIA prevalence was 9.4% (95% Confidence Interval [95% CI] = 8.8–10.0) among car drivers and 11.2% (95% CI = 10.4–12.1) among motorcyclists. Among car drivers, DUIA prevalence was higher in men, young adults, those without a spouse/partner, and lower in individuals with lower income and education level. Among motorcyclists, DUIA prevalence was higher in men, young adults, those living outside the capitals and metropolitan regions, and lower in individuals with lower income. DUIA increased the prevalence of self-reported RTIs in the previous 12 months among car drivers and motorcyclists. A high prevalence of DUIA was evident among drivers, particularly motorcyclists. The DUIA was more prevalent among men and young adults. The DUIA was associated with an increased magnitude of self-reported RTIs among car drivers and motorcyclists. Despite the extensive legislation for zero tolerance toward DUIA in the country, actions need stricter enforcement. [ABSTRACT FROM AUTHOR]

Alcohol or drug impairment is a major risk factor for road traffic crashes, and studies on this issue are essential to provide evidence-based data for policymakers. In low- and middle-income countries (LMICs), such studies are often conducted in partnership with one or more organizations in high-income countries (HICs). The aim of this article is to provide recommendations for improving project planning and decision-making processes in epidemiological studies on alcohol, drug and traffic safety in LMICs involving HICs. We searched Pubmed, Google Scholar, and Google Search for articles and reports in English about lessons learned when conducting collaborative research in LMIC as well as papers presenting recommendations for effective research collaboration with partners in LMICs. Based on the search results, we selected 200 papers for full text examination. Few were related to studies on the effect of alcohol or drug use on road traffic safety. However, several conclusions and recommendations from other studies were found to be relevant. We combined the findings with our own experience in a narrative review. We also present a checklist for risk and quality assessment. Many papers presented similar recommendations, which included the importance of addressing local needs, ensuring adequate resources, local project ownership and leadership, establishing strong partnerships among all involved stakeholders, promoting shared decision-making and planning, and implementing strategies to translate research findings into policy, practice, and publications. It is also important to avoid HIC bias, which prioritizes the interests or perspectives of HICs over those of LMICs. [ABSTRACT FROM AUTHOR]

Driving under the influence (DUI) remains an important threat to public health in the United States, and a substantial literature has evaluated the effectiveness of state-mandated penalties. Researchers have overlooked accelerated use of obscured fees and surcharges levied by local and state court systems added to penalties in the past 15 years. We present data regarding DUI penalties for offenders with a blood alcohol content (BAC of 0.08) and the fees and surcharges attached to them in Minnesota, Illinois, Wisconsin, Michigan, and Iowa, and variation in these within Wisconsin at four BAC levels. In all states, surcharges and fees exceed penalty fines substantially. Variation within Wisconsin is also meaningful. Our data suggest that opaque costs in state court systems add a substantial financial burden to DUI penalties, particularly for those with lower incomes. An appraisal of the deterrent role of these added costs is warranted. [ABSTRACT FROM AUTHOR]

Real-life driving studies evaluating the impact of alcohol influence on the ability to park a car are rare but necessary to assess a possible impairment to drive a car in the event of prosecution. In this study, 29 test persons (13 m, 16 f) completed three test drives with real cars, each made up of three different parking situations. While four test persons remained sober, the majority drank a previously calculated amount of alcohol before the second drive; the aim was to reach a blood alcohol concentration (BAC) of 1.1 g/kg. The third drive took place about 2 h later without any further ingestion of alcohol. The impact of BAC on the number of accidents, time needed to finish the drive, the amount of correction moves and quality of the final parking position (in the centre of the parking space) were analysed. Furthermore, pressure measuring films were applied to the test cars, measuring the average pressure and load in the areas of the accident impact. A significant increase of accidents could be noted with rising BAC. While a single accident happened to both sober and drivers under the influence of alcohol, more than one accident was only seen in drivers after the ingestion of alcohol (> 0.63 g/kg). The BAC had no impact on the other considered aspects. Concludingly, more than one impact site or accident while parking a car can serve as an indication for alcohol impairment of the driver at the time of the accident. [ABSTRACT FROM AUTHOR]

Ride-hailing businesses, including Uber and Lyft, have reshaped road traffic since they first began operating in the United States approximately a decade ago. It follows that ride-hailing may also alter the incidence and distribution of road traffic crash injuries and deaths. The available evidence relating ride-hailing to crashes is critically reviewed in this article. We present a theoretical model that synthesizes the hypothesized mechanisms, and we identify common methodological challenges and suggest priorities for future research. Mixed results have been reported for the overall incidence of road traffic crash injuries and deaths, likely due to heterogeneous impacts on vehicular traffic flow (e.g., increasing the volume of vehicles); on vehicle-, person-, and event-level characteristics (e.g., reducing alcohol-impaired driver crashes); on road-user types (e.g., increasing pedestrian crashes); and on environmental conditions (e.g., reducing crashes most substantially where public transit access is poorest). The lack of a well-developed theory of human mobility and methodological challenges that are common to many ecological studies impede exploration of these sources of moderation. Innovative solutions are required to explicate ride-hailing's heterogeneous impacts, to guide policy that can take advantage of the public health benefits of ride-hailing, and to ensure that research keeps pace with technological advances that continue to reshape road traffic use.

Research summary: This study estimates disparities in driving under the influence (DUI) convictions relative to the frequency with which racial/ethnic groups engage in alcohol-impaired driving. We use had-been-drinking crashes and self-reported alcohol-impaired driving to approximate alcohol-impaired driving frequency for racial/ethnic groups in California from 2001 to 2016. DUI conviction and had-been-drinking crash data are from a sample of 72,368 California men aged 21–49 in 2001. Self-reported alcohol-impaired driving rates are from male Californians who responded to the Behavioral Risk Factor Surveillance System. Relative to race/ethnicity-specific estimated rates of engaging in alcohol-impaired driving, Latino/Hispanic men had higher rates of DUI conviction than White men. This suggests racial bias plays a role in DUI convictions, with White men experiencing a lower probability of conviction than Latino/Hispanic men who engage in similar behavior. Policy implications: These findings suggest actions aimed at reducing individual and structural biases could lead to more equitable DUI conviction rates. Such actions could include limiting discretion at each level of the criminal justice system, for example, by providing prescriptive guidance to officers on when to stop drivers or using local had-been-drinking crash rates to determine sobriety checkpoint and saturation patrol locations.

Abstract Background Data on driving under the influence of alcohol (DUIA) are not always available, accurate, or reliable, making it difficult to study the effects of alcohol policies on road traffic outcomes. The objectives of our study were twofold: 1) to describe how road traffic outcomes of alcohol policies are assessed when DUIA data are missing, and 2) to explore the effects of alcohol policies when DUIA data are missing. Methods We conducted a scoping review of non-randomized studies that assessed the road traffic outcomes of alcohol policies when DUIA data are missing. Until November 2021, we searched studies published between 2000 and 2021, in English or French, via MEDLINE, APA PsycInfo, CINAHL, and SocINDEX. We assessed the risk of bias in the included studies with the Quality Assessment Tool for Before-After (Pre-Post) Studies With No Control Group. The selection process, data extraction, and the risk of bias assessment were conducted independently and in duplicate. We used vote counting based on the direction of the effects of alcohol policies as a synthesis method. The protocol for this review was published in PROSPERO under record number CRD42021266744. Results Twenty-four eligible studies were included. Regarding objective 1, most studies used uncontrolled interrupted time series designs to assess road traffic fatalities resulting from night-time crashes. The reasons for missing DUIA data were generally not reported. Regarding objective 2, we found evidence for an association between alcohol policies and decreased road traffic fatalities. Subgroup analyses found no evidence for an association between methodological modifiers and positive effect directions for road traffic fatalities. Conclusion Caution is needed when interpreting road traffic outcomes associated with alcohol policies when DUIA data are missing. Greater efforts should be made to improve the reporting of outcomes assessments. Future studies must address several methodological issues (e.g., more granular data, well-defined intervention and implementation, and controlled designs). Our results should be compared to those from others reviews where DUIA data were available to confirm or recalibrate the associations found in studies where DUIA data were missing.

Driving under the influence (DUI) of alcohol or drugs is a major contributing factor to road traffic crashes. Most countries have implemented legal limits for alcohol, and some countries have also implemented legislation on DUI of drugs, in most cases impairment-based or zero- tolerance legislation. Based on searching PubMed, Google Scholar, and the internet, we identified several jurisdictions that had defined legal limits for drugs in the road traffic legislation. This included ten European countries, seven US states, Canada, and New Zealand. Most of these jurisdictions have defined low limits corresponding to the “lower effect limits” proposed by the European DRUID Project, and four countries have also defined higher, graded sanction limits, for some drugs. There were large variations between jurisdictions.

ABSTRACT OBJECTIVE This study aimed to measure the proportion of Uber use instead of drinking and driving in ten Brazilian capitals, in 2019. METHODS A cross-sectional survey was developed in ten Brazilian capitals. Data were collected in agglomeration points (AP) and sobriety checkpoints (SC). Based on responses to a standardized questionnaire, the proportion of drivers who used Uber instead of drinking and driving was measured for total sample of each methodology and stratified by municipality, age group, gender, education level, and type of vehicle. Fisher’s exact test was used to make comparisons between the strata. RESULTS A total of 8,864 drivers were interviewed. The most used means of transport to replace driving after drinking alcohol was the Uber system (AP: 54.6%; 95%CI: 51.2–58.0. SC: 58.6%; 95%CI: 55.2–61.9). Most of these users were aged from 18 to 29 years, women, with at least one higher education degree. According to the AP methodology, the highest magnitude of this indicator was found in Vitória (ES) (71.0%; 95%CI: 63.5–77.5), whereas the lowest was observed in Teresina (PI) (33.1%; 95%CI: 22.7–45.5). According to the SC methodology, the highest magnitude of the indicator was also found in Vitória (ES) (78.3%; 95%CI: 68.8–85.5), whereas the lowest was observed in Boa Vista (RR) (36.6%; 95%CI: 26.8–47.7). CONCLUSION In Brazilian capitals, the study showed higher proportions of Uber use instead of drinking and driving. This type of scientific evidence on factors associated with road traffic injuries presents the potential to guide public health interventions.

Driving under the influence (DUI) is one of the major causes of traffic crashes in Taiwan, leading to huge medical expenditures and human capital loss. Although the authorities have enacted several policies to reduce drunk driving, most penalties are based on drunk drivers' alcohol levels. According to Taiwan regulations, drivers could pay a fine to refuse the breath test if they are not involved in a traffic collision, and there is no clear evidence showing that they are DUI. Therefore, increased sanctions for DUI may lead to increased breath test refusals. If breath tests for drunk driving could be refused with little or no punishments for drivers, then the detection of behavioral impairment would weaken, and the deterrent effect of DUI punishment would be limited. This research uses interrupted time-series analysis (ITSA) to examine how policy reforms from 2007 to 2020 affected driver's breath refusal rate in Taiwan. We find that said reforms that exclusively increase the punishment of DUI offenders did raise the refusal rate immediately and persistently, suggesting that more drunk drivers would refuse a breath test to avoid more severe DUI punishment. Policy reforms that increase penalties for drivers refusing to take breath tests may instantly lower the refusal rate, but the long-term effects are contingent upon the DUI punishment. It appears that drunk drivers could still decide on breath test refusal to avoid a DUI conviction if the punishment for refusing the test is less severe than that for DUI. Aggravating penalties for refusing breath tests would decrease the refusal rate and help reinforce DUI's deterrent effect. [ABSTRACT FROM AUTHOR]

Driving under the influence (DUI) of alcohol is a road safety problem. Driving license regranting is based on the evaluation of medicolegal and toxicological variables that may include serum carbohydrate‐deficient transferrin (CDT) and hair ethyl glucuronide (hEtG). The aim of the study was to compare the diagnostic performance of CDT and hEtG in a population of DUI offenders. Other factors potentially associated with heavy alcohol use were explored. The population included DUI offenders examined during the period of January 1, 2019, through June 30, 2022. Sociodemographic, medicolegal, and toxicological variables were collected. CDT in serum and EtG in head hair were determined in all subjects. Excessive alcohol intake (hEtG ≥30 pg/mg) was considered cause for unfitness to drive. Cohen's kappa coefficient was calculated. Descriptive analyses were performed using chi‐square and Mann–Whitney tests. Variables significantly different between the groups were included in a multivariate binary logistic regression model. The sample encompassed 838 subjects (case group: 179, comparison group: 689). CDT exhibited poor agreement (κ = 0.053) with hEtG as the reference test. Lower education, age at DUI, heavy smoking, and GGT levels associated with heavy alcohol consumption differentiated the two groups. For DUI offenders, the use of CDT to assess heavy alcohol consumption is limited, possibly due to the time‐window assessed, the time required for normalization, and the different amount of ethanol needed to reach higher CDT levels, in comparison to hEtG; thus, hEtG assessment is strongly recommended for this population. Heavy smoking, GGT, education, and age could be related to heavy alcohol consumption and higher risk of DUI. [ABSTRACT FROM AUTHOR]

Pedestrian fatality rates in the US began to increase in 2009, after three decades of decline. This increase is occurring at the same time policy makers are encouraging walking as a healthy and sustainable transportation mode. The increase in pedestrian fatalities is also concurrent with the spread of liberalization of marijuana use laws across the US. Has the liberalization of marijuana laws contributed to the increase in pedestrian fatalities?Using a Poisson regression generalized difference in difference design, we measure the relationship between pedestrian fatalities and liberalization of marijuana laws. We employ randomization inference since persistent idiosyncratic shocks in the state time series may create spurious correlations that inflate type 1 error rates for conventional hypothesis tests. Consistent with the alcohol substitution hypothesis, we find both medical and recreational marijuana laws are followed by a statistically significant reduction in daytime fatalities involving alcohol. Both are also followed by a reduction in nighttime fatalities involving alcohol, but the declines are not statistically significant.

Background: Data on driving under the influence of alcohol (DUIA) are not always available, accurate, or reliable, making it difficult to study the effects of alcohol policies on road traffic outcomes. The objectives of our study were twofold: 1) to describe how road traffic outcomes of alcohol policies are assessed when DUIA data are missing, and 2) to explore the effects of alcohol policies when DUIA data are missing. Methods: We conducted a scoping review of non-randomized studies that assessed the road traffic outcomes of alcohol policies when DUIA data are missing. Until November 2021, we searched studies published between 2000 and 2021, in English or French, via MEDLINE, APA PsycInfo, CINAHL, and SocINDEX. We assessed the risk of bias in the included studies with the Quality Assessment Tool for Before-After (Pre-Post) Studies With No Control Group. The selection process, data extraction, and the risk of bias assessment were conducted independently and in duplicate. We used vote counting based on the direction of the effects of alcohol policies as a synthesis method. The protocol for this review was published in PROSPERO under record number CRD42021266744. Results: Twenty-four eligible studies were included. Regarding objective 1, most studies used uncontrolled interrupted time series designs to assess road traffic fatalities resulting from night-time crashes. The reasons for missing DUIA data were generally not reported. Regarding objective 2, we found evidence for an association between alcohol policies and decreased road traffic fatalities. Subgroup analyses found no evidence for an association between methodological modifiers and positive effect directions for road traffic fatalities. Conclusion: Caution is needed when interpreting road traffic outcomes associated with alcohol policies when DUIA data are missing. Greater efforts should be made to improve the reporting of outcomes assessments. Future studies must address several methodological issues (e.g., more granular data, well-defined intervention and implementation, and controlled designs). Our results should be compared to those from others reviews where DUIA data were available to confirm or recalibrate the associations found in studies where DUIA data were missing. [ABSTRACT FROM AUTHOR]

Background: Driving under the influence of alcohol (DUI) can he studied from several angles. One is the study of the socio-cognitive factors that underlie this behavior. The Theory of Planned Behavior (TPB) has successfully explained DUI. Objectives: i) to synthesize and characterize the articles that approached DUI within the TPB framework in the last ten years, ii) to describe methodological aspects of the articles, and iii) to identify key concepts and research gaps. Methods: We followed the PRISMA ScR guideline. We included articles from 2011 to 2021 in English, Spanish and Portuguese. We excluded articles focused on risky driving (not specific to DUI), articles that studied cycling under the influence, articles that only included one TPB dimension (e.g., attitudes), and articles that focused on another substance. Sources of evidence: PubMed, Scielo, Lilacs, Science Direct, Base, and Scilit databases, complemented with manual searches from articles' references. The data search was conducted in December 2021. After removing duplicates and screening abstracts and full articles, 29 articles were included. Results: in its different versions, the TPB model helps to predict driving under the influence of alcohol and the intention to do it. However, we found no unified criteria for assessing the model dimensions and a wide range of explained variance. Research gaps: Among others, we highlight the low amount of studies from Global South countries. Conclusion: The TPB framework helps to understand the socio-cognitive reasons why people intend and decide to DUI. Future studies should try to overcome limitations regarding how the TPB dimensions are measured, power estimations, and Global South sources. [ABSTRACT FROM AUTHOR]

Classification systems concerning driving-impairing medicines can help healthcare providers identify medicinal drugs with no or the least impairing effects and inform patients of the potential risks of certain medicines to safe driving. This study aimed to comprehensively assess the characteristics of classifications and labeling systems regarding driving-impairing medicines. Google Scholar and several databases, including PubMed, Scopus, Web of Science, EMBASE, safetylit.org, and TRID were searched to identify the relevant published material. The retrieved material was assessed for eligibility. Data extraction was done to compare the categorization/labeling systems concerning driving-impairing medicines in terms of characteristics such as the number of categories, description of each category, and description of pictograms. After screening 5,852 records, 20 studies were selected for inclusion in the review. This review identified 22 categorization/labeling systems regarding medicines and driving. Classification systems had different characteristics, but most of them were designed based on the graded categorization system described by Wolschrijn. Initially, categorization systems had seven levels, but later the medicine impacts were summarized into 3 or 4 levels. Although different categorization/labeling systems regarding driving-impairing medicines are available, the most effective systems in changing driver's behavior are the simple and understandable ones. Besides, health care providers should consider patient's socio-demographic features when informing them about driving under the influence. [ABSTRACT FROM AUTHOR]

ImportanceAlcohol use is a risk factor for firearm-related violence, and firearm owners are more likely than others to report risky drinking behaviors.ObjectiveTo study the association between prior convictions for driving under the influence (DUI) and risk of subsequent arrest for violent crimes among handgun purchasers.DesignIn this retrospective, longitudinal cohort study, 79 678 individuals were followed up from their first handgun purchase in 2001 through 2013. The study cohort included all legally authorized handgun purchasers in California aged 21 to 49 years at the time of purchase in 2001. Individuals were identified using the California Department of Justice (CA DOJ) Dealer's Record of Sale (DROS) database, which retains information on all legal handgun transfers in the state.ExposuresThe primary exposure was DUI conviction prior to the first handgun purchase in 2001, as recorded in the CA DOJ Criminal History Information System.Main outcomes and measuresPrespecified outcomes included arrests for violent crimes listed in the Crime Index published by the Federal Bureau of Investigation (murder, rape, robbery, and aggravated assault), firearm-related violent crimes, and any violent crimes.ResultsOf the study population (N=79 678), 91.0% were males and 68.9% were white individuals; the median age was 34 (range, 21-49) years. The analytic sample for multivariable models included 78 878 purchasers after exclusions. Compared with purchasers who had no prior criminal history, those with prior DUI convictions and no other criminal history were at increased risk of arrest for a Crime Index-listed violent crime (adjusted hazard ratio [AHR], 2.6; 95% CI, 1.7-4.1), a firearm-related violent crime (AHR, 2.8; 95% CI, 1.3-6.4), and any violent crime (AHR, 3.3; 95% CI, 2.4-4.5). Among purchasers with a history of arrests or convictions for crimes other than DUI, associations specifically with DUI conviction remained.Conclusions and relevanceThis study's findings suggest that prior DUI convictions may be associated with the risk of subsequent violence, including firearm-related violence, among legal purchasers of handguns. Although the magnitude was diminished, the risk associated with DUI conviction remained elevated even among those with a history of arrests or convictions for crimes of other types.

Literature shows that Latinos who drink are more likely to experience alcohol-related consequences and less likely to seek care for alcohol misuse than Whites. We aim to understand characteristics, consumption patterns, and openness to treatment among Latino first-time offenders driving under the influence. Latino participants were significantly younger (29.0 years) than non-Latinos (37.7 years). In adjusted models, Latino participants were significantly more likely than non-Latinos to binge drink, but there were no significant group differences in amount of alcohol consumed in a typical week. There was no significant difference in incidence of alcohol-related consequences, readiness to change drinking, and driving behaviors in this sample. [ABSTRACT FROM AUTHOR]

Pedestrian fatality rates in the US began to increase in 2009, after three decades of decline. This increase is occurring at the same time policy makers are encouraging walking as a healthy and sustainable transportation mode. The increase in pedestrian fatalities is also concurrent with the spread of liberalization of marijuana use laws across the US. Has the liberalization of marijuana laws contributed to the increase in pedestrian fatalities? Using a Poisson regression generalized difference in difference design, we measure the relationship between pedestrian fatalities and liberalization of marijuana laws. We employ randomization inference since persistent idiosyncratic shocks in the state time series may create spurious correlations that inflate type 1 error rates for conventional hypothesis tests. Consistent with the alcohol substitution hypothesis, we find both medical and recreational marijuana laws are followed by a statistically significant reduction in daytime fatalities involving alcohol. Both are also followed by a reduction in nighttime fatalities involving alcohol, but the declines are not statistically significant. • Pedestrian fatality rates in the US began to rise in 2009, concurrent with the liberalization of marijuana use laws. • Daytime alcohol related pedestrian fatalities fall after medical (p = 0.007) and recreational (p = 0.004) marijuana laws. • Nighttime alcohol related fatalities fall after medical (p = 0.383) and recreational (p = 0.348) marijuana laws. • Findings are consistent with the alcohol substitution hypothesis. [ABSTRACT FROM AUTHOR]

To examine the prevalence, frequency and characteristics of drug driving and being caught for a drug driving offense and their key correlates among people who used methamphetamine in rural and metropolitan areas of Victoria, Australia. Cross-sectional analysis of a sample of 744 people who used methamphetamine. Outcomes included self-reported drug driving (driving within three hours of consuming drugs, yes/no) and having been caught for a drug driving offense (yes/no). Sociodemographic (including rurality) and drug use variables were included in multivariable analyses. Of the 511 participants who reported driving in the six months prior to the survey, 407 (80%) reported drug driving (driving within three hours of taking an illicit drug). Most drug drivers (92.6%) reported taking methamphetamine (in combination with other drugs (59.5%) or in isolation (33.2%)) before driving. Most reported drug driving daily (31%) or weekly (25%), with passengers often (31%) or sometimes (28%). Most reported believing their driving was not at all impaired (49%), or only slightly impaired (32%) when preceded by drug taking. Multivariable analysis revealed that drug driving was not associated with rurality, nor with other socio-demographic characteristics. However, participants residing outside metropolitan areas were more likely to report having been caught previously for a drug driving offense (Adjusted odds ratio [aOR] = 1.93, 95% CI = 1.18–3.16). The majority of people within this cohort of people who used methamphetamine reported drug driving. An enhanced focus on public health campaigns and strategies to prevent drug driving is needed. [ABSTRACT FROM AUTHOR]

ObjectiveDriving under the influence of alcohol and/or drugs impairs skills essential for safe driving, increases the risk of being involved in a traffic accident and is particularly prevalent in Spain. The aim is to assess the prevalence of positive substance driving cases, what factors may be associated with driving after substance use, and the evolution of the progress in the prevalence of drug use among drivers in drivers based on the 2008, 2013, 2018, and 2021 studies.Study design and settingThe present study was conducted in a representative sample of Spanish drivers in 2021 for alcohol (breath) and psychoactive substances [oral fluid (OF)]. The sample size was 2980 drivers, mostly males (76.5%) with a mean age of 41.35 ± 13.34 years.ResultsIn 2021, 9.3% of drivers tested positive for alcohol and/or drugs. The presence of alcohol alone was observed in 4.2% of drivers, alcohol and another substance in 0.3%, a single drug in 4.4%, and two or drugs other than alcohol in 0.4%. Overall, cocaine cases were the highest registered in 2021 (2.4%), while cannabis (1.9%) and polydrug cases (0.7%) were the lowest, with respect to the 2008/2013/2018 studies.ConclusionsAccording to our research, in 2021, 9 out of 100 drivers were detected to have some substance in their system. This prevalence remains unacceptably high in Spain, with a marked increase in the frequency of driving after cocaine use. Further interventions and measures must be taken to avoid driving under the influence of alcohol and/or drugs.

BackgroundAlcohol consumption and problems are increasing among older adults, who are at elevated risk for alcohol-related accidents and medical problems. This paper describes a pilot follow-up of older adults with a history of alcohol dependence that was designed to determine the feasibility of conducting a more extensive investigation.MethodsThe sample consisted of previously assessed subjects in the Collaborative Studies on the Genetics of Alcoholism who: (i) were age 50+; (ii) had lifetime DSM-IV AD; and (iii) had DNA available. Individuals were located through family contacts, Internet searches, and death registries. A brief telephone interview assessed demographics, health, and alcohol involvement.ResultsOf the total sample (N = 2,174), 36% were contacted, 24% were deceased, and 40% were not yet located. Most (89%) contacted subjects were interviewed, and 99% of them agreed to future evaluation. Thirty percent of interviewed subjects reported abstinence for 10+ years, 56% reported drinking within the past year, and 14% last drank between >1 and 10 years ago. There were no age-related past-year differences in weekly consumption (overall sample mean: 16 drinks), number of drinking weeks (30.8), maximum number of drinks in 24 hours (8.1), or prevalence of weekly risky drinking (19%). Among those who drank within the past 5 years, the 3 most common alcohol-related problems were spending excessive time drinking or recovering (49%), drinking more/longer than intended (35%), and driving while intoxicated (35%); and about a third (32%) received some form of treatment.ConclusionsOver a 1-year period, we located 60% of individuals last seen an average of 23 years ago. The majority of contacted individuals were interviewed and willing to be evaluated again. Although the proportion of individuals currently drinking diminished with age, subjects exhibited troublesome levels of alcohol consumption and problems. Our findings suggest the importance and feasibility of a more comprehensive follow-up.

RationaleGamma-hydroxybutyrate acid (GHB), a GABAB receptor agonist approved for treatment of narcolepsy, impairs driving ability, but little is known about doses and plasma concentrations associated with impairment and time course of recovery.ObjectiveTo assess effects of oral GHB (Xyrem®) upon driving as measured by a driving simulator, and to determine plasma concentrations associated with impairment and the time course of recovery.MethodsRandomized, double-blind, two-arm crossover study, during which 16 participants received GHB 50 mg/kg orally or placebo. GHB blood samples were collected prior to and at 1, 3, and 6 h post dosing. Driving simulator sessions occurred immediately after blood sampling.ResultsPlasma GHB was not detectable at baseline or 6 h post dosing. Median GHB concentrations at 1 and 3 h were 83.1 mg/L (range 54-110) and 24.4 mg/L (range 7.2-49.7), respectively. Compared to placebo, at 1 h post GHB dosing, significant differences were seen for the life-threatening outcome collisions (p

Sentencing studies have stressed the importance of looking beyond between-court sentencing disparities by also observing within-court sources of variation. In the current study, we examine court- and judge-level variation in aggravated driving under the influence sentences (N = 10,481) in Finnish district courts using a three-level regression approach. Results indicate that 6.4% of the variance in the decision to incarcerate are explained by the differences between judges and 4.3% by the differences between courts. Consequently, our results suggest that sentencing disparities cannot be attributed solely to differences between courts but also to the individual judges within those courts. In addition, certain extra-legal factors on all three levels are associated with the outcome, namely the mode of conviction, position of the judge, court’s driving under the influence caseload, crime rate of the court jurisdiction and the urbanization of the court jurisdiction. Implications of the findings for both future research and policies are discussed. [ABSTRACT FROM AUTHOR]

Abstract Background Worldwide, alcohol-related road traffic accidents represent a major avoidable health risk. The aim of this study was to evaluate the accuracy of self-estimating the degree of acute alcohol intoxication regarding the legal driving limit, and to identify risk factors for misjudgement. Methods In this prospective randomised controlled crossover trial, 90 social drinkers (mean age 23.9 ± 3.5 years, 50% female) consumed either beer or wine. Study group subjects were made aware when exceeding the legal driving limit (BrAC = 0.05%). Controls received no information about their BrAC. For crossover, beer or wine were consumed in the opposite order. Results 39–53% of all participants exceeded the legal driving limit whilst under the impression to be still permitted to drive. Self-estimation was significantly more accurate on study day 2 (p = 0.009). Increasing BrAC positively correlated with self-estimation inaccuracy, which was reproducible during crossover. Multiple regression analysis revealed fast drinking and higher alcohol levels as independent risk factors for inaccurate self-estimation. Conclusions Social drinkers are commonly unaware of exceeding the legal driving limit when consuming alcohol. Self-estimating alcohol intoxication can be improved through awareness. Dedicated awareness programs, social media campaigns and government advice communications should be utilised to address this avoidable hazard. Trial registration The trial was registered prospectively at the Witten/Herdecke University Ethics Committee (trial registration number 140/2016 on 04/11/2016) and at the DRKS—German Clinical Trials Register (trial registration number DRKS00015285 on 08/22/2018—Retrospectively registered). Trial protocol can be accessed online.

Purpose: To assess the effects of alcohol on the ability to drive an e-scooter, driving tests reflecting real-life situations accompanied by medical examinations focusing on balance were conducted at different blood alcohol concentrations (BACs). Methods: Fifty-seven subjects who consumed alcohol (28 female, 29 male) and 6 consistently sober subjects (3 female, 3 male) participated in the study. Alcohol was administered on a fixed schedule, and the individual drinking quantity was individually calculated in advance using the Widmark formula. Repeated runs through a fixed course were performed. Following each ride, a blood sample was taken for BAC determination, and medical tests were performed. Results: Even at low BACs (0.21–0.60 g/kg), subjects showed a significant decrease in driving performance, to approximately 60% of the initial level. Differences in driving performance at different BAC ranges were observed for different obstacles, especially for the narrowing track, gate passage, slalom, and driving in circles obstacles. Furthermore, worse Romberg and Unterberger test results were correlated with worse driving performance. It cannot be assumed that learning effects during the study had a relevant effect, as shown in the comparison of the driving performance of the alcohol-consuming group with that of the control group. Sex-specific differences were not found. Discussion: Significant deteriorations in driving performance at BACs below 1.10 g/kg confirmed alcohol-related risk potential when using e-scooters. At this time, these findings may lead to the assumption of "relative driving impairment" in Germany. The Romberg and Unterberger tests could be considered a complementary investigation method for the assessment of e-scooter driving impairment. Conclusion: Even at rather low BACs between 0.21 and 0.40 g/kg, there was a significant deterioration in driving performance under the influence of alcohol compared to sober, which highlights the negative effects of alcohol on e-scooter driving. [ABSTRACT FROM AUTHOR]

The evaluation of drinking behaviors can help in limiting high‐risk situation, such as driving under the influence (DUI). We investigate ethyl glucuronide in hair (hEtG) levels to evaluate alcohol consumption behavior in subjects followed up after having been charged for DUI of psychoactive substances and/or alcohol. We performed a retrospective observational cohort study on 4328 subjects over 18 years old who underwent hEtG analysis in the period 2015–2019 in the Italian Province of Pavia. hEtG level was used as a proxy for the alcohol consumption behavior. Effects of age, sex, and district on alcohol drinking behavior were investigated with an ordinal logit model. A state sequence analysis was used to study people's alcohol consumption behavior over time. hEtG was found ≥7.0 pg/mg in 22.2% of the drivers (of which 7% has an hEtG ≥30.0 pg/mg). Among positive cases, a prevalence of males (96.3%) aged 35–44 (32.6%), coming from main city and hinterland (38.2%), was observed. The propensity to drink was higher for males (odds ratio [OR] ≈ 2.28, p < 0.001) and for subject coming from the district devoted to the cultivation of vineyards. Young age classes have a reduced drinking risk if compared to the drivers over 55 years old (p < 0.001). A general decreasing trend over time in hEtG values was observed. Being male, age ≥ 55 years, and coming from rural areas are potential risk factors related to alcohol drinking habits among drivers. Ethyl glucuronide in hair test in the driving license reissuing protocol contributed to decrease alcohol misuse behaviors. [ABSTRACT FROM AUTHOR]

The current meta-analysis explored the efficacy of the theory of planned behaviour (TPB) in predicting high-risk driving behaviours. Specifically, we examined speeding (in relation to exceeding the limit as well as speed compliance), driving under the influence, distracted driving, and seat belt use. We searched four electronic databases (i.e., PubMed, Web of Science, Scopus, and ProQuest) and included original studies that quantitatively measured the relationships between the TPB variables (attitude, subjective norm, perceived behavioural control [PBC], intention, and prospective/objective behaviour). The study identified 80 records with 94 independent samples. Studies were assessed for risk of bias using the JBI checklist for cross-sectional studies and compliance with the TPB guidelines. Together, attitude, subjective norm and PBC explained between 30 % and 51 % of variance found in intention, with attitude showing as the strongest predictor for intention across the different driving behaviours. The findings also showed that the model explained 36 %-48 % variance found in predicting the observed and/or prospective behaviours for distracted driving, speed compliance and speeding. Understanding the varying strengths and thus relative importance of TPB constructs in predicting different risky driving behaviours is crucial for developing targeted road safety interventions., Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2024 The Author(s). Published by Elsevier Ltd.. All rights reserved.)

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.

Background: With the decline of the use of ketamine, one of the common drugs of abuse in Hong Kong, detection of ketamine-related analogues in local laboratories has been encountered., Aim: A brief account of the occurrence of fluorodeschloroketamine (FDCK) in forensic cases is reported through a retrospective study of all drug seizures and driving under the influence of drugs (DUID) cases since its first appearance., Methods: Identification of FDCK in drug seizures was achieved through gas chromatography - mass spectrometry (GC-MS) and/or liquid chromatography - diode array detection (LC-DAD) methods while its quantification was performed using gas chromatography - flame ionization detection (GC-FID). For the analysis of blood samples in DUID cases, identification and quantification were performed using LC-MS/MS by monitoring the respective transitions of FDCK and fluorodeschloronorketamine (FDCNK) using ketamine-d 4 and norketamine-d 4 respectively as internal standards., Results: Since its first submission in November 2018, a total of 74 drug seizure cases (151 items) and 6 drug driving cases were encountered till December 2019. Drug seizures found with FDCK were physically similar to those of ketamine seizures. The majority of items were detected with FDCK only (103 items, ∼67%) or as a mixture of FDCK with ketamine (42 items, ∼28%). The drug purity detected with either FDCK only or FDCK mixed with ketamine was high which was similar to those purity found in ketamine seizures. The blood drug concentrations of FDCK of the 6 drug driving cases were in the range of <0.002-1.1 μg/mL and other psychoactive drug(s)/metabolite(s) were also identified. Except for one case where the analysis of the metabolite, fluorodeschloronorketamine (FDCNK), was not conducted due to insufficient sample, the FDCK (FDCNK) concentrations in blood found in the 6 cases were <0.002 (0.005), 0.002 (0.002), 0.002 (0.003), 0.02 (0.035), 0.87 (0.44) and 1.1 (not determined) μg/mL., Conclusions: With the drug seizures found with FDCK resembled in physical appearance with ketamine seizures, users might likely misuse it as ketamine. Though complicated by other drugs found, it is speculated that the two cases with higher concentration of FDCK found in blood (1.1 and 0.87 μg/mL) might have contributed to the impairment observed., Competing Interests: Declaration of Competing Interest The authors declare that they have no known financial or personal interest that could have appeared to influence the work reported in this paper., (Copyright © 2024 Elsevier B.V. All rights reserved.)

Background and aims: Cannabis and alcohol are frequently detected in fatal and injury motor vehicle crashes. While epidemiological meta‐analyses of cannabis and alcohol have found associations with an increase in crash risk, convergent evidence from driving performance measures is insufficiently quantitatively characterized. Our objectives were to quantify the magnitude of the effect of cannabis and alcohol—alone and in combination—on driving performance and behaviour. Methods: Systematic review and meta‐analysis. We systematically searched Academic Search Complete, CINAHL, Embase, Scopus, Google Scholar, MEDLINE, PsycINFO, SPORTDiscus and TRID. Of the 616 studies that underwent full‐text review, this meta‐analysis represents 57 studies and 1725 participants. We extracted data for hazard response time, lateral position variability, lane deviations or excursions, time out of lane, driving speed, driving speed variability, speed violations, time speeding, headway, headway variability and crashes from experimental driving studies (i.e. driving simulator, closed‐course, on‐road) involving cannabis and/or alcohol administration. We reported meta‐analyses of effect sizes using Hedges' g and r. Results: Cannabis alone was associated with impaired lateral control [e.g. g = 0.331, 95% confidence interval (CI) = 0.212–0.451 for lateral position variability; g = 0.198, 95% CI = 0.001–0.395 for lane excursions) and decreased driving speed (g = –0.176, 95% CI = –0.298 to –0.053]. The combination of cannabis and alcohol was associated with greater driving performance decrements than either drug in isolation [e.g. g = 0.480, 95% CI = 0.096–0.865 for lateral position variability (combination versus alcohol); g = 0.525, 95% CI = 0.049–1.002 for time out of lane (versus alcohol); g = 0.336, 95% CI = 0.036–0.636 for lateral position variability (combination versus cannabis; g = 0.475, 95% CI = 0.002–0.949 for time out of lane (combination versus cannabis)]. Subgroup analyses indicated that the effects of cannabis on driving performance measures were similar to low blood alcohol concentrations. A scarcity of data and study heterogeneity limited the interpretation of some measures. Conclusions: This meta‐analysis indicates that cannabis, like alcohol, impairs driving, and the combination of the two drugs is more detrimental to driving performance than either in isolation. [ABSTRACT FROM AUTHOR]

Isopropanol intoxication, whether accidental or intentional, is not unusual. Alcoholics have long‐resorted to isopropanol because of its availability and cost. The incidence of isopropanol intoxication with driving, however, has been reported only a few times in the literature. A unique case is reported where an individual intentionally drank isopropanol and was involved in a minor traffic incident. The individual's impairment was not consistent with a preliminary breath test of 0.062%. The officer proceeded to an evidential breath test, but received an "interferent‐detected" result, and then requested a drug recognition expert (DRE). A full DRE evaluation was performed, indicating central nervous system depressants, marijuana, and narcotic analgesics. Laboratory analysis included chromatographic testing for volatiles and an immunoassay drug screen. Results were positive for isopropanol and acetone; no other compounds were detected. This case report provides a unique comprehensive evaluation of a driver under the influence of isopropanol. [ABSTRACT FROM AUTHOR]

With a sample of college students in emerging adulthood (age range: 18–25), the current study investigated sex differences in the impact of parental psychological control and perceived social capital on three types of health-risk behaviors, including binge drinking, drug use, and driving under the influence (i.e., DUI). The moderation of social capital on the relations between parental psychological control and health-risk behaviors was also studied. The findings suggested that more paternal psychological control and less social capital were positively associated with binge drinking and drug use in men and all three types of risky behavior in women. However, maternal psychological control only predicted more binge drinking and drug use for women. Perceived social capital exacerbated the negative influence of paternal psychological control on males' drinking behaviors, whereas it buffered the effect of paternal psychological control on females' DUI behavior. Parenting programs need to focus on sex-specific parenting skills that can encourage children to develop internalized values and internalize positive social rules, attitudes, and behaviors. Prevention or intervention programs may consider enhancing the involvement of fathers in parenting and develop practices sensitive to paternal roles. Parents may consider capitalizing on community resources to facilitate female children's socialization. Highlights: Paternal psychological control predicted risky behaviors in men and women. Maternal psychological control was a risk factor to women's risk behaviors. Perceived social capital exacerbated the negative influence of paternal psychological control on males' drinking behaviors. Perceived social capital buffered the effect of paternal psychological control on females' driving under the influence behavior. [ABSTRACT FROM AUTHOR]

The ignition interlock device, an onboard alcohol detection system for supervising cases of driving under the influence (DUI), is crucial for ensuring traffic safety. As a key component of this system, ethanol sensor faces challenges like integration difficulties and poor anti-humidity property, limiting its potential applications. Herein, from the perspective of miniaturization and integration, a carbon-based field effect transistor (FET) gas sensor with a floating-gate (FG) structure is proposed for fast ethanol detection in exhaled breath. The proposed sensing FG structure enables the traditional FET to acquire the perceptibility toward target gas, and the FET with excellent amplification ability further enhances the gas-sensing response. The detection range of the sensor is 0–600 ppm, with a response deviation of merely 11 % toward 50 ppm ethanol within a humidity range of 10 %-90 % relative humidity (RH). Additionally, benefited from the good consistency of the semiconductor technology, relative standard deviation (RSD) of the responses from different batches is 2.1 %, confirming its potential for mass production. The tiny size (1.5 mm×1.5 mm) of the sensor and the compatible fabrication process with MEMS process are conducive to the on-chip integration. This work provides a boost to the process of advancing the research and development of automotive alcohol locks, and facilitate their popularization. • A chip-scale sensor used for alcohol lock is developed for drunk driving monitoring. • The response deviation of Pd/ZnO-FET sensor is only 11 % at the range of 10 %-90 % RH. • The whole manufacturing process adopting semiconductor technology enables microminiaturization and mass-production. [ABSTRACT FROM AUTHOR]

ObjectiveAddressing drinking and driving remains a challenge in the United States. The present study aims to provide feedback on driving under the influence (DUI) in California by assessing whether drinking and driving behavior is associated with the DUI arrest rates in the city in which the driver lives; whether this is due to perceptions that one can get arrested for this behavior; and whether this differed by those drivers who would be most affected by deterrence efforts (those most likely to drink outside the home).MethodsThis study consisted of a 2012 roadside survey of 1,147 weekend nighttime drivers in California. City DUI arrest rates for 2009-2011 were used as an indicator of local enforcement efforts. Population average logistic modeling was conducted modeling the odds of perceived high arrest likelihood for DUI and drinking and driving behavior within the past year.ResultsAs the DUI arrest rates for the city in which the driver lives increased, perceived high risk of DUI arrest increased. There was no significant relationship between either city DUI arrest rates or perceived high risk of DUI arrest with self-reported drinking and driving behavior in the full sample. Among a much smaller sample of those most likely to drink outside the home, self-reported drinking and driving behavior was negatively associated with DUI arrests rates in their city of residence but this was not mediated by perceptions.ConclusionThe results of the present study suggest that perceptions are correlated with one aspect of DUI efforts in one's community. Those who were more likely to drink outside the home could be behaviorally influenced by these efforts.

Risky driving behaviors are disproportionately high among young adults and impulsivity is a robust risk factor. Recent conceptualizations have proposed multidimensional facets of impulsivity comprised of negative urgency, premeditation, perseverance, sensation seeking, and positive urgency (UPPS-P model). Prior studies have found these facets are associated with risky driving behaviors in college student samples, but no prior studies have examined these facets in clinical samples. This study examined the unique and interactive effects of UPPS-P impulsivity facets on past-year risky driving behaviors in a sample of high-risk young adults (ages 18-30 years) with a history of substance use and antisocial behavior and their siblings (n=1,100). Multilevel Poisson regressions indicated that sensation seeking and negative urgency were uniquely and positively associated with both frequency of past-year reckless driving and driving under the influence. Moreover, lack of premeditation was uniquely and positively associated with reckless driving, whereas lack of perseverance was uniquely and positively associated with driving under the influence. Furthermore, lack of premeditation moderated and strengthened the positive association between sensation seeking and driving under the influence. These study findings suggest that assessing multiple facets of trait impulsivity could facilitate targeted prevention efforts among young adults with a history of externalizing psychopathology.

Objective. To report demographic and substance use characteristics and risk of road traffic injury (RTI) from alcohol use, cannabis use, and combined use in a sample of emergency department patients from two countries in Latin America and the Caribbean. Methods. A cross-sectional study in which patients 18 years and older admitted within six hours of suffering an RTI to one emergency department in Santa Domingo, Dominican Republic (n = 501) and in Lima, Peru (n = 431) were interviewed. Case-crossover analysis, based on self-reported use prior to the RTI, was used to analyze risk from alcohol, cannabis, and co-use. Results. Overall, 15.3% reported alcohol use prior to the event and 2.5% cannabis use. Drivers using alcohol only were over twice as likely to have an RTI (OR = 2.46, p < 0.001), and nearly eight times more likely if using both alcohol and cannabis (OR = 6.89, p < 0.01), but risk was not elevated for cannabis alone. Significant differences were not found for passengers or pedestrians. Conclusions. Risk of RTI for drivers in these two samples is significantly elevated from alcohol use, and more so for co-use with cannabis. Differences between the two countries underscore the need for similar data from the region to determine risk of RTI from substance use, including risk for passengers and pedestrians. Data suggest that alcohol contributes significantly to the burden of RTI, which calls for more stringent enforcement of alcohol control policy related to drink driving in the region.

• Lower risk perception of driving after cannabis use (DACU) is associated with higher likelihood in engaging in DACU. • Sociodemographic and psychological factors, substance use and driving behaviors, and peer influence shape risk perception related to DACU. • Low-risk perception DACU can be changed by modifying social norms and attitudes among cannabis users. Modifying risk perceptions related to driving after cannabis use (DACU) could deter individuals from enacting this behavior, as low-risk perception is associated with DACU engagement. This study identified sociodemographic characteristics, substance use, other driving behaviors, peer norms, and psychological characteristics that are associated with lower risk perception regarding DACU. Canadian drivers aged 17–35 who have used cannabis in the past year (n = 1,467) completed an online questionnaire. A multivariate linear regression model allowed for identifying variables associated with the low-risk perception of DACU (i.e. believing it to be safe as one's driving ability is not impaired by cannabis or by being high). Lower risk perception of DACU was associated with identifying as male, weekly to daily cannabis use, engagement in DACU, general risky driving behaviors, being a passenger of a driver who engages in DACU, number of friends who engage in DACU, and peer approval of DACU. Having driven under the influence of alcohol, living in urban areas, having received traffic tickets in the past three years, and declaring past-week irritability and cognitive problems were associated with holding a higher risk perception related to DACU. Road education and prevention programs should target attitudes and perceptions regarding risks shaped by sociocultural norms and past risky driving experiences. They need to reach out more specifically to drivers with the identified characteristics associated with the low-risk perception of DACU. These interventions can potentially help reduce the rate of individuals who engage in this behavior. [ABSTRACT FROM AUTHOR]

• Supervised drinking as a teen predicts alcohol misuse in adulthood. • Supervised drinking as a teen predicts alcohol impaired driving in adulthood. • Supervised drinking as a teen predicts riding with an impaired driver as an adult. • Adverse effects of supervised drinking are longitudinally similar in both countries. • Poor family management during the teens predicts alcohol-related harms in adulthood. Prior studies suggest that adult supervised drinking in adolescence predicts greater adolescent alcohol misuse. Long-term follow up data examining how adult supervised drinking during adolescence relates to alcohol misuse in adulthood are lacking. Longitudinal data from the International Youth Development Study tested associations between adult supervised drinking during adolescence (ages 13–16; 2002–2004) and adult alcohol misuse (ages 25–31; 2014, 2018, 2020). Cross-nationally matched samples were compared in Washington State, USA (n = 961) and Victoria, Australia (n = 1,957; total N = 2,918, 55 % female, 83 % White), where adult-supervised adolescent alcohol use was more common. Multilevel analyses adjusted for state, sex, adolescent drinking, parent education, family management, family history of substance use problems, and parent alcohol-related norms. Adult supervised drinking in adolescence (at dinner or parties, on holidays) predicted more adult alcohol misuse (mean Alcohol Use Disorders Identification Test score; b[SE] 0.07[0.03]; p = 0.004) and higher rates of alcohol-impaired driving (Odds Ratio [OR] 1.501, p = 0.034) and riding with an alcohol-impaired driver (OR 1.669, p = 0.005), but not the use of strategies to moderate alcohol intake (e.g., counting drinks). Better family management (monitoring, clear rules) in adolescence predicted less adult alcohol misuse. Associations were similar in the two states. Reducing the frequency of adult supervised drinking and improving family management practices in adolescence may help to decrease alcohol misuse well into adulthood. Findings support the widespread implementation of substance use prevention and family management training programs. [ABSTRACT FROM AUTHOR]