Skip to main content
Key Specialties
Cardiology Diabetology Endocrinology Gastroenterology Geriatrics and Gerontology Gynecology and Obstetrics Hematology Infectious Disease Internal Medicine Nephrology Neurology Oncology Pediatrics Respiratory Medicine Rheumatology Surgery
Congress Coverage
2024 ACC Congress 2023 ESMO Congress 2023 EASD Congress 2023 ERS Congress 2023 ESC Congress
Clinical Collections
Advances in Alzheimer’s

At a glance: The STEP trials

A round-up of the STEP phase 3 clinical trials evaluating semaglutide for weight loss in people with overweight or obesity.
ADVANCED SEARCH
Log in
Top
BMC Public Health
Published in: BMC Public Health 1/2012

Open Access 01-12-2012 | Research article

Alcohol, psychoactive substances and non-fatal road traffic accidents - a case-control study

Authors: Stig Tore Bogstrand, Hallvard Gjerde, Per Trygve Normann, Ingeborg Rossow, Øivind Ekeberg

Published in: BMC Public Health | Issue 1/2012

Login to get access

Abstract

Background

The prevalence of alcohol and other psychoactive substances is high in biological specimens from injured drivers, while the prevalence of these psychoactive substances in samples from drivers in normal traffic is low. The aim of this study was to compare the prevalence of alcohol and psychoactive substances in drivers admitted to hospital for treatment of injuries after road traffic accidents with that in drivers in normal traffic, and calculate risk estimates for the substances, and combinations of substances found in both groups.

Methods

Injured drivers were recruited in the hospital emergency department and drivers in normal conditions were taken from the hospital catchment area in roadside tests of moving traffic. Substances found in blood samples from injured drivers and oral fluid samples from drivers in moving traffic were compared using equivalent cut off concentrations, and risk estimates were calculated using logistic regression analyses.

Results

In 21.9% of the injured drivers, substances were found: most commonly alcohol (11.5%) and stimulants eg. cocaine or amphetamines (9.4%). This compares to 3.2% of drivers in normal traffic where the most commonly found substances were z-hypnotics (0.9%) and benzodiazepines (0.8%). The greatest increase in risk of being injured was for alcohol combined with any other substance (OR: 231.9, 95% CI: 33.3- 1615.4, p < 0.001), for more than three psychoactive substances (OR: 38.9, 95% CI: 8.2- 185.0, p < 0.001) and for alcohol alone (OR: 36.1, 95% CI: 13.2- 98.6, p < 0.001). Single use of non-alcohol substances was not associated with increased accident risk.

Conclusion

The prevalence of psychoactive substances was higher among injured drivers than drivers in normal moving traffic. The risk of accident is greatly increased among drivers who tested positive for alcohol, in particular, those who had also ingested one or more psychoactive substances. Various preventive measures should be considered to curb the prevalence of driving under the influence of psychoactive substances as these drivers constitute a significant risk for other road users as well as themselves.
Literature
1.
Bogstrand ST, Normann PT, Rossow I, Larsen M, Morland J, Ekeberg O: Prevalence of alcohol and other substances of abuse among injured patients in a Norwegian emergency department. Drug Alcohol Depend. 2011, 117: 132-138. 10.1016/j.drugalcdep.2011.01.007.CrossRefPubMed
2.
Drummer OH, Kourtis I, Beyer J, Tayler P, Boorman M, Gerostamoulos D: The prevalence of drugs in injured drivers. Forensic Sci Int. 2012, 215: 14-7. 10.1016/j.forsciint.2011.01.040.CrossRefPubMed
3.
Walsh JM, Flegel R, Cangianelli LA, Atkins R, Soderstrom CA, Kerns TJ: Epidemiology of alcohol and other drug use among motor vehicle crash victims admitted to a trauma center. Traffic Inj Prev. 2004, 5: 254-260. 10.1080/15389580490465319.CrossRefPubMed
4.
Behrensdorff I, Steentoft A: Medicinal and illegal drugs among Danish car drivers. Accid Anal Prev. 2003, 35: 851-860. 10.1016/S0001-4575(02)00090-8.CrossRefPubMed
5.
Gjerde H, Normann PT, Pettersen BS, Assum T, Aldrin M, Johansen U, et al: Prevalence of alcohol and drugs among Norwegian motor vehicle drivers: a roadside survey. Accid Anal Prev. 2008, 40: 1765-1772. 10.1016/j.aap.2008.06.015.CrossRefPubMed
6.
Vanlaar W: Drink driving in Belgium: results from the third and improved roadside survey. Accid Anal Prev. 2005, 37: 391-397. 10.1016/j.aap.2004.12.001.CrossRefPubMed
7.
Gjerde H, Normann PT, Christophersen AS, Samuelsen SO, Morland J: Alcohol, psychoactive drugs and fatal road traffic accidents in Norway: a case–control study. Accid Anal Prev. 2011, 43: 1197-1203. 10.1016/j.aap.2010.12.034.CrossRefPubMed
8.
Movig KL, Mathijssen MP, Nagel PH, van Egmond T, De Gier JJ, Leufkens HG, et al: Psychoactive substance use and the risk of motor vehicle accidents. Accid Anal Prev. 2004, 36: 631-636. 10.1016/S0001-4575(03)00084-8.CrossRefPubMed
9.
Mura P, Kintz P, Ludes B, Gaulier JM, Marquet P, Martin-Dupont S, et al: Comparison of the prevalence of alcohol, cannabis and other drugs between 900 injured drivers and 900 control subjects: results of a French collaborative study. Forensic Sci Int. 2003, 133: 79-85. 10.1016/S0379-0738(03)00052-5.CrossRefPubMed
10.
Woratanarat P, Ingsathit A, Suriyawongpaisal P, Rattanasiri S, Chatchaipun P, Wattayakorn K, et al: Alcohol, illicit and non-illicit psychoactive drug use and road traffic injury in Thailand: a case–control study. Accid Anal Prev. 2009, 41: 651-657. 10.1016/j.aap.2009.03.002.CrossRefPubMed
11.
Kelly E, Darke S, Ross J: A review of drug use and driving: epidemiology, impairment, risk factors and risk perceptions. Drug Alcohol Rev. 2004, 23: 319-344. 10.1080/09595230412331289482.CrossRefPubMed
12.
Verstraete AG: Detection times of drugs of abuse in blood, urine, and oral fluid. Ther Drug Monit. 2004, 26: 200-205. 10.1097/00007691-200404000-00020.CrossRefPubMed
13.
Lacey JH, Kelley-Baker T, Furr-Holden D, Brainard K, Moore C: Pilot Test of New Roadside Survey Methodology for Impaired Driving. 2007, Springfield, VA: National Technical Information ServiceCrossRef
14.
Gjerde H, Verstraete AG: Estimating equivalent cutoff thresholds for drugs in blood and oral fluid using prevalence regression: A study of tetrahydrocannabinol and amphetamine. Forensic Sci Int. 2011, 212: e26-e30. 10.1016/j.forsciint.2011.06.024.CrossRefPubMed
15.
Longo MC, Hunter CE, Lokan RJ, White JM, White MA: 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 drive the drug-positive group. Accid Anal Prev. 2000, 32: 613-622. 10.1016/S0001-4575(99)00111-6.CrossRefPubMed
16.
Gjerde H, Christophersen AS, Skuterud B, Klemetsen K, Morland J: Screening for drugs in forensic blood samples using EMIT urine assays. Forensic Sci Int. 1990, 44: 179-185. 10.1016/0379-0738(90)90248-W.CrossRefPubMed
17.
Christophersen AS, Gulliksen M, Hasvold I, Johansen U, Karinen R, Ripel A, et al: Screening, confirmation and quantification of drugs of abuse in whole blood by LC-MS (ESI). Abstracts of the 39th Meeting of The International Association of Forensic Toxicologists (TIAFT), August 26-30, 2001, Prague. Edited by: Balikova M, Novakova E. 2001, Prague: Charles University, P85-
18.
Gjerde H, Fongen U, Gundersen H, Christophersen AS: Evaluation of a method for simultaneous quantification of codeine, ethylmorphine and morphine in blood. Forensic Sci Int. 1991, 51: 105-110. 10.1016/0379-0738(91)90210-A.CrossRefPubMed
19.
Christophersen AS: Tetrahydrocannabinol stability in whole blood: plastic versus glass containers. J Anal Toxicol. 1986, 10: 129-131.CrossRefPubMed
20.
Gjerde H, Hasvold I, Pettersen G, Christophersen AS: Determination of amphetamine and methamphetamine in blood by derivatization with perfluorooctanoyl chloride and gas chromatography/mass spectrometry. J Anal Toxicol. 1993, 17: 65-68.CrossRefPubMed
21.
Kristoffersen L, Smith-Kielland A: An automated alcohol dehydrogenase method for ethanol quantification in urine and whole blood. J Anal Toxicol. 2005, 29: 387-389.CrossRefPubMed
22.
Morland J: Driving under the Influence of Non-Alcohol Drugs. Forensic Science Review. 2000, 12: 79-106.PubMed
23.
Houwing S, Hagenzieker M, Mathijssen R, Bernhoft IM, Hels T, Janstrup K, et al: Prevalence of Alcohol and Other Psychoactive Substances in Drivers in General Traffic. Part 1: General Results. 2011, Leidschendam: SWOV
24.
Øiestad EL, Johansen U, Christophersen AS: Drug screening of preserved oral fluid by liquid chromatography-tandem mass spectrometry. Clin Chem. 2007, 53: 300-309.CrossRefPubMed
25.
Vindenes V, Jordbru D, Knapskog AB, Kvan E, Mathisrud G, Slordal L, et al: Impairment based legislative limits for driving under the influence of non-alcohol drugs in Norway. Forensic Sci Int. 2012, 219: 1-11. 10.1016/j.forsciint.2011.11.004.CrossRefPubMed
26.
Verstraete A, Knoche A, Jantos R, Skopp G, Gjerde H, Vindenes V: Per Se Limits - Methods of Defining Cut-off Values for Zero Tolerance. DRUID Deliverable D1.4.2. 2011, Ghent: Ghent University
27.
Taylor B, Irving HM, Kanteres F, Room R, Borges G, Cherpitel C, et al: The more you drink, the harder you fall: a systematic review and meta-analysis of how acute alcohol consumption and injury or collision risk increase together. Drug Alcohol Depend. 2010, 110: 108-116. 10.1016/j.drugalcdep.2010.02.011.CrossRefPubMedPubMedCentral
28.
Borkenstein RF, Crowther RF, Shumate RP, Ziel WB, Zylman R: The role of the drinking driver in traffic accidents (The Grand Rapids Study). Blutalkohol. 1974, 11 (Suppl. 1): 1-131.
29.
Blomberg RD, Peck RC, Moskowitz H, Burns M, Fiorentino D: The Long Beach/Fort Lauderdale relative risk study. J Safety Res. 2009, 40: 285-292. 10.1016/j.jsr.2009.07.002.CrossRefPubMed
30.
Christophersen AS, Morland J: Frequent detection of benzodiazepines in drugged drivers in Norway. Traffic Inj Prev. 2008, 9: 98-104. 10.1080/15389580701869190.CrossRefPubMed
31.
32.
Fell JC, Voas RB: The effectiveness of reducing illegal blood alcohol concentration (BAC) limits for driving: evidence for lowering the limit to .05 BAC. J Safety Res. 2006, 37: 233-243. 10.1016/j.jsr.2005.07.006.CrossRefPubMed
33.
Babor T, Caetano R, Edwards G, Giesbrecht N, Graham K, et al: Alcohol: No ordinary commodity. Reseach and public policy. 2010, Oxford: Oxford University Press, 2CrossRef
34.
Wagenaar AC, Salois MJ, Komro KA: Effects of beverage alcohol price and tax levels on drinking: a meta-analysis of 1003 estimates from 112 studies. Addiction. 2009, 104: 179-190. 10.1111/j.1360-0443.2008.02438.x.CrossRefPubMed
35.
Wagenaar AC, Toomey TL: Effects of minimum drinking age laws: review and analyses of the literature from 1960 to 2000. J Stud Alcohol Suppl. 2002, Suppl. 14: 206-225.CrossRef
36.
Brand DA, Saisana M, Rynn LA, Pennoni F, Lowenfels AB: Comparative analysis of alcohol control policies in 30 countries. PLoS Med. 2007, 4: e151-10.1371/journal.pmed.0040151.CrossRefPubMedPubMedCentral
37.
Shults RA, Elder RW, Nichols JL, Sleet DA, Compton R, Chattopadhyay SK: Effectiveness of multicomponent programs with community mobilization for reducing alcohol-impaired driving. Am J Prev Med. 2009, 37: 360-371. 10.1016/j.amepre.2009.07.005.CrossRefPubMed
38.
Elder RW, Voas R, Beirness D, Shults RA, Sleet DA, Nichols JL, et al: Effectiveness of ignition interlocks for preventing alcohol-impaired driving and alcohol-related crashes: a Community Guide systematic review. Am J Prev Med. 2011, 40: 362-376. 10.1016/j.amepre.2010.11.012.CrossRefPubMed
39.
Elder RW, Shults RA, Sleet DA, Nichols JL, Thompson RS, Rajab W: Effectiveness of mass media campaigns for reducing drinking and driving and alcohol-involved crashes: a systematic review. Am J Prev Med. 2004, 27: 57-65. 10.1016/j.amepre.2004.03.002.CrossRefPubMed
40.
Matthews A, Bruno R, Johnston J, Black E, Degenhardt L, Dunn M: Factors associated with driving under the influence of alcohol and drugs among an Australian sample of regular ecstasy users. Drug Alcohol Depend. 2009, 100: 24-31. 10.1016/j.drugalcdep.2008.08.012.CrossRefPubMed
41.
Appenzeller BM, Schneider S, Yegles M, Maul A, Wennig R: Drugs and chronic alcohol abuse in drivers. Forensic Sci Int. 2005, 155: 83-90. 10.1016/j.forsciint.2004.07.023.CrossRefPubMed
42.
Havard A, Shakeshaft AP, Conigrave KM, Doran CM: Randomized controlled trial of mailed personalized feedback for problem drinkers in the emergency department: the short-term impact. Alcohol Clin Exp Res. 2012, 36: 523-531. 10.1111/j.1530-0277.2011.01632.x.CrossRefPubMed
Metadata
Title
Alcohol, psychoactive substances and non-fatal road traffic accidents - a case-control study
Authors
Stig Tore Bogstrand
Hallvard Gjerde
Per Trygve Normann
Ingeborg Rossow
Øivind Ekeberg
Publication date
01-12-2012
Publisher
BioMed Central
Published in
BMC Public Health / Issue 1/2012
Electronic ISSN: 1471-2458
DOI
https://doi.org/10.1186/1471-2458-12-734

Other articles of this Issue 1/2012

BMC Public Health 1/2012 Go to the issue

Study protocol

The early identification of risk factors on the pathway to school dropout in the SIODO study: a sequential mixed-methods study

Study protocol

Enhancing self-regulation as a strategy for obesity prevention in Head Start preschoolers: the growing healthy study

Study protocol

Efficacy of a text messaging (SMS) based smoking cessation intervention for adolescents and young adults: Study protocol of a cluster randomised controlled trial

Research article

Aspects of functioning and environmental factors in medical work capacity evaluations of persons with chronic widespread pain and low back pain can be represented by a combination of applicable ICF Core Sets

Research article

Family affluence and cultural capital as indicators of social inequalities in adolescent’s eating behaviours: a population-based survey

Research article

Physical and mental health among caregivers: findings from a cross-sectional study of Open University students in Thailand