DRUGS IN INJURED DRIVERS

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DRUGS IN INJURED DRIVERS
Inger Marie Bernhoft, Senior Researcher,
M.Sc. Danish Transport Research Institute
www.dtf.dk
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Objectives

• To get information on accident involved drivers
• Drug impairment, medicinal and illicit
• Drug and alcohol impairment
• Demonstration of the relation between drugs and
  traffic accidents
• Attitudes to driving under the influence of drugs
  and medicines
• Knowledge of drugs that may impair driving

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MethodA qualitative approach - Interviews

• The mental state of the driver prior to the
  accident
• Impaired by medicinal drugs
• Impaired by illicit drugs
• Subjective opinion on the ability to drive the
  trip
• The course of the accident
• Accident causation factors
• Knowledge of drugs
• Knowledge about the effect on driving
• Who provided the driver with the drugs
• Impact on behaviour in traffic after the accident

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Data collection

• Detection of impairment
• Saliva samples
• patients visiting the casualty department
• patients brought to the casualty department
• Blood samples
• patients admitted to the orthopaedic department
• Analysis of specimen - both saliva and blood
• Screening (Cozart Micro plate EIA kit)
• Confirmation of positive samples (GC-MS, LC-MS/MS)

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333 patients included in the survey

• Drug positive patients (26)
• drug positive while driving - 23 patients
• 15 patients - 1 drug, 5 of these also alcohol
  impaired
• 8 patients - 2 drugs, 4 of these also alcohol
  impaired
• 16 patients illegal drugs
• impaired driving abilities 15 patients
• 9 drivers strong suspicion of impairment
• 6 drivers impairment is likely
• Self reported drug use (26)

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• Confirmed drugs
• Medicinal drugs
• 10 benzodiazepines
• 3 morphine
• 1 codeine
• Illicit drugs
• 4 amphetamines
• 1 ecstasy
• 11 cannabis
• 2 benzoylegonine

• Self-reported drugs
• Medicinal drugs
• Antirheumatics
• Antihypotensiva
• Analgesics
• Antihistamines
• Antiepilepticum
• Barbiturates
• Benzodiazepines
• Codeine
• Psychoactive drugs
• Tranquillizer
• Illicit drugs
• Cannabis

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Results accident causation factors
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Results characteristics

• Young persons
• men, non academics
• well functioning, under education or working
• illicit drugs
• Middle aged persons
• mostly men, early retired
• prescribed medicines
• former alcohol dependency or alcoholics
• Older persons
• over-the-counter or prescribed medicines
• no alcohol

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Results knowledge

• Young persons
• Do not mix drugs and alcohol
• Think that alcohol is worse than drugs when
  driving
• Knowledge from school
• Middle aged and older persons
• Some were also alcohol impaired
• Take prescribed medicinal drugs
• Are very concerned about their medicine use
• Are not aware of the enhanced risk
• Knowledge from other sources than the GP

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Results impact on behaviour

• Most of the interviewees take more care after the
  accident
• Some start using seat belt
• No changes in use of prescribed medicine
• No changes in mixing alcohol and medicines
• Young men say that they will try to stop using
  drugs

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Conclusions and recommendations

• Saliva seems to result in many false positives
• Screening kits can only detect a few different
  drugs
• Accident factors are mostly related to the driver
• Combination of alc/drugs and other human factors
• More specific information is needed regarding
• Warnings of prescribed medicines
• Combined use of drugs and alcohol
• Health consequences of using illicit drugs