Trends in reports of driving following illicit drug consumption among regular drug users in Australia, 2007-2013: Has random roadside drug testing had a deterrent effect?

Increase in driving after cocaine use in Spain: a cross-sectional dataset analysis for 2021

Objective

Driving 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 setting

The 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.

Results

In 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.

Conclusions

According 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.

What contributes to drug driving? An exploratory investigation into the influence of problematic substance use, roadside testing and alternative transport options

Despite a strong reliance on enforcement approaches to prevent drug driving in Australia, this behaviour is still prevalent. The objective of this study was to investigate the influence of problematic drug use (i.e., showing indications of addiction), exposure to roadside drug testing, the use of detection avoidance strategies, and perceptions relating to alternative transport options on drug driving among illicit drug users. A total of 1,541 licensed drivers from the states of Queensland, New South Wales, and Victoria completed an online survey. The survey collected demographic and problematic substance use information, as well as items assessing drug driving behaviour. Cannabis was reported to be the most commonly used drug (36.0%); the most common drug of problematic use (27.9%), and the drug most often taken prior to driving (43.5%). Observing police operating Roadside Drug Tests (RDT) was more common among the participants than being tested by RDT (35.7% vs 23%). The results indicated a significant association between being a drug driver and observing or being tested by RDT. The drug drivers were significantly more likely to report using a range of strategies to avoid police detection than the non-drug drivers. Similarly, the drug drivers reported that it was more difficult for them to use various alternative transport options than the non-drug drivers. Decision tree analyses found that significant predictors of self-reported drug driving were problematic drug use, holding a provisional or probationary licence, earning a low- or middle-income, and using detection avoidance strategies like remaining watchful for police vehicles and taking back streets. The findings of this study suggest that ongoing improvements to drug driving enforcement will need to be complemented by health-based approaches designed to reduce drug abuse and dependence, and improvements to public transport, in order to achieve a sustainable reduction in drug driving.

The prevalence of drug driving and being caught for a drug driving offense among community-recruited people who use methamphetamine in metropolitan and rural Victoria, Australia

OBJECTIVE

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.

METHODS

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.

RESULTS

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).

CONCLUSIONS

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.

A study into the nature and extent of drug driving recidivism in Queensland (Australia)

INTRODUCTION

While research has reported on overall prevalence rates of drug driving, the extent of recidivist offending has yet to be explored. The objective of this research was to examine recidivistic behaviors detected through Roadside Drug Testing (RDT) in Queensland (between December 2007 and June 2020), with a focus on: Delta-9-tetrahydrocannabinol (THC), 3,4-Methylenedioxymethylamphetamine (MDMA), and methamphetamine (MA).

METHOD

Data were provided by the Queensland Police Service, and contained information on positive drug detections that were confirmed via laboratory analysis.

RESULTS

The analyses revealed 50,442 unique offenders with a total of 67,727 offenses, as 25% (N = 12,490) of all offenders had been apprehended more than once (ranging from 2 to 11 offences). MA use was more common among recidivist offenders, whereas THC was more common for those with one offense. On average, the days between offenses decreased with increases in offense number.

CONCLUSIONS

The findings provide evidence for the extent of drug driving recidivism on Queensland roads.

PRACTICAL APPLICATIONS

To deter recidivists and the greater motorist population from drug driving, there is need for greater resources dedicated to RDT to increase both the perceived and real likelihood of detection.

A systematic review of factors associated with illegal drug driving

Drug driving is a serious problem worldwide that can increase the risk of road crashes. This systematic review seeks to identify factors associated with drug driving (i.e., driving after consuming drugs other than alcohol) to highlight gaps in existing knowledge and inform the design of more effective countermeasures. A search of the literature was conducted for the period January 1, 2005 to July 31, 2021 using six different databases. The search protocol followed PRISMA guidelines and was registered in PROSPERO (#CRD42021234616). Studies that met inclusion criteria compared drug drivers with either non-drug drivers, alcohol-only drivers or drug drivers from an earlier time period, to identify factors specifically associated with drug driving, rather than common to all drivers. Two hundred and nineteen publications met the inclusion criteria and were included within the review. Based on the findings, a logic model was developed that presents the factors associated with drug driving. Various sociodemographic, psychosocial and legal factors emerged as the main factors associated with illegal drug driving. At the sociodemographic and psychological levels, drug drivers were more likely to be single, young males who often drive after using cannabis and who score high on sensation-seeking and impulsivity scales. The key social factor found to be associated with drug driving was peer acceptance/disapproval of the behaviour. At the legal level, the review suggested that the effectiveness of current enforcement approaches to drug driving vary among jurisdictions around the world due to differences in the level of perceived certainty of apprehension and the chances of punishment avoidance. Future research into the anticipated and actual rewards for drug driving is needed to inform the development of more effective countermeasures.

Investigating self-regulation in young adults who drug-drive

OBJECTIVE

Drug-driving among young adults is a growing concern. Methods other than enforcement are required to reduce engagement in such behavior. Research has identified satisfaction of individual's inherent psychological needs is predictive of positive behavioral outcomes sustainable in the long-term via the internalization of self-regulatory processes. Drug-driving behavior and self-regulation was explored through the lens of self-determination theory's needs-supportive model.

METHODS

An online cross-sectional survey of 304 participants (males = 78), aged 18-24 years (M = 20.61, SD = 1.92) was conducted. Participants were recruited via convenience sampling across Queensland, Australia. Measures included drug use, drug-driving behavior and self-regulation.

RESULTS

A hierarchical binary logistic regression showed that, aside from problematic drug use predicting drug-driving, higher scores for age, effort/importance, an indicator of internalization of regulatory processes, and trait self-regulation significantly predicted a decrease in the likelihood of young adult drug-driving, with 61% variance accounted for in the model.

CONCLUSIONS

Problematic drug use as the underlying issue contributing to drug-driving requires continued attention. However, viewing the issue of drug-driving as the result of unmet inherent psychological needs supports the notion that meeting these needs may reduce drug-driving in the long-term, instead of relying on the short-term effectiveness of enforcement measures. The study contributes to the limited research understanding the role of self-regulation in drug-driving behaviors. The implications of these findings include recommendations for psychological-based interventions guided by self-determination theory targeting young adults' drug-driving and more generally their long-term safe driving practices.

Do they need to be tested to be deterred? Exploring the impact of exposure to roadside drug testing on drug driving

INTRODUCTION

Maximizing the deterrent effects of Roadside Drug Testing (RDT) operations remains critical for improving road safety. While preliminary research has explored the impact of being tested at RDT sites, there is yet to be an investigation of different types of exposure (e.g., seeing an operation, being tested) and the subsequent relationship(s) with perceptions of certainty of apprehension and future intentions to offend. The overall objective of this research was to explore these relationships with a sample of drug takers.

METHOD

A total of 803 Queensland motorists aged between 16 and 75 (M = 27.12, SD = 13.09) completed an online-based survey, and all reported consuming marijuana, MDMA, and/or methamphetamine at least once in the previous 12 months. A convenience sampling method was utilized (via Facebook).

RESULTS

The drug driving proportion of the sample (58%) reported a total of 30,858 instances of drug driving, or 66 instances on average. Seeing RDT in the previous 12 months (26% of sample) was more common than being tested at RDT (7%). The results indicated that seeing RDT two or more times was related to increased certainty of apprehension (compared to those who had seen it only once or never), although the increase was relatively small. Correlational analyses suggest there were some positive (albeit weak relationships) between exposure to RDT (seen and tested) and past and future offending. However, only three significant predictors of future offending emerged: older age, lower perceptions of apprehension certainty, and greater use of marijuana. Practical Applications: The results illuminate the extent of the drug driving problem and the need for greater resourcing to increase the real threat of detection. While the effect of exposure to enforcement was small, it was positive, incremental and supportive of increased roadside police enforcement as well as further research to quantify such deterrent processes.

Interventions to Prevent Drugged Driving: A Systematic Review

CONTEXT

Literature suggests that cannabis legalization may increase fatal motor vehicle collisions. However, evidence on the effectiveness of interventions to prevent drugged driving is limited.

EVIDENCE ACQUISITION

MEDLINE, PsycINFO, Web of Science, Embase, SafetyLit, Criminal Justice Database, Transport Research International Documentation, bibliographies, and relevant gray literature were searched systematically through May 2020. Randomized and nonrandomized studies of preventive interventions measuring drugged driving outcomes were included. Evidence certainty was judged per Grading of Recommendations Assessment, Development, and Evaluation guidelines to designate quality ratings from very low to high.

EVIDENCE SYNTHESIS

The search identified 11 RCTs and 17 nonrandomized studies conducted predominantly among youth (aged 15-25 years; n=33,711 of 37,117 active research participants). In the public, cannabis packaging with health warnings increases the knowledge about drugged driving effects (high certainty); roadside drug testing can reduce drugged driving among cannabis users (moderate certainty); media campaigns may increase deterrent attitudes and knowledge (low certainty); and state sanctions, including traffic offense criminalization, license withdrawal, and per se drugged driving laws, may have little or no effect on drug-related fatalities or injuries (very low-low certainty). For youth or previous offenders, motivational interviewing can prevent drugged driving and driver education programs can increase knowledge (moderate certainty), whereas drug abuse prevention, substance abuse treatment, and driver rehabilitation may prevent drugged driving (very low certainty).

CONCLUSIONS

Overall, there is evidence to support the interventions that may improve drugged driving knowledge, attitudes, and behaviors. However, the impact of such interventions on measures of drugged driving-related morbidity and mortality is uncertain. Further research is urgently required to address these gaps in knowledge.

An Update to Aircrew Grounding Periods After Ketamine Use

INTRODUCTION: Ketamine is a rapidly acting general anesthetic which is globally used in surgical analgesia, as well as in the management of pain. It is also used as a recreational drug. Because of its widespread use in surgical settings, the use of this drug presents an aeromedical problemin addition, of course, to the underlying condition for which it has been used. The literature around the mechanisms and side effects of ketamine is reasonably mature, and it is possible to make fairly dependable risk management decisions about return to flying based on the information available. Accordingly, following ketamine use it is recommended that aviators be grounded for 48 h following Aviation Medical Examiner review. If review is unavailable, the aviator should be grounded for 1 wk to allow sufficient time to identify the existence of prolonged side effects, such as psychomimetic effects or cognitive changes.Boyd NL, Navathe PD. An update to aircrew grounding periods after ketamine use. Aerosp Med Hum Perform. 2021; 92(8):670-675.

Prevalence of alcohol and other psychoactive substances in motor vehicle drivers in Spain, 2018: Cross-sectional dataset analysis with studies from 2008 and 2013

Driving under the influence of substances is particularly common in developed countries. In Spain, in 2010, roadside oral fluid drug screening became mandatory, and in 2014, the zero tolerance legal system was established. The aim of the current study is to analyze the prevalence of alcohol (in breath) and drugs (in oral fluids) in a representative sample of motor vehicle drivers in Spain in 2018. This study focuses specifically on multiple substance use (i.e., polysubstance use), and seeks to analyze the factors associated with driving after consumption of substances, as well as the evolution of the presence of drugs in drivers from 2008, 2013 and 2018 studies. A total of 2881 drivers were included in this study. In 2018, alcohol was detected in 3.9 % of the cases, alcohol plus another substance(s) was found in 0.8 % of the cases, only one drug (excluding alcohol) made up 5.1 % of the cases and drivers testing positives to more than one drug at a time (apart from alcohol) constituted 1.1 %. There were less cases of positives for any drugs or alcohol in 2018 and 2013 (2018: 10.9 %, z=3.6, p=0.0003; 2013: 9.3 %, z=5.7, p<0.0001) than in 2008 (14.0 %), yet the frequency observed in 2018 is more than that of 2013 (z=2, p=0.05). Multiple drug use (without alcohol), increased from 0.5 % in 2008 to 1.1 % in 2018 (z=2.2, p=0.03). Alcohol/drug driving continues to be frequent in Spain, leading to the need for intervention in this field, particularly on polydrug use and driving.

Assessing the validity of eyelid parameters to detect impairment due to benzodiazepines

OBJECTIVE

Benzodiazepines impair driving ability and psychomotor function. Eyelid parameters accurately reflect drowsiness; however, the effects of benzodiazepines on these measures have not been extensively studied. The aim of this study was to investigate the effect of benzodiazepines on eyelid parameters and evaluate their accuracy for detecting psychomotor impairment.

METHODS

Eyelid parameters were recorded during a psychomotor vigilance task (PVT) and driving simulation over 2 days, baseline, and after 20-mg oral temazepam. The utility of eyelid parameters for detecting PVT lapses was evaluated using receiver operating characteristic curves, and cut-off levels indicating impairment (≥1 and ≥2 PVT lapses per min) were identified. The accuracy of these cut-off levels for detecting driving simulator crashes was then examined.

RESULTS

PVT and driving simulator performance was significantly impaired following benzodiazepine administration (p < .05). Average eyelid closure duration (inter-event duration) was a reliable indicator of PVT lapses (area under the curve [AUC] of 0.87-0.90). The cut-off value of eyelid closure duration derived from PVT AUC was able to predict driving simulator crashes with moderately high sensitivity and specificity (76.23% and 75.00%).

CONCLUSIONS

Eyelid parameters were affected by benzodiazepines and accurately detected the psychomotor impairment. In particular, eyelid closure duration is a promising real-time indicator of benzodiazepine impairment.

Illicit drugs are now more common than alcohol among South Australian crash-involved drivers and riders

Objectives: For a jurisdiction to apply appropriate countermeasures for impaired driving, it is necessary to track drug and alcohol involvement in road crashes. In South Australia, it is mandated that all injured road users aged over 10 who attend a hospital for treatment must have a blood sample taken, which is tested for alcohol and drugs. The drug testing covers the three drugs included in South Australia's roadside drug testing program: delta-9-tetrahydrocannabinol (THC or cannabis), methamphetamine ('ice') and 3,4-methylenedioxymethamphetamine (MDMA or 'ecstasy').Methods: The present study involved analysis of the results of drug tests from 2014 to 2017 for road users over the age of 16 at the major trauma hospital in Adelaide, the capital city of South Australia. Comparisons were made to the results of blood tests from an earlier study using data from 2008 to 2010.Results: It was found in the most recent dataset that just over 11 per cent of drivers and just under 5 per cent of motorcyclists had a blood alcohol concentration (BAC) above the legal limit of 0.05 g/100 ml. In regard to the three proscribed drugs, the rates for both drivers and motorcyclists were over 15 per cent. Among drivers, methamphetamine was most common (9.7%), followed by THC (6.3%). Among motorcyclists, THC was most common (9.4%), followed by methamphetamine (6.2%). Inspection of data from 2008 to 2010 reveals that rates of having an illegal BAC when involved in a crash have declined over the past decade (from 20.2% down to 9.3%), while rates of drug use among crash involved drivers and riders have increased (from 10.5% to 15.2%).Conclusions: Although the apparent decline in alcohol involvement in road crashes in recent years in South Australia is to be welcomed, the increasing proportion of road crashes involving drug impaired drivers, particularly those affected by methamphetamine, is cause for concern. A National Drug Driving Working Group has been set up by Austroads to examine improvements in drug driving enforcement practices. The recommendations arising from their work need to be considered for implementation to prevent rising drug driving crashes from replacing the reduction in road crashes attributable to drink driving.

Drivers who tested positive for cannabis in oral fluid: a longitudinal analysis of administrative data for Spain between 2011 and 2016

OBJECTIVES

This study aimed to assess the association between positive roadside tests for delta-9-tetrahydrocannabinol (THC) and other driving-impairing substances and THC concentrations and the age and gender of THC-positive drivers.

DESIGN

This study is based on administrative data.

SETTING, PARTICIPANTS AND EXPOSURES

National administrative data on drivers who tested positive in confirmation analysis of driving-impairing substances in oral fluid were assessed (2011-2016, 179 645 tests).

PRIMARY AND SECONDARY OUTCOME MEASURES

Frequencies of positivity for THC, THC alone and THC plus non-THC substances (stratification by age and gender in 2016) and THC concentration were obtained. Comparisons and univariate and multivariate regression analyses were performed.

RESULTS

Of the 65 244 confirmed drug-positive tests, 51 869 were positive for THC (79.5%). In 50.8% of the THC-positive tests, cocaine and amphetamines were also detected. Positivity for THC and non-THC substances predominated among drivers with low THC concentrations and represented 58.6% of those with levels lower than 25 ng/mL. The mean±SD for age was 29.6±7.7 years (year 2016, n=24 941). Men accounted for 96.3% of all THC-positive drivers. With increasing age, positivity for THC decreased (OR 0.948; 95% CI 0.945 to 0.952; p<0.0001), and positivity for THC and non-THC substances increased (OR 1.021; 95% CI 1.017 to 1.024; p<0.0001). Men were associated with higher THC concentrations (OR 1.394; 95% CI 1.188 to 1.636; p<0.0001).

CONCLUSIONS

Cannabis positivity is frequent among drivers, and polysubstance use is common. Hence, focusing on younger drivers and those with low THC concentrations is encouraged. This study provides evidence on the current implementation of roadside drug testing in Spain and aims to characterise driving under the influence (DUI) of cannabis to increase the awareness of all involved to help them avoid DUI.

Bad behaviour or societal failure? Perceptions of the factors contributing to drivers' engagement in the fatal five driving behaviours

The so-called 'fatal five' behaviours (drink and drug driving, distraction and inattention, speeding, fatigue, and failure to wear a seat belt) are known to be the major behavioural contributory factors to road trauma. However, little is known about the factors that lead to drivers engaging in each behaviour. This article presents the findings from a study which collected and analysed data on the factors that lead to drivers engaging in each behaviour. The study involved a survey of drivers' perceptions of the causes of each behaviour and a subject matter expert workshop to gain the views of road safety experts. The results were mapped onto a systems ergonomics model of the road transport system in Queensland, Australia, to show where in the system the factors reside. In addition to well-known factors relating to drivers' knowledge, experience and personality, additional factors at the higher levels of the road transport system related to road safety policy, transport system design, road rules and regulations, and societal issues were identified. It is concluded that the fatal five behaviours have a web of interacting contributory factors underpinning them and are systems problems rather than driver-centric problems. The implications for road safety interventions are discussed.