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Mørland J, Innerdal CR, Markussen O, Vindenes V, Aamo TO, Slørdal L. Faste grenser for andre rusgivende stoff enn alkohol i veitrafikken. TIDSSKRIFT FOR DEN NORSKE LEGEFORENING 2024; 144:24-0160. [PMID: 38934312 DOI: 10.4045/tidsskr.24.0160] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/28/2024] Open
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Jamt REG, Bukten A, Stavseth MR, Bogstrand ST, Tverborgvik T. All-cause and cause-specific mortality among individuals imprisoned for driving under the influence of alcohol and drugs in Norway (2000-2016): a retrospective cohort study. BMJ Open 2023; 13:e078848. [PMID: 38159948 PMCID: PMC10759136 DOI: 10.1136/bmjopen-2023-078848] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/14/2023] [Accepted: 11/27/2023] [Indexed: 01/03/2024] Open
Abstract
AIMS To describe all-cause and cause-specific mortality and to investigate factors associated with mortality among individuals imprisoned for driving under the influence (DUI) of alcohol and psychoactive drugs in the Norwegian prison population. DESIGN Retrospective cohort study. The Norwegian prison registry was linked to the Norwegian Cause of Death Registry (2000-2016). SETTING Norway. PARTICIPANTS/CASES The cohort consisted of 96 856 individuals imprisoned in Norway over a 17-year period obtained from the Norwegian prison registry. PRIMARY AND SECONDARY OUTCOME MEASURES Adjusted ORs (aOR) with 95% CI were calculated for death due to any, natural and unnatural causes of death. Analyses were stratified according to DUI convictions: no DUI convictions, only DUI convictions (DUI only), DUI and at least one other drug and alcohol conviction (DUI drug), and DUI and at least one conviction other than drug and alcohol conviction (DUI other). RESULTS In total, 29.3% individuals had one or more imprisonments for DUI. The risk of all-cause mortality was elevated for those convicted for DUI, but only in combination with other types of crimes (DUI drug: aOR=1.5, 95% CI 1.4 to 1.6, DUI other: aOR=1.2, 95% CI 1.1 to 1.4). The risk of death from natural causes was significantly elevated for DUI drug (aOR: 1.8, 95% CI 1.6 to 2.0) and for DUI other (aOR=1.3, 95% CI 1.1 to 1.6). The risk of death from unnatural causes was lower for DUI only (aOR=0.8, 95% CI 0.7 to 0.9) and elevated for DUI drug (aOR=1.5, 95% CI 1.3 to 1.6). CONCLUSIONS The risk of all-cause mortality was significantly elevated for those convicted of DUI, but only in combination with other types of crimes.
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Affiliation(s)
| | - Anne Bukten
- Norwegian Centre For Addiction Research, University of Oslo, Oslo, Norway
- Section for Clinical Addiction Research, Oslo University Hospital, Oslo, Norway
- University College of Norwegian Correctional Service, Lillestrøm, Norway
| | - Marianne Riksheim Stavseth
- Norwegian Centre For Addiction Research, University of Oslo, Oslo, Norway
- Section for Clinical Addiction Research, Oslo University Hospital, Oslo, Norway
| | - Stig Tore Bogstrand
- Department of Forensic Sciences, Oslo University Hospital, Oslo, Norway
- Department of Public Health Science, University of Oslo, Oslo, Norway
| | - Torill Tverborgvik
- Norwegian Centre For Addiction Research, University of Oslo, Oslo, Norway
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Bråthen CC, Jørgenrud BM, Bogstrand ST, Gjerde H, Rosseland LA, Kristiansen T. Prevalence of use and impairment from drugs and alcohol among trauma patients: A national prospective observational study. Injury 2023; 54:111160. [PMID: 37944451 DOI: 10.1016/j.injury.2023.111160] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/07/2023] [Revised: 10/22/2023] [Accepted: 10/23/2023] [Indexed: 11/12/2023]
Abstract
BACKGROUND Being under the influence of psychoactive substances increases the risk of involvement in and dying from a traumatic event. The study is a prospective population-based observational study that aims to determine the prevalence of use and likely impairment from psychoactive substances among patients with suspected severe traumatic injury. METHOD This study was conducted at 35 of 38 Norwegian trauma hospitals from 1 March 2019 to 29 February 2020. All trauma admissions for patients aged ≥ 16 years admitted via trauma team activation during the study period were eligible for inclusion. Blood samples collected on admission were analysed for alcohol, benzodiazepines, benzodiazepine-like hypnotics (Z-drugs), opioids, stimulants, and cannabis (tetrahydrocannabinol). RESULTS Of the 4878 trauma admissions included, psychoactive substances were detected in 1714 (35 %) and in 771 (45 %) of these, a combination of two or more psychoactive substances was detected. Regarding the level of impairment, 1373 (28 %) admissions revealed a concentration of one or more psychoactive substances indicating likely impairment, and 1052 (22 %) highly impairment. Alcohol was found in 1009 (21 %) admissions, benzodiazepines and Z-drugs in 613 (13 %), opioids in 467 (10 %), cannabis in 352 (7 %), and stimulants in 371 (8 %). Men aged 27-43 years and patients with violence-related trauma had the highest prevalence of psychoactive substance use with respectively 424 (50 %) and 275 (80 %) testing positive for one or more compounds. CONCLUSION The results revealed psychoactive substances in 35 % of trauma admissions, 80 % of which were likely impaired at the time of traumatic injury. A combination of several psychoactive substances was common, and younger males and patients with violence-related injuries were most often impaired. Injury prevention strategies should focus on high-risk groups and involve the prescription of controlled substances. We should consider toxicological screening in trauma admissions and incorporation of toxicological data into trauma registries.
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Affiliation(s)
- Camilla C Bråthen
- Department of Acute Medicine, Division of Elverum-Hamar, Innlandet Hospital Trust, 2381 Brumunddal, Norway; Institute of Clinical Medicine, University of Oslo, 0318 Oslo, Norway.
| | - Benedicte M Jørgenrud
- Department of Forensic Sciences, Division of Laboratory Medicine, Section of Drug Abuse Research, Oslo University Hospital, 0424 Oslo, Norway
| | - Stig Tore Bogstrand
- Department of Forensic Sciences, Division of Laboratory Medicine, Section of Drug Abuse Research, Oslo University Hospital, 0424 Oslo, Norway; Faculty of Health Sciences, Department of Nursing and Health Promotion, Acute and Critical Illness, Oslo Metropolitan University, 0130 Oslo, Norway; Department of Public Health Science, Institute of Health and Society, Faculty of Medicine, University of Oslo, 0318 Oslo, Norway
| | - Hallvard Gjerde
- Department of Forensic Sciences, Division of Laboratory Medicine, Section of Drug Abuse Research, Oslo University Hospital, 0424 Oslo, Norway
| | - Leiv Arne Rosseland
- Institute of Clinical Medicine, University of Oslo, 0318 Oslo, Norway; Department of Research & Development, Division of Emergencies and Critical Care, Oslo University Hospital, 0424 Oslo, Norway
| | - Thomas Kristiansen
- Institute of Clinical Medicine, University of Oslo, 0318 Oslo, Norway; Department of Anaesthesiology, Division of Emergencies and Critical Care, Radiumhospitalet, Oslo University Hospital, 0424 Oslo, Norway
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Gjerde H, Bogstrand ST, Jamt REG, Vindenes V. Crash-involved THC-positive drivers in Norway have a high frequency of polysubstance use. Drug Alcohol Depend 2023; 244:109800. [PMID: 36774807 DOI: 10.1016/j.drugalcdep.2023.109800] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/17/2022] [Revised: 01/25/2023] [Accepted: 01/26/2023] [Indexed: 02/11/2023]
Abstract
BACKGROUND Tetrahydrocannabinol (THC) is the most frequently detected drug in blood samples from apprehended drug driving suspects in Norway. This investigation aimed to study the extent of polysubstance use among apprehended crash-involved drivers with THC concentrations above the legal limit and explore the importance of THC in polysubstance cases. METHODS We selected all drug driving cases where blood samples had been submitted for forensic toxicology testing after involvement in road traffic crashes during 2013-2020, except drivers who were fatally injured. RESULTS Twenty percent (n = 2133) of the 10,520 apprehended crash-involved drivers had concentrations of THC in their blood above the legal limit of 1.3 ng/mL, and 84 % of those also had concentrations of alcohol or other drugs above the legal limits; 61 % for sedatives, 38 % for stimulants, 33 % for alcohol, and 10 % for opioids. The most frequent substance combination was cannabis together with sedatives and stimulants (22.9 %; n = 488). Polysubstance use was least common among drivers under 24 years. The proportion of drivers with THC > 5 ng/mL was highest if the blood sample was collected within 90 min after the crash, and when only THC was detected. There was a statistically significant inverse association between THC > 5 ng/mL and concentrations of alcohol or amphetamines at the highest sanction level. CONCLUSIONS Most apprehended crash-involved THC-positive drivers also tested positive for other psychoactive substances. Drivers with high blood THC concentrations had less often high concentrations of other substances; cannabis might then have been a more important contributor to impairment.
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Affiliation(s)
- Hallvard Gjerde
- Section of Drug Abuse Research, Department of Forensic Sciences, Oslo University Hospital, Oslo, Norway.
| | - Stig Tore Bogstrand
- Section of Drug Abuse Research, Department of Forensic Sciences, Oslo University Hospital, Oslo, Norway; Department of Public Health Science, Institute of Health and Society, Faculty of Medicine, University of Oslo, Oslo, Norway; Department of Nursing and Health Promotion, Acute and Critical Illness, Faculty of Health Sciences, OsloMet - Oslo Metropolitan University, Oslo, Norway
| | - Ragnhild Elén Gjulem Jamt
- Section of Drug Abuse Research, Department of Forensic Sciences, Oslo University Hospital, Oslo, Norway
| | - Vigdis Vindenes
- Section of Drug Abuse Research, Department of Forensic Sciences, Oslo University Hospital, Oslo, Norway; Department of Forensic Medicine, Institute of Clinical Medicine, Faculty of Medicine, University of Oslo, Oslo, Norway
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Gjerde H, Frost J. Prevalence of alcohol and drugs among drivers killed in road traffic crashes in Norway during 2011-2020. TRAFFIC INJURY PREVENTION 2023; 24:256-261. [PMID: 36763459 DOI: 10.1080/15389588.2023.2174801] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/01/2022] [Revised: 01/26/2023] [Accepted: 01/26/2023] [Indexed: 06/18/2023]
Abstract
OBJECTIVE Driving under the influence of alcohol or drugs is one of the main contributing causes of serious road traffic crashes (RTCs). This study aimed to investigate the involvement of alcohol and drugs in driver fatalities in Norway during 2011-2020 and compare the findings with data from the previous decade. METHODS We linked the results of forensic toxicology testing for alcohol and the 17 most commonly used drugs assigned with legal limits with data on fatal road traffic crashes obtained from Statistics Norway and the Norwegian Public Roads Administration. RESULTS The number of fatalities had decreased significantly since the previous decade, while the proportion of drivers and riders tested for alcohol and drug use increased. Blood alcohol concentrations at the legal limit or higher were found in 14.4% and psychoactive drugs were detected in 15.8% of the cases; 10.7% tested positive for illicit drugs, and 10.1% for medicinal drugs. The most prevalent illicit drugs were tetrahydrocannabinol (7.9%) and amphetamine/methamphetamine (4.7%), whereas the most prevalent medicinal drugs were clonazepam (3.7%) and diazepam (2.2%). CONCLUSIONS There was a marked reduction in the number of motor vehicle drivers killed in RTCs compared with the previous decade, and also a reduction in the prevalence of alcohol. For other substances, there were no marked changes in the prevalence.
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Affiliation(s)
- Hallvard Gjerde
- Department of Forensic Sciences, Oslo University Hospital, Oslo, Norway
| | - Joachim Frost
- Department of Clinical Pharmacology, St. Olav's University Hospital, Trondheim, Norway
- Department of Clinical and Molecular Medicine, Norwegian University of Science and Technology, Trondheim, Norway
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Isles S, McBride P, Gee P, Fleischer D, Kappatos D, Pandey R, Civil I, Gabbe B. Prevalence of psychoactive drugs in injured patients presenting to an emergency department. Emerg Med Australas 2023; 35:25-33. [PMID: 35859101 DOI: 10.1111/1742-6723.14040] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2022] [Revised: 06/09/2022] [Accepted: 06/12/2022] [Indexed: 01/19/2023]
Abstract
OBJECTIVE The aim of the present study was to obtain an unbiased understanding of the prevalence of psychoactive drugs in trauma patients presenting to a large ED. METHODS Consecutive adult patients presenting to the ED with an injury resulting in a trauma call had an anonymised, additional blood test taken for detection of over 2000 drugs. Laboratory testing was to judicial standards. Drugs given by ambulance pre-hospital were detected but excluded from the analysis. RESULTS Over 6 months 276 (74.7%) of 371 patients were tested. Of the 276 patients tested, 158 (57.2%) had one or more psychoactive drug present. Recreational drugs were detected in 101 (36.6%) patients and medicinal drugs in 88 (31.8%) patients, with a combination of both detected in 31 (11.2%) patients. The most common drugs detected were cannabis (22.1%), antidepressants (18.4%), alcohol (15.5%), opioids (10.1%), benzodiazepine/z-drugs (9.4%) and methamphetamine (7.2%). The prevalence of psychoactive drugs differed by age group, sex and cause of injury. CONCLUSIONS The prevalence of psychoactive drugs in injury presentations to an ED is high, and provides an opportunity to reduce harm. The present study demonstrates the feasibility of an approach which limits bias and obtains results that accurately reflect the drug prevalence in injured cohorts. Systematic testing of injured patients is an important contribution to the epidemiology of injury.
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Affiliation(s)
| | - Paul McBride
- Health Quality and Safety Commission, Wellington, New Zealand
| | - Paul Gee
- Emergency Department, Christchurch Hospital, Christchurch, New Zealand
| | - Dominic Fleischer
- Emergency Department, Christchurch Hospital, Christchurch, New Zealand
| | - Diana Kappatos
- Institute of Environmental Science and Research, Porirua, New Zealand
| | - Rishi Pandey
- Institute of Environmental Science and Research, Porirua, New Zealand
| | - Ian Civil
- National Trauma Network, Wellington, New Zealand
| | - Belinda Gabbe
- School of Public Health and Preventive Medicine, Monash University, Melbourne, Victoria, Australia
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Randomly controlled drivers using minimally invasive sampling: assessment of drug prevalence in Western Switzerland over two time periods. BMC Public Health 2022; 22:2446. [PMID: 36577956 PMCID: PMC9795657 DOI: 10.1186/s12889-022-14883-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2022] [Accepted: 12/16/2022] [Indexed: 12/29/2022] Open
Abstract
BACKGROUND According to the World Health Organization, road traffic injuries lead to 1.3 million deaths each year and represent the leading cause of death for young adults under 30 years old. The use of psychoactive substances, including alcohol, drugs and pharmaceuticals, is a well-known risk factor for road traffic injuries. Our study aims to assess the prevalence of substances consumed by drivers in western Switzerland. Such studies are pivotal to improving prevention and developing public awareness campaigns. METHODS To assess the prevalence of psychoactive substances among drivers, roadside controls were performed in collaboration with local police, using their classical sampling procedures to detect drivers under the influence of drugs or alcohol over two time periods (P1: 2006-2008, P2: 2017-2020). When impaired driving was not suspected by the police, minimally invasive sampling strategies (i.e., oral fluids during P1 and dried blood spots during P2) were performed on volunteer drivers after a road safety survey. A posteriori analyses and statistical interpretation were then performed. RESULTS Among the 1605 drivers included in the study, 1048 volunteers provided an oral fluid sample, while 299 provided a dried blood spot sample. The percentage of drivers testing positive for at least one substance that can impact driving abilities was stable over time, with a rate of 10.5% positivity measured over both periods. Considering the different categories of substances, a slight variation was observed between both periods, with 7.6 and 6.3% of pharmaceuticals and 3.6 and 4.9% of illicit drugs for P1 and P2, respectively. Regarding the consumption of illicit drugs, the highest percentage of positivity was measured in biological fluids of drivers under the age of 35, during nights and week-ends, periods which are considered particularly prone to fatal accidents for this age group. Disturbingly, the road safety survey highlighted that drivers' perception of the risk of getting positively controlled while driving after drug consumption is low (3.3 on a 1-to-10 scale, N = 299). CONCLUSION The number of positive cases measured in voluntary drivers who passed the preliminary police check demonstrates the importance of systematic biofluid sampling strategies regarding driving under the influence of psychoactive substances. Although the number of fatal road accidents globally has decreased over time, the results of this study reveal the need for both better prevention and deterrent processes that could potentially reduce the risk of fatal road accidents associated with drug consumption.
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Drug consumption of suspected drug-influenced drivers in Hungary (2016-2018). Forensic Sci Int 2022; 336:111325. [DOI: 10.1016/j.forsciint.2022.111325] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2022] [Revised: 04/22/2022] [Accepted: 04/26/2022] [Indexed: 11/22/2022]
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Hasan R, Watson B, Haworth N, Oviedo-Trespalacios O. A systematic review of factors associated with illegal drug driving. ACCIDENT; ANALYSIS AND PREVENTION 2022; 168:106574. [PMID: 35152044 DOI: 10.1016/j.aap.2022.106574] [Citation(s) in RCA: 17] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/12/2021] [Revised: 01/18/2022] [Accepted: 01/19/2022] [Indexed: 06/14/2023]
Abstract
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.
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Affiliation(s)
- Razi Hasan
- Queensland University of Technology (QUT), Centre for Accident Research and Road Safety- Queensland (CARRS-Q), K Block, 130 Victoria Park Road, Kelvin Grove, QLD 4059, Australia
| | - Barry Watson
- Queensland University of Technology (QUT), Centre for Accident Research and Road Safety- Queensland (CARRS-Q), K Block, 130 Victoria Park Road, Kelvin Grove, QLD 4059, Australia
| | - Narelle Haworth
- Queensland University of Technology (QUT), Centre for Accident Research and Road Safety- Queensland (CARRS-Q), K Block, 130 Victoria Park Road, Kelvin Grove, QLD 4059, Australia
| | - Oscar Oviedo-Trespalacios
- Queensland University of Technology (QUT), Centre for Accident Research and Road Safety- Queensland (CARRS-Q), K Block, 130 Victoria Park Road, Kelvin Grove, QLD 4059, Australia.
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Akabri M, Sarikhani Y, Khatami K, Ardalan A, Safarpour H, Imanieh MH, Ostovar T, Tabrizi R, Mani A, Heydari ST, Bagheri Lankarani K. The association between the score of adult attention-deficit/hyperactivity traits and risky driving behaviors with alcohol intake and narcotics consumption among Iranian motorcyclists. TRAFFIC INJURY PREVENTION 2021; 22:189-194. [PMID: 33661079 DOI: 10.1080/15389588.2021.1877278] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/08/2023]
Abstract
BACKGROUND Motorcycle drivers are among the most vulnerable road users, accounting for a large proportion of global traffic accidents. This study aimed to investigate the association between the score of adult attention-deficit/hyperactivity (ADHD) traits and risky driving behaviors (RDB) with alcohol intake (AI) and narcotics consumption (NC) among motorcyclists in Iran. METHODS This multi-center cross-sectional study encompassed 1747 motorcyclists from three cities in Iran. A random sampling method was applied in this study, and the required data was collected using three standard questionnaires on ADHD, substance abuse, and RDB. Independent sample t-test, covariance analysis, and quantile regression (QR) were used to analyze the data. RESULTS The results of t-test and analysis of covariance indicated that AI and NC were significantly associated with ADHD score and RDB among the motorcycle drivers. Additionally, the QR models showed that these effects were significant at all quantiles of ADHD and RDB, even for individuals who were at lower quantiles. CONCLUSIONS Considering the potential dangers of driving after AI and NC, appropriate measures should be adopted before certifying a driving license to screen ADHD as a predisposing factor for substance abuse and RDB. Furthermore, it is essential to equip traffic police with adequate diagnosis kits and establish heavy penalties for the offenders. In this regard, all interventions aimed to reduce traffic accidents among motorcycle drivers should be done considering the interrelationship between ADHD, RDB, and substance abuse.
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Affiliation(s)
- Maryam Akabri
- Student Research Committee, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Yaser Sarikhani
- Research Center for Social Determinants of Health, Jahrom University of Medical Sciences, Jahrom, Iran
| | - Kiana Khatami
- Health Policy Research Center, Institute of Health, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Arash Ardalan
- Department of Mathematics, Yasouj University, Yasouj, Iran
| | - Heidar Safarpour
- Health Policy Research Center, Institute of Health, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Mohammad Hadi Imanieh
- Department of Pediatrics, Namazee Hospital, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Tahereh Ostovar
- Health Policy Research Center, Institute of Health, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Reza Tabrizi
- Health Policy Research Center, Institute of Health, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Arash Mani
- Research Center for Psychiatry and Behavioral Sciences, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Seyed Taghi Heydari
- Health Policy Research Center, Institute of Health, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Kamran Bagheri Lankarani
- Health Policy Research Center, Institute of Health, Shiraz University of Medical Sciences, Shiraz, Iran
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Vaillancourt L, Viel E, Dombrowski C, Desharnais B, Mireault P. Drugs and driving prior to cannabis legalization: A 5-year review from DECP (DRE) cases in the province of Quebec, Canada. ACCIDENT; ANALYSIS AND PREVENTION 2021; 149:105832. [PMID: 33220606 DOI: 10.1016/j.aap.2020.105832] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/30/2020] [Revised: 08/14/2020] [Accepted: 10/05/2020] [Indexed: 06/11/2023]
Abstract
OBJECTIVES To examine alleged drug-impaired driving in the province of Quebec (Canada), including drug use profile amongst suspected impaired drivers, prior to recreational cannabis legalization and major modifications to the legislation regarding driving under the influence of drugs (DUID). METHODS The Laboratoire de sciences judiciaires et de médecine légale (LSJML) performs toxicological analyses on all biological samples collected during a Drug Evaluation and Classification Program (DECP) evaluation by a Drug Recognition Expert (DRE). A targeted analysis of 137 drugs and metabolites by liquid chromatography - tandem mass spectrometry (LC-MS/MS) is systematically carried out, enhanced by gas chromatography - mass spectrometry (GC-MS) general unknown screening if deemed necessary. Data from all DECP cases analyzed from January 2014 to December 2018 was compiled and summarized. RESULTS In the 5-year period studied, a total of 2 982 DECP cases underwent toxicological analysis. Age of the intercepted drivers varied between 14-82 years old (average 33 years old), with 79 % men and 21 % women. At least one substance with impairing potential was detected in 98 % of cases. In 89 % of cases (n = 2 640), at least one substance detected matched a category of drug suspected of causing impairment. At the other end of the spectrum, there were 270 cases (9%) where the findings did not match any of the categorie(s) suspected by the DRE, 66 negative cases (2%) and 6 incomplete evaluations. Substances most commonly detected belonged to the central nervous system (CNS) stimulants (72 %), CNS depressants (61 %) and cannabis (48 %) categories. Most prevalent substances were methamphetamine (54%), cannabis (11-nor-9-carboxy-tetrahydrocannabinol or THC-COOH, 48 %), cocaine (29 %) and gamma-hydroxybutyrate (GHB, 24 %). Polydrug consumption was common, with two or more substances with impairing potential detected in 79 % of cases. There were 113 occurrences of new psychoactive substances (NPS), the most prevalent being rolicyclidine (PCPy, 47 %), methylenedioxypyrovalerone (MDPV, 17 %), methylbenzylpiperazine (MBZP, 13 %) and flubromazolam (10 %). Drug prevalence patterns varied geographically, as well as with age and gender. Indeed, methamphetamine and GHB were more popular amongst women, whereas cannabis and cocaine were more prevalent amongst men. Cannabis and CNS stimulants were more common amongst younger drivers (14-34 years old); CNS depressants, dissociative anesthetics and non-psychoactive drugs prevalence increased with age. CONCLUSIONS An up-to-date database of DUID cases is a powerful tool in identifying trends and threats, focusing resources and orienting research and development activities. Such a database, combined with the data presented in the current study, will be key in evaluating the impact of new regulations, i.e., recreational cannabis legalization and modifications to the DUID legislation.
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Affiliation(s)
- Lucie Vaillancourt
- Laboratoire de sciences judiciaires et de médecine légale, Department of Toxicology, 1701 Parthenais Street, 12(th)floor, Montreal, Quebec, Canada
| | - Edith Viel
- Laboratoire de sciences judiciaires et de médecine légale, Department of Toxicology, 1701 Parthenais Street, 12(th)floor, Montreal, Quebec, Canada.
| | - Cynthia Dombrowski
- Laboratoire de sciences judiciaires et de médecine légale, Department of Toxicology, 1701 Parthenais Street, 12(th)floor, Montreal, Quebec, Canada
| | - Brigitte Desharnais
- Laboratoire de sciences judiciaires et de médecine légale, Department of Toxicology, 1701 Parthenais Street, 12(th)floor, Montreal, Quebec, Canada
| | - Pascal Mireault
- Laboratoire de sciences judiciaires et de médecine légale, Department of Toxicology, 1701 Parthenais Street, 12(th)floor, Montreal, Quebec, Canada
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Desharnais B, Lajoie MJ, Laquerre J, Mireault P, Skinner CD. A threshold LC-MS/MS method for 92 analytes in oral fluid collected with the Quantisal® device. Forensic Sci Int 2020; 317:110506. [PMID: 33035929 DOI: 10.1016/j.forsciint.2020.110506] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2020] [Revised: 09/07/2020] [Accepted: 09/08/2020] [Indexed: 11/30/2022]
Abstract
A study of impaired driving rates in the province of Québec is currently planned following the legalization of recreational cannabis in Canada. Oral fluid (OF) samples are to be collected with a Quantisal® device and sent to the laboratory for analysis. In order to prepare for this project, a qualitative decision point analysis method monitoring for the presence of 97 drugs and metabolites in OF was developed and validated. This high throughput method uses incubation with a precipitation solvent (acetone:acetonitrile 30:70 v:v) to boost drug recovery from the collecting device and improve stability of benzodiazepines (e.g., α-hydroxyalprazolam, clonazepam, 7-aminoclonazepam, flunitrazepam, 7-aminoflunitrazepam, N-desmethylflunitrazepam, nitrazepam). The Quantisal® device has polyglycol in its stabilizing buffer, but timed use of the mass spectrometer waste valve proved sufficient to avoid the glycol interferences for nearly all analytes. Interferences from OF matrices and 140 potentially interfering compounds, carryover, ion ratios, stability, recovery, reproducibility, robustness, false positive rate, false negative rate, selectivity, sensitivity and reliability rates were tested in the validation process. Five of the targeted analytes (olanzapine, oxazepam, 7-aminoclonazepam, flunitrazepam and nitrazepam) did not meet the set validation criteria but will be monitored for identification purposes (no comparison to a cut-off level). Blind internal proficiency testing was performed, where six OF samples were tested and analytes were classified as "negative", "likely positive" or "positive" with success. The final validated OF qualitative decision point method covers 92 analytes, and the presence of 5 additional analytes is screened in this high throughput analysis.
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Affiliation(s)
- Brigitte Desharnais
- Laboratoire de sciences judiciaires et de médecine légale, Department of Toxicology, 1701 Parthenais Street, Montréal, Québec, H2K 3S7, Canada; Concordia University, Department of Chemistry & Biochemistry, 7141 Sherbrooke Street West, Montréal, Québec, H4B 1R6, Canada.
| | - Marie-Jo Lajoie
- Laboratoire de sciences judiciaires et de médecine légale, Department of Toxicology, 1701 Parthenais Street, Montréal, Québec, H2K 3S7, Canada
| | - Julie Laquerre
- Laboratoire de sciences judiciaires et de médecine légale, Department of Toxicology, 1701 Parthenais Street, Montréal, Québec, H2K 3S7, Canada
| | - Pascal Mireault
- Laboratoire de sciences judiciaires et de médecine légale, Department of Toxicology, 1701 Parthenais Street, Montréal, Québec, H2K 3S7, Canada
| | - Cameron D Skinner
- Concordia University, Department of Chemistry & Biochemistry, 7141 Sherbrooke Street West, Montréal, Québec, H4B 1R6, Canada
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Jamt REG, Gjerde H, Furuhaugen H, Romeo G, Vindenes V, Ramaekers JG, Bogstrand ST. Associations between psychoactive substance use and sensation seeking behavior among drivers in Norway. BMC Public Health 2020; 20:23. [PMID: 31914964 PMCID: PMC6950984 DOI: 10.1186/s12889-019-8087-0] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2019] [Accepted: 12/15/2019] [Indexed: 11/17/2022] Open
Abstract
Background/aim Drug use and risky driving is associated with sensation seeking. The aim of this study was to investigate the association between use of psychoactive substances and levels of the sensation seeking personality trait as measured with the Brief Sensation Seeking Scale 4 among drivers in Norway. Method A cross-sectional design was applied to estimate the association between psychoactive substance use and sensation seeking behavior. Drivers in normal traffic were included in two roadside surveys: one in the north (September 2014 – October 2015) and the other in the south-east of Norway (April 2016 – April 2017). Oral fluid was analyzed for alcohol and psychoactive drugs, and data on sex, age and time of participation were recorded. Participants filled in the Brief Sensation Seeking Scale 4 questionnaire. Results A total of 8053 drivers were included, of which 32% were women and 62% were under 40 years. The prevalence of alcohol was 0.3%, stimulants 0.6%, tetrahydrocannabinol 1.4%, benzodiazepines and/or z-hypnotics 2.0% and polydrug use 0.6%. Associations were found between the use of tetrahydrocannabinol or benzodiazepines and/or z-hypnotics and a low score on the “thrill and adventure seeking” domain of the Brief Sensation Seeking Scale 4 (OR = 1.723, 95% C.I. = 1.001–2.966). Associations were also found between the use of stimulants and the highest scores on the “experience seeking” (OR = 2.085, 95% C.I. = 1.084–4.009) and “disinhibition” (OR = 4.791, 95% C.I. =1.748–13.135) domains of the Brief Sensation Seeking Scale 4. No associations were found between sensation seeking behavior and alcohol or polydrug use. Conclusion A high degree of sensation seeking was found among drivers who had used stimulating drugs, in contrast to drives who had used tetrahydrocannabinol and benzodiazepines and/or z-hypnotics who showed a low degree of sensation seeking. The combination of sensation seeking behavior and the use of stimulants might lead to increased risky behavior and thus traffic crashes.
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Affiliation(s)
- Ragnhild E G Jamt
- Department of Forensic Sciences, Oslo University Hospital, P.O. Box 4950, Nydalen, N-0424, Oslo, Norway. .,Department of Nursing Science, Institute of Health and Society, University of Oslo, Oslo, Norway.
| | - Hallvard Gjerde
- Department of Forensic Sciences, Oslo University Hospital, P.O. Box 4950, Nydalen, N-0424, Oslo, Norway
| | - Håvard Furuhaugen
- Department of Forensic Sciences, Oslo University Hospital, P.O. Box 4950, Nydalen, N-0424, Oslo, Norway
| | - Giovanni Romeo
- Department of Biostatistics, Oslo Centre for Biostatistics and Epidemiology, University of Oslo, Oslo, Norway
| | - Vigdis Vindenes
- Department of Forensic Sciences, Oslo University Hospital, P.O. Box 4950, Nydalen, N-0424, Oslo, Norway.,Institute of Clinical Medicine, University of Oslo, Oslo, Norway
| | - Jan G Ramaekers
- Department of Neuropsychology and Psychopharmacology, Faculty of Psychology and Neuroscience, University of Maastricht, Maastricht, The Netherlands
| | - Stig T Bogstrand
- Department of Forensic Sciences, Oslo University Hospital, P.O. Box 4950, Nydalen, N-0424, Oslo, Norway.,Department of Nursing Science, Institute of Health and Society, University of Oslo, Oslo, Norway
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Ji Kwon N, Han E. A review of drug abuse in recently reported cases of driving under the influence of drugs (DUID) in Asia, USA, and Europe. Forensic Sci Int 2019; 302:109854. [PMID: 31255839 DOI: 10.1016/j.forsciint.2019.06.012] [Citation(s) in RCA: 25] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2019] [Revised: 06/05/2019] [Accepted: 06/09/2019] [Indexed: 11/17/2022]
Abstract
Driving Under the Influence of Drugs (DUID) is considered a serious issue related to the abuse of illegal drugs. DUID cases, including deaths, are being continuously reported in Asia, USA, and Europe. This literature review focuses on illegal drug abuse in recent DUID cases reported in Asia, USA, and Europe. To determine illegal drug abuse in DUID suspects, previous studies collected and analyzed biological samples, such as blood, urine, oral fluids, and hair. In addition, there were forensic autopsies and surveys for investigation of illegal drugs in DUID cases and drivers. In previous studies, ketamine, morphine, methamphetamine (MA), and khat were mainly reported in Asia, whereas amphetamine, benzodiazepines (BZDs), and cannabinoids were mainly reported in USA, and synthetic cannabinoids (SCs), opiates, and cocaine were mainly reported in Europe. Since DUID suspects related to illegal drugs have been frequently reported in Asia, USA, and Europe, there is a need to plan for national monitoring for drivers or motor vehicles to regulate and prevent drug abuse and relevant DUID cases.
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Affiliation(s)
- Nam Ji Kwon
- College of Pharmacy, Duksung Women's University, Seoul, South Korea
| | - Eunyoung Han
- College of Pharmacy, Duksung Women's University, Seoul, South Korea.
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Jørgenrud B, Bogstrand ST, Furuhaugen H, Jamt REG, Vindenes V, Gjerde H. Association between speeding and use of alcohol and medicinal and illegal drugs and involvement in road traffic crashes among motor vehicle drivers. TRAFFIC INJURY PREVENTION 2019; 19:779-785. [PMID: 30681887 DOI: 10.1080/15389588.2018.1518577] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/14/2018] [Revised: 08/28/2018] [Accepted: 08/28/2018] [Indexed: 06/09/2023]
Abstract
OBJECTIVE The objective of this study was to study the association between self-reported road traffic crashes (RTCs) and recent use of alcohol and medicinal and illicit drug use and self-reported speeding in the previous 2 years. METHODS During the period from April 2016 to April 2017, drivers of cars, vans, motorcycles, and mopeds were stopped in a Norwegian roadside survey performed in collaboration with the police. Participation was voluntary and anonymous. The drivers were asked to deliver an oral fluid sample (mixed saliva), which was analyzed for alcohol and 39 illicit and medicinal drugs and metabolites. In addition, data on age, sex, and self-reported speeding tickets and RTCs during the previous 2 years were collected. RESULTS A total of 5,031 participants were included in the study, and 4.9% tested positive for the use of one or more illicit or medicinal drugs or alcohol. We found a significant, positive association between the use of cannabis and RTC involvement (odds ratio [OR] = 1.93; 95% confidence interval [CI], 1.05-3.57; P = 0.035) and also between previous speeding tickets and RTC involvement (OR = 1.39; 95% CI, 1.08-1.80; P = 0.012). In addition, older age groups were found to have a significant, negative association with RTC involvement, with ORs equal to or less than 0.49, when using the age group 16-24 as reference. CONCLUSION Speeding, as an indicator of risk behavior, and the use of cannabis were associated with previous RTC involvement, whereas increasing age was significantly associated with lower risk. This is consistent with previous studies on RTCs.
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Affiliation(s)
- Benedicte Jørgenrud
- a Department of Forensic Sciences , Oslo University Hospital , Oslo , Norway
| | - Stig Tore Bogstrand
- a Department of Forensic Sciences , Oslo University Hospital , Oslo , Norway
| | - Håvard Furuhaugen
- a Department of Forensic Sciences , Oslo University Hospital , Oslo , Norway
| | - Ragnhild E G Jamt
- a Department of Forensic Sciences , Oslo University Hospital , Oslo , Norway
- b Department of Nursing Science , Institute of Health and Society, University of Oslo , Oslo , Norway
| | - Vigdis Vindenes
- a Department of Forensic Sciences , Oslo University Hospital , Oslo , Norway
- c Department of Forensic Medicine , Institute of Clinical Medicine, University of Oslo , Oslo , Norway
| | - Hallvard Gjerde
- a Department of Forensic Sciences , Oslo University Hospital , Oslo , Norway
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Affiliation(s)
- Maude Marillier
- Department of Continuing Education of the Faculty of Medicine Lille University Lille France
| | - Alain G. Verstraete
- Department of Diagnostic Sciences Ghent University Ghent Belgium
- Department of Laboratory Medicine Ghent University Hospital Ghent Belgium
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