1
|
Hasan R, Watson B, Haworth N, Oviedo-Trespalacios O. What contributes to drug driving? An exploratory investigation into the influence of problematic substance use, roadside testing and alternative transport options. ACCIDENT; ANALYSIS AND PREVENTION 2023; 184:106990. [PMID: 36791605 DOI: 10.1016/j.aap.2023.106990] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/13/2022] [Revised: 12/23/2022] [Accepted: 01/24/2023] [Indexed: 06/18/2023]
Abstract
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.
Collapse
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
- Delft University of Technology, Faculty of Technology, Policy and Management, Section of Safety and Security Science, Jaffalaan 5, 2628 BX Delft, The Netherlands.
| |
Collapse
|
2
|
Andrew Yockey R, Barroso CS. Drugged driving among U.S. adolescents, 2016-2019, USA. JOURNAL OF SAFETY RESEARCH 2023; 84:1-6. [PMID: 36868638 DOI: 10.1016/j.jsr.2022.10.002] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/06/2022] [Revised: 07/21/2022] [Accepted: 10/17/2022] [Indexed: 06/18/2023]
Abstract
INTRODUCTION Drugged driving, the operation of a vehicle under the influence of any illegal drugs and alcohol, is a growing problem, but remains understudied among adolescents. The purpose of this article is to estimate past-year driving under the influence of alcohol, marijuana, and other drugs among a large sample of U.S. adolescents and potential associations (e.g., age, race, metropolitan status, sex). DESIGN A cross-sectional secondary data analysis of the 2016-2019 National Survey on Drug Use and Health among 17,520 adolescents ages 16-17-years old was conducted. Weighted logistic regression models were built to determine potential associations to drugged driving. RESULTS An estimated 2.00% of adolescents drove under the influence of alcohol in the past year, 5.65% drove under the influence of marijuana in the past year, and an estimated 0.48% drove under the influence of other drugs other than marijuana in the past year. Differences were based on race, past-year drug use, and county status. CONCLUSIONS Drugged driving is a growing problem among adolescents and interventions are greatly needed to mitigate these behaviors among youth.
Collapse
Affiliation(s)
- Robert Andrew Yockey
- Department of Biostatistics and Epidemiology, University of North Texas Health Science Center, Fort Worth, TX 76107, United States.
| | - Cristina S Barroso
- College of Nursing, University of Tennessee, Knoxville, TN 37996, United States
| |
Collapse
|
3
|
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.
Collapse
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.
| |
Collapse
|
4
|
Le TL, Tuck A, Agic B, Ialomiteanu AR, McDonald AJ, Mann RE, Wickens CM. Ethnicity, Immigration Status, And Driving Under The Influence Of Alcohol. J Ethn Subst Abuse 2021; 21:1-17. [PMID: 33656975 DOI: 10.1080/15332640.2021.1885550] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
BACKGROUND Understanding risk factors for driving under the influence of alcohol (DUIA) informs development of effective interventions. This study examined the association between ethnicity, immigration status, and DUIA, exploring psychological distress and hazardous drinking as additional contributors. METHOD Data were derived from the 2003-2011 cycles of the Centre for Addiction and Mental Health (CAMH) Monitor of 16,101 adults from Ontario, Canada. Hierarchical binary logistic regression analysis assessed self-identified ethnicity and immigration status as predictors of DUIA, adjusting for sociodemographics and driving exposure (Model 1), psychological distress (Model 2), and hazardous drinking (Model 3). RESULTS In Model 1, respondents born outside of Canada had reduced odds of engaging in DUIA compared to those born in Canada (AOR = 0.72, 95%CI = 0.56 - 0.92). Relative to those identifying as Canadian, the odds of DUIA were significantly reduced for those identifying as East Asian (AOR = 0.28, 95%CI = 0.13 - 0.61) and South Asian (AOR = 0.52, 95%CI = 0.27 - 0.98). In Model 3, individuals who reported psychological distress (AOR = 1.69, 95%CI = 1.33 - 2.16) and those who reported hazardous drinking (AOR = 6.28, 95%CI= 5.13 - 7.69) were more likely to DUIA. Those identifying as East Asian continued to have reduced odds of DUIA compared to those identifying as Canadian (AOR = 0.38, 95%CI = 0.17 - 0.85). CONCLUSION Individuals born outside of Canada were less likely to engage in DUIA than individuals born in Canada. Drivers who self-identified as East Asian were less likely to DUIA than those who self-identified as Canadian. Understanding ethnic differences underlying divergent risks for DUIA will improve prevention initiatives and remedial measures programming.
Collapse
Affiliation(s)
- Thao Lan Le
- Institute for Mental Health Policy Research, Centre for Addiction and Mental Health, Toronto, Ontario, Canada
| | - Andrew Tuck
- Health Equity, Centre for Addiction and Mental Health, Toronto, Ontario, Canada
| | - Branka Agic
- Institute for Mental Health Policy Research, Centre for Addiction and Mental Health, Toronto, Ontario, Canada
- Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada
| | - Anca R Ialomiteanu
- Institute for Mental Health Policy Research, Centre for Addiction and Mental Health, Toronto, Ontario, Canada
| | - André J McDonald
- Institute for Mental Health Policy Research, Centre for Addiction and Mental Health, Toronto, Ontario, Canada
- Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada
| | - Robert E Mann
- Institute for Mental Health Policy Research, Centre for Addiction and Mental Health, Toronto, Ontario, Canada
- Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada
- Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health, Toronto, Ontario, Canada
| | - Christine M Wickens
- Institute for Mental Health Policy Research, Centre for Addiction and Mental Health, Toronto, Ontario, Canada
- Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada
- Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health, Toronto, Ontario, Canada
- Institute of Mental Health Policy, Management and Evaluation, University of Toronto, Toronto, Ontario, Canada
- Department of Pharmacology and Toxicology, University of Toronto, Toronto, Ontario, Canada
| |
Collapse
|
5
|
Nelson SE, LaRaja A, Juviler J, Williams PM. Evaluating the Computerized Assessment and Referral System (CARS) Screener: Sensitivity and Specificity as a Screening Tool for Mental Health Disorders among DUI Offenders. Subst Use Misuse 2021; 56:1785-1796. [PMID: 34304704 DOI: 10.1080/10826084.2021.1954024] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
Background/Purpose: A growing body of evidence suggests that people who are arrested for driving under the influence (DUI) of alcohol are more likely to screen positive for psychiatric disorders than the general population. Additionally, psychiatric comorbidity has been shown to increase vulnerability to criminal re-offense. However, DUI programs face many barriers to screening for psychiatric disorders. This paper evaluates the sensitivity and specificity of a screening tool developed for these programs, the Computerized Assessment and Referral System (CARS) Screener. Methods: We used data from 381 DUI offenders in Massachusetts, as well as a secondary data source, the National Comorbidity Survey-Replication (NCS-R: N = 9,282) to examine the accuracy of the CARS Screener when compared to full assessment. Results: Based on both sets of analyses, we found that the CARS Screener offers a sensitive and specific method to screen for many psychiatric disorders. Specifically, the CARS Screener has a high sensitivity and specificity for bipolar disorder, intermittent explosive disorder, depressive disorders, generalized anxiety disorder, alcohol and drug use disorders, gambling disorder, post-traumatic stress disorder, panic attacks, and social phobia. Conclusion: The CARS Screener appears to be an effective tool that will help DUI programs better understand and address the mental health issues facing their clients.
Collapse
Affiliation(s)
- Sarah E Nelson
- Division on Addiction, Cambridge Health Alliance, Malden, Massachusetts, USA.,Department of Psychiatry, Harvard Medical School, Boston, Massachusetts, USA
| | - Alex LaRaja
- School of Medicine, Boston University, Boston, Massachusetts, USA
| | - Jamie Juviler
- Division on Addiction, Cambridge Health Alliance, Malden, Massachusetts, USA
| | - Pat M Williams
- Suffolk University Law School, Boston, Massachusetts, USA
| |
Collapse
|
6
|
Tapiainen V, Hartikainen S, Taipale H, Tiihonen J, Tolppanen AM. Hospital-treated mental and behavioral disorders and risk of Alzheimer's disease: A nationwide nested case-control study. Eur Psychiatry 2020; 43:92-98. [DOI: 10.1016/j.eurpsy.2017.02.486] [Citation(s) in RCA: 35] [Impact Index Per Article: 8.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/18/2016] [Revised: 02/07/2017] [Accepted: 02/15/2017] [Indexed: 01/16/2023] Open
Abstract
AbstractBackground:Studies investigating psychiatric disorders as Alzheimer's disease (AD) risk factors have yielded heterogeneous findings. Differences in time windows between the exposure and outcome could be one explanation. We examined whether (1) mental and behavioral disorders in general or (2) specific mental and behavioral disorder categories increase the risk of AD and (3) how the width of the time window between the exposure and outcome affects the results.Methods:A nationwide nested case-control study of all Finnish clinically verified AD cases, alive in 2005 and their age, sex and region of residence matched controls (n of case-control pairs 27,948). History of hospital-treated mental and behavioral disorders was available since 1972.Results:Altogether 6.9% (n = 1932) of the AD cases and 6.4% (n = 1784) of controls had a history of any mental and behavioral disorder. Having any mental and behavioral disorder (adjusted OR = 1.07, 95% CI = 1.00–1.16) or depression/other mood disorder (adjusted OR = 1.17, 95% CI = 1.05–1.30) were associated with higher risk of AD with 5-year time window but not with 10-year time window (adjusted OR, 95% CI 0.99, 0.91–1.08 for any disorder and 1.08, 0.96–1.23 for depression).Conclusions:The associations between mental and behavioral disorders and AD were modest and dependent on the time window. Therefore, some of the disorders may represent misdiagnosed prodromal symptoms of AD, which underlines the importance of proper differential diagnostics among older persons. These findings also highlight the importance of appropriate time window in psychiatric and neuroepidemiology research.
Collapse
|
7
|
Scherer JN, Silvello D, Volpato VL, Roglio VS, Fara L, Ornell F, von Diemen L, Kessler FP, Pechansky F. Predictive factors associated with driving under the influence among Brazilian drug-using drivers. ACCIDENT; ANALYSIS AND PREVENTION 2019; 123:256-262. [PMID: 30553128 DOI: 10.1016/j.aap.2018.12.003] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/05/2018] [Revised: 12/04/2018] [Accepted: 12/05/2018] [Indexed: 06/09/2023]
Abstract
The incidence of driving under the influence of psychoactive substances (DUI) and its recidivism can be curtailed by the proper identification of specific and predictive characteristics among drug users. In this sense, interpersonal violence (IV), psychiatric comorbidity and impulsivity seem to play an important role in DUI engagement according to previous studies. There are, however, limited data originated from low and middle income countries. In the present study, drug-using Brazilian drivers reporting DUI (n = 75) presented a higher prevalence of bipolar disorders (BD; DUI: 8% vs. non-DUI: 0%, p < 0.001), lower prevalence of obsessive-compulsive disorder (OCD; DUI: 0% vs. non-DUI: 12.6%, p < 0.001), and higher prevalence of childhood trauma (DUI: 65.3% vs. non-DUI: 46.8%, p = 0.022) than those not reporting DUI (n = 79). The evaluation of impulsivity though the Barratt Impulsivity Scale, which give impulsivity scores ranging from 30 to 120, showed higher impulsivity scores in the DUI group (80.4 ± 8) than in the non-DUI group (77.2 ± 10, p = 0.045). In general, subjects were young adults (mean age of 36 ± 9 years), Caucasians (58.4%), not married (61.0%), and with elementary schooling (40.3%) with no significant differences in demographic characteristics between drivers with and without DUI behavior. A multiple Poisson regression model showed that individuals reporting IV as perpetrators and history of childhood trauma were more likely to report DUI (PR: 1.66, 95%CI 1.22-2.7; PR: 1.57, 95%CI 1.02-2.42, respectively). The overlapping of violent situations (childhood trauma, IV and DUI) in some individuals presented here corroborates literature data suggesting that DUI can be an externalizing expression of a range of risky behavior, such as impulsiveness and aggressiveness. Moreover, while BD and higher impulsivity scores seem to act as risk factors for DUI, OCD was shown as a protective factor. These results corroborate the hypothesis that individuals with high risk for DUI could probably be identified by multidimensional assessment of cognitive, risky taking, and personality traits, which perhaps could facilitate the development of focused interventions.
Collapse
Affiliation(s)
- Juliana N Scherer
- Center for Drug and Alcohol Research, Hospital de Clínicas de Porto Alegre, Rua Professor Álvaro Alvim, 400, 90420-020, Porto Alegre, RS, Brazil.
| | - Daiane Silvello
- Center for Drug and Alcohol Research, Hospital de Clínicas de Porto Alegre, Rua Professor Álvaro Alvim, 400, 90420-020, Porto Alegre, RS, Brazil
| | - Vanessa L Volpato
- Center for Drug and Alcohol Research, Hospital de Clínicas de Porto Alegre, Rua Professor Álvaro Alvim, 400, 90420-020, Porto Alegre, RS, Brazil
| | - Vinícius S Roglio
- Center for Drug and Alcohol Research, Hospital de Clínicas de Porto Alegre, Rua Professor Álvaro Alvim, 400, 90420-020, Porto Alegre, RS, Brazil
| | - Letícia Fara
- Center for Drug and Alcohol Research, Hospital de Clínicas de Porto Alegre, Rua Professor Álvaro Alvim, 400, 90420-020, Porto Alegre, RS, Brazil
| | - Felipe Ornell
- Center for Drug and Alcohol Research, Hospital de Clínicas de Porto Alegre, Rua Professor Álvaro Alvim, 400, 90420-020, Porto Alegre, RS, Brazil
| | - Lisia von Diemen
- Center for Drug and Alcohol Research, Hospital de Clínicas de Porto Alegre, Rua Professor Álvaro Alvim, 400, 90420-020, Porto Alegre, RS, Brazil
| | - Felix Paim Kessler
- Center for Drug and Alcohol Research, Hospital de Clínicas de Porto Alegre, Rua Professor Álvaro Alvim, 400, 90420-020, Porto Alegre, RS, Brazil
| | - Flavio Pechansky
- Center for Drug and Alcohol Research, Hospital de Clínicas de Porto Alegre, Rua Professor Álvaro Alvim, 400, 90420-020, Porto Alegre, RS, Brazil
| |
Collapse
|
8
|
Kujansuu A, Rautiainen S, Hakko H, Kanamüller J, Sihvola N, Riipinen P. Drivers' psychiatric disorders and fatal motor vehicle accidents in Finland. J Psychiatr Res 2017; 84:227-236. [PMID: 27770742 DOI: 10.1016/j.jpsychires.2016.10.010] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/01/2016] [Revised: 10/10/2016] [Accepted: 10/14/2016] [Indexed: 11/19/2022]
Abstract
Relatively little is known about fatal motor vehicle accidents (FMVA) involving drivers with psychiatric disorders. In this study of all drivers killed in FMVAs in Finland between 1990 and 2011, we aimed to study drivers' death rate trends in FMVAs, with special focus on drivers with a history of psychiatric disorders. Prevalence of drivers' hospital treated psychiatric disorders, and characteristics of drivers with psychiatric disorders were also studied. For the purpose of this study, three national registers were accessed. Drivers' hospital treated psychiatric disorders were screened in a five-year period prior to death. Drivers with (n = 425) and without (n = 3856) psychiatric disorders were compared, female and male drivers separately. The main outcome measure was any psychiatric disorder in drivers within the five-year timescale. Socio-demographic factors, use of intoxicants and medication at the time of death, recent adverse life events, and drivers' physical and emotional states were used as covariates in the statistical analyses. During the study period, death rates increased for females with psychiatric disorders, and decreased for females without psychiatric disorders. Death rates for males with psychiatric disorders decreased between the years 1990-2000 and 2007-2011, and increased between the years 2000-2007. Death rates decreased over the whole study period in males without psychiatric disorders. Alcohol related disorders and affective disorders were the most prevalent hospital treated psychiatric disorders among drivers involved in FMVAs. Use of medications at the time of death, and committing suicide in traffic both associated with being a driver with psychiatric disorders involved in FMVAs for both genders. As FMVAs involving drivers with psychiatric disorders have increased, a more focused and detailed evaluation of the driving performance of drivers with psychiatric disorders is recommended. These evaluations should also be extended to drivers with non-psychotic disorders.
Collapse
Affiliation(s)
- Antti Kujansuu
- Department of Psychiatry, Research Unit of Clinical Neuroscience, University of Oulu, P.O. Box 5000, Peltolantie 17, 90014 Oulu, Finland
| | - Simo Rautiainen
- Department of Psychiatry, Research Unit of Clinical Neuroscience, University of Oulu, P.O. Box 5000, Peltolantie 17, 90014 Oulu, Finland.
| | - Helinä Hakko
- Department of Psychiatry, Oulu University Hospital, P.O. Box 26, 90029 Oulu, Finland
| | - Juha Kanamüller
- Department of Psychiatry, Oulu University Hospital, P.O. Box 26, 90029 Oulu, Finland
| | - Niina Sihvola
- Finnish Motor Insurers' Centre, Bulevardi 28, 00120 Helsinki, Finland
| | - Pirkko Riipinen
- Department of Psychiatry, Research Unit of Clinical Neuroscience, University of Oulu, P.O. Box 5000, Peltolantie 17, 90014 Oulu, Finland
| |
Collapse
|
9
|
Scherer JN, Silvestrin R, Ornell F, Roglio V, Sousa TRV, Von Diemen L, Kessler FHP, Pechansky F. Prevalence of driving under the influence of psychoactive substances and road traffic crashes among Brazilian crack-using drivers. Drug Alcohol Depend 2016; 168:255-262. [PMID: 27736679 DOI: 10.1016/j.drugalcdep.2016.09.017] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/25/2016] [Revised: 09/19/2016] [Accepted: 09/23/2016] [Indexed: 01/12/2023]
Abstract
BACKGROUND Substance use disorders are associated with the increased risk of driving under the influence (DUI), but little is known about crack-cocaine and its relationship with road traffic crashes (RTC). METHOD A multicenter sample of 765 crack-cocaine users was recruited in six Brazilian capitals in order to estimate the prevalence of DUI and RTC involvement. Legal, psychiatric, and drug-use aspects related with traffic safety were evaluated using the Addiction Severity Index - 6th version (ASI-6) and the Mini International Neuropsychiatric Interview. RESULTS Seventy-six (28.3%) current drivers reported accident involvement following crack-cocaine use. Among drivers (n=269), 45.7% and 30.5% reported DUIs in the past 6 months and 30 days, respectively. Drivers reporting DUI's in the past month (n=82) had higher scores in the "psychiatric", "legal", and "family problems" subscales from the ASI-6, and lower scores in the "family social support" subscale in comparison to those without a history of DUIs (n=187). An overall high prevalence of psychiatric comorbidity and substance consumption was observed. Participants with 5+ years of crack-cocaine use were more likely to have been in a RTC (RR=1.52, 95%IC: 1.02-2.75), independently of marijuana use, binge drinking and psychiatric comorbidities. CONCLUSION The high prevalence of RTC and DUI involvement among crack-using drivers supports the idea that they are at a high risk group regarding traffic safety. Years of crack consumption seem to be associated with RTC involvement. Also, the presence of psychiatric comorbidities, poly-drug use, and cognitive impairment usually associated with crack addiction could yield additional risk of accidents.
Collapse
Affiliation(s)
- Juliana Nichterwitz Scherer
- Center for Drug and Alcohol Research and Collaborating Center on Alcohol and Drugs - HCPA/SENAD, Hospital de Clínicas de Porto Alegre, Federal University of Rio Grande do Sul, Rua Professor Álvaro Alvim, 400, 90420-020, Porto Alegre, RS, Brazil.
| | - Roberta Silvestrin
- Center for Drug and Alcohol Research and Collaborating Center on Alcohol and Drugs - HCPA/SENAD, Hospital de Clínicas de Porto Alegre, Federal University of Rio Grande do Sul, Rua Professor Álvaro Alvim, 400, 90420-020, Porto Alegre, RS, Brazil
| | - Felipe Ornell
- Center for Drug and Alcohol Research and Collaborating Center on Alcohol and Drugs - HCPA/SENAD, Hospital de Clínicas de Porto Alegre, Federal University of Rio Grande do Sul, Rua Professor Álvaro Alvim, 400, 90420-020, Porto Alegre, RS, Brazil
| | - Vinícius Roglio
- Center for Drug and Alcohol Research and Collaborating Center on Alcohol and Drugs - HCPA/SENAD, Hospital de Clínicas de Porto Alegre, Federal University of Rio Grande do Sul, Rua Professor Álvaro Alvim, 400, 90420-020, Porto Alegre, RS, Brazil
| | - Tanara Rosangela Vieira Sousa
- Center for Drug and Alcohol Research and Collaborating Center on Alcohol and Drugs - HCPA/SENAD, Hospital de Clínicas de Porto Alegre, Federal University of Rio Grande do Sul, Rua Professor Álvaro Alvim, 400, 90420-020, Porto Alegre, RS, Brazil
| | -
- Center for Drug and Alcohol Research and Collaborating Center on Alcohol and Drugs - HCPA/SENAD, Hospital de Clínicas de Porto Alegre, Federal University of Rio Grande do Sul, Rua Professor Álvaro Alvim, 400, 90420-020, Porto Alegre, RS, Brazil
| | - Lisia Von Diemen
- Center for Drug and Alcohol Research and Collaborating Center on Alcohol and Drugs - HCPA/SENAD, Hospital de Clínicas de Porto Alegre, Federal University of Rio Grande do Sul, Rua Professor Álvaro Alvim, 400, 90420-020, Porto Alegre, RS, Brazil
| | - Felix Henrique Paim Kessler
- Center for Drug and Alcohol Research and Collaborating Center on Alcohol and Drugs - HCPA/SENAD, Hospital de Clínicas de Porto Alegre, Federal University of Rio Grande do Sul, Rua Professor Álvaro Alvim, 400, 90420-020, Porto Alegre, RS, Brazil
| | - Flavio Pechansky
- Center for Drug and Alcohol Research and Collaborating Center on Alcohol and Drugs - HCPA/SENAD, Hospital de Clínicas de Porto Alegre, Federal University of Rio Grande do Sul, Rua Professor Álvaro Alvim, 400, 90420-020, Porto Alegre, RS, Brazil
| |
Collapse
|
10
|
Tjäderborn M, Jönsson AK, Sandström TZ, Ahlner J, Hägg S. Non-prescribed use of psychoactive prescription drugs among drug-impaired drivers in Sweden. Drug Alcohol Depend 2016; 161:77-85. [PMID: 26875672 DOI: 10.1016/j.drugalcdep.2016.01.031] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/18/2015] [Revised: 01/14/2016] [Accepted: 01/20/2016] [Indexed: 12/20/2022]
Abstract
AIMS To determine the prevalence of non-prescribed drug use among subjects suspected of drug-impaired driving with a psychoactive prescription drug, and to identify associated factors. METHODS Subjects investigated for drug-impaired driving in Sweden during 2006-2009 with a confirmed intake of diazepam, flunitrazepam, tramadol, zolpidem or zopiclone were identified using the Swedish Forensic Toxicology Database. Information on dispensed prescription drugs was retrieved from the Swedish Prescribed Drug Register. Non-prescribed use was our outcome, defined as a psychoactive prescription drug intake confirmed by toxicological analysis in a subject by whom it was not dispensed in the 12 months preceding the sampling. Prevalence proportions were calculated for each drug and logistic regression was used to identify associated factors. RESULTS In total, 2225 subjects were included. The median age (range) was 34 (15-80) years and 1864 (83.8%) subjects were male. Non-prescribed use was found in 1513 subjects (58.7%); for flunitrazepam 103 (76.3%), diazepam 1098 (74.1%), tramadol 192 (40.3%), zopiclone 60 (29.7%), and zolpidem 60 (21.2%) subjects, respectively. Younger age and multiple-substance use were associated with non-prescribed use, whereas ongoing treatment with other psychoactive drugs was negatively associated with non-prescribed use. CONCLUSIONS Non-prescribed use of psychoactive prescription drugs was common in subjects suspected of drug-impaired driving and was more frequent for benzodiazepines and tramadol compared to zolpidem and zopiclone. The young and multi-substance users were more likely, whereas subjects with ongoing prescribed treatment with other psychoactive drugs were less likely, to use non-prescribed drugs.
Collapse
Affiliation(s)
- Micaela Tjäderborn
- Division of Drug Research/Clinical Pharmacology, Department of Medical and Health Sciences, Linköping University, Linköping, Sweden.
| | - Anna K Jönsson
- Division of Drug Research/Clinical Pharmacology, Department of Medical and Health Sciences, Linköping University, Linköping, Sweden; Department of Forensic Genetics and Forensic Toxicology, National Board of Forensic Medicine, Linköping, Sweden
| | - Tatiana Zverkova Sandström
- Institute of Medicine, Department of Molecular and Clinical Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - Johan Ahlner
- Division of Drug Research/Clinical Pharmacology, Department of Medical and Health Sciences, Linköping University, Linköping, Sweden; Department of Forensic Genetics and Forensic Toxicology, National Board of Forensic Medicine, Linköping, Sweden
| | - Staffan Hägg
- Division of Drug Research/Clinical Pharmacology, Department of Medical and Health Sciences, Linköping University, Linköping, Sweden; Futurum, Academy for Health and Care, Region Jönköping County, Jönköping, Sweden
| |
Collapse
|
11
|
Ahlner J, Holmgren A, Jones AW. Demographics and post-mortem toxicology findings in deaths among people arrested multiple times for use of illicit drugs and/or impaired driving. Forensic Sci Int 2016; 265:138-43. [PMID: 26901639 DOI: 10.1016/j.forsciint.2016.01.036] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/25/2015] [Revised: 01/20/2016] [Accepted: 01/21/2016] [Indexed: 10/22/2022]
Abstract
BACKGROUND Multiple arrests for use of illicit drugs and/or impaired driving strongly suggests the existence of a personality disorder and/or a substance abuse problem. METHODS This retrospective study (1993-2010) used a national forensic toxicology database (TOXBASE), and we identified 3943 individuals with two or more arrests for use of illicit drugs and/or impaired driving. These individuals had subsequently died from a fatal drug poisoning or some other cause of death, such as trauma. RESULTS Of the 3943 repeat offenders 1807 (46%) died from a fatal drug overdose and 2136 (54%) died from other causes (p<0.001). The repeat offenders were predominantly male (90% vs 10%) and mean age of drug poisoning deaths was 5 y younger (mean 35 y) than other causes of death (mean 40 y). Significantly more repeat offenders (46%) died from drug overdose compared with all other forensic autopsies (14%) (p<0.001). Four or more drugs were identified in femoral blood in 44% of deaths from poisoning (drug overdose) compared with 18% of deaths by other causes (p<0.001). The manner of death was considered accidental in 54% of deaths among repeat offenders compared with 28% for other suspicious deaths (p<0.001). The psychoactive substances most commonly identified in autopsy blood from repeat offenders were ethanol, morphine (from heroin), diazepam, amphetamines, cannabis, and various opioids. CONCLUSIONS This study shows that people arrested multiple times for use of illicit drugs and/or impaired driving are more likely to die by accidentally overdosing with drugs. Lives might be saved if repeat offenders were sentenced to treatment and rehabilitation for their drug abuse problem instead of conventional penalties for drug-related crimes.
Collapse
Affiliation(s)
- Johan Ahlner
- Department of Forensic Genetics and Forensic Toxicology, Swedish National Board of Forensic Medicine, Linköping, Sweden; Department of Clinical Pharmacology, Faculty of Medicine, Linköping University, Linköping, Sweden
| | - Anita Holmgren
- Department of Forensic Genetics and Forensic Toxicology, Swedish National Board of Forensic Medicine, Linköping, Sweden
| | - Alan Wayne Jones
- Department of Forensic Genetics and Forensic Toxicology, Swedish National Board of Forensic Medicine, Linköping, Sweden; Department of Clinical Pharmacology, Faculty of Medicine, Linköping University, Linköping, Sweden.
| |
Collapse
|
12
|
Karjalainen K, Haukka J, Lintonen T, Joukamaa M, Lillsunde P. The use of psychoactive prescription drugs among DUI suspects. Drug Alcohol Depend 2015; 155:215-21. [PMID: 26282109 DOI: 10.1016/j.drugalcdep.2015.07.1195] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/06/2015] [Revised: 07/06/2015] [Accepted: 07/10/2015] [Indexed: 10/23/2022]
Abstract
BACKGROUND The study seeks to increase understanding of the use of psychoactive prescription drugs among persons suspected of driving under the influence (DUI). We studied whether the use of prescribed psychoactive medication was associated with DUI, and examined the difference in the use of prescription drugs between DUI recidivists and those arrested only once. METHODS In this register-based study, persons suspected of DUI (n=29470) were drawn from the Register of DUI suspects, and an age- and gender-matched reference population (n=30043) was drawn from the Finnish general population. Data on prescription drug use was obtained by linkage to the National Prescription Register. The associations of DUI arrest and use of psychoactive prescription drugs in different DUI groups (findings for alcohol only, prescription drugs, prescription drugs and alcohol, illicit drugs) were estimated by using mixed-effect logistic regression. RESULTS The use of psychoactive prescription drugs and DUI appeared to be strongly associated, with DUI suspects significantly more likely to use psychoactive prescription drugs compared to the reference population. Gender differences existed, with the use of benzodiazepines being more common among female DUI suspects. Moreover, DUI recidivists were more likely to use psychoactive prescription drugs compared to those arrested only once. CONCLUSIONS In addition to alcohol and/or illicit drug use, a significant proportion of DUI suspects were using psychoactive prescription drugs. When prescribing psychoactive medication, especially benzodiazepines, physicians are challenged to screen for possible substance use problems and also to monitor for patients' alcohol or illicit drug use while being medicated.
Collapse
Affiliation(s)
| | - Jari Haukka
- National Institute for Health and Welfare, P.O. Box 30, FI-00271 Helsinki, Finland; Hjelt-Institute, Department of Public Health, University of Helsinki, P.O. Box 41, FI-00014 Helsinki, Finland
| | - Tomi Lintonen
- The Finnish Foundation for Alcohol Studies, P.O. Box 30, FI-00271 Helsinki, Finland; School of Health Sciences, University of Tampere, FI-33014 Tampere, Finland
| | - Matti Joukamaa
- School of Health Sciences, University of Tampere, FI-33014 Tampere, Finland
| | - Pirjo Lillsunde
- National Institute for Health and Welfare, P.O. Box 30, FI-00271 Helsinki, Finland
| |
Collapse
|
13
|
Poikolainen K. The Weakness of Stern Alcohol Control Policies. Alcohol Alcohol 2015; 51:93-7. [DOI: 10.1093/alcalc/agv081] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2015] [Accepted: 06/10/2015] [Indexed: 11/12/2022] Open
|
14
|
The arrest of drivers under the influence as a predictor of subsequent social disadvantage and death. Drug Alcohol Depend 2014; 137:114-20. [PMID: 24566278 DOI: 10.1016/j.drugalcdep.2014.01.018] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/17/2013] [Revised: 01/21/2014] [Accepted: 01/22/2014] [Indexed: 11/22/2022]
Abstract
BACKGROUND The association between DUI (driving under the influence) and disadvantaged social background has been shown in cross-sectional studies, but less is known about the processes behind this phenomenon. We aimed to examine the effect of DUI arrest on subsequent social disadvantage in Finland during 1993-2006 to provide more understanding about the dynamics of DUI and marginalization and to study DUI arrest as a potential point of intervention. METHODS In this longitudinal, register-based study the Register of DUI suspects (n=68894) was linked with the Employment Register. An age- and gender-matched reference population (n=67740) was drawn from the general Finnish population. A multi-state model was used to estimate the transition intensities between three different states (advantaged social status/disadvantaged social status/death) among three different DUI groups (alcohol only, prescription drugs, illicit drugs). RESULTS Compared to references, the movement of DUI suspects between different social states was more dynamic in that they were more likely to either move to a disadvantaged social state or to an improved status (except DUI suspects using prescription drugs). A DUI's relative risk of death compared to references was high, especially if currently in advantaged social status. The effect of DUI did not diminish over time. CONCLUSIONS Driving under the influence is associated with an increased long-term risk for social disadvantage. DUI arrest could serve as an opportunity for intervention in the marginalization process.
Collapse
|
15
|
Gjerde H, Bogstrand ST, Lillsunde P. Commentary: why is the odds ratio for involvement in serious road traffic accident among drunk drivers in Norway and Finland higher than in other countries? TRAFFIC INJURY PREVENTION 2014; 15:1-5. [PMID: 24279959 DOI: 10.1080/15389588.2013.780651] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/02/2023]
Abstract
OBJECTIVE Recent Norwegian and Finnish studies have found high odds ratios for serious or fatal injury in road traffic accidents among drivers after drinking alcohol. In this report we have compared the odds ratios with results from studies in other countries. METHODS A literature review was conducted. RESULTS The odds ratios were significantly higher than in countries where drunk driving is more common. CONCLUSION The calculated odds ratios are not only related to alcohol use or blood alcohol concentration per se but also related to the study design-for example, the inclusion of nonculpable drivers among cases-and confounding factors not included in statistical analysis; for example, risk-taking behavior. Those two issues may contribute to explaining why the reported odds ratios are higher for Norway and Finland.
Collapse
|
16
|
Klimkiewicz A, Jakubczyk A, Wnorowska A, Klimkiewicz J, Bohnert A, Ilgen MA, Brower KJ, Wojnar M. Violent behavior and driving under the influence of alcohol: prevalence and association with impulsivity among individuals in treatment for alcohol dependence in Poland. Eur Addict Res 2014; 20:151-8. [PMID: 24356779 DOI: 10.1159/000356192] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/30/2013] [Accepted: 10/04/2013] [Indexed: 11/19/2022]
Abstract
BACKGROUND Driving while intoxicated or under the influence (DUI; for the purposes of this paper, we use the following terms synonymously: driving under the influence, driving while intoxicated, and drunk driving) and engaging in interpersonal violence are two injury-related problems of high public health importance that have both been linked to alcohol consumption. This study sought to estimate the prevalence of DUI and violence in a sample of individuals in treatment for alcohol dependence in Poland. Patient characteristics associated with DUI and violence involvement, with a particular focus on impulsivity, were examined. METHODS Three hundred and sixty-four patients consecutively admitted to four alcohol treatment programs in Warsaw, Poland participated in this study. Questions concerning history of interpersonal violence as well as those about DUI were derived from the Michigan Alcoholism Screening Test. Impulsivity level was measured using the Barratt Impulsiveness Scale 11, the Revised NEO Personality Inventory, and the stop-signal task. RESULTS Among all participants in the study, 148 (40.1%) had been arrested in the past for DUI, and 196 (55%) reported involvement in a fight under the influence of alcohol (FUI). The DUI group had a significantly earlier onset of alcohol problems, a longer period of heavy alcohol use, and fewer women in comparison to participants without a DUI history. FUI patients were significantly younger, with a younger average age of onset of drinking problems, longer period of heavy drinking, and lower percentage of women than the non-FUI group. CONCLUSION Both of the self-reported measures of impulsivity indicated a higher level of impulsivity among participants from the FUI group than those from the non-FUI group.
Collapse
Affiliation(s)
- Anna Klimkiewicz
- Department of Psychiatry, Medical University of Warsaw, Warsaw, Poland
| | | | | | | | | | | | | | | |
Collapse
|