The existing literature on the prevalence of drug driving, the effects of drugs on driving performance, risk factors and risk perceptions associated with drug driving was reviewed. The 12-month pre...

A review of drug use and driving: epidemiology, impairment, risk factors and risk perceptions

Drugged driving, a review based on the experience in Norway

Police enforcement strategies to reduce traffic casualties in Europe

Drugged driving in the Nordic countries–: a comparative study between five countries

Objective. Road injuries are the leading injury-related cause of death among people aged 15-44. A clear dose-effect relationship has been demonstrated for drug and alcohol use and road traffic accidents. The objective of our study was to estimate the prevalence of drug and/or alcohol use in subjects admitted for road traffic accidents to an Emergency Department.
Methods. In this study, conducted between January and April
2006, 100 patients of both sexes (age 18-65) examined after
road traffic accidents were consecutively enrolled. A commercial
rapid urine test was used to detect drugs by the Emergency
Department staff. The alcohol concentration was determined
from a blood sample at the central laboratory.
Results. Most of the patients were drivers under 35 years of age.
67/100 road traffic accidents occurred at the weekend (Friday-
Sunday), nearly 60% between 24:00-09:00 hrs; on non-weekend
days about 80% of road traffic accidents were recorded between
14:00-24:00 hrs (p inf. 0.0001). With the alcoholemia test and
urine test for drugs detection 43/100 patients showed a single
or multiple positivity. Alcohol and drug presence is relevant
during the weekend (37/43 cases), in contrast with non weekend
(6/43 cases) [OR 3.04 (95% CI 1.43; 6.46)]. Alcohol was
the most frequently detected abuse substance (72%), followed
by benzodiazepines (42%), tetrahydrocannabinol (21%) and
cocaine (14%).
Discussion. 43% of patients examined were under the influence
of psychotropic substances (alcohol, drugs or both). The
greater part of road traffic accidents in positive test patients
occurred during the week-end, in particular during the late
night/early morning hours, probably after recreational time.
The high incidence of alcohol and/or drug abuse may have
caused physical and/or psychological problems, therefore the
high number of road traffic accidents, especially if taken in
combination.
Conclusion. The rapid urine test used cannot represent a diagnosis,
and requires a confirmation test. It can be used for medical
purposes as an easy and fast preliminary response which
enables a faster diagnostic and therapeutic guideline, but it
cannot be used for sanctions. Further studies are advisable with
an increase of number of patients, in a wider temporal range,
including control subjects, and using confirmation tests.

/pdf/prevalence-of-alcohol-and-drugs-in-urine-of-patients-q0sp2cdc67.pdf

Prevalence of alcohol and drugs in urine of patients involved in road accidents

Deaths due to road accidents during weekends have become a worrying phenomenon in Italy. With the aim of highlighting the role of psychotropic substances (alcohol, drugs of abuse, psychoactive drugs) in causing road accidents, a survey based on clinical and chemico toxicological analyses was carried out on car drivers in the Veneto region during the weekends of the three-month period June-August 1994. Rapid clinical screening was carried out on 1237 drivers. 265 of these, suspected to be under the influence of psychotropic substances, were subjected to complete clinical and toxicological ascertainment involving anamnesis, objective clinical examination and double sampling of blood and urine. Results demonstrated that: (1) 58 percent of the drivers examined had consumed alcohol; (2) 34.8 percent had BACs higher than the threshold permitted in Italy (80mg percent per mL); (3) 10.56 percent of drivers were found to be under the influence of drugs of abuse or psychoactive drugs; (4) 42.8 percent of the BACs in the range 50 to 100mg percent mL as ascertained by breathalyser, showed significant discrepancies with respect to direct blood dosage; (5) the most frequently found substances were (in order): cannabinoids, cocaine, amphetamines, opiates, benzodiazepines, barbiturates. (a) For the record of the covering entry of this conference, please see IRRD abstract no 868581.

Psychoactive substances and driving disability: epidemiological roadside survey in north-east italy

Population study and paternity testing of seven Y-chromosome STR-loci in an italian population sample

The aim of this work is to verify the presence of objectively observable morphological alterations caused by the direct action of opiates on brain structures controlling respiration in cases of drug-related deaths. A computer-assisted morphometric study was carried out on the Dorsal Motor Nucleus of the Vagus Nerve (DMNV) in seven subjects (four of whom died of drug overdose, and 3 controls). Serial sections 10-15 microns thick were stained according to Nissl. The sections were then examined under the optical microscope and 200 fields per subject were digitalized. The resulting images, regarding at least 700 neurons per subject were segmented using a semi-automatic procedure and analysed by the Optilab software. The data obtained were subjected to cluster analysis to identify the neuron classes in the DMNV. Each subject was characterized with a vector of percentages indicating the fraction of neurons falling in each of these classes. Discriminant analysis was then applied to verify to what extent the variables discriminated between the two populations. Results indicated that: the statistical methods adopted have a good power of discrimination; in subjects who died of opiate overdose, the neurons are distributed to a greater extent in classes composed of smaller neurons than in controls.

Opiate-related death: morphometric study of neurons from the dorsal motor nucleus of the vagus nerve.

The international literature reveals discrepancies regarding experimental and epidemiological evidence on the disabling role of blood alcohol concentration less than 50 mg per 100 mL, and variation is more pronounced in the case of subjects with different metabolisms. To obtain experimental evidence, the effects of low BACs on driving ability were investigated using 16 alcohol tolerating and non tolerating healthy volunteers, whose mean intake of ethyl alcohol was less than 0.5 and more than 1.5 g per kg per week. Neuropsychomotor functions were examined by correlation of GLC-HS serial dosages of ethyl alcohol in blood and saliva and computerized tests administered 15, 30, 60, 90, 120 and 180 minutes after intake of lorazepam, alcohol or placebo. The tests explored various functions such as cerebral activation, eye-hand coordination, short-term serial memory, vigilance and discrimination of deviant stimuli. Results showed: alteration of some neuro-psychomotor functions which are important for driving, in both sample groups; significant functional variations between subjects tolerating and not tolerating ethyl alcohol; and good correlation of blood and saliva levels of ethyl alcohol. (a) For the record of the covering entry of this conference, please see IRRD abstract no 868581.

Low blood alcohol concentrations and psychomotor performance in tolerating and non-tolerating subjects

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Papers

Psychoactive substances and driving disability: epidemiological roadside survey in north-east italy

Population study and paternity testing of seven Y-chromosome STR-loci in an italian population sample

Opiate-related death: morphometric study of neurons from the dorsal motor nucleus of the vagus nerve.

Low blood alcohol concentrations and psychomotor performance in tolerating and non-tolerating subjects