Trends in Alcohol and Other Drugs Detected in Fatally Injured Drivers in the United States, 1999–2010

Joanne E. Brady; Guohua Li

Disclosures

Am J Epidemiol. 2014;179(6):692-699. 

In This Article

Results

Overall, 23,591 (90.9%) of the 25,951 drivers who died within 1 hour of a crash in these 6 states underwent toxicological testing. Drivers who were tested for drugs were similar in crash circumstances to those who were not tested, but they appeared to be slightly younger (mean age = 39.4 (standard deviation, 19.4) years vs. 43.4 (standard deviation, 27.7) years), more likely to be male (77.7% vs. 75.8%), more likely to be involved in nighttime crashes (51.4% vs. 47.0%), and more likely to have been involved in a crash in the previous 3 years (15.7% vs. 13.9%) than those who were not tested.

Of the 23,591 drivers tested, 39.7% were positive for alcohol, and 24.8% tested positive for other drugs. The prevalence of alcohol involvement was stable at approximately 39% from 1999 to 2010 (Z = −1.4, P = 0.16). Alcohol involvement was more prevalent in men (43.6%) than in women (26.1%), but trends were stable for both sexes (Table 1). In contrast, the prevalence of nonalcohol drugs showed a statistically significant increasing trend over the study period, rising from 16.6% (95% confidence interval (CI): 14.8, 18.4) in 1999 to 28.3% (95% CI: 26.0, 30.7) in 2010 (Z = −10.19, P < 0.0001). The prevalence rates of nonalcohol drugs and 2 or more nonalcohol drugs increased significantly over the study period in both sexes (Table 1). The prevalence of nonalcohol drug use increased significantly across all age groups (Figure 1).

Figure 1.

Prevalence of nonalcohol drugs in drivers who died within 1 hour of a crash by year and age group, Fatality Analysis Reporting System, selected states, 1999–2010. Unfilled circle, <25 years; unfilled triangle, 25–44 years; unfilled square, 45–64 years; filled circle, ≥65 years.

When time trends of nonalcohol drugs were examined by drug class, the prevalence of narcotics tripled during the study period, increasing from 1.8% in 1999 (95% CI: 1.3, 2.6) to 5.4% (95% CI: 4.4, 6.8) in 2010 (Z = −7.07, P < 0.0001, Figure 2), and the increase occurred in both sexes (Table 1). The prevalence of depressants (excluding alcohol) and other drugs also increased significantly over the study period (Z = −4.54, P < 0.0001, and Z = −2.61, P = 0.01, respectively). There was not a monotonic trend in the prevalence of stimulants during the study period (Figure 2). Overall, the prevalence of cannabinol nearly tripled over the study period, increasing from 4.2% (95% CI: 3.3, 5.2) in 1999 to 12.2% (95% CI: 10.6, 14.1) in 2010 (Z = −13.63, P < 0.0001, Figure 2), and the upward trends in the prevalence of cannabinol were similar for men and women (Table 1). By the end of the study period, cannabinol became the most prevalent nonalcohol drug detected in fatally injured drivers (Figure 2). The prevalence of cannabinol increased significantly across age groups (Figure 3). The increase in the prevalence of cannabinol was most pronounced among fatally injured drivers less than 25 years of age (Figure 3).

Figure 2.

Prevalence of drug involvement in drivers who died within 1 hour of a crash by year and drug category, Fatality Analysis Reporting System, selected states, 1999–2010. Unfilled circle, narcotics; unfilled triangle, stimulants; unfilled square, cannabinol; filled circle, depressants (excluding alcohol); filled triangle, other drugs.

Figure 3.

Prevalence of cannabinol involvement in drivers who died within 1 hour of a crash by year and age group, Fatality Analysis Reporting System, selected states, 1999–2010. Unfilled circle, <25 years; unfilled triangle, 25–44 years; unfilled square, 45–64 years; filled circle, ≥65 years.

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