Drug use among drivers who drank on alcohol outlets from Porto Alegre, Brazil

• Published in: Accident analysis and prevention 2014-01, Vol.62, p.137-142
• Main Authors: De Boni, Raquel B., Bastos, Francisco Inacio, de Vasconcellos, Mauricio, Oliveira, Fernanda, Limberger, Renata P., Pechansky, Flavio
• Format: Article
• Language: English
• Subjects: Addictive behaviors; Adolescent; Adult; Adult and adolescent clinical studies; Alcohol Drinking - epidemiology; Alcohol Drinking - legislation & jurisprudence; Alcohol outlets; Alcohols; Automobile Driving - legislation & jurisprudence; Automobile Driving - statistics & numerical data; Benzodiazepines - metabolism; Biological and medical sciences; Brazil; Breath Tests; Cocaine - metabolism; Crashes; Drug addiction; Drugs; Female; Humans; Illicit drug use; Impaired driving; Inclusions; Logistic Models; Low and middle-income countries; Male; Medical sciences; Miscellaneous; Multivariate Analysis; Outlets; Population-based surveys; Prevalence; Prevention and actions; Psychology. Psychoanalysis. Psychiatry; Psychopathology. Psychiatry; Public health. Hygiene; Public health. Hygiene-occupational medicine; Risk Factors; Saliva; Saliva - chemistry; Screening; Substance Abuse Detection; Substance-Related Disorders - epidemiology; Young Adult
• ISSN: 0001-4575; 1879-2057
• DOI: 10.1016/j.aap.2013.09.017

•A probability survey with drivers who had drank on alcohol outlets was conducted.•Drivers were breathalyzed and had their saliva collected for drug screening.•Benzodiazepines (3.9%) and cocaine (3.8%) were the most frequently detected drugs.•Among drivers who were going to drive, 11% had at least one other drug detected.•A BAC>0.06% was associated with higher chance of a positive drug screening. Driving under the influence of multiple substances is a public health concern, but there is little epidemiological data about their combined use and putative impact on driving in low and middle-income countries where traffic crashes have been clustering in recent years. The aim of this study is to estimate the prevalence of alcohol and drug use – as well as their associated factors – among drivers in the context of alcohol outlets (AOs). A probability three-stage sample survey was conducted in Porto Alegre, Brazil. Individuals who were leaving AO were screened, with the selection of 683 drivers who met the inclusion criteria. Drivers answered a structured interview, were breathalyzed, and had their saliva collected for drug screening. Prevalences were assessed using domain estimation and logistic regression models assessed covariates associated with substance use. Benzodiazepines 3.9% (SE 2.13) and cocaine 3.8% (SE 1.3) were the most frequently detected drugs in saliva. Among drivers who were going to drive, 11% had at least one drug identified by the saliva drug screening, 0.4% two, and 0.1% three drugs in addition to alcohol. In multivariable analyses, having a blood alcohol concentration (BAC)>0.06% was found to be associated with a 3.64 times (CI 95% 1.79–7.39) higher chance of drug detection, compared with interviewees with lower BACs. To drive under the influence of multiple substances is likely to be found in this setting, highlighting an association between harmful patterns of consume of alcohol and the misuse of other substances.