Off-road vehicle crashes: dangers of alcohol and drug impairment

• Published in: Canadian journal of emergency medicine 2024-05, Vol.26 (5), p.321-326
• Main Authors: Kureshi, Nelofar, Clarke, David B., Audas, Lorelei, Magee, Kirk, Nassar, Bassam, Chan, Herbert, Yuan, Yue, Erdelyi, Shannon, Brubacher, Jeffrey R.
• Format: Article
• Language: English
• Subjects: Accidents, Traffic - statistics & numerical data; Adult; Alcohol Drinking - adverse effects; Alcohol Drinking - epidemiology; Brief Original Research; Canada - epidemiology; Driving Under the Influence - statistics & numerical data; Emergency Medicine; Female; Humans; Male; Medicine; Medicine & Public Health; Middle Aged; Prevalence; Public Health; Substance Abuse Detection - methods; Substance-Related Disorders - epidemiology
• ISSN: 1481-8035; 1481-8043; 1481-8043
• DOI: 10.1007/s43678-024-00656-w

Background Impaired driving is a public health issue, yet little is known concerning the prevalence of substance use in drivers involved in off-road vehicle crashes. The goal of the present study was to describe the demographics and prevalence of alcohol and drug use in drivers of off-road vehicle crashes. Methods In this observational substudy, we collected clinical and toxicological data on all moderately or severely injured off-road vehicle drivers who had blood samples obtained within 6 h of the crash. Clinical data were extracted from patients’ medical charts and toxicology analyses were performed for blood alcohol, cannabinoids, recreational drugs, and impairing medications. Results Thirty-three injured drivers met the inclusion criteria. The mean age was 37.6 ± 13.4 years and 79% were male. Blood alcohol was detected in 58% of drivers and 42% of these were above the legal limit. Tetrahydrocannabinol was positive in 12% of drivers, and 18% were positive for recreational drugs. Opiates were detected in 21% of drivers. Overall, 85% were positive for at least one substance and 39% tested positive for multiple substances. Conclusion This study presents the first evidence of alcohol and drug use in off-road vehicle drivers after cannabis legalization in Canada. Our results show that over half of drivers in off-road vehicle crashes test positive for alcohol and 30% tested positive for THC, cocaine, or amphetamines. Opiates are also commonly detected in off-road vehicle drivers. Emergency department (ED) visits resulting from drug driving of off-road vehicles serve as an opportunity for screening, initiating treatment, and connecting patients to interventions for substance use disorders.