Collisions and traffic violations of alcohol, cannabis and cocaine abuse clients before and after treatment

Macdonald, Sheila; Mann, Robert E.; Chipman, Mary L.; Anglin-Bodrug, Kristin

doi:10.1016/j.aap.2003.07.004

Cited by 44 publications

(25 citation statements)

References 18 publications

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“…Our study shows a decrease in traffic problems among alcohol-dependent patients who complete one year's treatment, the percentage passing from 15.9% to 4.3%, which agrees with existing scientific evidence (Wells-Parker et al, 1995;Macdonald et al, 2004). In this sense, a recent report carried out on alcohol-related problems for patients in treatment (n = 117) shows that these patients have a higher traffic violation and collision rate than matched controls.…”

Section: Discussionsupporting

confidence: 78%

“…This study also assessed whether or not a reduction in traffic events and collisions after treatment had occurred in relation to pre-treatment and in comparison with a matched control group. The average number of collisions for the alcohol group decreased after treatment, whereas the control group remained stable (Macdonald et al, 2004). On the other hand, those with alcohol-related problems who had been involved in traffic accidents, do not change their drinking habits if they do not follow a course of treatment (Mayou and Bryant, 1995).…”

Section: Discussionmentioning

confidence: 99%

“…Unlike other studies, the present prospective study was designed without a control group not undergoing treatment for matching with the patients (Macdonald et al, 2004). This lack does not allow us to establish whether or not such a reduction in traffic problems would take place in the control group and nor does it allow us to compare both groups.…”

Section: Discussionmentioning

confidence: 99%

“…Firstly, the data concerning accidents are reported by patients themselves in personal interviews, which can lead to minimisation of data due to underreporting or non-reporting of possible problems so as not to endanger their therapy; unlike other works in which the data concerning traffic problems was obtained from databases belonging to the police and traffic authorities (Macdonald et al, 2004). In order to avoid or minimise this, the information reported by patients was confirmed by reports from relatives, although confirmation was not possible in all cases.…”

Section: Discussionmentioning

confidence: 99%

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Road traffic accidents among alcohol-dependent patients: The effect of treatment

Gomez-Talegon

Álvarez

2006

Accident Analysis & Prevention

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It is well known that driving under the influence of alcohol increases the risk of traffic accidents. Alcohol-dependent patients are responsible for two-thirds of motor vehicle crashes involving alcohol. Studies carried out on the general population have shown a relation between alcohol dependence and traffic accidents.The aim of the study is to analyse the effect on traffic accidents of treatment of patients with alcohol-related problems. To do so, the prevalence of traffic problems in a sample of patients with a diagnosed dependence on alcohol was assessed for three periods: during their lifetime, in the year preceding the start of treatment and over the year of treatment.A prospective study was carried out of 176 patients (147 males, 29 females; mean age 42.9 years) diagnosed as alcohol dependent according to the DSM-IV criteria in three alcoholic treatment centres in Castilla y León, Spain.36.9% of the alcohol-dependent patients had had some kind of traffic problem during their life and 8.5% in the year prior to starting treatment. The most frequent problem was positive breath tests, followed by accidents with damage to the vehicle. Sixty-nine of the 176 patients were still receiving treatment after a year. The prevalence of traffic problems among those patients who followed treatment for 1 year (4.3%) was lower than in the year before treatment (15.9%).The study showed that the treatment is also effective in reducing traffic problems.

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Section: Discussionsupporting

confidence: 78%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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Road traffic accidents among alcohol-dependent patients: The effect of treatment

Gomez-Talegon

Álvarez

2006

Accident Analysis & Prevention

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“…Au surplus, plusieurs de ces conducteurs étaient intoxiqués par l'alcool 12,16,18,[22][23] . Au Canada et dans plusieurs pays, le cannabis est impliqué dans un nombre signifi catif d'accidents de véhicules moteurs 12,[16][17][18][23][24][25] . Il produit des troubles de l'attention, de la perception, de la coordination et un ralentissement du temps de réaction.…”

Section: Cannabis Et Conduite De Véhicules Moteursunclassified

Pharmacologie du cannabis et synthèse des analyses des principaux comités d’experts

Amar

2004

dss

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RésuméLa première partie de cette étude est une exposition simplifiée de la pharmacologie du cannabis, la substance illicite la plus consommée au Québec, au Canada et dans le monde. Le cannabis contient plus de 460 produits connus, dont plus de 60 cannabinoïdes. L’ingrédient psychoactif majeur de la marijuana et du haschich est le delta-9-tétrahydrocannabinol (THC).Outre l’euphorie, le cannabis entraîne divers effets aigus et chroniques affectant principalement les systèmes nerveux central et périphérique, respiratoire, cardiovasculaire, endocrinien et immunitaire.De nombreux rapports anecdotiques et quelques études cliniques sur un nombre peu élevé de patients suggèrent les applications thérapeutiques suivantes du cannabis : sensation de bien-être, anxiolyse, stimulation de l’appétit, effet antiémétique, analgésie, effet antispasmodique et myorelaxant, soulagement du syndrome de la Tourette, effet anticonvulsivant, diminution de la pression intraoculaire dans le glaucome et traitement du sevrage à certains psychotropes. Au Canada, depuis le 31 juillet 2001, leRèglement sur l’accès à la marijuana à des fins médicalespermet à certains malades graves d’être admissibles à l’usage thérapeutique du cannabis. Parallèlement, Santé Canada a instauré depuis juin 1999 un programme de recherche sur l’emploi médicinal de la marijuana qui a débouché sur des essais cliniques en cours.L’Organisation mondiale de la santé (OMS) et divers comités d’experts nord-américains et européens concluent que le cannabis est moins dangereux pour la santé que beaucoup d’autres psychotropes. Nous comparerons la toxicité du cannabis, de l’héroïne, de la cocaïne, de l’alcool, de la nicotine (tabac) et de la caféine. Il n’y a pas d’évidence scientifique que le cannabis soit une drogue « gateway » incitant à l’usage de drogues plus dures comme l’héroïne ou la cocaïne. Contrairement à l’alcool et à plusieurs autres drogues, le cannabis ne conduit ni à la violence ni au crime. En fait, il tend à supprimer l’agressivité et à apaiser le récipiendaire.La deuxième partie de cet article traite du débat sur la législation entourant le cannabis puisque le Canada envisage une nouvelle politique dans ce domaine. Nous avons sélectionné certaines conclusions d’une série de rapports officiels émanant d’autorités scientifiques du Canada, des États-Unis, de la France et de la Grande-Bretagne. Elles font le point sur les effets du cannabis sur la santé et leurs retombées sur le plan législatif. La synthèse des analyses de ces comités d’experts permettra au lecteur de comprendre le contexte national et international qui a entouré le récent dépôt à la Chambre des communes du Canada du projet de loi fédéral visant, entre autres, la décriminalisation de la possession de petites quantités de cannabis.L’examen des principales conclusions de ces commissions d’experts nous conduit à constater que, jusqu’à récemment, les lois en matière de cannabis ont davantage été régies par des objectifs politiques que par des considérations scientifiques.

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Effectiveness of road safety interventions: An evidence and gap map

Goel,

Tiwari,

Varghese

et al. 2024

Campbell Systematic Reviews

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BackgroundRoad Traffic injuries (RTI) are among the top ten leading causes of death in the world resulting in 1.35 million deaths every year, about 93% of which occur in low‐ and middle‐income countries (LMICs). Despite several global resolutions to reduce traffic injuries, they have continued to grow in many countries. Many high‐income countries have successfully reduced RTI by using a public health approach and implementing evidence‐based interventions. As many LMICs develop their highway infrastructure, adopting a similar scientific approach towards road safety is crucial. The evidence also needs to be evaluated to assess external validity because measures that have worked in high‐income countries may not translate equally well to other contexts. An evidence gap map for RTI is the first step towards understanding what evidence is available, from where, and the key gaps in knowledge.ObjectivesThe objective of this evidence gap map (EGM) is to identify existing evidence from all effectiveness studies and systematic reviews related to road safety interventions. In addition, the EGM identifies gaps in evidence where new primary studies and systematic reviews could add value. This will help direct future research and discussions based on systematic evidence towards the approaches and interventions which are most effective in the road safety sector. This could enable the generation of evidence for informing policy at global, regional or national levels.Search MethodsThe EGM includes systematic reviews and impact evaluations assessing the effect of interventions for RTI reported in academic databases, organization websites, and grey literature sources. The studies were searched up to December 2019.Selection CriteriaThe interventions were divided into five broad categories: (a) human factors (e.g., enforcement or road user education), (b) road design, infrastructure and traffic control, (c) legal and institutional framework, (d) post‐crash pre‐hospital care, and (e) vehicle factors (except car design for occupant protection) and protective devices. Included studies reported two primary outcomes: fatal crashes and non‐fatal injury crashes; and four intermediate outcomes: change in use of seat belts, change in use of helmets, change in speed, and change in alcohol/drug use. Studies were excluded if they did not report injury or fatality as one of the outcomes.Data Collection and AnalysisThe EGM is presented in the form of a matrix with two primary dimensions: interventions (rows) and outcomes (columns). Additional dimensions are country income groups, region, quality level for systematic reviews, type of study design used (e.g., case‐control), type of road user studied (e.g., pedestrian, cyclists), age groups, and road type. The EGM is available online where the matrix of interventions and outcomes can be filtered by one or more dimensions. The webpage includes a bibliography of the selected studies and titles and abstracts available for preview. Quality appraisal for systematic reviews was conducted using a critical appraisal tool for systematic reviews, AMSTAR 2.Main ResultsThe EGM identified 1859 studies of which 322 were systematic reviews, 7 were protocol studies and 1530 were impact evaluations. Some studies included more than one intervention, outcome, study method, or study region. The studies were distributed among intervention categories as: human factors (n = 771), road design, infrastructure and traffic control (n = 661), legal and institutional framework (n = 424), post‐crash pre‐hospital care (n = 118) and vehicle factors and protective devices (n = 111). Fatal crashes as outcomes were reported in 1414 records and non‐fatal injury crashes in 1252 records. Among the four intermediate outcomes, speed was most commonly reported (n = 298) followed by alcohol (n = 206), use of seatbelts (n = 167), and use of helmets (n = 66). Ninety‐six percent of the studies were reported from high‐income countries (HIC), 4.5% from upper‐middle‐income countries, and only 1.4% from lower‐middle and low‐income countries. There were 25 systematic reviews of high quality, 4 of moderate quality, and 293 of low quality.Authors' ConclusionsThe EGM shows that the distribution of available road safety evidence is skewed across the world. A vast majority of the literature is from HICs. In contrast, only a small fraction of the literature reports on the many LMICs that are fast expanding their road infrastructure, experiencing rapid changes in traffic patterns, and witnessing growth in road injuries. This bias in literature explains why many interventions that are of high importance in the context of LMICs remain poorly studied. Besides, many interventions that have been tested only in HICs may not work equally effectively in LMICs. Another important finding was that a large majority of systematic reviews are of low quality. The scarcity of evidence on many important interventions and lack of good quality evidence‐synthesis have significant implications for future road safety research and practice in LMICs. The EGM presented here will help identify priority areas for researchers, while directing practitioners and policy makers towards proven interventions.

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Collisions and traffic violations of alcohol, cannabis and cocaine abuse clients before and after treatment

Cited by 44 publications

References 18 publications

Road traffic accidents among alcohol-dependent patients: The effect of treatment

Road traffic accidents among alcohol-dependent patients: The effect of treatment

Pharmacologie du cannabis et synthèse des analyses des principaux comités d’experts

Effectiveness of road safety interventions: An evidence and gap map

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