The prevalence of alcohol and other drugs in fatal road crashes in Victoria, Australia

Schumann, Jennifer; Perkins, Monica; Dietze, Paul; Nambiar, Dhanya; Mitra, Biswadev; Gerostamoulos, Dimitri; Drummer, Olaf H.; Cameron, Peter; Smith, Karen; Beck, Ben

doi:10.1016/j.aap.2020.105905

Cited by 30 publications

(15 citation statements)

References 46 publications

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“…The existence of polypharmacy, defined as the use of several psychotropic drugs simultaneously [ 28 ], may be of concern due to the potential occurrence of drug–drug interactions and unexpected toxicity phenomena [ 29 , 30 ]. Although polypharmacy is known to increase the risk of road traffic accidents [ 27 , 28 , 29 , 30 , 31 ], our findings showed an absence of association between traffic victims and polypharmacy, suggesting that road traffic accident victims were rarely associated with polypharmacy in our study ( Figure 1 ).…”

Section: Resultscontrasting

confidence: 61%

“…However, the problematic use of psychotropic drugs has risen drastically in developed countries. Due to their effects on the CNS, an increased presence and involvement of medical psychotropics in forensic issues seems evident [ 26 , 27 ]. Thus, in this same series, our group reported that BZDs, MOs, and ADPs were found more frequently in men who suffered a violent death and that BZDs use was positively associated with violent death [ 10 ], similar to data reported in Australia, where BZDs were detected in 13.2% of homicide and suicide deaths [ 28 , 29 ].…”

Section: Resultsmentioning

confidence: 99%

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Ethanol and Medical Psychotropics Co-Consumption in European Countries: Results from a Three-Year Retrospective Study of Forensic Samples in Spain

Almeida-González

Boada

Burillo-Putze

et al. 2022

Toxics

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Ethanol and medical psychotropics (MPs) are legal psychoactive substances widely consumed in Western countries that are routinely detected in standard toxicological analyses at compulsory autopsies, and toxicokinetic interactions between these drugs have been described. However, studies assessing the consequences of this co-consumption are scarce in Europe. We performed a retrospective study on toxicological results from compulsory autopsies in Spain. Thirty-five legal psychotropics, including ethanol, were measured in blood samples from 380 decedents to assess the determinants of such co-consumption. MPs were detected in 42.4% of the subjects. Polypharmacy was frequent in our series (25%), being more frequent in men than in women. More than one-third of the decedents had detectable levels of ethanol, and a significant positive association between ethanol levels and age was evident. About one-third of MPs consumers were also co-consumers of ethanol. The simultaneous consumption of ethanol and MPs was higher in men than in women. Blood alcohol concentrations (BAC) were lower in men who consumed MPs. In polypharmacy deaths, there was a significant negative association between the number of MPs consumed and BAC in men (r = −0.097; p = 0.029). Our results showed a high prevalence of co-consumption of MPs and ethanol in the European population involved in medico-legal issues and suggest that toxicokinetic interactions may be lowering BAC in men. This is a very worrying result, as it could indicate that the legal blood ethanol limits set by legislation would not be appropriate for men on MPs treatment.

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Section: Resultscontrasting

confidence: 61%

Section: Resultsmentioning

confidence: 99%

Ethanol and Medical Psychotropics Co-Consumption in European Countries: Results from a Three-Year Retrospective Study of Forensic Samples in Spain

Almeida-González

Boada

Burillo-Putze

et al. 2022

Toxics

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“…Driving under the influence (DUI) of alcohol causes thousands of deaths in traffic accidents each year worldwide [1][2][3][4]. The United States reported 10,511 alcohol-related driving fatalities in 2018, accounting for 29% of all road fatalities that year [5].…”

Section: Introductionmentioning

confidence: 99%

Cigarette Smoking as a Predictor of Male DUI Recidivism

Terranova

Forza

Beccegato

et al. 2021

IJERPH

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This study aimed to investigate the predictors of recidivism in first-time driving under the influence (DUI) offenders, analyzing variables derived from medico-legal and toxicological examinations. The research was structured as a comparative study for the period 2012–2019. DUI offenders with a blood alcohol concentration >0.5 were included in the study. The case group consisted of recidivist offenders, while the comparison group consisted of first-time offenders. Personal data, socioeconomics, and parameters linked to the DUI were compared between the two groups. Significance was determined by chi-square and Mann–Whitney tests. To prevent confounding effects, multivariate binary logistic regression analysis was performed. Our sample encompassed 1678 subjects (196 in the case group, 1482 in the comparison group). Gender, driving license category, education, and tobacco use resulted in significant differences between the groups. In a model including age at DUI, education, and smoking habit as independent variables, higher educational levels (high school, bachelor’s) and older age protected against recidivism, whereas smoking >20 cigarettes/day was an independent risk factor for recidivism. Recidivist offenders have specific characteristics indicating different therapeutic programs and carefulness in driving license regranting. A higher tobacco consumption in recidivists suggests that the use of this substance could influence the risk of DUI for reasons that will need to be explored.

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“…As recent research by Baldock and Lindsay (12) has demonstrated an increasing proportion of MA being detected in nonfatal crashes resulting in hospitalization, it could be that the nonsignificant findings in this study are skewed by the relatively low numbers of fatalities. An increasing prevalence of MA in injured drivers and road fatalities has been shown in Victoria over a similar time period (14, 21).…”

Section: Discussionmentioning

confidence: 81%

“…Baldock and Lindsay have shown an increase in recent years in illicit drug use among drivers and motorcycle operators admitted to hospital for testing in South Australia following crashes (12). This increasing trend has also been demonstrated in fatal collisions in Victoria, Australia (14). Primary prevention initiatives have involved the use of roadside drug testing of oral fluid for three illicit drugs specified in the South Australian Road Traffic Act (1961): N-methyl-alpha-methylphenethylamine (MA), in addition to delta-9-tetrahydrocannabinol (THC-the psychoactive ingredient in forms of cannabis) and 3,4-methylenedioxy-N-MA (MDMA or ecstasy).…”

Section: Introductionmentioning

confidence: 93%

Methamphetamine and alcohol detection in vehicle‐driver fatalities in South Australia: A 10‐year survey (2008–2018)

O'Donovan

Lewis

Heuvel

et al. 2021

Journal of Forensic Sciences

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Motor vehicle driver fatalities (≥18 years) from the files at Forensic Science South Australia were reviewed from January 2008 to December 2018 for cases in which either positive blood sample for methamphetamine (MA) or an illegal blood alcohol concentration (BAC) >0.05g/100 ml were found. Three hundred driver deaths were found with MA detected in 28 cases (age range 21–62 years; ave. 37.8 years; M:F 23:5). Hundred and fifteen cases with a BAC > 0.05 g/100 ml were identified (age range 18–67 years; ave 35.7 years; M:F 95:20). No change was found in numbers of MA cases, although alcohol cases showed a significant decline (p < 0.001). Drunk driving‐related fatal crashes tended to occur in the evening (5 p.m. to 11 p.m.), while MA‐related fatal crashes had a longer peak extending from late evening until late morning (11 p.m. to 8 a.m.). This study has demonstrated that while roadside breath testing, legislative changes, and increased monitoring have resulted in reduced levels of drunk driving, similar safety countermeasures have had negligible effects on MA use in drivers. Continued monitoring of MA use by drivers will, therefore, be necessary to assess the possible effects, or not, of new countermeasures.

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The prevalence of alcohol and other drugs in fatal road crashes in Victoria, Australia

Cited by 30 publications

References 46 publications

Ethanol and Medical Psychotropics Co-Consumption in European Countries: Results from a Three-Year Retrospective Study of Forensic Samples in Spain

Ethanol and Medical Psychotropics Co-Consumption in European Countries: Results from a Three-Year Retrospective Study of Forensic Samples in Spain

Cigarette Smoking as a Predictor of Male DUI Recidivism

Methamphetamine and alcohol detection in vehicle‐driver fatalities in South Australia: A 10‐year survey (2008–2018)

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