Underlying substance abuse problems in drunk drivers.

Area of Science:

• Forensic Toxicology
• Addiction Medicine
• Road Safety

Background:

• Polydrug use among individuals with alcohol use disorders presents significant public health and safety challenges.
• Assessing fitness to drive requires a thorough evaluation beyond alcohol consumption, encompassing illicit and pharmaceutical drug use.

Purpose of the Study:

• To investigate the prevalence and patterns of polydrug use in individuals apprehended for driving under the influence of alcohol.
• To evaluate the effectiveness of a comprehensive protocol in identifying drunk drivers with co-occurring alcohol and drug abuse.

Main Methods:

• A study involving 2,072 drunk drivers undergoing a driving license reissue protocol.
• Data collection included anamnesis, clinical examination, toxicological history, and analysis of multiple biological samples.

Main Results:

• 5.7% of drivers were deemed unfit due to illicit drug abuse, with cocaine being the most frequently detected substance.
• Cocaine, cannabis, opiates, and psychotropic pharmaceutical drugs were the most common illicit substances found.
• A comprehensive protocol identified 6.8% of subjects as unfit due to alcohol disorders and/or drug abuse.

Conclusions:

• The implemented protocol effectively identifies polydrug use in drunk drivers, revealing a higher prevalence of unfitness compared to alcohol assessment alone.
• The frequent co-occurrence of alcohol and cocaine use in this population differs from patterns observed in Northern Europe.
• A thorough toxicological and clinical assessment is crucial for accurate fitness-to-drive evaluations in drunk drivers.