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Fentanyl and Driving Impairment.

Timothy P Rohrig1, Emily Nash2, Kei A Osawa3

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Fentanyl-impaired driving cases surged 466-524% from 2014-2019. This potent opioid significantly impacts traffic safety, with drivers often found unresponsive or involved in crashes.

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Area of Science:

  • Forensic Toxicology
  • Drug-Impaired Driving
  • Public Health

Background:

  • Fentanyl's incidence in US forensic toxicology has surged.
  • Fentanyl's impact on drug-impaired driving (DUID) is understudied compared to overdose deaths.

Purpose of the Study:

  • To analyze fentanyl DUID case data from 2014 to 2019.
  • To assess the prevalence and characteristics of fentanyl-impaired driving across different US regions.

Main Methods:

  • Data collected from three toxicology labs (Northeast, Southeast, Midwest).
  • Analysis of fentanyl whole blood concentrations in living drivers.
  • Review of case histories, including poly-drug use and single-drug fentanyl cases.

Main Results:

  • Fentanyl-positive DUID cases increased 466-524% from 2014-2019.
  • Fentanyl whole blood concentrations ranged from 0.1 to 157 ng/mL.
  • Most cases involved poly-drug use; 20 cases involved fentanyl only (mean 5.2 ng/mL).
  • Common observations: driver unresponsive, vehicle leaving lane, crash involvement.

Conclusions:

  • Fentanyl poses a significant risk to traffic safety due to increased prevalence and impairment potential.
  • Fentanyl should be classified as a Tier I drug due to its DUID impact.
  • Tolerance or naloxone may mask impairment signs in some drivers.