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Substance use and driver fatality in Norway: An expanded case-control study.

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Summary

Driving under the influence of alcohol or drugs significantly increases fatal crash risk. Polysubstance use, particularly with alcohol, poses the highest danger, followed by stimulant use.

Keywords:
Driving under the influencealcoholcrash involvementdriver fatalitydrugsfatal injuryodds ratio

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Area of Science:

  • Road safety research
  • Toxicology
  • Epidemiology

Background:

  • Impaired driving, especially alcohol, is a known risk factor for traffic accidents.
  • The impact of various psychoactive drugs and combined substance use on driver fatality requires further investigation.

Purpose of the Study:

  • To expand a previous study on substance use and driver fatality by increasing sample size.
  • To enhance statistical power for analyzing the effects of single and combined substance use on driver fatality.

Main Methods:

  • A case-control study involving 1197 fatally injured drivers (cases) and 17,219 random drivers (controls) in Norway (2005-2020).
  • Analysis of blood and oral fluid samples for alcohol and drug detection.
  • Unconditional logistic regression used to calculate adjusted odds ratios (aORs) for driver fatality, controlling for demographic and contextual factors.

Main Results:

  • Alcohol use showed a high aOR of 91 for driver fatality.
  • Stimulant use (amphetamines) had an aOR of 22, benzodiazepines/z-hypnotics (BZDs) an aOR of 4.0, and tetrahydrocannabinol (THC) an aOR of 3.4.
  • Any polysubstance use demonstrated a very high aOR of 168, with combinations of BZDs and stimulants or THC showing markedly increased fatality risks.

Conclusions:

  • Alcohol and polysubstance use are critical predictors of fatal road traffic injuries.
  • Stimulant use is also a significant risk factor for driver fatality.