Cannabis use as a risk factor for causing motor vehicle crashes: a prospective study.


Journal

Addiction (Abingdon, England)
ISSN: 1360-0443
Titre abrégé: Addiction
Pays: England
ID NLM: 9304118

Informations de publication

Date de publication:
09 2019
Historique:
received: 31 10 2018
revised: 21 01 2019
accepted: 10 05 2019
pubmed: 21 5 2019
medline: 21 10 2020
entrez: 21 5 2019
Statut: ppublish

Résumé

We conducted a responsibility analysis to determine whether drivers injured in motor vehicle collisions who test positive for Δ-9-tetrahydrocannabinol (THC) or other drugs are more likely to have contributed to the crash than those who test negative. Prospective case-control study. Trauma centres in British Columbia, Canada. Injured drivers who required blood tests for clinical purposes following a motor vehicle collision. Excess whole blood remaining after clinical use was obtained and broad-spectrum toxicology testing performed. The analysis quantified alcohol and THC and gave semiquantitative levels of other impairing drugs and medications. Police crash reports were analysed to determine which drivers contributed to the crash (responsible) and which were 'innocently involved' (non-responsible). We used unconditional logistic regression to determine the likelihood (odds ratio: OR) of crash responsibility in drivers with 0 < THC < 2 ng/ml, 2 ng/ml ≤ THC < 5 ng/ml and THC ≥ 5 ng/ml (all versus THC = 0 ng/ml). Risk estimates were adjusted for age, sex and presence of other impairing substances. We obtained toxicology results on 3005 injured drivers and police reports on 2318. Alcohol was detected in 14.4% of drivers, THC in 8.3%, other drugs in 8.9% and sedating medications in 19.8%. There was no increased risk of crash responsibility in drivers with THC < 2 ng/ml or 2 ≤ THC < 5 ng/ml. In drivers with THC ≥ 5 ng/ml, the adjusted OR was 1.74 [95% confidence interval (CI) = 0.59-6.36; P = 0.35]. There was significantly increased risk of crash responsibility in drivers with blood alcohol concentration (BAC) ≥ 0.08% (OR = 6.00;95% CI = 3.87-9.75; P < 0.01), other recreational drugs detected (OR = 1.82;95% CI = 1.21-2.80; P < 0.01) or sedating medications detected (OR = 1.45; 95%CI = 1.11-1.91; P < 0.01). In this sample of non-fatally injured motor vehicle drivers in British Columbia, Canada, there was no evidence of increased crash risk in drivers with Δ-9-tetrahydrocannabinol < 5 ng/ml and a statistically non-significant increased risk of crash responsibility (odds ratio = 1.74) in drivers with Δ-9-tetrahydrocannabinol ≥ 5 ng/ml.

Identifiants

pubmed: 31106494
doi: 10.1111/add.14663
pmc: PMC6771478
doi:

Substances chimiques

Blood Alcohol Content 0
Hypnotics and Sedatives 0
Dronabinol 7J8897W37S

Types de publication

Journal Article Research Support, Non-U.S. Gov't

Langues

eng

Sous-ensembles de citation

IM

Pagination

1616-1626

Subventions

Organisme : CIHR
ID : MOP-111002
Pays : Canada

Commentaires et corrections

Type : CommentIn
Type : CommentIn

Informations de copyright

© 2019 The Authors. Addiction published by John Wiley & Sons Ltd on behalf of Society for the Study of Addiction.

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Auteurs

Jeffrey R Brubacher (JR)

Vancouver General Hospital and University of British Columbia, Vancouver, BC, Canada.

Herbert Chan (H)

University of British Columbia, Vancouver, BC, Canada.

Shannon Erdelyi (S)

University of British Columbia, Vancouver, BC, Canada.

Scott Macdonald (S)

University of Victoria, Victoria, BC, Canada.

Mark Asbridge (M)

Dalhousie University, Halifax, Nova Scotia, Canada.

Robert E Mann (RE)

Centre for Addiction and Mental Health, Toronto and University of Toronto, Toronto, Ontario, Canada.

Jeffrey Eppler (J)

Kelowna General Hospital and University of British Columbia, Kelowna, BC, Canada.

Adam Lund (A)

Royal Columbian Hospital and University of British Columbia, New Westminster, BC, Canada.

Andrew MacPherson (A)

Victoria General Hospital and University of British Columbia, Victoria, BC, Canada.

Walter Martz (W)

Institute of Forensic Medicine, Justus Liebig University, Giessen, Germany.

William E Schreiber (WE)

University of British Columbia, Vancouver, BC, Canada.

Rollin Brant (R)

University of British Columbia, Vancouver, BC, Canada.

Roy A Purssell (RA)

University of British Columbia, Vancouver, BC, Canada.

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