Driving under the influence of drugs (DUID) profiling in Spain: Data from oral fluid results between 2016 and 2022, including the effect of COVID-19 lockdown

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To provide information about driving under the influence of drugs (DUID) cases in Spain during the last 6 years and to evaluate the impact of the Spanish lockdown (March 14th to May 6th 2020) on drivers’ consumption profile. In total, 16,461 oral fluid samples were collected from drivers in Spain that tested positive on the roadside between January 1st 2016 and April 15th 2022. Samples were collected at different locations throughout the country and analyzed by LC-MS/MS at the Toxicology Service of the Institute of Forensic Sciences of the University of Santiago de Compostela. For data analysis, drugs and their metabolites were classified in 8 different groups (cannabis, cocaine, amphetamines, opioids, benzodiazepines, ketamine, methadone and zolpidem). Demographic characteristics and drug profile were evaluated during time. The impact of COVID-19 pandemic lockdown was also considered, applying Chi 2 test. Drivers were mainly young adults (33.3 ± 9.9 years old) and men (94.2% male). In 97.6% of cases, LC-MS/MS results confirmed at least one of the positive results detected on the roadside. Cannabis (72.6%) and cocaine (64.4%) were the most detected drugs, followed by amphetamines (13.8%), opioids (12.9%), benzodiazepines (7.7%), and methadone (7.4%). Polydrug use was observed in 55.1% of drivers, being the combination of substances from two different groups the most prevalent. Cannabis and cocaine were the most common combination (either only the two of them or mixed with more substances). Changes in drivers’ consumption profile was noticed when comparing data from the specimens collected during the Spanish lockdown period ( n = 151) vs. specimens obtained during 2020 before (“pre-lockdown”, n = 557) and after (“post-lockdown”, n = 1974) that period. During the lockdown period drivers were 3 years older in average, and polyconsumers of 4 and 5 different groups of substances doubled (in average, 4.5% vs. 9.9% for 4 groups; 0.7% vs. 1.3% for 5 groups). Nevertheless, results were only statistically different for consumers of 4 groups of substances during lockdown, either compared with pre- and post-lockdown results. Also, for polyconsumers, the combination of cannabis and cocaine with amphetamines, with high prevalence before lockdown, was substituted by the combination of cannabis and cocaine with methadone. Furthermore, opiates use was two times higher (in average, 14.0% vs. 24.5%), being this difference statistically significant when comparing the 3 periods. On the other hand, amphetamines and ketamine were less consumed by drivers during lockdown (in average, 11.2% vs. 9.9% for amphetamines; 3.2% vs. 0.7% for ketamine). Nevertheless, these differences were only statistically significant when considering ketamine consumption post-lockdown (either compared with pre-lockdown or lockdown results). The use of oral fluid samples was able to confirm the vast majority of the screening results found in roadside screening tests. In Spain, cannabis and cocaine remain the most detected drugs on the roadside, as previously reported from our group in the period 2013–2015 (Lema-Atán JA. Drug Alcohol Depend 2019;195:106–113). During the lockdown period in Spain, due to stay-at-home orders, mobility was only allowed for “essential workers”. Samples collected in those months showed an increase in polydrug use, especially for opiates and methadone, as well as a decrease in the use of “party drugs” (amphetamines and ketamine). LC-MS/MS confirmation result was negative in only 2.4% of the cases. The DUID driver profile was a young man, consuming either cannabis or a combination of cannabis and cocaine, alone or combined with more substances. During lockdown, drivers consumed less “party drugs” and more opiates and methadone. Moreover, there was a higher rate of polyconsumers (4 or 5 groups of substances).