Abstract
BackgroundDrug driving is an emerging global road safety problem. As the prevalence of alcohol-impaired driving decreases, and as more jurisdictions decriminalize or legalize cannabis, it is increasingly important for policy makers to have accurate information on the prevalence and pattern of drug driving. Unfortunately, this data is not widely available and the World Health Organization identifies lack of accurate data on the prevalence of drug driving as an important knowledge gap.MethodsIn this paper, we discuss the limitations of current methods of monitoring drug use in drivers. We then present a novel methodology from a multi-centre study that monitors the prevalence and pattern of drug use in injured drivers across Canada. This study uses “left-over” blood taken as part of routine medical care to quantify cannabis and other drugs in non-fatally injured drivers who present to participating emergency departments after a collision. Toxicology testing is done with waiver of consent as we have procedures that prevent results from being linked to any individual. These methods minimize non-response bias and have the advantages of measuring drug concentrations in blood obtained shortly after a collision.DiscussionOur methods can be applied in other jurisdictions and provide a consistent approach to collect data on drug driving. Consistent methods allow comparison of drug driving prevalence from different regions. Data from this research can be used to inform policies designed to prevent driving under the influence of cannabis and other impairing drugs.
Highlights
Drug driving is an emerging global road safety problem
We present the protocol for a national Canadian study of drug use in injured drivers
Eligibility criteria We include moderately or severely injured drivers of motorized vehicles who visit the emergency department (ED) of a participating hospital and have blood samples obtained within 6 h of the crash
Summary
Study design and setting This prospective observational study will obtain data from injured drivers treated in the emergency departments (EDs) in fifteen Canadian cities (Calgary, Edmonton, Halifax, Kelowna, Montreal, New Westminster, Ottawa, Quebec City, Regina, Saskatoon, Saint John, St John’s, Toronto, Vancouver, and Victoria). (Fig. 1) We plan to enroll 5200 participants over 2 years of recruitment This number will allow us to report the prevalence of drug driving according to substance (cannabis, impairing medications, etc) disaggregated by injury severity, region, sex, and age group. Blood samples are de-identified, and we have procedures in place to prevent linkage between toxicology results and individual drivers (Fig. 2). Blood handling and de-identification After eligible drivers are identified, excess blood is obtained from the hospital laboratory and relabelled with study identification numbers Data analysis We use descriptive statistics to report the proportion of injured drivers, disaggregated by sex and age range, who test positive for the following classes of psychotropic drugs: alcohol, cannabis (COOH-THC, THC), cocaine, amphetamines, opioids, benzodiazepines, antihistamines, antidepressants, and antipsychotics. Regional variation is described by reporting drug prevalence separately for each region of the country
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