Use of cannabis and/or prescription opioids among adult drivers in Ontario, Canada: Prevalence and association with motor vehicle collisions

Abstract

ObjectiveIn response to the opioid crisis, health practitioners and patients are seeking effective non-opioid analgesic alternatives for treatment of non-cancer pain. Cannabis is being considered as an alternative to opioids for this purpose. This shift may result in an increase in combined use of these drugs, which may have important health implications, including those related to road safety. This study was designed to provide a population-based estimate of the prevalence of cannabis and/or prescription opioid use and their impact on collision risk. MethodBased on data from a regionally stratified cross-sectional general population telephone survey of adults (18+ years) in Ontario, Canada conducted from 2010 through 2018 (N = 13,552), a binary logistic regression was conducted of self-reported past-year collision involvement, assessing demographic characteristics, year of interview, driving exposure, hazardous drinking, perceived general and mental health, and past-year use of cannabis and/or prescription opioids. ResultsApproximately 29.5 percent of respondents reported using either cannabis (11.1 percent) or prescription opioids (18.4 percent), whereas 3.8 percent reported using both cannabis and prescription opioids. Adjusting for potential covariates, relative to those who reported using either cannabis or prescription opioids, drivers who reported being users of both drugs faced more than a two-fold increase in their odds of past-year collision involvement (AdjOR = 2.29, 95% CI = 1.46–3.58, p < 0.001). ConclusionsThe identified increase in the odds of a crash among drivers who report use of both cannabis and of prescription opioids has important implications. Further research examining the impact of combined use on driver skills and behaviours is needed.