title: Drinking, drugs and driving in Ireland: more evidence for action.
abstract: OBJECTIVE
  To examine the prevalence of drug positivity among drivers suspected of driving under the influence of an intoxicant, and consequently apprehended by the police in Ireland.
  
  
  METHODS
  2000 specimens were selected for drug analysis, 1000 with results under the limit for alcohol and 1000 over the limit. The limit for alcohol is 80 mg/100 ml in blood and 107 mg/100 ml in urine. Seven drugs/drug classes were examined; amphetamines, methamphetamines, benzodiazapines, cannabinoids, cocaine, opiates and methadone.
  
  
  RESULTS
  331 (33.1%) of the drivers under the legal limit for alcohol tested positive for one or more of the relevant drugs, and the corresponding figures of drivers over the limit was 142 (14.2%; p<0.001). Using weighted analysis, this corresponds to 15.7% (95% confidence interval (CI) 13.5% to 18.1%) of all tested drivers (15.8% in men and 14.5% in women). Among drivers who had minimal blood alcohol levels, 67.9% (95% CI 61.2% to 74.1%) were taking at least one type of drug. The prevalence of taking drugs reduced steadily as alcohol concentrations increased, but still remained as high as 11.1% (95% CI 8.3% to 14.6%) for drivers with blood alcohol concentrations >200 mg/100 ml. Being under the limit for alcohol, stopped in a city area, stopped between 6 am and 4 pm, or 4 pm and 9 pm, and being of a younger age were each independently associated with drug positivity.
  
  
  CONCLUSIONS
  There are immediate implications for the evidential breath alcohol program and for checkpoints; in the event of a nil or low alcohol reading being obtained, a separate blood or urine specimen should be sought for analysis, which is currently non-routine.
authors.affiliation: UCD School of Public Health & Population Science, University College Dublin, Dublin, Ireland. patricia.fitzpatrick@ucd.ie
authors.forename: P
authors.initials: P
authors.lastname: Fitzpatrick
authors.forename: L
authors.initials: L
authors.lastname: Daly
authors.forename: C P
authors.initials: CP
authors.lastname: Leavy
authors.forename: D A
authors.initials: DA
authors.lastname: Cusack
mesh_terms: D000328:Adult; D017677:Age Distribution; D000368:Aged; D000428:Alcohol Drinking / Q000097:blood / Q000453:epidemiology*; D001334:Automobile Driving / Q000706:statistics & numerical data*; D000431:Ethanol / Q000097:blood; D005260:Female; D006801:Humans; D007494:Ireland / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D016495:Police; D015995:Prevalence; D015813:Substance Abuse Detection; D019966:Substance-Related Disorders / Q000175:diagnosis / Q000453:epidemiology*
chemical_list: D000431:Ethanol