title: The relation between the use of psychoactive substances and the severity of the injury in a group of crash-involved drivers admitted to a regional trauma center.
abstract: OBJECTIVE
  There is much evidence that driving under the influence of alcohol and/or drugs of abuse is related to an increased accident risk. A remaining question is whether the use of psychoactive substances is also related to clinically more severe accidents. The aim of this study is to explore the relationship between the use of psychoactive substances and the injury severity in a group of crash-involved drivers.
  
  
  METHODS
  The study group included all injured car drivers, admitted to the regional trauma center, in the period from May 2000 until August 2001. The outcome of interest was the severity of injury, measured by using the Injury Severity Score (ISS). The determinant was the presence of psychoactive substances in blood and urine samples. Psychoactive substances tested for were alcohol, amphetamines, barbiturates, benzodiazepines, cannabis, methadone, opiates, and tricyclic antidepressants in blood and urine.
  
  
  RESULTS
  The number of injured car drivers included in this study was 106. Overall, 43% (46/106) of the drivers tested positive for at least one psychoactive substance. Comparison of the means of the log ISS suggests that there is no significant difference between drivers who tested positive for alcohol and/or drugs, compared to drivers tested negative.
  
  
  CONCLUSIONS
  The results of this study support the hypothesis that there is no clear association between use of psychoactive substances and the severity of crash-related injury.
authors.affiliation: Department of Toxicology, Netherlands Forensic Institute, The Hague, The Netherlands. b.smink@nfi.minjus.nl
authors.forename: B E
authors.initials: BE
authors.lastname: Smink
authors.forename: K L L
authors.initials: KL
authors.lastname: Movig
authors.forename: K J
authors.initials: KJ
authors.lastname: Lusthof
authors.forename: J J
authors.initials: JJ
authors.lastname: De Gier
authors.forename: D R A
authors.initials: DR
authors.lastname: Uges
authors.forename: A C G
authors.initials: AC
authors.lastname: Egberts
mesh_terms: D000063:Accidents, Traffic; D000293:Adolescent; D000328:Adult; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009426:Netherlands; D011619:Psychotropic Drugs / Q000097:blood / Q000302:isolation & purification* / Q000652:urine; D012189:Retrospective Studies; D014193:Trauma Centers; D015599:Trauma Severity Indices; D014947:Wounds and Injuries / Q000145:classification / Q000473:pathology*
chemical_list: D011619:Psychotropic Drugs