title: Drugs related to motor vehicle crashes in northern European countries: a study of fatally injured drivers.
abstract: The aim of this study was to find which drugs and drug combinations were most common in drivers who died, in particular, in single vehicle crashes where the responsibility for the crash would be referred to the driver killed. The study included all available blood samples from drivers, who died within 24h of the accident, in the years 2001 and 2002 in the five Nordic countries (total population about 24 million inhabitants). The samples were analysed for more than 200 different drugs in addition to alcohol, using a similar analytical programme and cut-off limits in all countries. In three countries (Finland, Norway and Sweden) blood samples were available for more than 70% of the drivers, allowing representative prevalence data to be collected. 60% of the drivers in single vehicle crashes had alcohol and/or drug in their blood samples, compared with 30% of drivers killed in collisions with other vehicles. In single vehicle accidents, 66% of the drivers under 30 years of age had alcohol and/or drugs in their blood (alcohol only - 40%; drugs only - 12%; alcohol and drugs - 14%). The drugs found were mostly illicit drugs and psychoactive medicinal drugs with warning labels (in 57% and 58% respectively of the drivers under 30 with drugs present). Similar findings were obtained for drivers 30-49 years of age (63% with alcohol and/or drugs). In drivers aged 50 years and above, killed in single vehicle crashes (48% with alcohol and/or drugs) illicit drugs were found in only one case, and psychoactive medicinal drugs were detected less frequently than in younger age groups. In 75% of single vehicle crashes, the driver was under 50 years. Thus, the majority of accidents where the drivers must be considered responsible, occurred with drivers who had recently used alcohol, or drugs, alone or in combination. The drugs involved were often illicit and/or psychoactive drugs with warning labels. Therefore a large proportion of single vehicle accidents appear to be preventable, if more effective measures against driving after intake of alcohol and drugs can be implemented.
authors.affiliation: Norwegian Institute of Public Health, Division of Forensic Toxicology and Drug Abuse, P.O. Box 4404 Nydalen, NO-0403 Oslo, Norway. Electronic address: jorg.morland@fhi.no.
authors.forename: Jørg
authors.initials: J
authors.lastname: Mørland
authors.affiliation: Department of Forensic Medicine, Section of Forensic Chemistry, Faculty of Health Sciences, University of Copenhagen, Denmark.
authors.forename: Anni
authors.initials: A
authors.lastname: Steentoft
authors.affiliation: Department of Forensic Medicine, Section of Forensic Chemistry, Faculty of Health Sciences, University of Copenhagen, Denmark.
authors.forename: Kirsten Wiese
authors.initials: KW
authors.lastname: Simonsen
authors.affiliation: Hjelt Institute, Department of Forensic Medicine, PO Box 40 (Kytösuontie 11), FI-00014 University of Helsinki, Finland.
authors.forename: Ilkka
authors.initials: I
authors.lastname: Ojanperä
authors.affiliation: Hjelt Institute, Department of Forensic Medicine, PO Box 40 (Kytösuontie 11), FI-00014 University of Helsinki, Finland.
authors.forename: Erkki
authors.initials: E
authors.lastname: Vuori
authors.affiliation: Department of Pharmacology and Toxicology, University of Iceland, Iceland.
authors.forename: Kristin
authors.initials: K
authors.lastname: Magnusdottir
authors.affiliation: Department of Pharmacology and Toxicology, University of Iceland, Iceland.
authors.forename: Jakob
authors.initials: J
authors.lastname: Kristinsson
authors.affiliation: Department of Forensic Genetics and Forensic Toxicology, National Board of Forensic Medicine, Artillerigatan 12, 58758 Linköping, Sweden.
authors.forename: Gunnel
authors.initials: G
authors.lastname: Ceder
authors.affiliation: Department of Forensic Genetics and Forensic Toxicology, National Board of Forensic Medicine, Artillerigatan 12, 58758 Linköping, Sweden.
authors.forename: Robert
authors.initials: R
authors.lastname: Kronstrand
authors.affiliation: Norwegian Institute of Public Health, Division of Forensic Toxicology and Drug Abuse, P.O. Box 4404 Nydalen, NO-0403 Oslo, Norway.
authors.forename: Asbjørg
authors.initials: A
authors.lastname: Christophersen
mesh_terms: D000063:Accidents, Traffic / Q000401:mortality* / Q000517:prevention & control; D000328:Adult; D000428:Alcohol Drinking / Q000453:epidemiology; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011619:Psychotropic Drugs; D012537:Scandinavian and Nordic Countries / Q000453:epidemiology; D019966:Substance-Related Disorders / Q000453:epidemiology; D055815:Young Adult
chemical_list: D011619:Psychotropic Drugs