title: Drug use among drivers who drank on alcohol outlets from Porto Alegre, Brazil.
abstract: BACKGROUND
  Driving under the influence of multiple substances is a public health concern, but there is little epidemiological data about their combined use and putative impact on driving in low and middle-income countries where traffic crashes have been clustering in recent years. The aim of this study is to estimate the prevalence of alcohol and drug use - as well as their associated factors - among drivers in the context of alcohol outlets (AOs).
  
  
  METHODS
  A probability three-stage sample survey was conducted in Porto Alegre, Brazil. Individuals who were leaving AO were screened, with the selection of 683 drivers who met the inclusion criteria. Drivers answered a structured interview, were breathalyzed, and had their saliva collected for drug screening. Prevalences were assessed using domain estimation and logistic regression models assessed covariates associated with substance use.
  
  
  RESULTS
  Benzodiazepines 3.9% (SE 2.13) and cocaine 3.8% (SE 1.3) were the most frequently detected drugs in saliva. Among drivers who were going to drive, 11% had at least one drug identified by the saliva drug screening, 0.4% two, and 0.1% three drugs in addition to alcohol. In multivariable analyses, having a blood alcohol concentration (BAC)>0.06% was found to be associated with a 3.64 times (CI 95% 1.79-7.39) higher chance of drug detection, compared with interviewees with lower BACs.
  
  
  CONCLUSIONS
  To drive under the influence of multiple substances is likely to be found in this setting, highlighting an association between harmful patterns of consume of alcohol and the misuse of other substances.
authors.affiliation: Department of Health Information, Oswaldo Cruz Foundation, Rio de Janeiro, Brazil. Electronic address: raqueldeboni@msn.com.
authors.forename: Raquel B
authors.initials: RB
authors.lastname: De Boni
authors.forename: Francisco Inacio
authors.initials: FI
authors.lastname: Bastos
authors.forename: Mauricio
authors.initials: M
authors.lastname: de Vasconcellos
authors.forename: Fernanda
authors.initials: F
authors.lastname: Oliveira
authors.forename: Renata P
authors.initials: RP
authors.lastname: Limberger
authors.forename: Flavio
authors.initials: F
authors.lastname: Pechansky
mesh_terms: D000293:Adolescent; D000328:Adult; D000428:Alcohol Drinking / Q000453:epidemiology* / Q000331:legislation & jurisprudence; D001334:Automobile Driving / Q000331:legislation & jurisprudence / Q000706:statistics & numerical data*; D001569:Benzodiazepines / Q000378:metabolism; D001938:Brazil; D001944:Breath Tests; D003042:Cocaine / Q000378:metabolism; D005260:Female; D006801:Humans; D016015:Logistic Models; D008297:Male; D015999:Multivariate Analysis; D015995:Prevalence; D012307:Risk Factors; D012463:Saliva / Q000737:chemistry; D015813:Substance Abuse Detection; D019966:Substance-Related Disorders / Q000453:epidemiology*; D055815:Young Adult
chemical_list: D001569:Benzodiazepines; D003042:Cocaine
keywords: Alcohol outlets; Illicit drug use; Impaired driving; Low and middle-income countries; Population-based surveys