title: Underlying substance abuse problems in drunk drivers.
abstract: OBJECTIVE
  The aim of this study was to investigate polydrug use in drunk drivers.
  
  
  METHODS
  The experimental study was conducted on 2,072 drunk drivers undergoing a driving license reissue protocol at the Department of Legal Medicine of Padova University Hospital in the period between January 2011 and December 2012. The study protocol involved anamnesis, clinical examination, toxicological history, and toxicological analyses on multiple biological samples.
  
  
  RESULTS
  One thousand eight hundred seventy-seven subjects (90.6%) were assessed as fit to drive, and 195 (9.5%) were declared unfit. Among those unfit, 32 subjects (1.6%) were declared unfit due to recent use of an illicit drug (time span < 6 months), 23 (1.1%) spontaneously interrupted the protocol before its end, and 140 (6.8%) completed the assessment. Ineligibility to drive after completeness of the protocol was established in 1.2% of cases for alcohol disorders and in 5.7% of cases for illicit drug abuse; only one subject was included in both subgroups. Cocaine was the most widely used substance, followed by cannabis, opiates, and psychotropic pharmaceutical drugs.
  
  
  CONCLUSIONS
  The application of the protocol presented in this study allowed the identification of underlying polydrug use in drunk drivers. The study led to the identification of 6.8% unfit subjects on the basis of alcohol disorders and/or drug abuse, compared to 1.2% of identifiable unfitness if the protocol were limited to the mere assessment of alcohol consumption. The frequent association of alcohol and cocaine is different from other patterns of use in North Europe countries.
authors.affiliation: a Forensic Toxicology and Antidoping , University Hospital of Padova , Padova , Italy.
authors.forename: Rossella
authors.initials: R
authors.lastname: Snenghi
authors.forename: Giovanni
authors.initials: G
authors.lastname: Forza
authors.forename: Donata
authors.initials: D
authors.lastname: Favretto
authors.forename: Daniela
authors.initials: D
authors.lastname: Sartore
authors.forename: Silvia
authors.initials: S
authors.lastname: Rodinis
authors.forename: Claudio
authors.initials: C
authors.lastname: Terranova
authors.forename: Alessandro
authors.initials: A
authors.lastname: Nalesso
authors.forename: Massimo
authors.initials: M
authors.lastname: Montisci
authors.forename: Santo Davide
authors.initials: SD
authors.lastname: Ferrara
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000435:Alcoholic Intoxication / Q000453:epidemiology*; D001334:Automobile Driving / Q000706:statistics & numerical data*; D003042:Cocaine / Q000032:analysis; D005060:Europe / Q000453:epidemiology; D005260:Female; D006801:Humans; D013287:Illicit Drugs / Q000032:analysis; D008004:Licensure; D008297:Male; D008875:Middle Aged; D015813:Substance Abuse Detection / Q000706:statistics & numerical data*; D019966:Substance-Related Disorders / Q000453:epidemiology*; D055815:Young Adult
chemical_list: D013287:Illicit Drugs; D003042:Cocaine
keywords: driving license reissuing; drunk drivers; polydrug use; road safety