title: High prevalence of previous arrests for illicit drug use and/or impaired driving among drivers killed in motor vehicle crashes in Sweden with amphetamine in blood at autopsy.
abstract: BACKGROUND
  Amphetamine, and to a lesser extent the secondary amine methamphetamine, are major recreational drugs of abuse in Sweden. These central stimulant amines are identified in blood from roughly 50% of people arrested for driving under the influence of drugs (DUID). However, much less information is available about the presence of amphetamine in blood of drivers killed in road-traffic crashes.
  
  
  METHODS
  This retrospective 10-year study (2001-2010) used a forensic toxicology database (TOXBASE) to retrieve information about road-traffic crashes when the driver had amphetamine and/or methamphetamine in autopsy blood. Forensic toxicology results were available from over 95% of all drivers killed on Swedish roads during this 10-year period.
  
  
  RESULTS
  Amphetamine was present in the blood of 106 drivers (3.9%) either alone or together with other psychoactive substances (e.g. alcohol, cannabis, diazepam, alprazolam, etc.). The vast majority of fatalities were male (95%) with a mean age (±standard deviation) of 37±11.4 years (range 16-67 years). The mean (median) and highest concentrations of amphetamine in femoral blood were 1.36 mg/L (1.0mg/L) and 6.74 mg/L, respectively. Many of the victims (75%) had been arrested previously for use of illicit drugs or DUID. The median number of previous arrests was 4 (range 0-83) and amphetamine or methamphetamine were among the drugs identified in blood samples from 89% of cases (0-100%).
  
  
  CONCLUSIONS
  The high prevalence of repeat DUID offending and/or use of illicit drugs among the drivers killed in road-traffic crashes suggests that an early intervention and treatment for stimulant abuse might have been more beneficial than conventional punishments for such drug-related crimes.
authors.affiliation: Department of Forensic Genetics and Forensic Toxicology, National Board of Forensic Medicine, Sweden; Department of Clinical Pharmacology, University of Linköping, Faculty of Health Sciences, Linköping, Sweden. Electronic address: wayne.jones@liu.se.
authors.forename: Alan Wayne
authors.initials: AW
authors.lastname: Jones
authors.affiliation: Department of Forensic Genetics and Forensic Toxicology, National Board of Forensic Medicine, Sweden.
authors.forename: Anita
authors.initials: A
authors.lastname: Holmgren
authors.affiliation: Department of Forensic Genetics and Forensic Toxicology, National Board of Forensic Medicine, Sweden; Department of Clinical Pharmacology, University of Linköping, Faculty of Health Sciences, Linköping, Sweden.
authors.forename: Johan
authors.initials: J
authors.lastname: Ahlner
mesh_terms: D000063:Accidents, Traffic / Q000706:statistics & numerical data*; D000293:Adolescent; D000328:Adult; D000368:Aged; D000661:Amphetamine / Q000097:blood*; D001344:Autopsy; D003415:Crime / Q000706:statistics & numerical data*; D005260:Female; D053593:Forensic Toxicology; D006801:Humans; D013287:Illicit Drugs; D008297:Male; D008875:Middle Aged; D015995:Prevalence; D019966:Substance-Related Disorders / Q000453:epidemiology*; D013548:Sweden / Q000453:epidemiology
chemical_list: D013287:Illicit Drugs; D000661:Amphetamine
keywords: Abuse; Amphetamine; Driving; Impairment; Recidivism; Traffic fatalities