title: International trends in alcohol and drug use among vehicle drivers.
abstract: Trends in the use of alcohol and drugs among motor vehicle drivers in Australia, Brazil, Norway, Spain, and the United States have been reviewed. Laws, regulations, enforcement, and studies on alcohol and drugs in biological samples from motor vehicle drivers in general road traffic and fatal road traffic crashes (RTCs) are discussed. Roadside surveys showed a reduction of drunk driving over time in the studied countries; however, the pattern varied within and between different countries. The reduction of alcohol use may be related to changes in road traffic laws, public information campaigns, and enforcement, including implementation of random breath testing or sobriety checkpoints. For non-alcohol drugs, the trend in general road traffic is an increase in use. However, drugs were not included in older studies; it is therefore impossible to assess the trends over longer time periods. Data from the studied countries, except Brazil, have shown a significant decrease in fatal RTCs per 100,000 inhabitants over the last decades; from 18.6 to 4.9 in Australia, 14.5 to 2.9 in Norway, 11.1 to 3.6 in Spain, and 19.3 to 10.3 in the United States. The number of alcohol-related fatal RTCs also decreased during the same time period. The proportion of fatal RTCs related to non-alcohol drugs increased, particularly for cannabis and stimulants. A general challenge when comparing alcohol and drug findings in biological samples from several countries is connected to differences in study design, particularly the time period for performing roadside surveys, biological matrix types, drugs included in the analytical program, and the cutoff limits used for evaluation of results. For RTC fatalities, the cases included are based on the police requests for legal autopsy or drug testing, which may introduce a significant selection bias. General comparisons between high-income countries and low- and middle-income countries as well as a discussion of possible future trends are included.
authors: Division of Forensic Sciences, Norwegian Institute of Public Health, Oslo, Norway.|Department of International Public Health, Norwegian Institute of Public Health, Oslo, Norway.
authors: A S
authors: AS
authors: Christophersen
authors: Division of Forensic Sciences, Norwegian Institute of Public Health, Oslo, Norway.
authors: J
authors: J
authors: Mørland
authors: Prevention Research Center, Safety and Policy Analysis International, Oakland, CA, USA.
authors: K
authors: K
authors: Stewart
authors: Division of Forensic Sciences, Norwegian Institute of Public Health, Oslo, Norway.
authors: H
authors: H
authors: Gjerde
mesh_terms: D000063:Accidents, Traffic; D001315:Australia / Q000453:epidemiology; D000067401:Blood Alcohol Content; D001938:Brazil / Q000453:epidemiology; D019049:Developed Countries; D003906:Developing Countries; D000066448:Driving Under the Influence / Q000331:legislation & jurisprudence* / Q000639:trends*; D006801:Humans; D013287:Illicit Drugs / Q000032:analysis; D038622:Internationality; D009664:Norway / Q000453:epidemiology; D004364:Pharmaceutical Preparations / Q000032:analysis; D013030:Spain / Q000453:epidemiology; D015813:Substance Abuse Detection; D019966:Substance-Related Disorders / Q000453:epidemiology; D014481:United States / Q000453:epidemiology
chemical_list: D000067401:Blood Alcohol Content; D013287:Illicit Drugs; D004364:Pharmaceutical Preparations
keywords: Alcohol; driving under the influence; drugs; legislation; road traffic crashes (RTCs); roadside surveys; trends