title: Differences in state drug testing and reporting by driver type in U.S. fatal traffic crashes.
abstract: BACKGROUND
  Driving under the influence of drugs, including marijuana, has become more prevalent in recent years despite local, state, and federal efforts to prevent such increases. The Fatality Analysis Reporting System (FARS) is the primary source of drugged driving data for fatal crashes in the United States but lacks the completeness required to calculate unbiased estimates of drug use among drivers involved in fatal crashes.
  
  
  METHODS
  This article uses the 2013 FARS dataset to present differences in state drug testing rates by driver type, driver fault type, and state-level factors; discusses limitations related to analysis and interpretation of drugged driving data; and offers suggestions for improvements that may enable appropriate use of FARS drug testing data in the future.
  
  
  RESULTS
  Results showed that state drug testing rates were highest among drivers who died at the scene of the crash (median=70.8%) and drivers who died and were at fault in the crash (median=64.4%). The lowest testing rates were seen among surviving drivers who were not transported to a hospital (median=14.0%) and surviving drivers who were not at fault in the crash (median=10.0%). Drug testing rates differed by state blood alcohol content (BAC) testing rate across all driver types and driver fault types, and in general, states that tested a higher percentage of drivers for BAC had higher drug testing rates.
  
  
  CONCLUSIONS
  Testing rates might be increased through standardization and mandatory testing policies. FARS data users should continue to be cautious about the limitations of using currently available data to quantify drugged driving. More efforts are needed to improve drug testing and reporting practices, and more research is warranted to establish drug concentration levels at which driving skills become impaired.
authors.affiliation: CSR, Incorporated, 4250 Fairfax Drive, Suite 500, Arlington, VA 22203, United States. Electronic address: mslater@csrincorporated.com.
authors.forename: Megan E
authors.initials: ME
authors.lastname: Slater
authors.affiliation: CSR, Incorporated, 4250 Fairfax Drive, Suite 500, Arlington, VA 22203, United States.
authors.forename: I-Jen P
authors.initials: IJ
authors.lastname: Castle
authors.affiliation: NMS Labs, 3701 Welsh Road, Willow Grove, PA 19090, United States.
authors.forename: Barry K
authors.initials: BK
authors.lastname: Logan
authors.affiliation: National Institute on Alcohol Abuse and Alcoholism, 5635 Fishers LN, Rockville, MD 20852, United States.
authors.forename: Ralph W
authors.initials: RW
authors.lastname: Hingson
mesh_terms: D000063:Accidents, Traffic / Q000401:mortality* / Q000706:statistics & numerical data*; D000328:Adult; D000368:Aged; D001334:Automobile Driving / Q000523:psychology / Q000706:statistics & numerical data*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D015995:Prevalence; D015813:Substance Abuse Detection; D019966:Substance-Related Disorders / Q000453:epidemiology; D013597:Systems Analysis; D014481:United States / Q000453:epidemiology; D055815:Young Adult
keywords: Drug testing rates; Drugged driving; FARS data; Marijuana; State variation