title: Prevalence of driving under the influence of psychoactive substances and road traffic crashes among Brazilian crack-using drivers.
abstract: Substance use disorders are associated with the increased risk of driving under the influence (DUI), but little is known about crack-cocaine and its relationship with road traffic crashes (RTC).
  
  
  
  A multicenter sample of 765 crack-cocaine users was recruited in six Brazilian capitals in order to estimate the prevalence of DUI and RTC involvement. Legal, psychiatric, and drug-use aspects related with traffic safety were evaluated using the Addiction Severity Index - 6th version (ASI-6) and the Mini International Neuropsychiatric Interview.
  
  
  
  Seventy-six (28.3%) current drivers reported accident involvement following crack-cocaine use. Among drivers (n=269), 45.7% and 30.5% reported DUIs in the past 6 months and 30 days, respectively. Drivers reporting DUI's in the past month (n=82) had higher scores in the "psychiatric", "legal", and "family problems" subscales from the ASI-6, and lower scores in the "family social support" subscale in comparison to those without a history of DUIs (n=187). An overall high prevalence of psychiatric comorbidity and substance consumption was observed. Participants with 5+ years of crack-cocaine use were more likely to have been in a RTC (RR=1.52, 95%IC: 1.02-2.75), independently of marijuana use, binge drinking and psychiatric comorbidities.
  
  
  
  The high prevalence of RTC and DUI involvement among crack-using drivers supports the idea that they are at a high risk group regarding traffic safety. Years of crack consumption seem to be associated with RTC involvement. Also, the presence of psychiatric comorbidities, poly-drug use, and cognitive impairment usually associated with crack addiction could yield additional risk of accidents.
authors.affiliation: Center for Drug and Alcohol Research and Collaborating Center on Alcohol and Drugs - HCPA/SENAD, Hospital de Clínicas de Porto Alegre, Federal University of Rio Grande do Sul, Rua Professor Álvaro Alvim, 400, 90420-020, Porto Alegre, RS, Brazil. Electronic address: juliananscherer@gmail.com.
authors.forename: Juliana Nichterwitz
authors.initials: JN
authors.lastname: Scherer
authors.affiliation: Center for Drug and Alcohol Research and Collaborating Center on Alcohol and Drugs - HCPA/SENAD, Hospital de Clínicas de Porto Alegre, Federal University of Rio Grande do Sul, Rua Professor Álvaro Alvim, 400, 90420-020, Porto Alegre, RS, Brazil.
authors.forename: Roberta
authors.initials: R
authors.lastname: Silvestrin
authors.affiliation: Center for Drug and Alcohol Research and Collaborating Center on Alcohol and Drugs - HCPA/SENAD, Hospital de Clínicas de Porto Alegre, Federal University of Rio Grande do Sul, Rua Professor Álvaro Alvim, 400, 90420-020, Porto Alegre, RS, Brazil.
authors.forename: Felipe
authors.initials: F
authors.lastname: Ornell
authors.affiliation: Center for Drug and Alcohol Research and Collaborating Center on Alcohol and Drugs - HCPA/SENAD, Hospital de Clínicas de Porto Alegre, Federal University of Rio Grande do Sul, Rua Professor Álvaro Alvim, 400, 90420-020, Porto Alegre, RS, Brazil.
authors.forename: Vinícius
authors.initials: V
authors.lastname: Roglio
authors.affiliation: Center for Drug and Alcohol Research and Collaborating Center on Alcohol and Drugs - HCPA/SENAD, Hospital de Clínicas de Porto Alegre, Federal University of Rio Grande do Sul, Rua Professor Álvaro Alvim, 400, 90420-020, Porto Alegre, RS, Brazil.
authors.forename: Tanara Rosangela Vieira
authors.initials: TRV
authors.lastname: Sousa
authors.affiliation: Center for Drug and Alcohol Research and Collaborating Center on Alcohol and Drugs - HCPA/SENAD, Hospital de Clínicas de Porto Alegre, Federal University of Rio Grande do Sul, Rua Professor Álvaro Alvim, 400, 90420-020, Porto Alegre, RS, Brazil.
authors.affiliation: Center for Drug and Alcohol Research and Collaborating Center on Alcohol and Drugs - HCPA/SENAD, Hospital de Clínicas de Porto Alegre, Federal University of Rio Grande do Sul, Rua Professor Álvaro Alvim, 400, 90420-020, Porto Alegre, RS, Brazil.
authors.forename: Lisia
authors.initials: L
authors.lastname: Von Diemen
authors.affiliation: Center for Drug and Alcohol Research and Collaborating Center on Alcohol and Drugs - HCPA/SENAD, Hospital de Clínicas de Porto Alegre, Federal University of Rio Grande do Sul, Rua Professor Álvaro Alvim, 400, 90420-020, Porto Alegre, RS, Brazil.
authors.forename: Felix Henrique Paim
authors.initials: FHP
authors.lastname: Kessler
authors.affiliation: Center for Drug and Alcohol Research and Collaborating Center on Alcohol and Drugs - HCPA/SENAD, Hospital de Clínicas de Porto Alegre, Federal University of Rio Grande do Sul, Rua Professor Álvaro Alvim, 400, 90420-020, Porto Alegre, RS, Brazil.
authors.forename: Flavio
authors.initials: F
authors.lastname: Pechansky
mesh_terms: D000063:Accidents, Traffic / Q000523:psychology / Q000706:statistics & numerical data*; D000328:Adult; D001334:Automobile Driving / Q000523:psychology*; D001938:Brazil / Q000453:epidemiology; D019970:Cocaine-Related Disorders / Q000523:psychology*; D016578:Crack Cocaine; D003430:Cross-Sectional Studies; D000066448:Driving Under the Influence / Q000523:psychology / Q000706:statistics & numerical data*; D005260:Female; D006801:Humans; D008297:Male; D015995:Prevalence
chemical_list: D016578:Crack Cocaine
keywords: Crack-cocaine; Driving under the influence; Drug Abuse; Psychiatric comorbidities; Road traffic crashes