Drivers who tested positive for cannabis in oral fluid: a longitudinal analysis of administrative data for Spain between 2011 and 2016

There is no author summary for this article yet. Authors can add summaries to their articles on ScienceOpen to make them more accessible to a non-specialist audience.

Abstract

Objectives

This study aimed to assess the association between positive roadside tests for delta-9-tetrahydrocannabinol (THC) and other driving-impairing substances and THC concentrations and the age and gender of THC-positive drivers.

Design

This study is based on administrative data.

Setting, participants and exposures

National administrative data on drivers who tested positive in confirmation analysis of driving-impairing substances in oral fluid were assessed (2011–2016, 179 645 tests).

Primary and secondary outcome measures

Frequencies of positivity for THC, THC alone and THC plus non-THC substances (stratification by age and gender in 2016) and THC concentration were obtained. Comparisons and univariate and multivariate regression analyses were performed.

Results

Of the 65 244 confirmed drug-positive tests, 51 869 were positive for THC (79.5%). In 50.8% of the THC-positive tests, cocaine and amphetamines were also detected. Positivity for THC and non-THC substances predominated among drivers with low THC concentrations and represented 58.6% of those with levels lower than 25 ng/mL. The mean±SD for age was 29.6±7.7 years (year 2016, n=24 941). Men accounted for 96.3% of all THC-positive drivers. With increasing age, positivity for THC decreased (OR 0.948; 95% CI 0.945 to 0.952; p<0.0001), and positivity for THC and non-THC substances increased (OR 1.021; 95% CI 1.017 to 1.024; p<0.0001). Men were associated with higher THC concentrations (OR 1.394; 95% CI 1.188 to 1.636; p<0.0001).

Conclusions

Cannabis positivity is frequent among drivers, and polysubstance use is common. Hence, focusing on younger drivers and those with low THC concentrations is encouraged. This study provides evidence on the current implementation of roadside drug testing in Spain and aims to characterise driving under the influence (DUI) of cannabis to increase the awareness of all involved to help them avoid DUI.

Related collections

Most cited references 23

Record: found
Abstract: found
Article: found

Is Open Access

Acute cannabis consumption and motor vehicle collision risk: systematic review of observational studies and meta-analysis

Mark Asbridge, Jill Hayden, Jennifer L Cartwright (2012)

Objective To determine whether the acute consumption of cannabis (cannabinoids) by drivers increases the risk of a motor vehicle collision. Design Systematic review of observational studies, with meta-analysis. Data sources We did electronic searches in 19 databases, unrestricted by year or language of publication. We also did manual searches of reference lists, conducted a search for unpublished studies, and reviewed the personal libraries of the research team. Review methods We included observational epidemiology studies of motor vehicle collisions with an appropriate control group, and selected studies that measured recent cannabis use in drivers by toxicological analysis of whole blood or self report. We excluded experimental or simulator studies. Two independent reviewers assessed risk of bias in each selected study, with consensus, using the Newcastle-Ottawa scale. Risk estimates were combined using random effects models. Results We selected nine studies in the review and meta-analysis. Driving under the influence of cannabis was associated with a significantly increased risk of motor vehicle collisions compared with unimpaired driving (odds ratio 1.92 (95% confidence interval 1.35 to 2.73); P=0.0003); we noted heterogeneity among the individual study effects (I2=81). Collision risk estimates were higher in case-control studies (2.79 (1.23 to 6.33); P=0.01) and studies of fatal collisions (2.10 (1.31 to 3.36); P=0.002) than in culpability studies (1.65 (1.11 to 2.46); P=0.07) and studies of non-fatal collisions (1.74 (0.88 to 3.46); P=0.11). Conclusions Acute cannabis consumption is associated with an increased risk of a motor vehicle crash, especially for fatal collisions. This information could be used as the basis for campaigns against drug impaired driving, developing regional or national policies to control acute drug use while driving, and raising public awareness.

0 comments Cited 185 times – based on 0 reviews      Review now

Bookmark

Record: found
Abstract: found
Article: not found

Cannabis effects on driving skills.

Rebecca L Hartman, Marilyn A. Huestis (2013)

Cannabis is the most prevalent illicit drug identified in impaired drivers. The effects of cannabis on driving continue to be debated, making prosecution and legislation difficult. Historically, delays in sample collection, evaluating the inactive Δ(9)-tetrahydrocannabinol (THC) metabolite 11-nor-9-carboxy-THC, and polydrug use have complicated epidemiologic evaluations of driver impairment after cannabis use.

0 comments Cited 163 times – based on 0 reviews      Review now

Bookmark

Record: found
Abstract: found
Article: not found

Marijuana use and motor vehicle crashes.

M.-C. Li, J. Brady, C J DiMaggio … (2012)

Since 1996, 16 states and the District of Columbia in the United States have enacted legislation to decriminalize marijuana for medical use. Although marijuana is the most commonly detected nonalcohol drug in drivers, its role in crash causation remains unsettled. To assess the association between marijuana use and crash risk, the authors performed a meta-analysis of 9 epidemiologic studies published in English in the past 2 decades identified through a systematic search of bibliographic databases. Estimated odds ratios relating marijuana use to crash risk reported in these studies ranged from 0.85 to 7.16. Pooled analysis based on the random-effects model yielded a summary odds ratio of 2.66 (95% confidence interval: 2.07, 3.41). Analysis of individual studies indicated that the heightened risk of crash involvement associated with marijuana use persisted after adjustment for confounding variables and that the risk of crash involvement increased in a dose-response fashion with the concentration of 11-nor-9-carboxy-delta-9-tetrahydrocannabinol detected in the urine and the frequency of self-reported marijuana use. The results of this meta-analysis suggest that marijuana use by drivers is associated with a significantly increased risk of being involved in motor vehicle crashes.

0 comments Cited 103 times – based on 0 reviews      Review now

Bookmark

All references

Author and article information

Journal

Journal ID (nlm-ta): BMJ Open

Journal ID (iso-abbrev): BMJ Open

Journal ID (hwp): bmjopen

Journal ID (publisher-id): bmjopen

Title: BMJ Open

Publisher: BMJ Publishing Group (BMA House, Tavistock Square, London, WC1H 9JR )

ISSN (Electronic): 2044-6055

Publication date Collection: 2019

Publication date (Electronic): 26 August 2019

Volume: 9

Issue: 8

Electronic Location Identifier: e026648

Affiliations

[1 ] departmentPharmacological Big Data Laboratory, Pharmacology , Faculty of Medicine, University of Valladolid , Valladolid, Spain

[2 ] departmentNephrology , Complejo Asistencial de Zamora , Zamora, Spain

[3 ] Direccion General de Trafico , Madrid, Spain

[4 ] departmentSubdirección General de Coordinación de Programas, Delegación del Gobierno para el Plan Nacional sobre Drogas , Ministerio de Sanidad, Consumo y Bienestar Social , Madrid, Spain

[5 ] departmentCEIm , Hospital Clinico Universitario de Valladolid , Valladolid, Spain

Author notes

[Correspondence to ] Dr Francisco Herrera-Gómez; fherrerag@ 123456saludcastillayleon.es

Author information

Francisco Herrera-Gómez http://orcid.org/0000-0002-3110-692X

Juan Carlos González-Luque http://orcid.org/0000-0001-8081-0377

F Javier Alvarez http://orcid.org/0000-0002-7566-5678

Article

Publisher ID: bmjopen-2018-026648

DOI: 10.1136/bmjopen-2018-026648

PMC ID: 6720329

PubMed ID: 31455697

SO-VID: 4526441f-ce5c-4bfd-b1da-398d72457a68

License:

This is an open access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited, appropriate credit is given, any changes made indicated, and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/.

History

Date received : 12 September 2018

Date revision received : 16 July 2019

Date accepted : 18 July 2019

Funding

Funded by: FundRef http://dx.doi.org/10.13039/501100004587, Instituto de Salud Carlos III;

Award ID: RD16/0017/0006

Custom metadata

special-feature unlocked

ScienceOpen disciplines: Medicine

Keywords: cannabis,driving under the influence,substance abuse detection

Data availability:

ScienceOpen disciplines: Medicine

Keywords: cannabis, driving under the influence, substance abuse detection

Comments

Comment on this article

scite_

Cited by 4

See all cited by

Most referenced authors 227

See all reference authors

Drivers who tested positive for cannabis in oral fluid: a longitudinal analysis of administrative data for Spain between 2011 and 2016

Read this article at

Abstract

Objectives

Design

Setting, participants and exposures

Primary and secondary outcome measures

Results

Conclusions

Related collections

UCL: UN SDG 03 Good Health and Well-Being

Most cited references 23

Acute cannabis consumption and motor vehicle collision risk: systematic review of observational studies and meta-analysis

Cannabis effects on driving skills.

Marijuana use and motor vehicle crashes.

Author and article information

Journal

Affiliations

Author notes

Author information

Article

History

Funding

Categories

Custom metadata

Comments

Comment on this article

Similar content 342

Cited by 4

Most referenced authors 227