Until recently relatively little was known about the prevalence of drugs other than alcohol in the systems of drivers.

The National Highway Traffic Safety Administration has conducted studies using roadside data collection techniques to estimate the relative crash risk associated with drugs other than alcohol.  This work has provided substantial insights on the topic of drugged driving, but a gap in knowledge exists regarding drug use among drivers and other road users (pedestrians, bicyclists) who are seriously or fatally injured in crashes.

For those involved in serious or fatal accidents, measure if and how much legal or illegal drugs were present in those impacted.

The objective of the current study was to examine the prevalence of selected over-the-counter, prescription, and illegal drugs in the blood of drivers and other road users who were seriously or fatally injured in crashes before and during the COVID-19 public health emergency. Data were collected at Level 1 trauma centers and medical examiner offices. The 3,003 participants represented a convenience sample of roadway users who were seriously or fatally injured during the study period (2019 to 2022). The participating trauma centers and medical examiners provided deidentified blood samples that were already collected during their routine clinical treatment for seriously- or fatally-injured patients involved in crashes.

The study then conducted independent drug toxicology testing to determine the prevalence of alcohol and other drugs in the systems of the injured parties. NORC’s role was to provide the platform for the data entry which was designed for use on tablets that were used by the trauma centers and medical examiners research teams.

Drug prevalence was high among seriously and fatally injured roadway users and even higher during the COVID-19 pandemic.

The results indicate drug prevalence was high among seriously and fatally injured roadway users before the public health emergency began and was even higher during the COVID-19 pandemic especially for alcohol, cannabinoids (active THC), and opioids.

Drivers showed significantly higher overall drug prevalence during the COVID-19 public health emergency:

• 50.8% testing positive for at least one active drug before the pandemic, compared to 64.7% during the pandemic. *
• 17.6% testing positive for two or more categories of drugs before the pandemic compared to 25.3% during the pandemic. *
   

Of particular note, active THC was more prevalent among drivers during the public health emergency and opioid use among drivers almost doubled.

• Alcohol - 32.7% before COVID pandemic versus 28.3% during COVID pandemic. *
• Opioid Use - 7.5% before COVID pandemic versus 13.9% during COVID pandemic. *
   

Overall, the results of this study suggest the highway safety community should be concerned about the impact of other drugs as well as alcohol. In particular, the observed cannabis and opioid prevalence rates before and during the public health emergency could be indicative of a growing problem.

(* These findings are prevalence rates only and cannot be used to determine whether the people were impaired at the time of their crash.)