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Quinn PD, Chang Z, Pujol TA, Bair MJ, Gibbons RD, Kroenke K, D’Onofrio BM. Association between prescribed opioid dose and risk of motor vehicle crashes. Pain 2023; 164:e228-e236. [PMID: 36155384 PMCID: PMC11104685 DOI: 10.1097/j.pain.0000000000002790] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2021] [Accepted: 09/12/2022] [Indexed: 11/26/2022]
Abstract
ABSTRACT Opioid-involved motor vehicle traffic fatalities have increased over the past 2 decades. However, the extent to which prescribed opioids increase the risk of motor vehicle crashes remains uncertain. This study used real-world healthcare claims data to examine the association between prescription opioid dose and motor vehicle crash risk. Using nationwide US commercial insurance claims data for 2010 to 2018, we identified 772,404 adults who received incident, noncancer opioid therapy. We examined associations between daily prescription opioid dose, calculated in morphine milligram equivalents (MME) from filled prescription claims, and risk of motor vehicle crashes, assessed as diagnoses of motor vehicle injuries in claims for emergency visits, inpatient hospitalizations, and ambulance transportation. We estimated associations using a within-individual design, which ruled out all time-stable confounding. We complemented the design with time-varying statistical adjustment for other pharmacotherapies and a negative control pain pharmacotherapy analysis (with incident cyclic antidepressant prescriptions). During 2,150,009 person-years of follow-up, there were 12,123 motor vehicle crashes (5.64 crashes per 1000 person-years). In within-individual comparisons, crash risk was greater during opioid prescription periods involving doses ≤60 MME/day (odds ratio [OR], 3.86; 95% confidence interval [CI], 3.54, 4.21), >60 to 120 MME/day (OR, 5.46; 95% CI, 4.44, 6.73), and >120 MME/day (OR, 3.45; 95% CI, 2.31, 5.15) than during off-treatment periods. The negative control analysis supported the specificity of the results to opioids rather than to other processes associated with pharmacologic pain management. These findings suggest that the receipt of prescription opioids, even at doses ≤60 MME/day, is associated with an increased risk of motor vehicle crashes.
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Affiliation(s)
- Patrick D. Quinn
- Department of Applied Health Science, School of Public Health, Indiana University, Bloomington, Indiana
| | - Zheng Chang
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden
| | | | - Matthew J. Bair
- VA HSR&D Center for Health Information and Communication, Roudebush VA Medical Center, Indianapolis, Indiana
- Department of Medicine, Indiana University School of Medicine, Indianapolis, Indiana
- Regenstrief Institute, Indianapolis, Indiana
| | - Robert D. Gibbons
- Center for Health Statistics, University of Chicago, Chicago, Illinois
- Department of Medicine, University of Chicago, Chicago, Illinois
- Department of Public Health Sciences, University of Chicago, Chicago, Illinois
| | - Kurt Kroenke
- Department of Medicine, Indiana University School of Medicine, Indianapolis, Indiana
- Regenstrief Institute, Indianapolis, Indiana
| | - Brian M. D’Onofrio
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden
- Department of Psychological and Brain Sciences, Indiana University, Bloomington, Indiana
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Morrison CN, Gobaud AN, Mehranbod CA, Bushover BR, Branas CC, Wiebe DJ, Peek-Asa C, Chen Q, Ferris J. Optimizing sobriety checkpoints to maximize public health benefits and minimize operational costs. Inj Epidemiol 2023; 10:17. [PMID: 36915163 PMCID: PMC10010209 DOI: 10.1186/s40621-023-00427-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2023] [Accepted: 03/03/2023] [Indexed: 03/14/2023] Open
Abstract
BACKGROUND Sobriety checkpoints are a highly effective strategy to reduce alcohol-impaired driving, but they are used infrequently in the USA. Recent evidence from observational studies suggests that using optimized sobriety checkpoints-operating for shorter duration with fewer officers-can minimize operational costs without reducing public health benefits. The aim of this research was to conduct a pilot study to test whether police can feasibly implement optimized sobriety checkpoints and whether researchers can examine optimized sobriety checkpoints compared to usual practice within a non-randomized controlled trial study design. METHODS The study site was the Town of Apex, NC. We worked with Apex Police Department to develop a schedule of sobriety checkpoints during calendar year 2021 that comprised 2 control checkpoints (conducted according to routine practice) and 4 optimized checkpoints staffed by fewer officers. Our primary operations aim was to test whether police can feasibly implement optimized sobriety checkpoints. Our primary research aim was to identify barriers and facilitators for conducting an intervention study of optimized sobriety checkpoints compared to usual practice. A secondary aim was to assess motorist support for sobriety checkpoints and momentary stress while passing through checkpoints. RESULTS Apex PD conducted 5 of the 6 checkpoints and reported similar operational capabilities and results during the optimized checkpoints compared to control checkpoints. For example, a mean of 4 drivers were investigated for possibly driving while impaired at the optimized checkpoints, compared to 2 drivers at control checkpoints. The field team conducted intercept surveys among 112 motorists at 4 of the 6 checkpoints in the trial schedule. The survey response rate was 11% from among 1,045 motorists who passed through these checkpoints. Over 90% of respondents supported sobriety checkpoints, and momentary stress during checkpoints was greater for motorists who reported consuming any alcohol in the last 90 days compared to nondrinkers (OR = 6.7, 95%CI: 1.6, 27.1). CONCLUSIONS Results of this study indicate the sobriety checkpoints can feasibly be optimized by municipal police departments, but it will be very difficult to assess the impacts of optimized checkpoints compared to usual practice using an experimental study design.
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Affiliation(s)
- Christopher N Morrison
- Department of Epidemiology, Mailman School of Public Health, Columbia University, 722 West 168th St, R505, New York, NY, 10032, USA. .,Department of Epidemiology and Preventive Medicine, School of Public Health and Preventive Medicine, Monash University, Melbourne, VIC, Australia.
| | - Ariana N Gobaud
- Department of Epidemiology, Mailman School of Public Health, Columbia University, 722 West 168th St, R505, New York, NY, 10032, USA
| | - Christina A Mehranbod
- Department of Epidemiology, Mailman School of Public Health, Columbia University, 722 West 168th St, R505, New York, NY, 10032, USA
| | - Brady R Bushover
- Department of Epidemiology, Mailman School of Public Health, Columbia University, 722 West 168th St, R505, New York, NY, 10032, USA
| | - Charles C Branas
- Department of Epidemiology, Mailman School of Public Health, Columbia University, 722 West 168th St, R505, New York, NY, 10032, USA
| | - Douglas J Wiebe
- Department of Epidemiology, School of Public Health, University of Michigan, Ann Arbor, MI, USA
| | - Corinne Peek-Asa
- Office of Research Affairs, University of California San Diego, San Diego, CA, USA
| | - Qixuan Chen
- Department of Biostatistics, Mailman School of Public Health, Columbia University, New York, NY, USA
| | - Jason Ferris
- Centre for Health Services Research, The University of Queensland, Woolloongabba, Queensland, Australia
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Harzand-Jadidi S, Pourasghar F, Sadeghi-Bazargani H, Farahbakhsh M. Categorization and labeling systems concerning driving-impairing medicines: A scoping review. TRAFFIC INJURY PREVENTION 2023; 24:287-292. [PMID: 36971426 DOI: 10.1080/15389588.2022.2150393] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/09/2022] [Revised: 11/16/2022] [Accepted: 11/16/2022] [Indexed: 05/23/2023]
Abstract
OBJECTIVE Classification systems concerning driving-impairing medicines can help healthcare providers identify medicinal drugs with no or the least impairing effects and inform patients of the potential risks of certain medicines to safe driving. This study aimed to comprehensively assess the characteristics of classifications and labeling systems regarding driving-impairing medicines. METHODS Google Scholar and several databases, including PubMed, Scopus, Web of Science, EMBASE, safetylit.org, and TRID were searched to identify the relevant published material. The retrieved material was assessed for eligibility. Data extraction was done to compare the categorization/labeling systems concerning driving-impairing medicines in terms of characteristics such as the number of categories, description of each category, and description of pictograms. RESULTS After screening 5,852 records, 20 studies were selected for inclusion in the review. This review identified 22 categorization/labeling systems regarding medicines and driving. Classification systems had different characteristics, but most of them were designed based on the graded categorization system described by Wolschrijn. Initially, categorization systems had seven levels, but later the medicine impacts were summarized into 3 or 4 levels. CONCLUSIONS Although different categorization/labeling systems regarding driving-impairing medicines are available, the most effective systems in changing driver's behavior are the simple and understandable ones. Besides, health care providers should consider patient's socio-demographic features when informing them about driving under the influence.
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Affiliation(s)
- Sepideh Harzand-Jadidi
- Road Traffic Injury Research Centre, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Faramarz Pourasghar
- Department of Health Policy and Management, School of Management and Medical Informatics, Tabriz University of Medical Sciences, Tabriz, Iran
| | | | - Mostafa Farahbakhsh
- Department of Psychiatry, Tabriz University of Medical Sciences, Tabriz, Iran
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Randomly controlled drivers using minimally invasive sampling: assessment of drug prevalence in Western Switzerland over two time periods. BMC Public Health 2022; 22:2446. [PMID: 36577956 PMCID: PMC9795657 DOI: 10.1186/s12889-022-14883-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2022] [Accepted: 12/16/2022] [Indexed: 12/29/2022] Open
Abstract
BACKGROUND According to the World Health Organization, road traffic injuries lead to 1.3 million deaths each year and represent the leading cause of death for young adults under 30 years old. The use of psychoactive substances, including alcohol, drugs and pharmaceuticals, is a well-known risk factor for road traffic injuries. Our study aims to assess the prevalence of substances consumed by drivers in western Switzerland. Such studies are pivotal to improving prevention and developing public awareness campaigns. METHODS To assess the prevalence of psychoactive substances among drivers, roadside controls were performed in collaboration with local police, using their classical sampling procedures to detect drivers under the influence of drugs or alcohol over two time periods (P1: 2006-2008, P2: 2017-2020). When impaired driving was not suspected by the police, minimally invasive sampling strategies (i.e., oral fluids during P1 and dried blood spots during P2) were performed on volunteer drivers after a road safety survey. A posteriori analyses and statistical interpretation were then performed. RESULTS Among the 1605 drivers included in the study, 1048 volunteers provided an oral fluid sample, while 299 provided a dried blood spot sample. The percentage of drivers testing positive for at least one substance that can impact driving abilities was stable over time, with a rate of 10.5% positivity measured over both periods. Considering the different categories of substances, a slight variation was observed between both periods, with 7.6 and 6.3% of pharmaceuticals and 3.6 and 4.9% of illicit drugs for P1 and P2, respectively. Regarding the consumption of illicit drugs, the highest percentage of positivity was measured in biological fluids of drivers under the age of 35, during nights and week-ends, periods which are considered particularly prone to fatal accidents for this age group. Disturbingly, the road safety survey highlighted that drivers' perception of the risk of getting positively controlled while driving after drug consumption is low (3.3 on a 1-to-10 scale, N = 299). CONCLUSION The number of positive cases measured in voluntary drivers who passed the preliminary police check demonstrates the importance of systematic biofluid sampling strategies regarding driving under the influence of psychoactive substances. Although the number of fatal road accidents globally has decreased over time, the results of this study reveal the need for both better prevention and deterrent processes that could potentially reduce the risk of fatal road accidents associated with drug consumption.
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Fukuda Y, Saito M. Factors influencing changes in medication-taking and driving behavior after warnings about prescription medications that prohibit driving: an online survey. BMC Public Health 2022; 22:1020. [PMID: 35596168 PMCID: PMC9122546 DOI: 10.1186/s12889-022-13407-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2021] [Accepted: 05/11/2022] [Indexed: 11/10/2022] Open
Abstract
Background This study examined warning messages as a strategy for preventing automobile crashes by drivers on medications. We investigated the degree of awareness regarding the effects of medication on automobile driving and changes in medication-taking and driving behavior. We also assessed associations between socio-environmental factors and the driving and medication-taking behavior adopted by individuals after being warned about driving-related risks. Methods Responses to an online questionnaire from 1200 people with a driving license who were taking prescription medications at the time of inquiry (March 2019) were collected and analyzed. The items surveyed were sex, age, educational history, health literacy, current medications, and medication-taking and driving behavior after being warned. Results Of the total respondents, 30% were taking medicine that prohibited driving. Of those taking prohibited medications, 25.7% did not receive a warning about driving from healthcare professionals. Most respondents taking prohibited medications received euphemistic warnings, such as “practice caution” (30%), “refrain from calling attention” (29.4%), and “avoid driving” (19.8%); 16% of the direct warnings were about not driving. Medication’s effects on driving were recognized by 80% of the total respondents. The degree of awareness was significantly higher among respondents taking medications that prohibit driving than among those taking medications that did not prohibit driving or those taking unknown medications. Awareness of medicine’s influence on driving was associated with health literacy. No association was found between age, gender, health literacy, history of side effects, and driving and medication-taking behavior. Approximately 22% of respondents adjusted their medication use at their discretion and 39% maintained treatment compliance but continued driving. Among respondents taking medications that prohibit driving, whether driving was required for work was a significant factor in their driving and medication-taking behavior after being warned. Conclusions Healthcare professionals do not always fully inform patients about the driving-related risks of medications. To encourage patients who are taking medications that have a significant impact on their driving to either stop driving or consult a healthcare professional, healthcare professionals must first understand the patient’s social environment, such as whether driving is required for work, and then create an environment conducive to advice-seeking.
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Affiliation(s)
- Yasue Fukuda
- Facility of Pharmaceutical Science, Suzuka University of Medical Science, 3500-3 Minami-tamagaki, Suzuka, Mie, 513-8670, Japan.
| | - Moemi Saito
- Faculty of Pharmaceutical Sciences, Tokyo University of Pharmacy and Life Sciences, 192-0392 Horinouti Hachioji city, Tokyo, Japan
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Staples JA, Erdelyi S, Moe J, Khan M, Chan H, Brubacher JR. Prescription opioid use among drivers in British Columbia, 1997–2016. Inj Prev 2021; 27:527-534. [DOI: 10.1136/injuryprev-2020-043989] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2020] [Revised: 12/09/2020] [Accepted: 12/10/2020] [Indexed: 11/03/2022]
Abstract
BackgroundOpioids increase the risk of traffic crash by limiting coordination, slowing reflexes, impairing concentration and producing drowsiness. The epidemiology of prescription opioid use among drivers remains uncertain. We aimed to examine population-based trends and geographical variation in drivers’ prescription opioid consumption.MethodsWe linked 20 years of province-wide driving records to comprehensive population-based prescription data for all drivers in British Columbia (Canada). We calculated age- and sex-standardised rates of prescription opioid consumption. We assessed temporal trends using segmented linear regression and examined regional variation in prescription opioid use using maps and graphical techniques.ResultsA total of 46 million opioid prescriptions were filled by 3.0 million licensed drivers between 1997 and 2016. In 2016 alone, 14.7% of all drivers filled at least one opioid prescription. Prescription opioid use increased from 238 morphine milligram equivalents per driver year (MMEs/DY) in 1997 to a peak of 834 MMEs/DY in 2011. Increases in MMEs/DY were greatest for higher potency and long-acting prescription opioids. The interquartile range of prescription opioid dispensation by geographical region increased from 97 (Q1=220, Q3=317) to 416 (Q1=591, Q3=1007) MMEs/DY over the study interval.ImplicationsPatterns of prescription opioid consumption among drivers demonstrate substantial temporal and geographical variation, suggesting they may be modified by clinical and policy interventions. Interventions to curtail use of potentially impairing prescription medications might prevent impaired driving.
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Vingilis E, Johnson J, Rapoport MJ, Beirness D, Boase P, Byrne PA, Jonah B, Mann RE, Seeley J, Wickens CM, Wiesenthal DL. Addendum - Coronavirus Disease 2019: What Could Be the Effects on Road Safety? ACCIDENT; ANALYSIS AND PREVENTION 2021; 149:105712. [PMID: 32807368 PMCID: PMC7409794 DOI: 10.1016/j.aap.2020.105712] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/29/2020] [Accepted: 07/29/2020] [Indexed: 05/25/2023]
Affiliation(s)
- Evelyn Vingilis
- Population and Community Health Unit, Department of Family Medicine, Schulich School of Medicine and Dentistry, University of Western Ontario, London, Ontario, Canada; Department of Epidemiology and Biostatistics, Schulich School of Medicine and Dentistry, University of Western Ontario, London, Ontario, Canada.
| | | | - Mark J Rapoport
- Department of Psychiatry, Faculty of Medicine, University of Toronto, Ontario, Canada; Sunnybrook Health Sciences Centre, Toronto, Ontario, Canada
| | - Doug Beirness
- Canadian Centre on Substance Use and Addiction, Ottawa, Ontario, Canada
| | - Paul Boase
- Road Safety and Motor Vehicle Regulation, Transport, Canada, Ontario, Canada
| | - Patrick A Byrne
- Research and Evaluation Office, Ontario Ministry of Transportation, Ontario, Canada
| | - Brian Jonah
- Road Safety Canada Consulting, Ottawa, Ontario, Canada
| | - Robert E Mann
- Institute for Mental Health Policy Research, Centre for Addiction and Mental Health, Toronto, Ontario, Canada; Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada
| | - Jane Seeley
- Population and Community Health Unit, Department of Family Medicine Schulich School of Medicine and Dentistry, University of Western Ontario, London, Ontario, Canada
| | - Christine M Wickens
- Institute for Mental Health Policy Research, Centre for Addiction and Mental Health, London, Ontario, Canada; Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health, Toronto, Ontario, Canada; Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada; Institute of Health Policy, Management and Evaluation, University of Toronto, Toronto, Ontario, Canada; Department of Pharmacology and Toxicology, University of Toronto, Toronto, Ontario, Canada
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Fukuda Y, Ando S, Saito M. Risk awareness, medication adherence, and driving behavior as determined by the provision of drug information to patients. PATIENT EDUCATION AND COUNSELING 2020; 103:1574-1580. [PMID: 32173213 DOI: 10.1016/j.pec.2020.02.037] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/22/2019] [Revised: 02/24/2020] [Accepted: 02/27/2020] [Indexed: 06/10/2023]
Abstract
OBJECTIVE The study identifies appropriate risk expressions by healthcare professionals in communicating the risks of driving-impairing medicine to patients, gauging changed patient behavior, preventing traffic accidents due to drugs, and improving drug adherence. METHODS An online questionnaire survey was conducted on participants' perception of driving-related risks, and risk awareness, as well as reports of healthcare professionals' expressions and warning messages regarding driving-impairing drugs. RESULTS Approximately 80 % of participants were aware of the effects of pharmaceutical drugs on driving ability, and 50 % responded that they had received an explanation from their respective health professionals. As reported by participants, although healthcare professionals typically used more indirect expressions, direct warning messages were associated with high-risk awareness. CONCLUSION The content of the explanatory sentences and debriefing influenced risk perception among participants. Direct expressions were more desirable for appropriate risk perception by participants. Providing information from healthcare professional about the degree of risks and patients' determining their influence on driving behavior based on risk perception was necessary to clarify the predictors of driving behavior. PRACTICE IMPLICATIONS Health professionals should be aware that their warning messages could have a significant impact on patients' risk perception and driving behavior.
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Affiliation(s)
- Yasue Fukuda
- Suzuka University of Medical Science, 3500-3 Minami-tamagaki, Suzuka, Mie, 513-8670, Japan.
| | - Shuji Ando
- Department of Information and Computer Technology, Tokyo University of Science, 6-3-1 Niijuku, Katsushika-ku, Tokyo, 125-8585, Japan.
| | - Moemi Saito
- Faculty of Pharma-Science, Teikyo University, 2-11-1 Kaga, Itabashi-ku, Tokyo, 174-8605, Japan.
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Abstract
IMPORTANCE The prevalence of prescription opioids detected in fatally injured drivers has increased markedly in the past 2 decades in the United States. It is unclear whether driver use of prescription opioids plays a role in fatal crash causation. OBJECTIVE To assess the association between driver use of prescription opioids and the risk of being culpable of crash initiation in fatal 2-vehicle crashes. DESIGN, SETTING, AND PARTICIPANTS This pair-matched study was based on data from the Fatality Analysis Reporting System for drivers involved in fatal 2-vehicle crashes on US public roads between January 1, 1993, and December 31, 2016. Data analysis was conducted from December 8, 2017, to December 7, 2018. EXPOSURES Testing positive for prescription opioids compared with testing negative, and blood alcohol concentrations (BACs) based on toxicological testing results. MAIN OUTCOMES AND MEASURES Culpability of crash initiation and adjusted odds ratios and 95% CIs. RESULTS A total of 36 642 drivers involved in 18 321 fatal 2-vehicle crashes were included. The most common driving error leading to fatal 2-vehicle crashes was failure to keep in lane (7535 [41%]). Drivers culpable of initiating the crashes were more likely than their nonculpable counterparts to test positive for prescription opioids (918 [5.0%] vs 549 [3.0%]; P < .001), alcohol (BAC ≥0.01 g/dL, 5258 [28.7%] vs 1815 [9.9%]; P < .001), and both substances (1.0% vs 0.3%, P < .001). The adjusted odds ratio of crash initiation was 2.18 (95% CI, 1.91-2.48) for drivers testing positive for prescription opioids compared with drivers testing negative, and increased with BACs (BAC 0.01-0.07 g/dL: adjusted odds ratio, 1.97; 95% CI, 1.75-2.22; BAC ≥0.08 g/dL: adjusted odds ratio, 8.20; 95% CI, 7.42-9.07; compared with BAC <0.01 g/dL). There was no significant interaction effect on crash initiation between prescription opioid use and alcohol use. CONCLUSIONS AND RELEVANCE Driver use of prescription opioids was associated with initiation of 2-vehicle crashes, independent of alcohol use. Clinicians should take into consideration the adverse effect of opioid analgesics on driving safety while prescribing these medications and counseling patients.
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Affiliation(s)
- Stanford Chihuri
- Center for Injury Epidemiology and Prevention, Columbia University Medical Center, New York, New York
- Department of Anesthesiology, College of Physicians and Surgeons, Columbia University, New York, New York
| | - Guohua Li
- Center for Injury Epidemiology and Prevention, Columbia University Medical Center, New York, New York
- Department of Anesthesiology, College of Physicians and Surgeons, Columbia University, New York, New York
- Department of Epidemiology, Mailman School of Public Health, Columbia University, New York, New York
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Herrera-Gómez F, Gutierrez-Abejón E, Criado-Espegel P, Álvarez FJ. The Problem of Benzodiazepine Use and Its Extent in the Driver Population: A Population-Based Registry Study. Front Pharmacol 2018; 9:408. [PMID: 29755352 PMCID: PMC5933078 DOI: 10.3389/fphar.2018.00408] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2018] [Accepted: 04/09/2018] [Indexed: 11/13/2022] Open
Abstract
Background: Benzodiazepines are driving-impairing medicines (DIM). This study presents current consumption of dispensed benzodiazepines in the Spanish general population, with a focus in pattern of use and concomitant medicines consumed with. Methods: A population-based registry study was carried out to assess the year-2016 granted benzodiazepines dispensation in Castile and León. Weighting was performed to obtain the adjusted benzodiazepine consumption for licensed drivers according to age and gender using our national drivers' license census data. Results: Benzodiazepines were used by 15.38% of the general population and 10.97% of drivers. Nearly 2% of the population and more than 1% of drivers took these medicines every day. The amount consumed (until 3 or more benzodiazepines per day) and concomitant use of other DIM were also higher. Women were the most frequent consumers, and anxiolytic use was usual. Consumption increases with age, but there were differences between men and women drivers from 60 years old. Conclusions: The current use of benzodiazepines must serve to awareness of the healthcare personnel, patients, and authorities on their risks, above all on the road safety.
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Affiliation(s)
- Francisco Herrera-Gómez
- Pharmacology and Therapeutics, Faculty of Medicine, University of Valladolid, Valladolid, Spain.,Nephrology, Hospital Virgen de la Concha - Sanidad de Castilla y León, Zamora, Spain
| | - Eduardo Gutierrez-Abejón
- Technical Direction of Pharmaceutical Assistance, Gerencia Regional de Salud de Castilla y León, Valladolid, Spain
| | - Paloma Criado-Espegel
- Technical Direction of Pharmaceutical Assistance, Gerencia Regional de Salud de Castilla y León, Valladolid, Spain
| | - F Javier Álvarez
- Pharmacology and Therapeutics, Faculty of Medicine, University of Valladolid, Valladolid, Spain.,CEIm Área de Salud Valladolid Este, Hospital Clínico Universitario de Valladolid - Sanidad de Castilla y León, Valladolid, Spain
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