Marijuana trajectories and associations with driving risk behaviors in Canadian youth

Objective: Research on risky driving practices involving marijuana use among youth and young adults often relies on cross-sectional data, which fail to account for longitudinal changes in substance use patterns. A better understanding of the longitudinal patterns of marijuana use and its effect on risky driving practices during young adulthood is needed in order to better inform prevention efforts. The current study examined whether different longitudinal patterns of marijuana use across the transition from adolescence to young adulthood are associated with impaired driving risks in young adulthood.

Methods: Data were from the longitudinal Victoria Healthy Youth Survey, which interviewed youth biennially on 6 occasions across 10 years (2003 to 2013).

Results: Youth who reported consistently high levels of marijuana use from adolescence to young adulthood (chronic users) and youth who reported increasing levels of use across this period (increasers) were more likely to engage in risky impaired driving behaviors compared to the other 3 user groups (occasional users, decreasers, and abstainers). Frequency of marijuana use was also predictive of impaired driving risks in young adulthood after controlling for individual characteristics (age, sex, socioeconomic status, age of onset of marijuana use), frequency of other substance use (heavy episodic drinking and illicit drug use), and simultaneous use of marijuana and other substances (alcohol and illicit drugs). By young adulthood, youth who use marijuana more than once a week are more likely to simultaneously use alcohol and engage in heavy episodic drinking. They are also more likely take driving risks.

Conclusions: Harm reduction strategies and legislative approaches targeting impaired driving risks associated with marijuana use should include approaches to target these high-risk groups and to reduce simultaneous use of alcohol.     

Examining motor vehicle crash involvement and readiness to change on drinking and driving behaviors among injured emergency department patients

Objective: To measure the effect of motor vehicle crash (MVC) involvement and readiness to change drinking and driving behaviors on subsequent driving and drinking behaviors among injured emergency department (ED) patients who use alcohol at harmful levels.

Methods: This was a secondary analysis of a randomized controlled trial of injured ED patients who screened positive for harmful alcohol use, who at recruitment reported driving in the past 12 months and received at least one of the intended intervention sessions (brief behavioral intervention versus attention placebo control; N = 407). Outcome variables were as follows: (1) change in 6 impaired driving behaviors and (2) report of MVCs and traffic violations in the 12 months following recruitment; predictor variables were as follows: (1) treatment assignment, (2) MVC involvement at recruitment, and (3) baseline readiness to change alcohol use and drinking and driving.

Results: Modeling of change in the 6 impaired driving variables indicated that neither the recruitment visits being MVC related nor baseline readiness to change alcohol use and drinking and driving behaviors predicted greater changes in impaired driving over time. Baseline reports of past moving traffic violations and the ED visit being MVC related predicted a greater likelihood of each behavior at 12 months following study recruitment.

Conclusions: This study and others have demonstrated that ED patients with harmful alcohol use are willing to engage in behavioral interventions directed at changing risky behaviors. However, this study did not demonstrate that patients considered having the potential to be more engaged with the intervention because their ED visit was MVC related and/or they had expressed intent to change their risky alcohol use and drinking and driving behaviors were more likely to change these risky behaviors.     

Motorists' knowledge,attitudes and practices toward alcohol-impaired driving/riding in Ghana

Objectives: The main objective of this study was to establish the knowledge, attitudes, and practices toward drink driving/riding as a risk factor for road traffic crashes in 3 regional capitals in Ghana.

Methods: The study used a face-to-face approach to randomly sample motorists who were accessing various services at fuel/gas stations, garages, and lorry terminals in 3 cities in Ghana.

Results: Over the previous 12 months, 24% of all motorists and 55% of motorists who were current alcohol users reported driving or riding a vehicle within an hour of alcohol intake. On average, motorists/riders who were current alcohol users consumed 4 standard drinks per drinking occasion. Generally, 83% of motorists who currently use alcohol walked, rode, or drove home after consuming alcohol away from their homes. Motorists/riders who reported drink driving were 4 times more likely to have had previous traffic violation arrests compared to those who reported no drink driving/riding (P =.001). Respondents were of the opinion that speeding was the major cause of traffic crashes, followed by driver carelessness, poor road conditions, inexperienced driving, and drink driving, in that order. Thirty-six percent of motorists who use alcohol had the perception that consuming between 6 and 15 standard drinks was the volume of alcohol that will take them to the legal blood alcohol concentration (BAC) limit of 0.08%. Compared to females, male motorists/riders were more likely to report drink driving (adjusted odds ratio [AOR] = 5.15; 95% confidence interval [CI], 2.31 to 11.47). Private motorists also reported a higher likelihood of drink driving compared to commercial drivers (AOR = 3.36; 95% CI, 1.88 to 6.02). Only 4% of motorists knew the legal BAC limit of Ghana and only 2% had ever been tested for drink driving/riding.

Conclusion: The volumes of alcohol that motorists typically consume per drinking occasion were very high and their estimates of the number of drinks required to reach the legal BAC limit was also very high. Provision of authoritative information advising motorists about safe, responsible, or low-risk levels of alcohol consumption is imperative. Many traffic violations including drink driving were reported, thus suggesting a need for enhanced policing and enforcement. However, given the low level of knowledge of the legal BAC limit, educating motorists about how many drinks will approximate the legal BAC should be intensified prior to an increase in enforcement; otherwise, the desired outcome of enforcement may not be achieved.     

Marijuana use and driving in Washington State: Risk perceptions and behaviors before and after implementation of retail sales

Objective: Washington is among the first states to legalize recreational use of marijuana. This study examined marijuana use and risk perceptions before and after retail sales of recreational marijuana began in July 2014, the relationship between risk perceptions and marijuana use, and the relationship between self-reported marijuana use and drug test results.

Methods: Roadside surveys were conducted in 3 waves: June 2014, the month before retail sales of marijuana began; 5–6 months later (November–December 2014); and 1 year later (June 2015). A total of 2,355 drivers completed a marijuana questionnaire about their past and current marijuana use and perceived risks associated with driving after using marijuana. Data collection also included biological specimens (oral fluid and/or blood for marijuana testing and breath for alcohol testing). Drivers who tested positive for delta-9-tetrahydrocannabinol or 11-hydroxy-delta-9-tetrahydrocannabinol in oral fluid or blood were defined as THC-positive.

Results: The proportion of drivers who reported recent marijuana use was similar across the 3 surveys. However, the proportion of THC-positive daytime drivers increased from 8% before retail sales to 23% 6 months after retail sales; this proportion did not change among nighttime drivers (19 and 20%). Drivers’ perceived risk of impairment by marijuana and perceived risk of being arrested for marijuana-impaired driving were similar before and after retail sales. The odds of being THC-positive were 40% lower among drivers who perceived that marijuana was very likely to impair driving, compared to other drivers. Drivers’ perceived risk of being arrested for marijuana-impaired driving was not predictive of THC-positive driving.

Conclusions: The prevalence of daytime THC-positive drivers increased substantially a few months after retail sales of marijuana were legal. Daytime and nighttime prevalence of THC-positive drivers was similar after retail sales. This pattern differs from that typically found for alcohol use, which is consistently higher among drivers at nighttime, compared to daytime. Reports of marijuana use were not always consistent with drug test results, which suggests that comparisons of self-reported marijuana use before and after legalization could be biased. This study examined marijuana use and risk perceptions over the course of 1 year. However, law changes may influence cultural norms gradually over a longer period of time. Future studies should continue to monitor marijuana use over time, as well as identify ways to determine whether drivers are impaired by marijuana.     

Drinking and driving and perceptions of arrest risk among California drivers: Relationships with DUI arrests in their city of residence

Objective: Addressing drinking and driving remains a challenge in the United States. The present study aims to provide feedback on driving under the influence (DUI) in California by assessing whether drinking and driving behavior is associated with the DUI arrest rates in the city in which the driver lives; whether this is due to perceptions that one can get arrested for this behavior; and whether this differed by those drivers who would be most affected by deterrence efforts (those most likely to drink outside the home).

Methods: This study consisted of a 2012 roadside survey of 1,147 weekend nighttime drivers in California. City DUI arrest rates for 2009–2011 were used as an indicator of local enforcement efforts. Population average logistic modeling was conducted modeling the odds of perceived high arrest likelihood for DUI and drinking and driving behavior within the past year.

Results: As the DUI arrest rates for the city in which the driver lives increased, perceived high risk of DUI arrest increased. There was no significant relationship between either city DUI arrest rates or perceived high risk of DUI arrest with self-reported drinking and driving behavior in the full sample. Among a much smaller sample of those most likely to drink outside the home, self-reported drinking and driving behavior was negatively associated with DUI arrests rates in their city of residence but this was not mediated by perceptions.

Conclusion: The results of the present study suggest that perceptions are correlated with one aspect of DUI efforts in one's community. Those who were more likely to drink outside the home could be behaviorally influenced by these efforts.     

DUID prevalence in Colorado's DUI citations

IntroductionThere are limited studies that measure the prevalence of driving under the influence of drugs (DUID) based upon impairment measures because most prevalence studies are based on drug tests. The aim of this study was to provide the first estimate of DUID prevalence in Colorado using data collected by Colorado law enforcement officers in vehicular homicide (VH) and vehicular assault (VA) cases, and reported in court records.MethodsThe four research questions of this study were answered by completing independent t-tests or Mann–Whitney U tests, Pearson chi-square analyses or Fisher's exact tests, and Kruskal–Wallis tests.ResultsSeventy percent (119 out of 170) of the cases involved alcohol only and 30% (51 out of 170) involved drugs. Of the latter cases, 32 cases involved a combination of alcohol and drugs and 19 cases identified drugs only, with no alcohol. Marijuana was the most commonly cited drug (23 cases); however, it was the sole impairing substance identified in only three cases.ConclusionPolydrug use was very common among DUID cases, which makes it difficult to identify which drug or drugs caused the impairment responsible for the Driving Under the Influence citation. This study revealed tha (a) drugged driving is a frequent cause of DUI citations in cases charged with VH or VA; (b) that polydrug use, rather than marijuana, is the most common cause of drugged driving in Colorado; and (c) that current warrant procedures render blood test results meaningless in cases of marijuana-impairment.Practical applicationStates should collect and analyze DUID data to ensure legislators focus on the right DUID problems to improve biological testing for drugs, adopt more appropriate roadside testing, and enact stronger DUID laws to protect the public.     

Marijuana-, alcohol-, and drug-impaired driving among emerging adults: Changes from high school to one-year post-high school

IntroductionDriving while impaired (DWI) increases the risk of a motor vehicle crash by impairing performance. Few studies have examined the prevalence and predictors of marijuana, alcohol, and drug-specific DWI among emerging adults.MethodsThe data from wave 3 (W3, high school seniors, 2012, N = 2407) and wave 4 (W4, one year after high school, N = 2178) of the NEXT Generation Health Study with a nationally representative cohort. W4 DWI (≥ 1 day of past 30 days) was specified for alcohol-specific, marijuana-specific, alcohol/marijuana-combined, illicit drug-related DWI. Multinomial logistic regression models estimated the association of W4 DWI with W3 covariates (perceived peer/parent influence, drinking/binge drinking, marijuana/illicit drug use), and W4 environmental status variables (work/school/residence) adjusting for W3 overall DWI, demographic, and complex survey variables.ResultsOverall DWI prevalence from W3 to W4 changed slightly (14% to 15%). W4 DWI consisted of 4.34% drinking-specific, 5.02% marijuana-specific, 2.41% drinking/marijuana combined, and 3.37% illicit drug-related DWI. W3 DWI was significantly associated with W4 alcohol-related and alcohol/marijuana-combined DWI, but not other DWI. W3 marijuana use, binge drinking, and illicit drug use were positively associated with W4 marijuana-specific, alcohol/marijuana-combined, and illicit drug-related DWI, respectively. W3 friend drunkenness and marijuana use were positively associated with W4 alcohol-specific and marijuana-related DWI, respectively. W3 peer marijuana use was negatively associated with W4 alcohol-specific DWI.ConclusionsDriving under the influence of alcohol, marijuana, and illicit drugs is a persistent, threatening public health concern among emerging U.S. adults. High school seniors' binge drinking as well as regular alcohol drinking and marijuana/illicit drug use were independently associated with respective DWI one year after high school. Peer drunkenness and marijuana use in high school may be related to subsequent DWI of emerging adults.Practical applicationsThe results support the use of injunctive peer norms about getting drunk and smoking marijuana in guiding the development of prevention programs to reduce youth DWI.     

Impaired driving enforcement practices among state and local law enforcement agencies in the United States

IntroductionAlcohol-impaired driving (DUI) persists as a substantial problem, yet detailed data on DUI enforcement practices are rarely collected. The present study surveyed state and local law enforcement agencies about their DUI enforcement activities.MethodTelephone interviews were conducted with law enforcement liaisons in state highway safety offices. Officers from a nationally representative sample of municipal, county, and state law enforcement agencies were also interviewed about their agency's DUI enforcement activities, including the types of enforcement, frequency of use, and whether activities were publicized. Response rates were 100% among law enforcement liaisons, 86% among county agencies, 93% among municipal agencies, and 98% among state agencies.ResultsBased on the highway safety office survey, 38 states conducted sobriety checkpoints in 2011. Nationally, 58% of law enforcement agencies reported that they conducted or helped conduct sobriety checkpoints during 2011–12, with 14% of all agencies conducting them monthly or more frequently. The vast majority (87%) of agencies reported conducting dedicated DUI patrols. However, dedicated DUI patrols were less likely to be publicized than checkpoints. Less than a quarter of agencies reported using passive alcohol sensors to improve detection of alcohol-impaired drivers.ConclusionsResults show that 38 states conducted sobriety checkpoints in 2011, little changed from a previous survey in 2000. Despite evidence of effectiveness, many agencies do not conduct frequent, publicized DUI enforcement or use passive alcohol sensors.Practical applicationsThe survey suggests that there are several areas in which impaired driving enforcement could be improved: increasing the frequency of special enforcement, such as sobriety checkpoints and/or dedicated patrols; publicizing these efforts to maximize deterrent effects; and using passive alcohol sensors to improve detection of alcohol-impaired drivers.     

Preventing alcohol-related convictions: the effect of a novel curriculum for first-time offenders on DUI recidivism

OBJECTIVE: To determine whether DUI offenders can better avoid future drinking and driving by controlling their vehicle usage rather than by controlling their drinking. METHODS: Using a randomized experimental post-test only design, 9,571 first-time DUI offenders were randomly assigned to receive one of two 12-hour educational programs: a traditional DUI curriculum or the PARC (Preventing Alcohol-Related Convictions) curriculum, which uses a novel theoretical approach to preventing DUI recidivism. Whereas traditional programs focus on participants controlling their drinking to avoid future drinking and driving, the PARC curriculum focuses on participants controlling their driving. Instead of trying to control alcohol consumption after driving to a drinking venue (previously found to be a flawed strategy), PARC teaches students to make a decision before leaving home not to drive to a drinking event, thus greatly limiting the possibility of drinking and driving. Driving records were obtained from the Florida Department of Motor Vehicles using driver's license numbers to assess DUI recidivism rates among the students in the PARC and Traditional curricula for the first year following program participation and again at 2 years post-intervention. RESULTS: Binary logistic regression analyses revealed that offenders receiving the PARC curriculum exhibited significantly lower 1-year and 2-year recidivism rates than those receiving the Traditional curriculum. The effect was consistent across two different measures of recidivism, and across gender, race, ethnicity, and location. CONCLUSION: Results suggest that the PARC educational approach may be more effective than the traditional approach in reducing DUI recidivism.     

Risky behaviors and helmet use among young adolescent motorcyclists in Southern Thailand

Background: In Thailand, road traffic injuries are the leading cause of death for youth ages 15–19 years, with 80% of the injuries and deaths from motorcycle accidents. Objectives: To determine the prevalence of child and young adolescent motorcyclists in Hat Yai municipality and their risk behaviors. Method: A cross-sectional study was conducted between June 2011 and March 2012 in which 2,471 students, ages 8 to 18 years, were recruited from 9 primary and secondary schools in Hat Yai municipality. The questionnaire included questions on being a motorcycle rider or passenger, risky behaviors, and helmet use while riding. Results: Of the total, 1,573 (63.7%) were riders and 898 (36.3%) were pillion passengers. The majority of the riders younger than 15 years rode their motorcycle mainly only in narrow streets for a short trip. Only 30% of the riders wore a helmet every time they rode a motorcycle. About 10% of the participants riding or a passenger on a motorcycle had consumed alcohol at least once before riding their motorcycle. Multiple logistic regression analysis found that motorcycle injuries were significantly associated with speeds greater than 60 km/h, not wearing a helmet while riding, and alcohol consumption before riding (odds ratios 1.63, 1.59, and 3.09, respectively). Conclusion: Nearly two thirds of young adolescents in Hat Yai municipality were motorcycle riders. These young adolescents were at risk of traffic injuries because more than 50% of them had ridden at high speed or not worn a helmet while riding, and some of them had consumed alcohol before riding.     

Drugged driving among US adults: Results from the 2016–2018 national survey on drug use and health

Introduction: Drugged driving, the act of driving while under the influence of one or more illicit substances, remains a critical problem needing to be addressed. The present study sought to analyze risk factors associated with past-year driving under the influence of alcohol and marijuana among a national sample of U.S. adults. Method: Pooled data from the 2016–2018 National Survey on Drug Use and Health were analyzed among 124,466 adults ages 18 years or older. Results: Weighted logistic regression analyses revealed that 8.52% of adults drove under the influence of alcohol in the past year and 4.49% of adults drove under the influence of marijuana in the past year. Of concern, compared to heterosexuals, greater than 1 in 10 sexual minorities drove under the influence of alcohol in the past year. Moreover, a sizeable percentage of adults used other drugs while under the influence of alcohol including inhalants (70.3%), cocaine (68.9%), and hallucinogens (63.7%). Moreover, a great percentage of adults (53.4%) reported using methamphetamine while also under the influence of marijuana. Practical Applications: We believe our findings can inform harm reduction efforts and prevention messaging surrounding the dangers of drugged driving.     

Ability to monitor driving under the influence of marijuana among non-fatal motor-vehicle crashes: An evaluation of the Colorado electronic accident reporting system

Introduction: As more states legalize medical/recreational marijuana use, it is important to determine if state motor-vehicle surveillance systems can effectively monitor and track driving under the influence (DUI) of marijuana. This study assessed Colorado's Department of Revenue motor-vehicle crash data system, Electronic Accident Reporting System (EARS), to monitor non-fatal crashes involving driving under the influence (DUI) of marijuana. Methods: Centers for Disease Control and Prevention guidelines on surveillance system evaluation were used to assess EARS' usefulness, flexibility, timeliness, simplicity, acceptability, and data quality. We assessed system components, interviewed key stakeholders, and analyzed completeness of Colorado statewide 2014 motor-vehicle crash records. Results: EARS contains timely and complete data, but does not effectively monitor non-fatal motor-vehicle crashes related to DUI of marijuana. Information on biological sample type collected from drivers and toxicology results were not recorded into EARS; however, EARS is a flexible system that can incorporate new data without increasing surveillance system burden. Conclusions: States, including Colorado, could consider standardization of drug testing and mandatory reporting policies for drivers involved in motor-vehicle crashes and proactively address the narrow window of time for sample collection to improve DUI of marijuana surveillance. Practical applications: The evaluation of state motor-vehicle crash systems' ability to capture crashes involving drug impaired driving (DUID) is a critical first step for identifying frequency and risk factors for crashes related to DUID.     

Teenage driving after using marijuana or drinking and traffic accident involvement

Anonymous random digit dialing telephone surveys of nearly 6000 16–19 year old respondents were conducted in Massachusetts and Upstate New York in 1979–1981. These surveys explored frequency of driving after using marijuana, driving after drinking, respondent accident involvement in the year prior to the interview, and a variety of other respondent characteristics. Frequency of driving after using marijuana and after drinking were each associated with greater accident involvement. To isolate the accident risk of driving after marijuana use, respondents who drove after drinking were excluded from a logistic regression analysis. This analysis also controlled for the distance respondents drove and several respondent demographic characteristics. Compared to respondents who did not drive after marijuana use, teenageers who drove after smoking marijuana on at least 6 occasions per month were 2.4 times more likely to be involved in traffic accidents. Those who drove after marijuana use on at least 15 occasions per month were 2.9 times more likely to have an accident.     

The alcohol interlock: an underutilized resource for predicting and controlling drunk drivers

This report summarizes evidence presented during the Third Annual Ignition Interlock Symposium at Vero Beach, Florida, 29 October 2002. The ignition interlock prevents a car from starting when blood alcohol concentration (BAC) is elevated. We review some of our prior work as well as introduce previously unpublished results to demonstrate the manner in which the data recorded by the alcohol ignition interlock device can serve as an advance predictor of future driving under the influence (DUI) of alcohol risks. Data used in this current report represent approximately 2,200 ignition interlock users from Alberta, Canada, and about 8,000 interlock users from Quebec, Canada; the Alberta data set contained 5.5 million breath tests and the Quebec data 18.8 million breath tests. All tests are time and date stamped and this information was used to characterize patterns of BAC and vehicle use, and the relationship between BAC elevations and DUI offenses that accumulated after the interlock was removed from the vehicles. Findings from Cox regression (Marques et al., 2003) show that BAC elevations > .02-.04% are more potent predictors of repeat DUI (p < .0001) than even prior DUI (p < .006), usually found to be the strongest indicator of driver risk. Prior DUI obviously has no use for scaling the risk of first-time offenders. Drivers who are both multiple offenders and who have more than a few elevated interlock BAC tests are much more likely to repeat DUI. The timing and pattern of elevated BAC tests provided during the time drivers were required to use an alcohol ignition interlock device are remarkably similar on both a daily basis and an hourly basis when the interlock programs from the two provinces are compared directly. Both provinces had higher rates of elevated tests on Saturday and Sunday, and the fewest elevated tests on Tuesdays. The absolute rate of elevated tests is similar despite the two provinces adhering to different interlock lockout points (.02% Quebec; .04% Alberta). Charts tracking the Monday-Friday timing of elevated BAC tests by hour are nearly identical for both provinces. The most elevated BAC tests occurred between 7 and 9 A.M. Monday to Friday, even though most vehicle start attempts occurred much later in the day. This higher rate of elevated morning BAC likely represents drinking from the prior evening with alcohol not yet cleared from circulation; those with elevated BAC in the early morning were more likely to have a repeat offense even after accounting for prior DUI and the higher overall rate of elevated BAC tests. This is viewed as evidence of a drinking problem that will lead to impaired driving after the controlling function of the interlock is removed. Policy changes are discussed that might take better advantage of interlock information to improve the public response to drunk driving.     

The alcohol interlock: an underutilized resource for predicting and controlling drunk drivers

This report summarizes evidence presented during the Third Annual Ignition Interlock Symposium at Vero Beach, Florida, 29 October 2002. The ignition interlock prevents a car from starting when blood alcohol concentration (BAC) is elevated. We review some of our prior work as well as introduce previously unpublished results to demonstrate the manner in which the data recorded by the alcohol ignition interlock device can serve as an advance predictor of future driving under the influence (DUI) of alcohol risks. Data used in this current report represent approximately 2,200 ignition interlock users from Alberta, Canada, and about 8,000 interlock users from Quebec, Canada; the Alberta data set contained 5.5 million breath tests and the Quebec data 18.8 million breath tests. All tests are time and date stamped and this information was used to characterize patterns of BAC and vehicle use, and the relationship between BAC elevations and DUI offenses that accumulated after the interlock was removed from the vehicles. Findings from Cox regression show that BAC elevations >.02-.04% are more potent predictors of repeat DUI (p<.0001) than even prior DUI (p<.006), usually found to be the strongest indicator of driver risk. Prior DUI obviously has no use for scaling the risk of first-time offenders. Drivers who are both multiple offenders and who have more than a few elevated interlock BAC tests are much more likely to repeat DUI. The timing and pattern of elevated BAC tests provided during the time drivers were required to use an alcohol ignition interlock device are remarkably similar on both a daily basis and an hourly basis when the interlock programs from the two provinces are compared directly. Both provinces had higher rates of elevated tests on Saturday and Sunday, and the fewest elevated tests on Tuesdays. The absolute rate of elevated tests is similar despite the two provinces adhering to different interlock lockout points (.02% Quebec;.04% Alberta). Charts tracking the Monday-Friday timing of elevated BAC tests by hour are nearly identical for both provinces. The most elevated BAC tests occurred between 7 and 9 A.M. Monday to Friday, even though most vehicle start attempts occurred much later in the day. This higher rate of elevated morning BAC likely represents drinking from the prior evening with alcohol not yet cleared from circulation; those with elevated BAC in the early morning were more likely to have a repeat offense even after accounting for prior DUI and the higher overall rate of elevated BAC tests. This is viewed as evidence of a drinking problem that will lead to impaired driving after the controlling function of the interlock is removed. Policy changes are discussed that might take better advantage of interlock information to improve the public response to drunk driving.     

Self-reported driving under the influence of alcohol and cannabis among Ontario students: Associations with graduated licensing,risk taking,and substance abuse

Objective: This article describes the patterns of self-reported driving under the influence of alcohol (DUIA) and driving under the influence of cannabis (DUIC) among licensed Ontario students in 2009 and examines their associations with graduated licensing, risk taking, and substance use problems for understanding DUIA and DUIC behaviors. Ontario's graduated licensing system requires new drivers to hold a G1 license for a minimum of 8 months and a G2 license for a minimum of 12 months before a full and unrestricted G license can be obtained. Among other restrictions, G1 drivers must maintain a 0 blood alcohol content (BAC), have an experienced driver in the passenger seat, not drive on any high-speed expressways, and not drive between the hours of midnight and 5 a.m. A G2 license is more similar to a G license, with fewer restrictions.

Method: This study analyzed data from the 2009 Ontario Student Drug Use and Health Survey (OSDUHS). The OSDUHS is a biennial population-based survey of students (grades 7 to 12) in Ontario, Canada.

Results: The results showed that 16.3% of licensed students in Ontario reported DUIC and 11.5% reported DUIA during the past year. After controlling for the effect of age, type of license emerged as a robust predictor for both DUIA and DUIC behavior, because students with a G2 and full license were significantly more likely to report DUIA and DUIC than drivers with a G1 license. Multivariate analyses suggested that risk-seeking behaviors were more important for understanding DUIA behavior than for DUIC behavior. Elevated problem indicators for alcohol and for cannabis were associated with DUIA and DUIC, respectively.

Conclusions: Though much attention has been paid to drinking and driving among adolescents, this research shows that more Ontario students now report driving after cannabis use than after drinking alcohol. The results identify important correlates of both behaviors that may be useful for prevention purposes.     

Delays in DUI blood testing: Impact on cannabis DUI assessments

Objective: This study examined the time from law enforcement dispatch to the first blood draw in cases of driving under the influence (DUI) vehicular homicide and a subset of DUI vehicular assault cases in Colorado in 2012. Laboratory toxicology results were also examined to understand the implications of delays in blood draws in cases of driving while under the influence of marijuana's delta-9-tetrahydrocannabinol (THC).

Methods: Colorado court records were reviewed and information regarding charges, presence of alcohol and/or drugs, time of law enforcement contact and blood draw, crash location, and other contextual factors were identified. The distributions of first blood draw times were studied by charge and by responding law enforcement agency. Toxicology data from a different cohort of DUI traffic arrests in Colorado and Washington were examined to determine the proportion of blood tests for THC that were above specified legal limits in those states.

Results: The average time from law enforcement dispatch to blood draw in cases of vehicular homicide and vehicular assault was 2.32 h (SD ± 1.31 h), with a range of 0.83 to 8.0 h and a median of 2.0 h. Data from DUI traffic arrests found that between 42 and 70% of all cannabinoid-positive traffic arrests tested below 5 ng/ml THC in blood, which is the legal limit in Colorado and Washington.

Conclusion: Given the current delays to blood testing in cases of arrests for vehicular homicide and vehicular assault in Colorado, many blood tests are unlikely to confirm that drivers who are impaired from smoking marijuana have THC levels above established legal limits.     

Young people driving after drinking and riding with drinking drivers: drinking locations--what do they tell us?

OBJECTIVE: The present study investigated the extent to which drinking in specific locations and heavy drinking mediated the effects of overall alcohol use on driving after drinking (DD) and riding with drinking drivers (RWDD) among young people. Additionally, this study examined the relationships among ethnicity, gender, drinking in specific locations, and DD and RWDD. METHOD: Using random-digit dialing procedures, participants were recruited to take part in a telephone survey in California, United States of America. Participants were 1,534 youth, ages 15-20 years (mean age = 17.6). Latinos, African Americans, and Asian Americans were over-sampled to allow cross-group comparisons. Along with background characteristics, overall alcohol use, heavy drinking, drinking in specific locations, DD, and RWDD were measured. RESULTS: Latent variable structural equation modeling showed that European Americans, males, older adolescents, those who have a driver license, and those who drive more often were more likely to report drinking alcohol in the past year. Heavy episodic drinking and drinking in cars increased both DD and RWDD. Drinking in restaurants also increased DD. The effects of overall alcohol consumption on DD were entirely mediated through heavy episodic drinking and drinking in restaurants and cars. Alcohol consumption had both direct and indirect effects on RWDD. With the exception of being Latino and frequency of driving, the effects of the background variables on RWDD were all entirely mediated through alcohol consumption. CONCLUSIONS: Heavy drinking and drinking in specific locations appeared to be important unique predictors of both DD and RWDD. In light of the relationship between drinking in restaurants and in cars, and DD, prevention programs and policies aimed at underage drinking should focus on developing more effective responsible beverage service programs, increasing compliance with laws limiting alcohol sales to youth, and enforcing graduated driver licensing and zero tolerance laws.     

The effectiveness of alternative transportation programs in reducing impaired driving: A literature review and synthesis

Introduction: Studies have shown that approximately half of arrested intoxicated drivers had their last alcoholic drink at a licensed bar or restaurant. Current efforts to prevent intoxicated patrons from leaving licensed establishments and driving home have been only partially successful. Since a high proportion of drinkers drive to their drinking destination, promoting the use of alternative transportation (AT) – including safe ride shuttles, free or subsidized taxi and ridesharing services, voluntary or paid designated driver programs, and more accessible public transportation – is an important strategy for preventing impaired driving. The primary goal of this study was to review and synthesize the findings of research studies designed to test the effectiveness of AT programs in reducing alcohol-impaired driving. A secondary goal was to report if using AT has led to any unintended consequences, in particular greater alcohol consumption. Method: We identified relevant academic articles, new articles, government reports, and other documents (English only) through the University of Chicago library, Google Scholar, and Google Search. We also included published articles recommended by peers. Key search terms included: alternative transportation; safe rides; designated driver; alcohol-impaired driving; alcohol consumption, cost effectiveness; and reduce drunk driving. Initially, we identified 168 potentially relevant sources, of which only 57 were academic articles. After a thorough review, we narrowed down the number of relevant articles to 125 including some background articles and government reports. Results: Some AT programs produced reductions in one or more of the following outcomes: (1) impaired driving; (2) impaired driving crashes; (3) driving under the influence (DUI) arrests; and (4) traffic crashes in general, but others were not shown to be effective. A few programs resulted in greater self-reported alcohol use, but there were no significant findings indicating that drinking when using AT led to an increase in alcohol-related harms such as public intoxication, assaults, or other alcohol-related crime. Of the studies that conducted a cost-benefit analysis, most showed that AT programs yielded a positive benefit, but these studies did not include a sufficient number of variables to be considered true cost-benefit analyses. Conclusions: There is mixed evidence regarding the effectiveness of AT programs. Evaluations with more rigorous quasi-experimental and experimental designs are needed to identify which types of AT programs work best for different types of communities and target groups. Practical Applications: The literature review and synthesis revealed that the most successful AT programs typically have some of these attributes: (1) social acceptance; (2) high level of public awareness; (3) low cost; (4) year-round availability; (5) provide rides to and from drinking venues; (6) several sponsors that provide funding); (7) user convenience; and (8) perceived safety.