The Drugged Driving Problem


Impairing Effects of Drugs

There are many drugs – including illegal, prescription and over-the-counter drugs – that have impairing effects.  Drug use can negatively impact coordination, reaction time, tracking, judgement, attention, and perception. The impairing effects of drugs may vary from person to person based on tolerance as well as drug-to-drug and drug-to-alcohol interactions. Impairment can be long-lasting.

The National Highway Traffic Safety Administration (NHTSA) developed Drugs and Human Performance Fact Sheets reviewing the pharmacodynamics, pharmacokinetics, duration of effects, drug interactions and performance effects for the following impairing drugs:

  • Lysergic acid diethylamide (LSD)
  • Methadone
  • Methamphetamine (and Amphetamine)
  • Methylenedioxymethamphetamine (MDMA, Ecstasy)
  • Morphine (and Heroin)
  • Phencyclidine (PCP)
  • Toluene
  • Zolpidem (and Zaleplon, Zopiclone)
  • Cannabis/Marijuana
  • Carisoprodol (and Meprobamate)
  • Cocaine
  • Dextromethorphan
  • Diazepam
  • Diphenhydramine
  • Gamma-Hydroxybutyrate (GHB, GBL, and 1,4-BD)
  • Ketamine

The National Institute on Drug Abuse also provides fact sheets on the short- and long-term health effects of varying illegal drugs.

Many scientific research studies have examined effects of specific drugs on driving among drug users, with particular interest in marijuana (see e.g., Hartman & Huestis, 2013, Cannabis effects on driving skills) and the combination of marijuana and alcohol (see e.g., Li, Chihuri & Brady, 2017, Role of alcohol and marijuana use in the initiation of fatal two-vehicle crashes; Chihuri, Li & Chen, 2017, Interaction of marijuana and alcohol on fatal motor vehicle crash risk: a case-control study). 


Rates of Drugged Driving

Fact Sheet from the Foundation for Advancing Alcohol Responsibility 

Fact Sheet from the Foundation for Advancing Alcohol Responsibility 

There is a substantial body of drugged driving research that clearly shows the high rates of drugs among drivers on the nation’s roads. From self-report data we know that in 2016, 27.6 million Americans aged 16 and older drove under the influence of alcohol or illegal drugs; 10.7 million Americans drove under the influence of marijuana, including nearly 1 in 10 drivers aged 16 to 20 for all of whom marijuana use is illegal.

In 2007 the National Roadside Survey (NRS) conducted by the National Highway Traffic Safety Administration (NHTSA) first included drug testing in addition to alcohol, showing 16.3% of weekend nighttime drivers were positive for potentially impairing drugs. 

The most recent NRS conducted in 2013-2014 reported that about 22% of drivers were positive for an illegal drug during both weekday days and weekend nights. Notably, 12% and 15% of these groups, respectively, were specifically positive for illegal drugs including marijuana. Among weekday day drivers, 1.1% were alcohol-positive and 8.3% of weekend night drivers were alcohol-positive.

The table at left from the Governors Highway Safety Association and Foundation for Advancing Alcohol Responsibility assembles 2013-14 NRS findings for various substances among drivers during weekday days and weekend nights.


Drug-Related Crashes, Injuries and Deaths

The extent of the drugged driving problem in the United States is only partially understood. In part this is due to limits on drug tests that are conducted on impaired driving suspects, drivers injured in motor vehicle crashes and fatally injured drivers. However, the available data on these drivers and crash victims presents a compelling picture about the negative impact of drugged driving on public safety. 

The Fatality Analysis Reporting System (FARS) is a national census of data on fatal injuries suffered in motor vehicle crashes. FARS data from 2009 shows that among fatally injured drivers with known drug test results, 33% tested positive for one or more potentially impairing drug.  In 2015, 43% of fatally injured drivers tested positive. (The imperative need to improve FARS data collection and reporting is discussed under Areas for More Research.) 

As shown below left, European crash risk studies have shown that drugs increase relative risk of crash for specific drugs; however, it is essential to remember that the limitless combinations of individual drugs and alcohol make determining crash risk more complex.

A 2005 study of seriously injured drivers showed over two thirds tested positive for alcohol and/or drugs, and 25% tested positive for more than one substance. The breakdown of drivers (shown above right) demonstrates common occurrence of polysubstance use. 

A Focus on Marijuana 

The Rocky Mountain High Intensity Drug Trafficking Area (RM-HIDTA) tracks the consequences of commercial recreational marijuana in the state of Colorado, including the prevalence of marijuana-related drugged driving. Among its findings:

Marijuana-related traffic deaths increased 66% in the four-year average (2013-2016) since Colorado legalized recreational marijuana compared to the four-year average (2009-2012) prior to legalization. During the same time period, all traffic deaths increased 16%.

Marijuana was first commercialized in Colorado with "medical marijuana". In 2013, marijuana was legalized for recreational uses. As shown on the right, the number of marijuana-related traffic deaths increased since commercialization, reaching a new peak in 2016. 

The AAA Foundation for Traffic Safety showed that fatal crashes involving marijuana doubled after marijuana was legalized and commercialized in Washington State. Additionally, the Washington State Traffic Safety Commission reported that drivers with only active THC in their blood who were in a fatal driving crash rose 122% from 2010 to 2014. But it is critical to recognize that drugged driving is not limited to marijuana – even in states with commercial marijuana legalization. The table above shows changes in the prevalence of alcohol, marijuana (THC and metabolites), and other drugs among fatally injured drivers in Washington State from 2010 to 2014. 

Among marijuana-positive drivers in Colorado in 2016 (shown at left), only 37% were positive for marijuana only; 35% were positive for marijuana and alcohol, 7% positive for marijuana, alcohol and other drugs, and 21% positive for marijuana and other drugs (no alcohol).

 


Need for Public Education

The impairing effects of drugs are greatly underappreciated by the public. The mantra “Don’t Drink and Drive” is widely accepted – we need to add the message “Don’t Drug and Drive.” In 2015, the Government Accountability Office underscored this need for education and in particular strong federal leadership it its report Drug-Impaired Driving: Additional Support Needed for Public Awareness Initiatives.

In light of state-based marijuana legalization, the need for education on the impairing effects of marijuana (alone and in combination of with other drugs) is even more pressing. The report Drug-Impaired Driving: A Guide for States from the Governors Highway Safety Association and Foundation for Advancing Alcohol Responsibility noted the following disturbing perceptions among marijuana users in states with commercial legal marijuana: 

In surveys and focus groups with regular marijuana users in Colorado and Washington, almost all believed that marijuana doesn’t impair their driving, and some believed that marijuana improves their driving (CDOT, 2014; PIRE, 2014; Hartman and Huestis, 2013). Most regular marijuana users surveyed in Colorado and Washington drove “high” on a regular basis. They believed it is safer to drive after using marijuana than after drinking alcohol. They believed that they have developed a tolerance for marijuana effects and can compensate for any effects, for instance by driving more slowly or by allowing greater headways. However, Ramaekers et al. (2016) found that marijuana effects on cognitive performance were similar for both frequent and infrequent marijuana users.

The Colorado Department of Transportation has released numerous public service announcements on marijuana-impaired driving: 

Other nations including Australia and New Zealand which have enforced strong laws against drugged driving have issued their own public education campaigns: 


Recommended Reading + Resources

The following is not a comprehensive list of related reading and resources but serves as a starting point for more information on these drugged driving issues. Be sure to also check out the Resources page.

National Surveys

Drug-involved Crash, Injury + Death

Marijuana-Impaired Driving

To request materials email the Institute for Behavior and Health at ContactUs@IBHinc.org

  


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