Alcohol- or drug-use disorders and motor vehicle accident mortality: A retrospective cohort study

• Published in: Accident analysis and prevention Vol. 53; pp. 149 - 155
• Main Authors: Callaghan, Russell C., Gatley, Jodi M., Veldhuizen, Scott, Lev-Ran, Shaul, Mann, Robert, Asbridge, Mark
• Format: Journal Article
• Language: English
• Published: Kidlington Elsevier Ltd 01-04-2013; Elsevier
• Subjects: Accidents, Traffic - mortality; Addictive behaviors; Adolescent; Adult; Adult and adolescent clinical studies; Aged; Aged, 80 and over; Alcohol; Alcohol-Related Disorders; Alcoholism; Alcoholism and acute alcohol poisoning; Biological and medical sciences; California - epidemiology; Cannabis; Cocaine; Cohort; Death Certificates; Female; Follow-Up Studies; Gender; Humans; Male; Medical sciences; Methamphetamine; Middle Aged; Miscellaneous; Motor vehicle accident fatality; Opioids; Patient Admission - statistics & numerical data; Psychology. Psychoanalysis. Psychiatry; Psychopathology. Psychiatry; Retrospective Studies; Risk Factors; Standardized mortality; Substance-Related Disorders; Toxicology; Young Adult; California; USA, California; Cannabis; Cohort; Methamphetamine; Opioids; Motor vehicle accident fatality; Alcohol; Cocaine; Gender; Standardized mortality; Amphetamine derivatives; Psychotropic; Metamfetamine; Sex; Cannabidaceae; Motor vehicle; Retrospective study; Epidemiology; Ester; Dicotyledones; Cohort study; Angiospermae; Drug of abuse; Public health; Drug; Ethanol; CNS stimulant; Alcoholism; Mortality; Substance abuse; Sympathomimetic; Accident; Death; Spermatophyta
• ISSN: 0001-4575; 1879-2057
• DOI: 10.1016/j.aap.2013.01.008

► We identified cohorts of individuals hospitalized in California from 1990 to 2005 with ICD-9 diagnoses of alcohol- or drug-use disorders and followed them for up to 16 years. ► We examined patterns of motor vehicle accident fatalities in these cohorts and generated age-, sex-, and race-adjusted mortality rates. ► We found elevated risks of MVA mortality across all cohorts of individuals with alcohol- or drug-use disorders. ► Our findings support driving-safety interventions targeting these cohorts to reduce their elevated MVA mortality risk.
A large body of research has linked alcohol consumption and motor vehicle accidents (MVAs), but far fewer studies have estimated the risk of MVA fatality among drug users. Our study addresses this gap. We identified cohorts of individuals hospitalized in California from 1990 to 2005 with ICD-9 diagnoses of methamphetamine- (n=74,170), alcohol- (n=592,406), opioids- (n=68,066), cannabis- (n=47,048), cocaine- (n=48,949), or polydrug-related disorders (n=411,175), and these groups were followed for up to 16 years. Age-, sex-, and race-adjusted standardized mortality rates (SMRs) for deaths due to MVAs were generated in relation to the California general population. Standardized MVA mortality ratios were elevated across all drug cohorts: alcohol (4.5, 95% CI, 4.1–4.9), cocaine (3.8, 95% CI, 2.3–5.3), opioids (2.8, 95% CI, 2.1–3.5), methamphetamine (2.6, 95% CI, 2–3.1), cannabis (2.3, 95% CI, 1.5–3.2) and polydrug (2.6, 95% CI, 2.4–2.9). Males and females had similar MVA SMRs. Our large, population-based study found elevated risk of MVA mortality across all cohorts of individuals with alcohol- or drug-use disorders. Given that illicit drug users are often unaware of or misperceive the impacts of drug use on safe driving, it may be important for health-service or public-health interventions to address such biases and improve road safety.