Prevalence of alcohol and drugs in urine of patients involved in road accidents

J Prev Med Hyg. 2008 Jun;49(2):89-95.


Objective: Road injuries are the leading injury-related cause of death among people aged 15-44. A clear dose-effect relationship has been demonstrated for drug and alcohol use and road traffic accidents. The objective of our study was to estimate the prevalence of drug and/or alcohol use in subjects admitted for road traffic accidents to an Emergency Department.

Methods: In this study, conducted between January and April 2006, 100 patients of both sexes (age 18-65) examined after road traffic accidents were consecutively enrolled. A commercial rapid urine test was used to detect drugs by the Emergency Department staff The alcohol concentration was determined from a blood sample at the central laboratory.

Results: Most of the patients were drivers under 35 years of age. 67/100 road traffic accidents occurred at the weekend (Friday-Sunday), nearly 60% between 24:00-09:00 hrs; on non-weekend days about 80% of road traffic accidents were recorded between 14:00-24:00 hrs (p < 0.0001). With the alcoholemia test and urine test for drugs detection 43/100 patients showed a single or multiple positivity. Alcohol and drug presence is relevant during the weekend (37/43 cases), in contrast with non weekend (6/43 cases) [OR 3.04 (95% CI 1.43; 6.46)]. Alcohol was the most frequently detected abuse substance (72%), followed by benzodiazepines (42%), tetrahydrocannabinol (21%) and cocaine (14%).

Discussion: 43% of patients examined were under the influence of psychotropic substances (alcohol, drugs or both). The greater part of road traffic accidents in positive test patients occurred during the week-end, in particular during the late night/early morning hours, probably after recreational time. The high incidence of alcohol and/or drug abuse may have caused physical and/or psychological problems, therefore the high number of road traffic accidents, especially if taken in combination.

Conclusion: The rapid urine test used cannot represent a diagnosis, and requires a confirmation test. It can be used for medical purposes as an easy and fast preliminary response which enables a faster diagnostic and therapeutic guideline, but it cannot be used for sanctions. Further studies are advisable with an increase of number of patients, in a wider temporal range, including control subjects, and using confirmation tests.

MeSH terms

  • Accidents, Traffic / statistics & numerical data*
  • Adolescent
  • Adult
  • Age Factors
  • Aged
  • Alcohol Drinking / adverse effects
  • Alcohol Drinking / epidemiology*
  • Central Nervous System Depressants / blood
  • Emergency Medicine
  • Ethanol / blood
  • Female
  • Hospitals
  • Humans
  • Italy / epidemiology
  • Male
  • Middle Aged
  • Prevalence
  • Prospective Studies
  • Psychotropic Drugs / adverse effects
  • Substance Abuse Detection / methods
  • Substance-Related Disorders / epidemiology*
  • Substance-Related Disorders / urine
  • Urinalysis


  • Central Nervous System Depressants
  • Psychotropic Drugs
  • Ethanol