Risk of road accident associated with the use of drugs: a systematic review and meta-analysis of evidence from epidemiological studies

Accid Anal Prev. 2013 Nov;60:254-67. doi: 10.1016/j.aap.2012.06.017. Epub 2012 Jul 9.


This paper is a corrigendum to a previously published paper where errors were detected. The errors have been corrected in this paper. The paper is otherwise identical to the previously published paper. A systematic review and meta-analysis of studies that have assessed the risk of accident associated with the use of drugs when driving is presented. The meta-analysis included 66 studies containing a total of 264 estimates of the effects on accident risk of using illicit or prescribed drugs when driving. Summary estimates of the odds ratio of accident involvement are presented for amphetamines, analgesics, anti-asthmatics, anti-depressives, anti-histamines, benzodiazepines, cannabis, cocaine, opiates, penicillin and zopiclone (a sleeping pill). For most of the drugs, small or moderate increases in accident risk associated with the use of the drugs were found. Information about whether the drugs were actually used while driving and about the doses used was often imprecise. Most studies that have evaluated the presence of a dose-response relationship between the dose of drugs taken and the effects on accident risk confirm the existence of a dose-response relationship. Use of drugs while driving tends to have a larger effect on the risk of fatal and serious injury accidents than on the risk of less serious accidents (usually property-damage-only accidents). The quality of the studies that have assessed risk varied greatly. There was a tendency for the estimated effects of drug use on accident risk to be smaller in well-controlled studies than in poorly controlled studies. Evidence of publication bias was found for some drugs. The associations found cannot be interpreted as causal relationships, principally because most studies do not control very well for potentially confounding factors.

Keywords: Accident risk; Drugs; Epidemiological studies; Meta-analysis; Systematic review.

Publication types

  • Meta-Analysis
  • Review
  • Systematic Review

MeSH terms

  • Accidents, Traffic / psychology*
  • Accidents, Traffic / statistics & numerical data
  • Automobile Driving / psychology*
  • Epidemiologic Studies
  • Global Health
  • Humans
  • Models, Statistical
  • Odds Ratio
  • Publication Bias
  • Risk Factors
  • Substance-Related Disorders*