Drug use and fatal motor vehicle crashes: a case-control study

Accid Anal Prev. 2013 Nov:60:205-10. doi: 10.1016/j.aap.2013.09.001. Epub 2013 Sep 8.


Drugged driving is a serious safety concern, but its role in motor vehicle crashes has not been adequately studied. Using a case-control design, the authors assessed the association between drug use and fatal crash risk. Cases (n=737) were drivers who were involved in fatal motor vehicle crashes in the continental United States during specific time periods in 2007, and controls (n=7719) were participants of the 2007 National Roadside Survey of Alcohol and Drug Use by Drivers. Overall, 31.9% of the cases and 13.7% of the controls tested positive for at least one non-alcohol drug. The estimated odds ratios of fatal crash involvement associated with specific drug categories were 1.83 [95% confidence interval (CI): 1.39, 2.39] for marijuana, 3.03 (95% CI: 2.00, 4.48) for narcotics, 3.57 (95% CI: 2.63, 4.76) for stimulants, and 4.83 (95% CI: 3.18, 7.21) for depressants. Drivers who tested positive for both alcohol and drugs were at substantially heightened risk relative to those using neither alcohol nor drugs (Odds Ratio=23.24; 95% CI: 17.79, 30.28). These results indicate that drug use is associated with a significantly increased risk of fatal crash involvement, particularly when used in combination with alcohol.

Keywords: Accidents; Alcohol; Case-control study; Driving under the influence; Drug abuse; Traffic injury.

Publication types

  • Research Support, U.S. Gov't, P.H.S.

MeSH terms

  • Accidents, Traffic / mortality*
  • Accidents, Traffic / psychology
  • Adolescent
  • Adult
  • Aged
  • Aged, 80 and over
  • Alcohol Drinking / adverse effects
  • Case-Control Studies
  • Confidence Intervals
  • Female
  • Health Surveys
  • Humans
  • Logistic Models
  • Male
  • Middle Aged
  • Odds Ratio
  • Risk Factors
  • Substance Abuse Detection
  • Substance-Related Disorders*
  • United States / epidemiology
  • Young Adult