This study aims to examine the prevalence of alcohol and/or other drugs (AOD) in a large sample of fatally injured drivers.Design
Using data from the Fatality Analysis Reporting System for 2005–09, the authors examined the prevalence of AOD detected in fatally injured drivers in the United States.Setting
Fatal motor vehicle crashes occurring on public roads.Participants
Drivers who died within 1 hour of the crash in 14 states that performed toxicological testing on more than 80% of these drivers.Measurements
The prevalence of AOD and multivariable-adjusted prevalence ratios (aPR).Findings
Of the 20 150 fatally injured drivers studied, 57.3% tested positive for AOD, including 19.9% being positive for two or more substances. Alcohol was the most commonly detected substance, present in 40.2% of the fatally injured drivers, followed by cannabinols (10.5%), stimulants (9.0%), narcotics (5.7%) and depressants (4.0%). Multivariable analysis revealed that AOD was significantly more prevalent among drivers who died in single-vehicle crashes [aPR 1.69, 95% confidence interval (CI): 1.62–1.76] or night-time crashes (aPR 1.43, 95% CI: 1.39–1.47), or who had a driving-while-intoxicated conviction within the past 3 years (aPR 1.41, 95% CI: 1.35–1.47), and less prevalent among drivers who were 65 years or older (aPR 0.45, 95% CI: 0.42–0.49), Asian (aPR 0.47, 95% CI 0.41–0.53) or female (aPR 0.88, 95% CI: 0.85–0.91) or who were operating a motor carrier (aPR 0.41, 95% CI 0.34–0.48).Conclusions
More than half of fatally injured drivers in the United States had been using AOD and approximately 20% had been using polydrugs. The prevalence of AOD use varies significantly with driver and crash characteristics.