Drug use among individuals injured in non-fatal motor vehicle crashes and related policies in 2023.

Abstract

Objective: Although driving-related policies aimed at mitigating drug-related motor vehicle crashes (MVCs) have been implemented in diverse communities, data regarding their effectiveness are largely absent. A comprehensive evaluation of these policies is necessary. Furthermore, as US states legalize the recreational use of cannabis, the impact of these policies on drug-related crashes also needs to be evaluated. The objective was to assess the association between drug use prevalence among individuals (age 16+) injured in non-fatal MVCs in 2023 and various related policies, including drug-impaired driving policies, sobriety checkpoints, enforcement programs, and state cannabis legalization status.

Methods: We analyzed 2023 emergency medical services (EMS) records of individuals (age 16+) injured in non-fatal MVCs across 19  US states where EMS personnel indicated drug use, excluding duplicate, incomplete, and alcohol-only records. Using these counts, we calculated the prevalence of drug use among individuals (age 16+) injured in non-fatal MVCs in each state. The association between drug use prevalence and state-level policies, including drug-impaired driving laws (i.e., per se or zero tolerance), sobriety checkpoints, enforcement programs, and cannabis legalization laws, was evaluated using adjusted Poisson regression with random effects for state differences. Policies were assessed individually and in a full model to evaluate their individual and additive effects.

Results: In 2023, 11,538 individuals (68.2% male) were injured in drug-related non-fatal crashes. Neither drug-impaired driving policies, the use of sobriety checkpoints, nor the implementation of State Judicial Outreach Liaisons influenced the prevalence of drug use among individuals injured in non-fatal crashes. In contrast, relative to states with no policy or cannabidiol/low tetrahydrocannabinol, those permitting recreational cannabis had significantly higher prevalence (adjusted prevalence ratio [aPR]: 1.57, 95% confidence interval [CI]: 1.22, 2.02). The implementation of sobriety checkpoints was associated with higher drug use prevalence (aPR: 1.59, 95% CI: 1.22, 2.09) when drug-impaired driving policies were absent, particularly in states permitting recreational cannabis.

Conclusion: Our findings show differences in drug use prevalence among individuals (age 16+) injured in non-fatal MVCs based on state-level policies, highlighting the need for holistic enforcement strategies to address drug-related crashes, especially amid the increasing risks associated with the legalization of recreational cannabis use.