Stimulant Drug Using, Road Traffic Accidents, and Illegal Activities among Highway Drivers in Iraq in 2022: A Nation-Wide Cross-Sectional Survey

Drug and stimulant abuse is especially common in low and middle- income countries, such as Iraq and certain populations, such as highway drivers. Moreover, Iraq has high rates of traffic and road accidents. Our objective was to assess the associations of using stimulants with traffic events among highway drivers in Iraq. We used a cross-sectional study design, in which a self-administered questionnaire was distributed online on different social media platforms. The study included male highway drivers who used drugs from all provinces of Iraq. The questionnaire consisted of demographic questions and an addiction questionnaire about stimulants specially validated for the Arabic language. We followed a convenience sampling method to recruit participants. A total of 1700 participants from 18 provinces were included with a median (IQR) age of 34 (24:55) years. Around 58% used drugs for reasons other than medical indications, while 81% reported abusing prescription drugs. Amphetamine and cocaine were used by 52% and 20% of the participants, respectively. Around 84% of the drivers had at least 56 driving hours per week, while 87% were involved in illegal activities due to drug use. Most of the participants (78%) had accidents at least three times per month. Most of the participants had social and medical issues. Drug use, especially stimulant use, is a major contributor to road accidents and thus, increased morbidity and mortality rates in Iraq. Urgent policies and regulations are needed regarding the dispensing of drugs and the working hours of the drivers.