In the Journals

More traffic fatalities linked to opioids

Guohua Li
Guohua Li

The percentage of fatally injured drivers who tested positive for prescription opioids rose sevenfold in 20 years, according to research that recently appeared in the American Journal of Public Health.

According to researchers, approximately 3,000 drivers are killed annually in car crashes while taking opioids.

“Most observational studies, particularly those a decade old and older, have reported a nonsignicant association between prescription opioid use and crash risk,” Stanford Chihuri, MPH, and Guohua Li, MD, MPH, of the Center for Injury Epidemiology and Prevention, Columbia University, wrote. “Conversely, recent epidemiological studies have found that driver opioid use is associated with signicantly increased risks of fatal crash involvement among drivers of all ages and crash culpability in older adult drivers.”

The researchers suggested that these discrepancies might be attributable to changes in opioid use among drivers in the past 20 years.

To sort out these differences, Chichuri and Li reviewed Fatality Analysis Reporting Data from six states from 1995 to 2015. Data from 36,729 drivers that had toxicology screens done within 1 hour of a fatal car crash were analyzed. The researchers then used the Cochran-Armitage test to ascertain the statistical significance of opioid use in the drivers over the 20-year period.

Chichuri and Li found that the occurrence of prescription opioids detected in fatally injured drivers increased from 1% (95% CI, 0.5-1.4) in 1995 to 7.2% (95% CI, 5.7-8.8) in 2015 (Z =–9.04; P < .001). In addition, 23.9% of the drivers tested positive for nonalcoholic drugs and of those, 3.3% (n = 1,194) had opioids in their system. Among these drivers, 42% had used hydrocodone, 22.4% had used morphine, and 16.4% had used oxycodone. Of the remaining drivers who did not test positive for opioids, 66.9% tested positive for other drugs and 30% had elevated blood alcohol concentrations.

“It is evident that driver opioid use increases the risk of being involved in fatal crashes. Concurrent use of opioids and alcohol and other substances is particularly dangerous while driving,” Li told Healio Family Medicine in an interview. “When prescribing opioid analgesics, a primary care physician should discuss the adverse effects of the medication, including the risk to affect driving safety, and tell the patient to refrain from driving while on opioids.” - by Janel Miller

Disclosure: Li reports no relevant financial disclosures. Healio Family Medicine was unable to determine Chichuri’s relevant disclosures prior to publication.

Guohua Li
Guohua Li

The percentage of fatally injured drivers who tested positive for prescription opioids rose sevenfold in 20 years, according to research that recently appeared in the American Journal of Public Health.

According to researchers, approximately 3,000 drivers are killed annually in car crashes while taking opioids.

“Most observational studies, particularly those a decade old and older, have reported a nonsignicant association between prescription opioid use and crash risk,” Stanford Chihuri, MPH, and Guohua Li, MD, MPH, of the Center for Injury Epidemiology and Prevention, Columbia University, wrote. “Conversely, recent epidemiological studies have found that driver opioid use is associated with signicantly increased risks of fatal crash involvement among drivers of all ages and crash culpability in older adult drivers.”

The researchers suggested that these discrepancies might be attributable to changes in opioid use among drivers in the past 20 years.

To sort out these differences, Chichuri and Li reviewed Fatality Analysis Reporting Data from six states from 1995 to 2015. Data from 36,729 drivers that had toxicology screens done within 1 hour of a fatal car crash were analyzed. The researchers then used the Cochran-Armitage test to ascertain the statistical significance of opioid use in the drivers over the 20-year period.

Chichuri and Li found that the occurrence of prescription opioids detected in fatally injured drivers increased from 1% (95% CI, 0.5-1.4) in 1995 to 7.2% (95% CI, 5.7-8.8) in 2015 (Z =–9.04; P < .001). In addition, 23.9% of the drivers tested positive for nonalcoholic drugs and of those, 3.3% (n = 1,194) had opioids in their system. Among these drivers, 42% had used hydrocodone, 22.4% had used morphine, and 16.4% had used oxycodone. Of the remaining drivers who did not test positive for opioids, 66.9% tested positive for other drugs and 30% had elevated blood alcohol concentrations.

“It is evident that driver opioid use increases the risk of being involved in fatal crashes. Concurrent use of opioids and alcohol and other substances is particularly dangerous while driving,” Li told Healio Family Medicine in an interview. “When prescribing opioid analgesics, a primary care physician should discuss the adverse effects of the medication, including the risk to affect driving safety, and tell the patient to refrain from driving while on opioids.” - by Janel Miller

Disclosure: Li reports no relevant financial disclosures. Healio Family Medicine was unable to determine Chichuri’s relevant disclosures prior to publication.