PREVALENCE OF DRUGS OF ABUSE IN URINE OF DRIVERS INVOLVED IN ROAD ACCIDENTS IN FRANCE - A COLLABORATIVE STUDY

This collaborative, anonymous, case-control study was intended to dete rmine the prevalence of opiates, cocaine metabolites, cannabinoids and amphetamines in the urine of drivers injured in road accidents and to compare these values with those of non-accident subjects (''patients' ') in France. Recruitment was performed nationwide in the emergency de partments of five hospitals and comprised 296 ''drivers'' aged 18 to 3 5 and 278 nontraumatic ''patients'' in the same age range. Females rep resented 28.4% of ''drivers'' and 44.2% of ''patients.'' Screening for drugs in urine was performed by fluorescence polarization immunoassay s in each center. Each positive result was verified using gas chromato graphy-mass spectrometry (GC-MS), in a single laboratory. Statistical analysis comprised single-step logistic regression and simultaneously took account of confounding factors and the final differences in preva lence values between the two populations or different subgroups. Canna binoids were found in 13.9% of drivers (16.0% of males and 8.3% of fem ales, p < 0.05) and 7.5% of patients (12.3% of males, 1.6% of females, p < 0.0001); only in females was this prevalence higher in injured dr ivers than in patients (p < 0.05). Opiates were present in 10.5% of dr ivers' and 10.4% of patients' urine samples (NS), and were more freque nt in urine samples positive for cannabinoids, in drivers (p < 0.01) a s well as in patients (p < 0.001). The prevalence of cocaine metabolit es in drivers and patients was 1.0 and 1.1% and that of amphetamines 1 .4 and 2.5%, respectively. No causal relationship between drugs and ac cidents should be inferred from this retrospective study. Nevertheless , the high prevalence of cannabis and opiate (licit or illicit) use in young people, whether injured drivers or patients, has potential impl ications for road traffic safety in France. Cocaine and amphetamines d id not appear to be a major problem, unlike the experience in other co untries.