Equipe Prévention et prise en charge des traumatismes, Centre de recherche INSERM U897 Epidémiologie et Biostatistiques, Institut de Santé Publique d'Epidémiologie et de Développement, Université Bordeaux Segalen, Case 11, 146 rue Léo Saignat, 33 076 Bordeaux cedex, France.
Drug Alcohol Depend. 2012 Jun 1;123(1-3):91-7. doi: 10.1016/j.drugalcdep.2011.10.022. Epub 2011 Nov 21.
Opioids have been shown to impair psychomotor and cognitive functioning in healthy volunteers with no history of opioid abuse. Few or no significant effects have been found in opioid-dependant patients in experimental or driving simulation studies. The risk of road traffic crash among patients under buprenorphine or methadone has not been subject to epidemiological investigation so far. The objective was to investigate the association between the risk of being responsible for a road traffic crash and the use of buprenorphine and methadone.
Data from three French national databases were extracted and matched: the national health care insurance database, police reports, and the national police database of injurious crashes. Case-control analysis comparing responsible versus non responsible drivers was conducted.
72,685 drivers involved in an injurious crash in France over the July 2005-May 2008 period, were identified by their national health care number. The 196 drivers exposed to buprenorphine or methadone on the day of crash were young, essentially males, with an important co-consumption of other substances (alcohol and benzodiazepines). Injured drivers exposed to buprenorphine or methadone on the day of crash, had an increased risk of being responsible for the crash (odds ratio (OR)=2.02, 95% confidence interval (CI): 1.40 and 2.91).
Users of methadone and buprenorphine were at increased risk of being responsible for injurious road traffic crashes. The increased risk could be explained by the combined effect of risky behaviors and treatments.
阿片类药物已被证明会损害无阿片类药物滥用史的健康志愿者的精神运动和认知功能。在实验或驾驶模拟研究中，阿片类药物依赖患者的影响很少或没有显著影响。到目前为止，尚未对丁丙诺啡或美沙酮患者发生道路交通事故的风险进行流行病学调查。目的是调查与负责道路交通事故风险相关的丁丙诺啡和美沙酮的使用之间的关联。
从三个法国国家数据库中提取并匹配数据：国家医疗保险数据库、警方报告和国家伤害性撞车警察数据库。对负责驾驶员与非负责驾驶员进行病例对照分析。
2005 年 7 月至 2008 年 5 月期间，法国有 72685 名驾驶员因受伤而卷入撞车事故，通过国家医疗保健号码识别。196 名在撞车当天暴露于丁丙诺啡或美沙酮的驾驶员年龄较小，主要为男性，其他物质（酒精和苯二氮䓬类药物）的共同消耗较大。在撞车当天暴露于丁丙诺啡或美沙酮的受伤驾驶员，发生撞车事故的责任风险增加（优势比（OR）=2.02，95%置信区间（CI）：1.40-2.91）。
美沙酮和丁丙诺啡的使用者发生伤害性道路交通事故的责任风险增加。风险增加可能是由于危险行为和治疗的综合影响所致。
