Centre for Addiction and Mental Health, Toronto, Ontario, Canada; Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada.
Centre for Addiction and Mental Health, Toronto, Ontario, Canada; Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada.
Accid Anal Prev. 2018 Dec;121:14-19. doi: 10.1016/j.aap.2018.08.026. Epub 2018 Sep 8.
Motor vehicle collisions are an important contributor to prescription opioid use-related morbidity and mortality. The purpose of the current study was to estimate the prevalence of driving under the influence of prescription opioids (DUIPO) in Ontario, Canada, and to measure the association between this behaviour and the risk of a motor vehicle collision.
Data were based on telephone interviews with 7857 respondents who reported having driven in the past year. Data were derived from the 2011-2016 cycles of the CAMH Monitor, an ongoing cross-sectional representative survey of adults aged 18 years and older. A binary logistic regression analysis of collision involvement in the previous 12 months was conducted and included demographic characteristics (sex, age, marital status, education, income, region), driving exposure, poor mental health, non-medical use of prescription opioids, and driving after use of alcohol.
The prevalence of past-year DUIPO was 3.1%. Controlling for demographic characteristics, driving exposure, and other risk factors, self-reported DUIPO significantly increased the odds of a collision (AdjOR = 1.97; 95% CI 1.08, 3.60; p = 0.026).
Based on these findings, DUIPO is a notable road safety issue. Research focused on better understanding the impact of prescription opioids on driver behaviour, reducing the prevalence of DUIPO, and improving drug-impaired driving policy and interventions should be prioritized in public health strategies.
机动车事故是导致处方阿片类药物使用相关发病率和死亡率的一个重要因素。本研究的目的是估计在加拿大安大略省，驾驶时受处方阿片类药物影响（DUIPO）的流行率，并测量这种行为与机动车事故风险之间的关联。
数据基于对 7857 名报告在过去一年中驾驶过的受访者的电话访谈。数据来自于 CAMH 监测的 2011-2016 年周期，CAMH 监测是一项正在进行的横断面代表性调查，调查对象为 18 岁及以上的成年人。对过去 12 个月中涉及碰撞的情况进行了二元逻辑回归分析，包括人口统计学特征（性别、年龄、婚姻状况、教育、收入、地区）、驾驶暴露、心理健康状况不佳、非医疗用途的处方阿片类药物以及饮酒后驾驶。
过去一年中 DUIPO 的流行率为 3.1%。在控制人口统计学特征、驾驶暴露和其他风险因素后，自我报告的 DUIPO 显著增加了发生碰撞的几率（调整后的优势比[AdjOR] = 1.97；95%置信区间[CI]为 1.08-3.60；p = 0.026）。
基于这些发现，DUIPO 是一个值得关注的道路安全问题。应该优先在公共卫生战略中开展研究，以更好地了解处方阿片类药物对驾驶员行为的影响，降低 DUIPO 的流行率，并改进针对药物影响驾驶的政策和干预措施。
