Staples John A, Erdelyi Shannon, Moe Jessica, Khan Mayesha, Chan Herbert, Brubacher Jeffrey R
Department of Medicine, University of British Columbia, Vancouver, British Columbia, Canada
Centre for Clinical Epidemiology & Evaluation (C2E2), Vancouver, British Columbia, Canada.
Inj Prev. 2021 Dec;27(6):527-534. doi: 10.1136/injuryprev-2020-043989. Epub 2021 Jan 13.
Opioids increase the risk of traffic crash by limiting coordination, slowing reflexes, impairing concentration and producing drowsiness. The epidemiology of prescription opioid use among drivers remains uncertain. We aimed to examine population-based trends and geographical variation in drivers' prescription opioid consumption.
We linked 20 years of province-wide driving records to comprehensive population-based prescription data for all drivers in British Columbia (Canada). We calculated age- and sex-standardised rates of prescription opioid consumption. We assessed temporal trends using segmented linear regression and examined regional variation in prescription opioid use using maps and graphical techniques.
A total of 46 million opioid prescriptions were filled by 3.0 million licensed drivers between 1997 and 2016. In 2016 alone, 14.7% of all drivers filled at least one opioid prescription. Prescription opioid use increased from 238 morphine milligram equivalents per driver year (MMEs/DY) in 1997 to a peak of 834 MMEs/DY in 2011. Increases in MMEs/DY were greatest for higher potency and long-acting prescription opioids. The interquartile range of prescription opioid dispensation by geographical region increased from 97 (Q1=220, Q3=317) to 416 (Q1=591, Q3=1007) MMEs/DY over the study interval.
Patterns of prescription opioid consumption among drivers demonstrate substantial temporal and geographical variation, suggesting they may be modified by clinical and policy interventions. Interventions to curtail use of potentially impairing prescription medications might prevent impaired driving.
阿片类药物会限制协调性、减缓反应速度、损害注意力并导致嗜睡，从而增加交通事故风险。驾驶员使用处方阿片类药物的流行病学情况仍不明确。我们旨在研究基于人群的驾驶员处方阿片类药物消费趋势及地理差异。
我们将20年的全省驾驶记录与加拿大不列颠哥伦比亚省所有驾驶员基于人群的综合处方数据相链接。我们计算了年龄和性别标准化的处方阿片类药物消费率。我们使用分段线性回归评估时间趋势，并使用地图和图形技术研究处方阿片类药物使用的区域差异。
1997年至2016年期间，300万名持证驾驶员共开具了4600万份阿片类药物处方。仅在2016年，就有14.7%的驾驶员开具了至少一份阿片类药物处方。处方阿片类药物的使用从1997年每位驾驶员每年238毫克吗啡当量（MMEs/DY）增加到2011年的峰值834 MMEs/DY。效力更高和长效的处方阿片类药物的MMEs/DY增长最为显著。在研究期间，地理区域处方阿片类药物配给的四分位间距从97（第一四分位数=220，第三四分位数=317）增加到416（第一四分位数=591，第三四分位数=1007）MMEs/DY。
驾驶员处方阿片类药物消费模式显示出显著的时间和地理差异，这表明它们可能会受到临床和政策干预的影响。减少使用可能会损害驾驶能力的处方药的干预措施可能会预防驾驶能力受损。
