Center of Global Mental Health, National Institute for Psychiatry Ramon de la Fuente Muniz, Ciudad de Mexico, Mexico
Center of Global Mental Health, National Institute for Psychiatry Ramon de la Fuente Muniz, Ciudad de Mexico, Mexico.
Inj Prev. 2023 Jun;29(3):207-212. doi: 10.1136/ip-2022-044782. Epub 2022 Dec 9.
There is debate on whether cannabis affects road traffic injuries (RTIs) separately from the effects of alcohol. Our goals are to report the possible increase in risk of an RTI among alcohol and cannabis users by type of exposure (biological, self-reported and combined) and the possible interaction of alcohol and cannabis in patients with an RTI in an emergency department in Mexico City.
A case-crossover study with 433 cases of RTI (as a pedestrian, driver or passenger) during the period January-April 2022. A breath sample, an oral sample for cannabis detection and self-reported alcohol and cannabis use 6 hours prior to the RTI and in two control periods were used. We report ORs and 95% CIs from conditional logistic regressions for the case-crossover estimates.
Alcohol alone increased the risk of an RTI (OR=6.02, 95% CI 3.29 to 10.99) for most RTIs, regardless of whether we used information from self-reports or a breath sample in the hazard period. Conversely, cannabis only increased the RTI when we added information in the hazard period from self-reports or oral samples. Nevertheless, this increase in risk disappeared (OR=2.06, 95% CI 0.90 to 4.70) among those who only used cannabis. We also found no evidence of interaction between alcohol and cannabis in the risk of an RTI.
Alcohol is the most commonly used substance in Mexico and a high-risk factor for RTI in Mexico City. Although cannabis alone was not associated with an RTI, continuous monitoring of its effects is required.
关于大麻是否会对道路交通伤害(RTI)产生影响,是否与酒精的影响分开,存在争议。我们的目标是报告在墨西哥城的急诊科中,按暴露类型(生物、自我报告和联合)报告酒精和大麻使用者发生 RTI 的风险增加情况,以及酒精和大麻在 RTI 患者中的可能相互作用。
这是一项病例交叉研究,纳入了 2022 年 1 月至 4 月期间的 433 例 RTI(作为行人、司机或乘客)病例。使用了呼吸样本、口腔大麻检测样本以及 RTI 前 6 小时和两个对照期内的自我报告的酒精和大麻使用情况。我们报告了病例交叉估计的条件逻辑回归的 OR 和 95%CI。
单独的酒精增加了大多数 RTI 的 RTI 风险(OR=6.02,95%CI 3.29 至 10.99),无论我们在危险期内使用自我报告还是呼吸样本的信息。相反,只有在我们在危险期内增加了自我报告或口腔样本的信息时,大麻才会增加 RTI 的风险。然而,在仅使用大麻的人群中,这种风险增加消失了(OR=2.06,95%CI 0.90 至 4.70)。我们也没有发现酒精和大麻在 RTI 风险之间存在相互作用的证据。
酒精是墨西哥最常用的物质,也是墨西哥城 RTI 的高风险因素。尽管单独使用大麻与 RTI 无关,但需要对其影响进行持续监测。