Prevalence of alcohol and drugs in New York City drivers
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PURPOSE: The purpose of this study was to investigate the potential relationship between alcohol and drug prevalence in drunk- and drug-impaired driving cases in New York City (NYC) between January 1, 2015 and December 31, 2017 and to determine how this prevalence has changed over time. The study also investigated the demographic characteristics of drivers to determine if there are certain groups who are consistently involved in alcohol and/or drug abuse while operating a motor vehicle. METHODS: This retrospective study determined the alcohol and drug prevalence in individual drivers represented as cases per year over three consecutive years. A total of 613 cases were included in the study for individuals, age 16 to 75 years old arrested for suspicion of driving while intoxicated (DWI) in NYC. Individual data collected included basic demographic information, time and day of incident, borough in which incident occurred, type of matrix used for toxicological analysis and the presence and absence of alcohol and/or drugs. Drug findings were combined into classes based on their likely effect and included the following categories: alcohol, antidepressants, cannabinoids, narcotic analgesics, sedatives, stimulants and other. RESULTS: Results from the study compared data over three consecutive years from DWI cases (2015 to 2017). In comparing prevalence of drug classes by year, the percent of cases tested positive for cannabinoids, narcotic analgesics and stimulants changed significantly from 2015 to 2017. Delta-9-tetrahydrocannabinol (THC), the active component of marijuana, was the most frequent individual drug identified using a screening method. The prevalence rate of cannabinoids increased significantly in 2017 to 43.0% from 32.5% the previous year and 29.3% in 2015. The narcotic analgesics prevalence rate increased significantly in 2016 to 28.5% from 13.4% in the previous year and slightly decreased to 26.9% in 2017. Comparison of stimulants by year showed a significant increase in 2017, 28.1% versus 19.0% (2016) versus 18.3% (2015). When comparing the 2017 results to the drugs tested for in 2015 and 2016, significantly higher daytime drug prevalence was found between the previous years and 2017. In evaluating race and drug use, white drivers were significantly more likely to test positive for sedatives and stimulants than other races. In Manhattan, there was a significantly higher alcohol detection rate compared to the other boroughs and in Staten Island there was a significantly higher narcotic analgesics detection rate. In comparing the top five individual drugs identified by borough, cannabinoids were the most common drug across all of the boroughs. Alprazolam and cocaine (identified by its metabolite, benzoylecgonine, 98% of the time) were the next most frequently encountered drugs alternating as the top two and three drugs identified in the following four boroughs: Manhattan, Queens, the Bronx, and Staten Island. Phencyclidine (PCP) (“angel dust”) was identified in the top five for Manhattan, the Bronx and Staten Island. A statistically significant negative association was found between cannabinoid-positive and alcohol-positive drivers. The percentage of drivers with a BAC greater than .08 g/dL was significantly lower among cannabinoid-positive drivers than those who tested negative for cannabinoids. Although there were no strong correlations between drug classes, sedatives were associated (according to significant correlations) most to other drugs (correlated to 6 out of 6 categories). CONCLUSIONS: This study summarizes the results of the first OCME FTL of NYC toxicological findings in DWI cases to estimate alcohol and drug-involved driving prevalence. It is important to note that this is a prevalence study and not a study that reports the risks associated with drugged-driving. Since many drugs may be detected long after its impairing effects are gone, the focus of this study was to merely convey the use of particular drugs in the driving population.