DRUGS, ALCOHOL AND DRIVING: PREVALENCE AND CRASH RISK

描述（改编自申请人的摘要）：非法和 人们普遍认为机动车碰撞中的药物是大量的， 但还没有研究确定主要精神活性物质的流行程度， 毒品在普通驾驶人群中。因此，不可能 评估他们参与药物碰撞的相对风险， 也有关系拟议项目（第1阶段）旨在解决这些差距 （1）确定此类药物在 车祸受伤驾驶人群，在医院和法医处抽样 设施，以及（2）通过获取数据来估计撞车的相对风险 关于毒品阳性与毒品阴性的流行率和毒品数量 车祸司机血液样本将为确定 严重和致命受伤的司机中的毒品和酒精含量。 拟议的项目地点是圣地亚哥县，唾液样本将在那里进行。 从受伤的司机收集，以确定双方的存在和数量 选择药物为了评估唾液测定的有效性和灵敏度， 将它们与每个驾驶员的血液化验进行比较。基于 令人鼓舞的结果，我们的血液/唾液有效性研究使用气体 色谱/串联质谱，拟议的研究提出了一个 有希望的机会，以确定有效性的唾液测定下， 有大量受伤司机的情况。圣地亚哥地区近 就毒品问题和城市活力而言， 致力于解决他们。该网站还提供了可用性和访问 科目鉴于这些人的唾液和血液分析之间的高度一致性， 住院司机，唾液的方法，然后可以单独使用，以确定药物 存在和数量之间的接触样本的风险人群， 司机，在随后的第二次现场研究（第二阶段）中使用路边调查。 本提案（第1阶段）的主要具体目标包括确定：（1） 不同的流行率，类型和数量的药物和酒精之间的 不同类别的驱动程序;（2）相对风险函数的主要 在第1阶段与第2阶段的司机中发现的毒品和酒精;（3） 对驾驶员责任的评估，包括相对风险、事故严重程度， 药物和酒精的种类和数量;（4）事故与 严重程度以及药物和/或酒精的存在、类型和数量;（5） 所发现药物的一般效果与意外类型之间的关系; 和（6）物质使用和滥用模型预测类型的效用 事故后果和危险驾驶。第2阶段后，中期 目标（第3阶段）涉及制定预防/干预项目 专注于毒品酗酒和驾车长期目标包括： 有效提高公众认识所需的关键信息 针对高风险群体的教育预防/干预方案 个人和群体，以及高风险药物和物质组合。

DESCRIPTION (Adapted from the Applicant's Abstract): The role of illicit and medicinal drugs in motor vehicle crashes is widely assumed to be substantial, but no study has yet determined even the prevalence of the major psychoactive drugs among the general driving population. Thus, it has not been possible to assess their relative risk of becoming involved in crashes in which drugs played a part. The proposed project (Phase 1) is designed to address these gaps by (1) determining the prevalence and quantity of such drugs in the crash-injured driving population, sampled at hospitals and medical examiner facilities, and (2) estimating the relative risk of crashing by obtaining data on the prevalence and quantity of drugs among drug-positive vs. drug-negative crash-involved drivers. Blood samples will provide the basis for determining drug and alcohol quantities among the seriously and fatally injured drivers. The proposed project site is San Diego County, where saliva samples will be collected from injured drivers to determine both the presence and quantity of selected drugs. To assess the validity and sensitivity of the saliva assays, they will be compared to the blood assays, within each driver. Based on encouraging results of our blood/ saliva validity studies using gas chromatography/tandem mass spectrometry, the proposed research presents a promising opportunity to determine the validity of saliva assays under field conditions with a large sample of injured drivers. The San Diego area is nearly ideal for such a study in terms of its drug problems and the civic energy engaged in addressing them. The site also offers availability of and access to subjects. Given high concordance between saliva and blood assays among these hospitalized drivers, saliva methods can then be used alone to determine drug presence and quantity among an exposure sample from the at-risk population of drivers, using roadside surveys in a second, subsequent field study (Phase 2). The major specific aims of this proposal (Phase 1) consist of determining: (1) differences in prevalence, type, and quantity of drugs and alcohol among the different categories of drivers; (2) relative risk functions for the major drugs and alcohol found among the drivers in Phase 1 versus Phase 2; (3) assessment of driver responsibility regarding relative risk, accident severity, and type and quantity of drugs and alcohol; (4) relation between accident severity and the presence, type, and quantity of drug and/or alcohol; (5) relation between the general effect of the drug found and the type of accident; and (6) utility of models of substance use and abuse for predicting type of consequences of accident, and dangerous driving. Following Phase 2, mid-term objectives (Phase 3) involve developing a prevention/intervention project focused on drugs, drinking, and driving. Long-term objectives include providing the critical information necessary for developing effective public awareness and educational prevention/intervention programs targeting high-risk individuals and groups, as well as high-risk drugs and substance combinations.