Background

Driving under the influence of drugs, including alcohol, is a globally recognised risk factor for road traffic crashes. While the prevalence of alcohol and other drugs in fatal road crashes has been examined in other countries, recent data investigating drug driving in fatal Australian crashes are limited. This study aimed to examine how the presence of alcohol and other drugs in fatal road trauma in Victoria has changed over time in different road users.

Methods

A population-based review of road trauma deaths was performed over the period of 01 July 2006 to 30 June 2016 in Victoria, Australia, using data from the National Coronial Information System (NCIS) and the Victorian State Trauma Registry (VSTR). Drugs were grouped according to type and analysed accordingly. Poisson regression models were used to determine change in incidence rates over the study period.

Results

There were 2287 road traffic fatalities with complete toxicology data (97% of all road traffic fatalities). Alcohol (blood alcohol concentration, BAC) was the most commonly detected drug (>0.001 g/100 mL: 21.1%; >0.05 g/100 mL: 18.4%), followed by opioids (17.3%), THC (13.1%), antidepressants (9.7%), benzodiazepines (8.8%), amphetamine-type stimulants (7.1%), ketamine (3.4%), antipsychotics (0.9%) and cocaine (0.2%). Trends demonstrated changing use over time with specific drugs. Alcohol positive road fatalities declined 9% per year in passenger car/4WD drivers (IRR = 0.91, 95% CI: 0.88−0.95). The incidence of strong opioids (oxycodone, fentanyl, morphine, and methadone) increased 6% per year (IRR = 1.06; 95% CI: 1.02–1.10). Methylamphetamine was detected in 6.6% of cases and showed a yearly increase of 7% (IRR = 1.07; 95% CI: 1.01–1.13). The incidence of THC remained unchanged over the period, observed in 13.1% of cases. Stronger opioids were more commonly detected among pedal cyclists (19.0%) and pedestrians (20.9%) while THC was more commonly detected among motorcyclists (19.8%) and other light vehicle drivers (17.6%).

Conclusions

A decline in the prevalence of alcohol in fatalities suggests that law enforcement and public health strategies in Australia to address road fatalities and drink-driving may have had a positive effect. However, increases were observed in the incidence of other potentially impairing drugs including opioids and amphetamines, specifically methylamphetamine, indicating a concerning trend in road safety in Victoria that warrants further monitoring.

中文翻译：

---

在澳大利亚维多利亚州致命的道路交通事故中，酒精和其他毒品的流行

背景

在包括酒精在内的毒品的影响下驾驶是全球公认的道路交通事故的风险因素。尽管在其他国家/地区已调查了致命道路交通事故中酒精和其他毒品的流行，但有关澳大利亚致命交通事故中毒品驾驶的最新数据有限。这项研究旨在研究维多利亚州致命道路创伤中酒精和其他药物的存在如何随着时间的推移在不同道路使用者中发生变化。

方法

在2006年7月1日至2016年6月30日期间，澳大利亚维多利亚使用国家冠状信息系统（NCIS）和维多利亚州创伤登记处（VSTR）的数据对人群的道路创伤死亡进行了回顾。根据类型将药物分组并进行相应分析。使用泊松回归模型来确定研究期间发生率的变化。

结果

具有完整毒理学数据的道路交通事故死亡人数为2287人（占所有道路交通事故死亡人数的97％）。酒精（血液酒精浓度，BAC）是最常见的药物（> 0.001 g / 100 mL：21.1％;> 0.05 g / 100 mL：18.4％），其次是阿片类药物（17.3％），四氢大麻酚（13.1％），抗抑郁药（9.7％），苯二氮卓类药物（8.8％），苯丙胺类兴奋剂（7.1％），氯胺酮（3.4％），抗精神病药（0.9％）和可卡因（0.2％）。趋势表明，特定药物的使用随时间而变化。乘用车/ 4WD驾驶员的酒精致死率每年下降9％（IRR = 0.91，95％CI：0.88-0.95）。强阿片类药物（羟考酮，芬太尼，吗啡和美沙酮）的发生率每年增加6％（IRR = 1.06； 95％CI：1.02-1.10）。在6.6％的病例中检出了甲基苯丙胺，并且每年增加7％（IRR = 1.07； 95％CI：1.01-1.13）。在此期间，THC的发生率保持不变，占13.1％的病例。在踏板骑行者（19.0％）和行人（20.9％）中更常见的阿片类药物更强，而在摩托车骑士（19.8％）和其他轻型车辆驾驶员（17.6％）中更常见的是THC。

结论

酒精致死率的下降表明，澳大利亚解决道路致死和酒后驾驶的执法和公共卫生策略可能产生了积极影响。但是，观察到其他潜在损害药物包括阿片类药物和苯丙胺，特别是甲基苯丙胺的发生率有所增加，这表明维多利亚州道路安全的趋势令人担忧，值得进一步监测。