Prevalence of psychoactive drugs in injured drivers over 10 years in Victoria, Australia.

One thousand of the mandatory blood specimens taken from injured drivers attending a hospital over a decade were analyzed for a full range of legal and illegal drugs in an accredited forensic toxicology laboratory with confirmation by a validated LC-MS/MS procedure. Ethanol ( ≥0.05 g/100 mL), methamphetamine (≥0.01 mg/L), THC (≥1 ng/mL) were present in 13.6 %, 12.7 % and 11.5 %, respectively with only minor variations over the decade. In contrast, the prevalence of ketamine, cocaine, fentanyl and new psychoactive substances (NPS) increased substantially over this period reaching 7.0 %, 1.8 %, 2.0 % and 3.0 % in the last 5 years of the study. A substantial proportion of drivers were also positive for opioids, antidepressants, and benzodiazepines, although some of these may have been given post-crash as part of their medical treatment. Overall, about 38 % of drivers had a potentially impairing drug detected in their blood on presentation to hospital and at least one common illicit drug with or without ethanol were present in almost 23 % of drivers. The presence of more than one common illicit drug (THC, methamphetamine, MDMA, cocaine, heroin), with or without ethanol, increased from 4.3 % in the first 5 years to 5.8 % in the last five years, which may reflect a higher crash risk for those drivers.