Citation

Chihuri S, Li G. Accid. Anal. Prev. 2017; 109: 123-131.

Affiliation

Center for Injury Epidemiology and Prevention, Columbia University Medical Center, New York, NY, United States; Department of Anesthesiology, College of Physicians and Surgeons, Columbia University, New York, NY, United States; Department of Epidemiology, Mailman School of Public Health, Columbia University, New York, NY, United States. Electronic address: GL2240@cumc.columbia.edu.

Copyright

(Copyright © 2017, Elsevier Publishing)

DOI

10.1016/j.aap.2017.10.004

PMID

29059534

Abstract

OBJECTIVES: Opioid analgesics are a major driver of the ongoing opioid epidemic in the United Sates, accounting for about two thirds of drug overdose fatalities. There are conflicting reports regarding the effects of prescription opioids on driving safety. A meta-analysis was performed to assess the epidemiologic evidence for the association between use of prescription opioids and the risk of motor vehicle crashes.

METHODS: Studies examining the association between driver prescription opioid use and motor vehicle crash involvement or crash culpability and published in English were identified through a comprehensive search of 15 bibliographic databases. Eligible articles were fully reviewed and summarized. Study quality was assessed using the Newcastle-Ottawa Scale. Overall summary odds ratios (ORs) and 95% confidence intervals (CIs) were estimated through random effects models.

RESULTS: Overall, 15 studies were included in the meta-analysis; of them, 10 assessed the association of prescription opioid use with the risk of crash involvement and 5 assessed the association of prescription opioid use with the risk of crash culpability. Reported crude ORs associated with prescription opioid use ranged from 1.15 to 8.19 for the risk of crash involvement and from 0.75 to 2.78 for the risk of crash culpability. Summary ORs based on pooled data were 2.29 (95% CI: 1.51, 3.48) for crash risk and 1.47 (95% CI: 1.01, 2.13) for crash culpability.

CONCLUSIONS: The existent epidemiologic evidence indicates that use of prescription opioids by drivers is associated with significantly increased risks of crash involvement and crash culpability. Further research is needed to understand the epidemiologic patterns of prescription opioid use in the driver population and the interaction effects between opioids and alcohol on driving safety.

Copyright © 2017 Elsevier Ltd. All rights reserved.

Language: en

Keywords

Driving safety; Drugged driving; Motor vehicle crashes; Opioids; Traffic injury