Research Papers

Driving Under the Influence of Opioids in the Ontario Adult Population: Prevalence, Impact on Collision Risk, and Characterization of the Drivers

Version 1
Date added June 28, 2017
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Category 2017 CARSP XXVII Toronto
Tags Research and Evaluation, Session 6A
Author/Auteur Christine Wickens
Stream/Volet Research and Evaluation

Slidedeck Presentation Only (no paper submitted)



According to a United Nations report, Canada is the world’s second largest per capita consumer of prescription opioids (POs). The use of opioids is associated with elevated rates of financial, social, and work-related problems, morbidity, and mortality. Motor vehicle collisions may constitute an important means by which PO use is increasing morbidity and mortality rates. Although some studies have found no significant differences in driving ability between individuals taking opioids versus those not taking opioids, other studies have identified increases in unsafe driving actions and collision risk associated with opioid use. A correlation between drug concentration in blood and vehicle weaving has also been reported. Given the prevalence of PO use in Canada, it is important to examine the impact of the drug using Canadian data. The current study analyzed Ontario data to determine the prevalence of driving under the influence of opioids (DUIO) and its association with collision risk, and to explore the demographic and risk-behaviour profile of those who reported engaging in DUIO. Data were based on telephone interviews with 7,876 respondents who reported having driven in the past year. Data were derived from the 2011-2015 cycles of the CAMH Monitor, an ongoing cross-sectional survey of adults aged 18+ years in Ontario. A binary logistic regression analysis of collision involvement in the previous 12 months was conducted and included demographic characteristics (sex, age, marital status, education, income, region), driving exposure, poor mental health, hazardous or harmful drinking, and driving after use of alcohol. Based on preliminary analyses, the prevalence of past-year DUIO among Ontario drivers was 2.8%. Controlling for demographic characteristics, driving exposure, poor mental health, hazardous or harmful drinking, and driving after use of alcohol, self-reported DUIO significantly increased the odds of a crash (OR=2.22, p=.017). A total of 13.0% of drivers who reported PO use indicated that they had engaged in DUIO. Based on independent sample t-tests, DUIO was more prevalent among males, middle-aged or older adults, those with less than a high school education, those with lower income, those living outside Toronto, those reporting poor mental health, those who report drinking alcohol at a hazardous or harmful level, and those who reported driving after drinking. Results indicated that DUIO in the Ontario adult population is associated with increased risk of a motor vehicle collision. A total of 13% of PO users reported DUIO. These drivers were also more likely to engage in other risky behaviours including harmful or hazardous drinking and driving after drinking. Future research should consider how pattern of use (i.e., medical or recreational use) and additional substance use (e.g., cannabis, benzodiazepines) affect the association between DUIO and collision risk. Driver safety initiatives in Ontario, including policy, education and enforcement efforts to reduce the incidence of motor vehicle crashes, should include a focus on DUIO.

Christine Wickens