A Comparison of Drug Use in Driver Fatalities and Similarly Exposed Drivers

Blackburn, R. R. (Robert R.); Woodhouse, Edward J. · 1977 · ROSA P / United States. National Highway Traffic Safety Administration

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Summary

This 1977 study, conducted by the Midwest Research Institute for the National Highway Traffic Safety Administration, investigates whether specific drugs are over-involved in fatal traffic crashes. Motivated by the known role of alcohol in fatalities and rising concerns about prescription and illegal drug use, the research aimed to determine the absolute incidence of drug involvement in driver fatalities and compare it against a control group of "similarly exposed" living drivers to calculate relative risk. The methodology involved a five-task research plan. First, data were collected from 900 fatally injured drivers across 22 areas in the United States. Medical examiners provided crash data and biological specimens, including urine, blood, and bile. Second, to establish a comparison group, roadside surveys were conducted in Dallas, Texas, and Memphis, Tennessee. Researchers stopped randomly selected living drivers at the same times and locations as recent fatal crashes. Of 1,255 motorists stopped, 1,196 provided usable data, including breath, urine, and blood samples. Third, laboratory analysis screened all specimens for 43 drugs classified into seven groups (e.g., sedatives, narcotics, stimulants) using thin-layer chromatography and gas chromatography. Alcohol content was also quantified. Finally, statistical analysis compared drug incidences between the two groups to determine relative risks. The results indicated that 14.3% of fatally injured drivers had used one or more of the tested drugs prior to the crash, compared to 7.9% of living drivers. The most frequently detected substances in both groups were antihistamines/decongestants (specifically phenylpropanolamine and chlorpheniramine), followed by sedatives (phenobarbital) and narcotics. Nicotine was present in 64.7% of fatalities and 56% of living drivers. Crucially, the study found that drivers using drugs were approximately 1.8 times more likely to be fatally injured than non-users. The relative risk was highest for narcotic analgesics (approximately 19 times), followed by sedatives/hypnotics (1.9 times) and nicotine (1.2 times). Alcohol remained the most significant causative factor, with drivers having a blood alcohol concentration of 0.15–0.19% facing a relative risk of 30.31. The study also noted a negative correlation between drug use and alcohol use among fatally injured drivers, suggesting distinct usage patterns. The significance of this research lies in its establishment of baseline relative risks for various drug classes in traffic fatalities. It confirmed that while alcohol is the primary drug-related cause of fatal crashes, other substances—particularly narcotics and sedatives—pose substantial dangers. The findings provided empirical evidence that drug use increases the likelihood of fatal crash involvement, supporting the need for further research into drug-impaired driving and informing traffic safety policies. The study also highlighted methodological challenges, such as the low detection rates of drugs in blood compared to urine, and the necessity of large sample sizes to achieve statistical precision for less common drug groups.

Key finding

Drivers using drugs are approximately 1.8 times more likely to be fatally injured in a vehicular crash than non-users, with the highest relative risk observed for narcotic analgesics at 19 times.

Methodology

mixed_methods

Sample size: 2096

Provenance

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Summary generated by qwen3.6-27b-prismaquant on 2026-06-10; verification: verified.

Topics

Ranked by relevance to this paper. Hover a topic for its definition.

• illicit drugs
• incidence prevalence
• polydrug
• cannabis

Information type

What kind of knowledge this paper contributes, grouped by family — independent of topic (what it is about) and method (how it was studied).

• Empirical Findings: observational prevalence, crash risk outcomes
• Methodological Resource: dataset resource