Prescription opioids may play a role in some fatal accidents involving two cars

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/ Source: Reuters

By Linda Carroll

According to a US study, in the fatal accident involving two cars, the alleged drivers at the origin of the wreck were almost twice as likely as those who were not at fault to check if the opioids were positive.

According to the results published last week in the JAMA Network Open, the most common mistake leading to fatalities, whether opioids or not, was getting out of the way.

"This shows that the ongoing national opioid epidemic has spread to our national highway network with fatal consequences," said study co-author Dr. Gouhua Li, founding director of the Center for Prevention of Epidemiology and Injury Prevention at the Mailman School of Public Health at Columbia University. . "Drivers who caused the collisions were about twice as likely to have taken prescription opiates as non-initiators of the crashes."

To take a closer look at the impact of drugs on fatalities, researchers turned to the Fatality Reporting System, compiled and maintained by the National Center for Statistics and Analysis of the National Highway Traffic Safety Administration.

The fatal accident enumeration contains detailed data on all road accidents on public roads in the United States resulting in at least one fatal accident. The researchers analyzed data from 18,321 two-car fatalities. The researchers found that the most common driver error at the origin of these accidents, "inability to stay on track", occurred in 7,535 cases.

Drivers who caused the accidents were more likely than those who were not at fault to take the positive test for prescription opioids (918 vs. 549) and for alcohol (5,258 against 1,815). As a sign that the problem is worsening, the proportion of prescription opioid crash initiators in their system has increased from 2% in 1993 to 7.1% in 2016.

Of the 1,467 drivers tested positive for prescription opioids, 32% were positive for hydrocodone, 27% for morphine, 19% for oxycodone, 14% for methadone and 9% for other prescribed opioids.

Because of its design, the study can only show an association rather than a proof that opioids cause collisions, said Dr. Andrew Stolbach, a toxicologist and emergency physician at the University of Ottawa. Johns Hopkins Hospital, Baltimore.

In addition, this does not mean that people who take opioids for the treatment of chronic pain have accidents because of the drugs, said Stolbach, also an associate professor of emergency medicine at the Faculty of Medicine at the University of Toronto. Johns Hopkins University. "You may have a psychomotor and cognitive impairment in people who are not used to taking them," he explained.

"But there is a scientific literature, using driving simulators, for example, which shows that when a person increases his tolerance, many psychomotor and cognitive effects that would affect driving are not detected. Chronic and stable opioid prescription patients can drive safely, "Stolbach said.

It's not the same for people taking opioids for an acute injury such as a burn or fractured limb, he noted.

Dr. Ajay Wasan, who did not participate in the study, questioned the importance of prescription opioid use among drivers involved in an accident, describing it as "very misleading because it's really abuse, not use. "

Since studies have shown that people taking prescription opioids chronically are not impaired driving, this type of accident, especially those where people have left their lane, is probably due to abuse of opioids, said Wasan, professor of anesthesiology in Pittsburgh and elected president of the American Academy of Pain Medicine.

In addition, Wasan expects that the number of accidents involving people taking prescription opioids has been reduced in recent years due to the decrease in the number of prescriptions prescribed for patients. opioids.

"This is sensational when one needs to improve science and clarity," Wasan said.

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