Forekomst av alkohol og andre rusmidler i blodprøver fra førere involvert i trafikkulykker

Anders Bjørneboe m.fl
2009 Norsk Epidemiologi  
<strong><span style="font-family: TimesNewRomanPS-BoldMT;"><span style="font-family: TimesNewRomanPS-BoldMT;"><p align="left"> </p></span></span><span style="font-size: x-small; font-family: TimesNewRomanPS-BoldMT;"><span style="font-size: x-small; font-family: TimesNewRomanPS-BoldMT;">SAMMENDRAG</span></span></strong><span style="font-size: x-small; font-family: TimesNewRomanPSMT;"><span style="font-size: x-small; font-family: TimesNewRomanPSMT;"><p align="left">Bilkjøring stiller store krav
more » ... tiller store krav til førernes sansing, oppmerksomhet, informasjonsbearbeiding og evne til å</p><p align="left">reagere. Førere som er under innflytelse av sentralnervøst aktive stoffer, vil derfor være en potensiell fare i</p><p align="left">trafikken. I perioden 1.8–31.12. 1993 identifiserte Statens rettstoksikologiske institutt (SRI) 394 ulykkesførere</p><p align="left">som politiet hadde rekvirert analyser av med hensyn på narkotiske stoff/sentralnervøst aktive medikamenter</p><p align="left">(andre rusmidler) og/eller alkohol. Blodprøver fra disse førerne ble analysert med hensyn på alkohol og et</p><p align="left">utvidet repertoar av andre rusmidler ved SRI. Da polititjenestemenn og medtrafikanter ofte ikke vil oppdage</p><p align="left">påvirkning av andre rusmidler enn alkohol, dels pga. manglende alkohollukt, vil andre rusmidler som ulykkesårsak</p><p align="left">være noe underrepresentert i dette materialet sammenliknet med alkohol. Hos 299 av ulykkesførerne</p><p align="left">ble det påvist alkohol og/eller andre rusmidler. 44 førere hadde tatt inn både alkohol og andre rusmidler, mens</p><p align="left">alkohol og andre rusmidler ble påvist alene i henholdsvis 204 og 51 saker. Totalt ble benzodiazepiner,</p><p align="left">cannabis, opiater og amfetamin påvist i henholdsvis 54, 30, 17 og 16 saker. Av de 95 som hadde tatt inn andre</p><p align="left">rusmidler, hadde 34 tatt inn mer enn ett rusmiddel (alkohol ikke medregnet) og i 72 av tilfellene ble analysefunnene</p><p align="left">vurdert (AB og JM) til sannsynligvis å ha gitt sentralnervøs påvirkning. Risikoøkningen for trafikkulykke</p><p align="left">ved nylig bruk av cannabisstoffer og diazepam i høydose ble estimert til å kunne tilsvare en blodalkoholkonsentrasjon</p><p align="left">på 1-1,5 promille. Alkohol er det rusmiddel som oftest påvises hos ulykkesførere, men</p><p align="left">forekomsten av benzodiazepiner, cannabis og amfetamin er såvidt høy blant ulykkesførere at disse stoffene</p><p align="left">må anses å være et alvorlig trafikksikkerhetsproblem.</p><p align="left">Bjørneboe A, Beylich K-M, Christophersen AS, Fosser S, Glad A, Mørland J.</p></span></span><strong><span style="font-size: x-small; font-family: TimesNewRomanPS-BoldMT;"><span style="font-size: x-small; font-family: TimesNewRomanPS-BoldMT;"><p align="left">Prevalence of alcohol and other intoxicants in blood samples from drivers involved in road traffic</p><strong><span style="font-size: x-small; font-family: TimesNewRomanPS-BoldMT;"><span style="font-size: x-small; font-family: TimesNewRomanPS-BoldMT;"><p align="left">accidents.</p></span></span></strong></span><strong><span style="font-size: x-small; font-family: TimesNewRomanPS-BoldMT;"><p align="left"> </p></span></strong></span><p align="left"> </p><strong><span style="font-family: TimesNewRomanPS-BoldMT;"><span style="font-family: TimesNewRomanPS-BoldMT;"><p align="left"> </p></span></span><span style="font-size: x-small; font-family: TimesNewRomanPS-BoldMT;"><span style="font-size: x-small; font-family: TimesNewRomanPS-BoldMT;">ENGLISH SUMMARY</span></span></strong><span style="font-size: x-small; font-family: TimesNewRomanPSMT;"><span style="font-size: x-small; font-family: TimesNewRomanPSMT;"><p align="left">Illegal and some legal drugs affect the central nervous system and drivers who use such drugs may represent a</p><p align="left">hazard in the road traffic. The prevalence of such drugs among drivers involved in accidents depends on the</p><p align="left">increase of the accident risk due to the drug and on the prevalence of the drugs among drivers on the road. In</p><p align="left">this study we have examined blood samples from 394 drivers involved in road traffic accidents during the</p><p align="left">period August–December 1993, to determine the prevalence of alcohol and drugs among drivers involved in</p><p align="left">accidents. Most of the drivers enrolled in the study were suspected by the police of driving under the influence</p><p align="left">of alcohol or drugs. The data are, however, probably somewhat biased, because drivers influenced by alcohol</p><p align="left">or drugs will, if possible, avoid contact with the police. Furthermore, the police's ability to detect drivers</p><p align="left">influenced by drugs is limited. Accordingly, the proportion of influenced drivers and especially drivers influenced</p><p align="left">by drugs could be too low compared with the proportion among all drivers involved in traffic accidents.</p><p align="left">In about 2/3 of the blood samples examined, alcohol was found either alone or together with other drugs,</p><p align="left">and in 1/4 of the cases drugs were found either alone or together with alcohol. The most prevalent drugs were</p><p align="left">benzodiazepines (13.7%), cannabis (7.5%), opiates (4.3%) and amphetamine (4.1%). In about 3/4 of the drug</p><p align="left">positive cases the drug concentration was so high that it was considered likely or very likely that the driver</p><p align="left">was influenced by the drug(s). The bias due to the police's inability to detect all drivers influenced by drugs</p></span></span><span style="font-family: TimesNewRomanPSMT;"><span style="font-family: TimesNewRomanPSMT;"><p align="left">50</p></span></span><p align="left"><span style="font-size: x-small; font-family: TimesNewRomanPSMT;"><span style="font-size: x-small; font-family: TimesNewRomanPSMT;">A. B</span></span><span style="font-size: xx-small; font-family: TimesNewRomanPSMT;"><span style="font-size: xx-small; font-family: TimesNewRomanPSMT;">JØRNEBOE OG MEDARBEIDERE</span></span></p><span style="font-size: x-small; font-family: TimesNewRomanPSMT;"><span style="font-size: x-small; font-family: TimesNewRomanPSMT;"><p align="left">was estimated. After correction for this bias it was estimated that at least 2.7% of drivers involved in injury</p><p align="left">accidents will have significant concentrations of drugs in the blood and at least 4.4% will have significant</p><p align="left">blood alcohol concentrations.</p><p align="left">Based on various sources of drug use in Norway we arrived at rough estimates of increase in risk of being</p><p align="left">involved in road traffic accidents after different drug intakes. Driving a car the first few hours after cannabis</p><p align="left">intake may increase the risk for an accident comparable to the risk involved when driving with a blood</p><p align="left">alcohol concentration in the range 1.0 - 1.5 per mill. High doses of diazepam intake will most likely increase</p><p align="left">the risk of an accident in the same order of magnitude.</p><p align="left">We conclude that drunken drivers still constitute the main problem with regard to influenced driving on</p><p align="left">Norwegian roads. Nevertheless, the relatively high frequency of drivers influenced by drugs among those</p><p>involved in accidents, demonstrates that these drivers are a serious safety problem.</p></span></span></strong><span style="font-size: x-small; font-family: TimesNewRomanPS-ItalicMT;"><span style="font-size: x-small; font-family: TimesNewRomanPS-ItalicMT;">Nor J Epidemiol </span></span><span style="font-size: x-small; font-family: TimesNewRomanPSMT;"><span style="font-size: x-small; font-family: TimesNewRomanPSMT;">1996; </span></span><strong><span style="font-size: x-small; font-family: TimesNewRomanPS-BoldMT;"><span style="font-size: x-small; font-family: TimesNewRomanPS-BoldMT;">6 </span></span></strong><span style="font-size: x-small; font-family: TimesNewRomanPSMT;"><span style="font-size: x-small; font-family: TimesNewRomanPSMT;">(1): 49-56.</span></span>
doi:10.5324/nje.v6i1.332 fatcat:dgjynvmg2javbkni4emeyzghhu