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Opioid Use Increases Risk of Fatality in Motor Vehicle Accidents

— May 2, 2019

Research finds driving under the influence of opioids increases the risk for fatal crashes.

New research published this month in the journal JAMA Network Open sought to “assess the association between driver use of prescription opioids and the risk of being culpable of crash initiation in fatal 2-vehicle crashes,” and revealed that drivers who are on prescribed opioids are “twice as likely to be in deadly two-vehicle accidents than those not using the drugs.”  The authors contend, “As the United States struggles with an opioid epidemic, these findings could affect health care providers’ decision-making processes.”

Statistics from the U.S. Center for Disease Control and Prevention show that “although the rate of opioids prescribed per 100 people decreased from 72.4% to 66.5% from 2006 to 2016, 214 million opioid prescriptions are issued to patients each year.”

Study author Dr. Guohua Li, a professor of epidemiology and anesthesiology and the founding director of the Center for Injury Epidemiology and Prevention at Columbia University, said he and co-author Stanford Chihuri, a staff associate in Columbia’s Department of Anesthesiology, were motivated to take on this research because “the ongoing opioid epidemic has spilled over to the nation’s roadways, with deadly consequences.”

Opioid Use Increases Risk of Fatality in Motor Vehicle Accidents
Photo by Karsten Würth (@inf1783) on Unsplash

For the study, the researchers used data from the National Highway Traffic Safety Administration’s Fatality Analysis Reporting System, which contains records from throughout the United States on motor vehicle crashes with at least one death within thirty days of the accident.  This data is based on “driver-related factors,” the unsafe actions leading to crashes.  A driver with at least one driving error resulting in that fatal crash is “the crash initiator.”

The researchers used this data to measure which drivers were at fault for crashes and toxicology results to look for the presence of opioids in the driver’s blood stream.  After scanning through the data related to 18,321 driver pairs who died in two-vehicle accidents between 1993 and 2016, Li and Chihuri found that 54.7% of deceased drivers who tested positive for prescribed opioids crashed because “they were unable to stay in their lane. Additionally, more crash initiators overall tested positive for prescribed opioids, alcohol or both than those who were not initiators.”

Opioids can impair drivers by causing them to be too dizzy or sedated to be behind the wheel of a vehicle.  They cause individuals to be less alert and to have slower reaction times.  The medications often include warning labels urging users to avoid driving or operating heavy machinery while taking them.

There are a couple of limitations to the authors study.  Those who tested positive for opioid use were not necessarily impaired, and the Fatality Analysis Reporting System does not record the dosage amounts of opioids or alcohol.

The researchers also conducted a previous study that revealed before the onset of the opioid epidemic in the 1990s, opioid use was responsible for only about 1% of driver deaths in motor vehicle accidents in the United States.  As use increased, the number of fatal accidents spiked to at least 7%. “To reverse this trend and ensure that patients do not fall victim to driving under the influence, education and collaboration between patients and clinicians is necessary,” the researchers state.


Use of Prescription Opioids and Initiation of Fatal 2-Vehicle Crashes

Opioid epidemic spilling over onto roads, study says

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