Prevalence and Profile of Drugs and Alcohol in Fatally Injured Drivers in Pretoria, South Africa

Abstract

South Africa (SA) is faced with continuing challenges pertaining to drug and alcohol abuse. Currently, there is a paucity of information regarding the involvement of non-alcohol substances in road-traffic accidents, as drugged-driving cases are seldom identified or prosecuted. The aim of this study was to establish the prevalence and profile of drug and alcohol use among drivers involved in fatal road accidents in Pretoria, SA.

A one-year prospective analytical study was conducted at the Pretoria Medico-Legal Laboratory. Biological samples were collected at autopsy and drug-screening was conducted using immunoassay techniques, followed by liquid chromatography-tandem mass spectrometry confirmation. Blood-alcohol concentrations were determined using headspace gas chromatography with flame ionization detection.

The presence of one or more drugs of abuse was confirmed in 8% of fatally injured drivers (N = 112). The majority of drivers who tested positive for drugs or alcohol were males and younger than 40 years of age. Amphetamine-type stimulants were detected in 4.5% of cases, followed by opioids (3.6%) and cannabis (2.7%). Alcohol was detected in 57.5% of cases, and in combination with a drug(s) in 4.5% of cases. Drugs were detected in approximately one in twelve drivers who were fatally injured in motor-vehicle accidents in Pretoria. Current practices for detecting driving under the influence in SA need to be reviewed and further research is necessary to better establish the extent of drug- and alcohol-impaired driving, in order to develop appropriate prevention strategies.