Online Program

Opioid Use and Fatal Motor Vehicle Crash Involvement: A Case-Control Study

Wednesday, November 4, 2015 : 10:45 a.m. - 11:00 a.m.

Alexander Mizenko, MPH, Center for Injury Epidemiology and Prevention, Columbia University Medical Center, New York, NY
Guohua Li, MD, DrPH, Departments of Anesthesiology and Epidemiology, Columbia University, New York, NY
Objective: Opioid use in the United States has increased markedly in the last two decades.   Epidemiologic evidence linking driver opioid use to crash risk is inconsistent. This population-based case-control study assessed the association of opioid use with fatal crash risk. Methods: Cases (n= 1841) were drivers involved in fatal motor vehicle crashes, identified from the 2006-2008 Fatality Analysis Reporting System, and controls (n= 7779) were a random sample of US drivers who participated in the 2007 National Roadside Survey of Alcohol and Drug Use by Drivers.  Odds ratios (ORs) and 95% confidence intervals (CIs) of fatal crash involvement associated with opioid use were estimated through multivariable logistic regression.   Results: Overall, 4.0% of cases tested positive for opioids, compared with 2.3% of controls (p<.0001). Opioid use was associated with a 72% increased risk of fatal crash involvement (OR: 1.72; (95%CI: 1.31, 2.27)).  The estimated odds ratios of fatal crash involvement were 35.25 (95%CI: 18.66, 66.59) for drivers testing positive for both opioids and alcohol compared to those testing positive for neither substance, and 4.94; (95%CI: 2.70, 9.04) for drivers testing positive for both opioids and cannabis compared to those testing positive for neither substances. Conclusions: Use of opioids is associated with a significantly elevated risk of fatal crash involvement.  The risk of fatal crash involvement is exceptionally high for drivers who use opioids in combination of alcohol or cannabis.

Learning Areas:


Learning Objectives:
Describe the risk of fatal crash risk associated with opioid use, mixing opioids with other drugs, and how demographic characteristics affect the relationship.

Keyword(s): Motor Vehicles, Drug Abuse

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: As an epidemiologist, I have been studying the role of alcohol and drugs in injury causation for over 20 years and published numerous manucripts in the subject area. I have presented my work at APHA and other professional meetings many times in the past 25 years.
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.

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