Intersection of drug use and transportation

Cases of substance impairment are increasing in all modes of transportation. In the United States, more than 10,000 people died in alcohol-impaired driving crashes, and 9.9 million reported driving under the influence of illicit drugs (NHTSA 2014; SAMHSA 2013). The NTSB recently studied trends in toxicology findings from fatally-injured airplane pilots and found their use of potentially impairing substances, including prescription and over-the-counter medications, has been increasing. In fact, the most common drug identified in these pilots was diphenhydramine, a sedating antihistamine available in a variety of allergy, cold, and sleep medications. With alcohol continuing to be a factor in nearly one-third of all motor vehicle fatalities and with prescription and over-the-counter drug sales increasing over the past decade, including controlled substances and other sedating medications, substance impairment has become a real concern for all transportation operators. We have seen how these substances impair the ability to fly, drive, and sail safely. I will be discussing why these issues are posing a public health problem.