Development of a mobile neurocognitive assessment to delineate CNS depressant and stimulant related deficits

Many commonly used drugs – whether they are prescription, over-the-counter or illicit – impair driving through reduced cognition, judgment and motor skills. Driving while under the influence of such substances results in a significantly increased risk of injuries and fatalities. An estimated 18% of vehicular deaths are drug-related (not including alcohol), and in 2008 over 10 million Americans admitted driving while using illicit drugs.

Marijuana is the most prevalent drug detected in impaired and fatally-injured drivers and victims, but benzodiazepines, cocaine, opiates, and amphetamines have all also been implicated. The National Highway Traffic Safety Administration (NHTSA) reported that 16% of weekend, nighttime drivers tested positive for illegal, prescription, or over-the-counter medication. Teenagers are most vulnerable to drugged driving.
Recent studies indicate that drugged driving is on par with drunken driving as a public health and safety concern, particularly for younger drivers. In one evaluation of 3,398 vehicular fatalities in southern Australia over a 10 year period in the 1990s, 23.5% tested positive for drugs, while 29.1% tested positive for alcohol at .05 BAC or above; the authors note that, while alcohol use went down during the period of the study, drug use increased.

In a recent study of 322 vehicular accident victims admitted to a trauma center in Maryland; Walsh and colleagues found that, while 16% tested positive for alcohol only, and 9.9% tested positive for both alcohol and drugs, an alarming 34% tested positive for drugs only. From 1991-2001, the use of sedatives increased by an estimated 90%, and the use of stimulants by 165%, a trend that continued in the past decade, indicating that drugged driving is likely increasing over time.

Acknowledgements. This work was made possible by an SBIR contract to Advanced Brain Monitoring, HHSN271201100009C

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