• Heraclito Barbosa de Carvalho, Gabriel Andreuccetti, Marcelo Rosa Rezende, Celso Bernini, Silva Jorge Santos JS Department of Surgery, University of Sao Paulo Medical School, Sao Paulo 01246-903, Brazil. Electronic address: jorge.ssilva@hc.fm.usp.br., Vilma Leyton, and Julia Maria D'Andréa Greve.
• Department of Preventive Medicine, University of Sao Paulo Medical School, Sao Paulo 01246-903, Brazil. Electronic address: heracc@usp.br.
• Drug Alcohol Depend. 2016 May 1; 162: 199-205.

BackgroundEarlier studies have already identified that a greater proportion of injured drivers are under the effects of illicit drugs than alcohol in Brazil, but the crash risk attributable to each substance is still unknown.MethodsInjured motorcycle drivers who were involved in traffic accidents in the West Zone of the city of Sao Paulo were recruited for a cross-sectional study based on crash culpability analysis. Alcohol and drug positivity among drivers was evaluated according to their responsibility for the crash. Culpability ratios were generated based on the proportion of drivers who were deemed culpable in relation to those considered not culpable according to the use of drugs and alcohol.ResultsOf the 273 drivers recruited, 10.6% tested positive for alcohol. Among those who were also tested for drugs (n=232), 20.3% had consumed either alcohol and/or other drugs, 15.5% of whom were positive only for drugs other than alcohol, specifically cannabis and cocaine. Drivers who tested positive for alcohol were significantly less likely to possess a valid driver's license and to report driving professionally, whereas those who had consumed only drugs were more likely to drive professionally. The culpability ratio estimated for alcohol-positive drivers was three times higher than that for alcohol-free drivers, showing a superior ratio than drivers who had consumed only drugs other than alcohol, who presented a 1.7 times higher culpability ratio than drug-free drivers.ConclusionSubstance use was overrepresented among culpable motorcycle drivers, with alcohol showing a greater contribution to crash culpability than other drugs.Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

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