Analysis of the Prevalence of Alcohol and Psychoactive Substances Among Drivers in the Material from the Department of Forensic Medicine at the Medical University of Bialystok in Poland.

In recent years, the issue of drivers under the influence of medications and psychoactive substances as a cause of road accidents has gained increasing importance. This study aimed to assess the prevalence and blood concentration ranges of alcohol and psychoactive substances among drivers in northeastern Poland between 2013 and 2024. To determine the prevalence of medications and psychoactive substances in drivers' blood, data were collected from 266 blood samples obtained from drivers (251 men and 15 women). Among these, 79 drivers died immediately, 61 drivers survived the accident, and 126 drivers were stopped for roadside checks. The presence of the studied substances was confirmed using gas chromatography combined with mass spectrometry detection (GC-MS) and liquid chromatography combined with mass spectrometry detection (LC-MS). Blood alcohol content was measured using headspace gas chromatography with a flame ionisation detector (HS-GC-FID). Psychoactive substances were detected in 152 of the 266 samples. Drivers testing positive for medications and psychoactive substances were most frequently stopped during roadside controls-67.46%. Among the total positive cases, psychoactive substances used alone or in combination included THC-46.3% (range 0.2-20 ng/mL), alcohol-26.8% (range 0.1-4.1‱), amphetamines-20.7% (range 15-2997 ng/mL), opiates-4.3% (morphine 66.0 ng/mL; methadone 174.0 ng/mL; ranges: tramadol 15.0-600.0 ng/mL; fentanyl 45.0-100.0 ng/mL), benzodiazepines-9.8% (ranges: diazepam 55.0-480.0 ng/mL; midazolam 17.0-1200.0 ng/mL; clonazepam 21.0-36.0 ng/mL), stimulants-6.10% (ranges: amphetamine 15.0-2997.0 ng/mL; cocaine 4.0-30.0 ng/mL; benzoylecgonine 38.0-602.0 ng/mL; PMMA 45.0-360.0 ng/mL; MDMA 20.0-75.0 ng/mL; mephedrone 37.5 ng/mL; alfa-PVP 120 ng/mL), psychotropic drugs-3.1% (carbamazepine 8.0-2100.0 ng/mL; zolpidem 233.0 ng/mL; citalopram 320.0 ng/mL; opipramol 220 ng/mL). The most commonly used substance among car and motorcycle drivers was THC (37.7% of car drivers and 60% of motorcyclists). Among operators of other types of vehicles, alcohol was the most frequently detected substance, present in 35% of cases. The majority of drivers (81.1%) were under the influence of a single substance. Among the drivers, 7.3% consumed alcohol in combination with at least one other substance, and 11.6% used two or more substances excluding alcohol. Among the psychoactive substances most frequently used alone or in combination with others, THC was predominant. Roadside testing, based on effects similar to alcohol intoxication, was mainly conducted on male drivers.