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The Additive Effects of Alcohol and Benzodiazepines on Driving

Abstract

Objectives

To examine the relationship between the combination of alcohol and benzodiazepines and the risk of committing an unsafe driver action.

Methods

We used data from the Fatality Analysis Reporting System (1993-2006) on drivers aged 20 or older who were tested for both alcohol and drugs. Using a case-control design, we compared drivers who had at least one unsafe driver action (UDA; e.g., weaving) recorded in relation to the crash (cases) to drivers who did not (controls).

Results

Drivers who tested positive for intermediate- and long-acting benzodiazepines in combination with alcohol had significantly greater odds of a UDA compared to those under the influence of alcohol alone, up to blood alcohol concentrations (BACs) of 0.08 and 0.05 g/100 ml, respectively. The odds of a UDA with short-acting benzodiazepines combined with alcohol were no different than for alcohol alone.

Conclusions

This study demonstrates that the combination of alcohol and benzodiazepines can have detrimental effects on driving beyond those of alcohol alone. By describing these combined effects in terms of BAC equivalencies, this study also allows for the extrapolation of simple, concrete concepts that communicate risk to the average benzodiazepine user.

Résumé

Objectif

Examiner la relation entre la combinaison d’alcool et les benzodiazépines et le risque de commettre un action de conducteur dangereux.

Méthodes

Nous avons utilisé les données du Fatality Analysis Reporting System (1993-2006) sur les conducteurs âgés de 20 ans ou plus qui ont été testés pour l’alcool et les drogues. En utilisant un devis cas-témoin, nous avons comparé les conducteurs ayant au moins une action de conduite dangereuse (par exemple, changements de voie fréquent) enregistré par rapport envers les accidents (cas) aux conducteurs qui n’ont pas (contrôles).

Résultats

Les conducteurs qui ont testés positifs pour les benzodiazépines à durée d’action intermédiaire et à longue durée d’action en combinaison avec l’alcool avaient une probabilité significativement plus élevée de commettre une action de conduite dangereuse par rapport à l’alcool seul, jusqu’à un taux d’alcool de 0,08 et 0,05 g/100mL, respectivement. Les benzodiazépines à effet de courte durée en combinaison avec l’alcool n’étaient pas différents de l’alcool seul.

Conclusions

Cette étude démontre que la combinaison d’alcool et de benzodiazépines peut avoir des effets néfastes sur la conduite au-delà de celles de l’alcool. En décrivant ces effets combinés sur le plan d’un taux d’alcoolémie équivalent, cette étude permet également l’extrapolation de concepts simples qui communiquent les risques aux utilisateurs de benzodiazépines.

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Affiliations

Authors

Corresponding author

Correspondence to Hillary G. Maxwell MPH.

Additional information

Acknowledgements: Funding for this research was provided through research grants from AUTO21, Network of Centres of Excellence, the Ontario Neurotrauma Foundation, and the Thunder Bay Foundation. Michel Bédard is a member of CanDRIVE, a team funded by the Canadian Institutes of Health Research, Institute of Aging. Michel Bédard is also a Canada Research Chair in Aging and Health (https://doi.org/www.chairs.gc.ca); he acknowledges the support of both programs.

Conflict of Interest: None to declare.

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Maxwell, H.G., Dubois, S., Weaver, B. et al. The Additive Effects of Alcohol and Benzodiazepines on Driving. Can J Public Health 101, 353–357 (2010). https://doi.org/10.1007/BF03404852

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Mots clés

  • conduite automobile
  • benzodiazépines
  • interactions de drogues
  • études cas-témoins

Key words

  • Automobile driving
  • benzodiazepines
  • alcohol drinking
  • drug interactions
  • case control studies