Examination of the role of the combination of alcohol and cannabis in South Australian road crashes.

OBJECTIVES: The aim of the present study was to examine the role of cannabis in road crashes in South Australia, with a particular focus on the extent to which crashes involving cannabis also involve alcohol. METHODS: Hospital data, police-reported crash data, and the results of forensic tests of blood samples for drugs and alcohol were collected for 1,074 crash participants (drivers or motorcyclists) admitted to hospital. A sample of 135 coroners' reports was also examined to determine the role of alcohol and cannabis in fatal crashes. RESULTS: The 3 years of linked data for hospital admission cases revealed that alcohol played a greater role in road crashes than other drugs. Approximately 1 in 5 drivers or motorcyclists had a blood alcohol concentration (BAC) above the legal limit of 0.05. Routine testing for cannabis, methamphetamine, and MDMA revealed a drug-positive rate of approximately 1 in 10 of those tested, with over half of these positive to cannabis. More than a third of cannabis cases also involved alcohol. The majority of those who were positive for alcohol had a BAC above 0.15 g/100 mL. BACs were similarly high among drivers positive for both alcohol and cannabis. CONCLUSIONS: The findings of the hospital data and the coroners' reports were consistent with each other in terms of providing confirmation that alcohol is still the drug associated with the greatest level of road trauma on South Australian roads. Furthermore, alcohol was also present in around half of the cannabis cases and, when present, tended to be present at very high levels. The results of this study emphasize that, although drug driving is clearly a problem, the most important form of impaired driving that needs to be the target of enforcement is drink driving. Roadside drug testing is important but should not be conducted in such a way that reduces the deterrent value of random breath testing.

Countermeasures to the problem of accidents to intoxicated pedestrians.

A substantial part of the pedestrian accident problem arises from intoxicated pedestrians. Possible countermeasures are reviewed, organised into: (a) prevention of high levels of intoxication in pedestrians, (b) minimising pedestrian activity in the intoxicated, and (c) minimising risk of injury among intoxicated pedestrians. It is concluded that improved safety of intoxicated pedestrians is most likely to come about by making the environment safer for all pedestrians, drunk or sober. The measure that would be expected to have the greatest effect quickest is a reduced speed limit, especially in locations where traffic is busy and there are many pedestrians.