Driving under the influence of prescription opioids among senior high-school students in Atlantic Canada: Prevalence, key correlates, and the role of intentions to use

Author(s): Mark Asbridge, Donald Langille, Jenny Cartwright

Slidedeck Presentation Only (no paper submitted):

2B Asbridge_Driving Under the Influence of Prescription Opioids

Abstract:

Background
In the last five years, Canadians have become the second largest per capita consumers of
prescription opioids. Opioids comprise a broad range of natural and synthetic compounds such
as morphine, codeine and oxycodone that are used for pain relief. Higher doses of these drugs
have demonstrated negative effects on the ability to operate a motor vehicle safely. As such,
opioid use rates represent a concern in the context of impaired driving and road safety.
Experimental and epidemiologic research indicates that opioid use prior to driving increases the
risk of a motor vehicle collision. While there are some estimates of driving under the influence
of opioids (DUIO) among adults, no research has examined this behaviour among adolescent
drivers.
Aim
Employing a sample of 3655 senior students (grades 10 and 12) in Atlantic Canada, this paper
examines three objectives: 1) What sociodemographic and psychosocial predictors are
associated with DUIO? 2) Is there a relationship between intentions to use opioids, either
medically or for nonmedical reasons, and DUIO? 3) Is DUIO associated with other risky driving
behaviours, including driving under the influence of alcohol (DUIA) or cannabis (DUIC), and
being a passenger of an impaired driver?
Methods
Participants were drawn from the 2012 Student Drug Use Survey of the Atlantic Provinces, an
anonymous cross-sectional survey of students attending public schools in Atlantic Canada.
Logistic regression techniques were employed in the analysis of unadjusted and adjusted
models of DUIO. Covariates included respondent gender, family structure, socioeconomic
status, school achievement, general health and well-being, sensation seeking, and parental
attachment. An indicator of the respondent’s intention to use opioids for medical or
nonmedical reasons was also included. DUIO was subsequently modeled as a predictor of other
risky driving behaviours that included DUIA, DUIC, and being a passenger of an impaired driver.
Results
Just over 32% of senior students report using a prescription opioid in the past 12 months.
Among senior students who had used an opioid, the prevalence of DUIO in the past year was
14%, varying depending on whether the student used opioids medically (9.6%) or nonmedically
(19.7%). Predictors of DUIO were socioeconomic status, sensation seeking, and parental
attachment, as well as nonmedical intentions to use prescription opioids. DUIO was significantly
associated with other risky driving behaviours, though only among students who used
prescription opioids nonmedically.
Discussion and conclusions
These findings extend our knowledge of DUIO as a socio-legal and public health issue with
implications on road safety. Effort must be placed on educating new drivers about opioid use in
the context of driving. Additionally, physicians must be encouraged to warn patients to whom
they have prescribed opioids about the potential of driver impairment. The control of, and
reductions in, the nonmedical use of prescription opioids must remain a health and legal
priority in the Atlantic Provinces and in Canada.