Explore the vast range of titles available.

Abstract Study Objectives To assess potential effects of lemborexant on next-morning driving performance in adult and elderly healthy volunteers. Methods Randomized, double-blind, double-dummy, placebo and active-controlled, four period incomplete crossover study in 48 healthy volunteers (22 females), 23–78 years old. Participants were treated at bedtime for eight consecutive nights with two of three dose levels of lemborexant (2.5, 5, or 10 mg), zopiclone 7.5 mg (on the first and last night with placebo on intervening nights), or placebo. Driving performance was assessed in the morning on days 2 and 9 using a standardized highway driving test in normal traffic, measuring standard deviation of lateral position (SDLP). Drug–placebo differences in SDLP >2.4 cm were considered to reflect clinically meaningful driving impairment. Results Mean drug–placebo differences in SDLP following lemborexant 2.5, 5, and 10 mg on days 2 and 9 were 0.74 cm or less. The upper bound of the 95% confidence intervals (CIs) for lemborexant treatment groups were all below 2.4 cm and the 95% CIs included zero, indicating that the effects were neither clinically meaningful nor statistically significant. Symmetry analysis further supported the lack of clinically meaningful impairment with lemborexant. Conclusions When assessed starting ~9 h after lemborexant administration at bedtime the previous night, there was no statistically significant or clinically meaningful effect on driving performance in healthy adults and elderly, as assessed by either mean differences in SDLP relative to placebo or symmetry analysis. In this study, lemborexant at doses up to 10 mg was well-tolerated. Clinical Trial Registration clinicaltrials.gov, NCT02583451. https://clinicaltrials.gov/ct2/show/NCT02583451.

Objectives. To examine trends in young adult self-reported driving under the influence of alcohol (DUI-A), cannabis (DUI-C), and simultaneous alcohol and cannabis use (DUI-AC) in a state with legalized nonmedical cannabis use from before to during the COVID-19 pandemic. Methods. We used logistic regression and annual statewide data from the Washington Young Adult Health Survey to assess DUI behaviors from 2016 to 2021. Results. Both prepandemic yearly changes in prevalence and deviations from those trends during the pandemic years were small and not statistically significant. However, prevalence estimates were alarming: 12.0% of participants reported DUI-A, 12.5% reported DUI-C, and 2.7% reported DUI-AC. Exploratory moderation analyses indicated a relative increase in DUI-A during 2020 among 4-year college students relative to young adults not attending 4-year colleges. Conclusions. Young adults in Washington State continued to engage in risky DUI behaviors during the pandemic. College students may have increased their likelihood of DUI-A during COVID-19. Public Health Implications. Young adults, for whom vehicle crashes remain a leading cause of death, showed little change in DUI behaviors during the COVID-19 pandemic. There is continued need for young adult DUI prevention efforts. ( Am J Public Health. 2024;114(S8):S698–S701. https://doi.org/10.2105/AJPH.2024.307767 )

Youth driving under the influence of cannabis (DUIC) is a growing public health concern. While brief smartphone interventions have shown promise in reducing substance use and alcohol-impaired driving among youth, their efficacy for DUIC remains limited. Using the six-step Intervention Mapping framework, we developed and tested High Alert, a digital smartphone intervention designed to reduce DUIC among high-risk Canadian youth. The intervention was previously tested in a pilot randomized controlled trial comparing High Alert to an active control (exposure to six DUIC infographics) and a passive control (no contact). This study presents a comprehensive evaluation of High Alert using Step 6 of the Intervention Mapping framework. Reporting on this evaluation serves as a practical guide for researchers utilizing Intervention Mapping, offering valuable insights into High Alert’s formative, process, outcome, and acceptability evaluations to enhance DUIC prevention efforts. Formative and acceptability evaluations revealed High Alert’s positive reception among youth, with most participants willing to engage with it and recommend it to their peers. The program received high ratings for content and delivery, surpassing the static infographics used in the active control. Outcome evaluations demonstrated preliminary efficacy in reducing DUIC behaviour, particularly driving after cannabis co-use, compared to the no-contact group. Process evaluations highlighted implementation challenges, including online study bot activity, recruitment barriers (e.g., participant skepticism, limited ad targeting options), high attrition rates, and low adherence. Findings highlight the importance of Step 6 in Intervention Mapping, emphasizing the need for transparent and rigorous evaluation to inform future interventions. Addressing recruitment and implementation challenges is essential for improving the scalability and effectiveness of interventions targeting high-risk behaviours such as DUIC and will inform High Alert’s future testing.

To examine trends and potential disparities in North Carolina (NC) driving while impaired by alcohol (alcohol-DWI) license suspensions from 2007-2016. Specific objectives included: 1) examining personal (e.g., race/ethnicity) and contextual (e.g., residential segregation) characteristics of alcohol-DWI license suspensions by suspension duration; and 2) examining trends in annual suspension rates by race/ethnicity, sex, and duration. We linked NC administrative licensing and county-level survey data from several sources from 2007-2016. Suspensions were categorized by duration: 1 to <4 years and 4 years or longer (proxies for initial and repeat suspensions, respectively). We calculated counts, percentages, and suspensions rates (per 1,000 person-years) with 95% confidence intervals, examined trends in annual suspension rates by race/ethnicity, sex, and suspension duration. We identified 220,471 initial and 41,526 repeat license suspensions. Rates among males were three times that of females. 21-24-year-old (rates: 6.9 per 1,000 person-years for initial; 1.5 for repeat) and Black (4.1 for initial; 1.0 for repeat) individuals had the highest suspension rates. We observed decreases in annual initial and repeat suspension rates among males, but only in repeat suspensions for females during the study period. A substantial decrease in annual initial suspension rates was observed among Hispanic individuals relative to other racial/ethnic groups, while annual repeat suspension rates exhibited large decreases for most racial/ethnic groups. The highest overall suspension rates occurred in counties with higher proportions of the population without health insurance and with the highest levels of Black/White residential segregation. Potential disparities by race/ethnicity and sex existed by alcohol-DWI license suspension duration (i.e., initial vs. repeat suspensions) in NC. Contextual characteristics associated with suspensions, including a high degree of residential segregation, may provide indications of underlying structures and mechanisms driving potential disparities in alcohol-DWI outcomes.

RationaleAlthough driving simulators (DS) are receiving increasing attention due to concern over traffic accidents under the influences of drugs, few DS are recognized for their reliability and validity. Therefore, the development of an evaluation system using DS for driving performance is urgently needed.ObjectivesTo investigate whether the standard deviation of lateral position (SDLP) increases with blood alcohol concentration (BAC) using a DS with reliability and calculate the SDLP threshold from the difference between BAC levels of 0 and 0.05%.MethodsTwenty healthy Japanese men performed the DS tasks up to 60 min in Study 1 and DS tasks twice at 1-week intervals in Study 2. Twenty-six healthy men conducted the same DS tasks under BAC level (0, 0.025, 0.05, and 0.09%) in double-blind, randomized, crossover trial in Study 3. The primary outcome was SDLP in a road-tracking test. The test–retest reliability of DS data was assessed, and the estimated difference in SDLP between BAC levels of 0 and 0.05% was calculated using a linear regression model.ResultsThe cumulative SDLP values at 5-min intervals were stable, and the intraclass correlation coefficient for its values was 0.93. SDLP increased with BAC in a concentration-dependent manner. The predicted ΔSDLP value for the difference between BAC levels of 0 and 0.05% was 9.23 cm. No participants dropped out because of simulator sickness.ConclusionsThe new DS used in these studies has reliability, validity, and tolerability and is considered suitable for evaluating the influence of drugs on driving performance.

This study evaluates the presence of drugs of abuse (DOA) in blood from drivers suspected of driving under the influence of drugs (DUID) in the Netherlands from 2017 to 2023. After the introduction of new Dutch DUID legislation in July 2017, police officers were provided roadside oral fluid drug testers to establish suspicion of DUID. Since, there has been a steady and continuing increase in the number of apprehended DUID drivers. A large set of 64,116 blood samples was analysed for the following DOA: cocaine, THC, morphine, GHB and Amphetamine Type Substances (ATS: amphetamine, methamphetamine, MDMA, MDA, and MDEA), and compared with the Dutch legal limits. Most of the apprehended drivers were men (92 %), with a median age of 29 years. Of the analyzed blood samples, 65 % was found positive for one or more DOA. The most prevalent drug was THC (71 %), followed by amphetamine type substances (ATS, 30 %), cocaine (15 %) and GHB (6.8 %). Poly-drug use was found in 14 % of the samples, main combinations being THC with amphetamine or cocaine, and GHB with amphetamine. Factors contributing to negative blood results are, amongst others, the blood-oral fluid ratio, a time delay between oral fluid testing and blood sample collection and sending in samples despite a negative oral fluid test. THC was more common amongst younger drivers (under 26 years old), whereas cocaine and ATS use increased with age. The study presents important knowledge for both policymakers and DUID prevention specialists. •In the Netherlands, the main drug used by impaired drivers is cannabis.•Blood samples for impaired driving drug testing rose tenfold from 2017 to 2023.•Drug-impaired driving is prevalent mostly among younger male drivers.•14 % of suspected impaired drivers had used multiple drugs.•35 % of blood samples were negative, in spite of suspicion for impaired driving.

Background Implemented in 2018, Proposition 64: The Adult Use of Marijuana Act legalized recreational cannabis use in California. This study aimed to assess driving-related knowledge, attitudes, and behaviors after the passage of Proposition 64. Methods An initial questionnaire was completed by 15,208 participants demographically matched to the 2020 California census. A subset of 4,020 participants who currently use cannabis, 523 who formerly used cannabis, and 635 who never used cannabis completed a detailed mixed qualitative and quantitative questionnaire, including questions about driving which were selected for this sub-analysis. Chi-square analysis was utilized for descriptive analysis. For this study “cannabis” was defined as THC-containing products. Results 62% of current cannabis users were aware that drivers and passengers cannot smoke or ingest cannabis in a moving vehicle, and 59% were aware that any container of cannabis inside a moving vehicle must be unopened and sealed. 74% knew that you could get a citation for driving under the influence of cannabis (DUIC). 64% of participants reported feeling safe to drive 3 h or less after inhalation of flower products and 55 % felt safe to drive 5 h or less after consumption of edible cannabis products. 13% reported that the passage of Proposition 64 increased their Likelihood of DUIC. Those with lower knowledge of Prop 64 driving related regulations were more likely to ever have been pulled over or involved in a crash while under the influence of cannabis. Conclusions Six years after legalization implementation, there remains mixed awareness of driving-related regulations among people who currently use cannabis. Lower knowledge of regulation was associated with an increase in adverse driving outcomes. Effective messaging to increase knowledge of regulations, duration of intoxication, and promotion of safe driving behaviors is an essential step for promoting public safety after the legalization of cannabis. Trial registration N/A

ABSTRACTIntroductionThe relationship between Alzheimer’s Disease (AD) and alcohol addiction is poorly characterized. Arrests for driving under the influence (DUI) can serve as a proxy for alcohol addiction. Therefore, the potential association between DUI and AD could be helpful in understanding the relationship between alcohol abuse and AD. Materials and methodsA retrospective, population-based cohort study using state health and law enforcement data was performed. The study cross-referenced 141,281 South Carolina Alzheimer’s Disease Registry cases with state law enforcement data. ResultsOf the 2,882 registry cases (1.4%) found to have a history of at least one DUI arrest, cases were predominantly White (58.7%) and male (77.4%). Results showed a correlation coefficient of 0.7 (p < 0.0001) between the age of first DUI arrest and the age of AD diagnosis. A dose-response relationship between the number of DUIs and age of AD onset was found to exist, where those with a history of DUI arrest were diagnosed an average of 9.1 years earlier, with a further 1.8 years earlier age at diagnosis in those with two or more arrests for DUI. A history of DUI arrest was also found to be negatively associated with survival after diagnosis, with a 10% decreased life expectancy in those with a DUI arrest history. ConclusionsDriving under the influence, a potential indicator of alcohol addiction, is associated with an earlier onset of AD registry diagnosis and shortened survival after diagnosis. This study contributes to the growing body of evidence suggesting that some cases of AD are alcohol related and, possibly, postponable or preventable.

•DUID cases related to drugs abuse have been reported in Asia, USA, and Europe.•Amphetamine, cocaine, cannabis, BZDs, and opiates were frequently reported in DUID.•Regular testing of drivers was needed to collect data for DUID in traffic accident. Driving Under the Influence of Drugs (DUID) is considered a serious issue related to the abuse of illegal drugs. DUID cases, including deaths, are being continuously reported in Asia, USA, and Europe. This literature review focuses on illegal drug abuse in recent DUID cases reported in Asia, USA, and Europe. To determine illegal drug abuse in DUID suspects, previous studies collected and analyzed biological samples, such as blood, urine, oral fluids, and hair. In addition, there were forensic autopsies and surveys for investigation of illegal drugs in DUID cases and drivers. In previous studies, ketamine, morphine, methamphetamine (MA), and khat were mainly reported in Asia, whereas amphetamine, benzodiazepines (BZDs), and cannabinoids were mainly reported in USA, and synthetic cannabinoids (SCs), opiates, and cocaine were mainly reported in Europe. Since DUID suspects related to illegal drugs have been frequently reported in Asia, USA, and Europe, there is a need to plan for national monitoring for drivers or motor vehicles to regulate and prevent drug abuse and relevant DUID cases.

ObjectiveDrunk driving is a major cause of road traffic injuries and deaths in Latin America. We evaluated the impact of a drunk driving intervention in Leon, Mexico on road traffic safety.MethodsThe intervention included increased drunk driving penalties, enhanced sobriety checkpoints and a young adult-focused mass media campaign, beginning 19 December 2018. We created a synthetic control Leon from 12 Mexican municipalities from a pool of 87 based on similarity to Leon using key predictors from 2015 to 2019. We assessed the effect of the intervention on road traffic collisions overall and collisions with injuries, deaths and involving alcohol, using data from police, insurance claims and vital registration.ResultsAs compared with the synthetic control, Leon experienced significant postintervention lower police-reported total collision rate (17%) and injury collisions (33%). Alcohol-involved collisions were 38% lower than the synthetic control. Fatal collisions reported by police were 28% lower while vital registration road traffic deaths were 12% lower, though these declines were not statistically significant. We found no impact on insurance collision claims. There was heterogeneity in these changes over the evaluation year, with stronger initial effects and weaker effects by the end of the year.ConclusionsDrunk driving policies in Leon led to fewer traffic collisions and injuries during the first year of implementation, with a weakening of this effect over time, similar to interventions in high-income settings and other Latin American countries. Supporting the expansion of similar policies to other cities in the region could improve road safety.