目的:本研究的目的是调查四种不同药物类别的血液浓度之间的关系;苯二氮卓类药物,苯丙胺和四氢大麻酚(THC)和通过临床损害测试(CTI)评估的驾驶员损害。
方法:数据从一个关于CTI评估和伴随血液药物浓度的国家数据库中检索。使用液相色谱-串联质谱法(LC-MS/MS)定量血液中的所有药物浓度,并与被归类为“未受损”的CTI结果进行比较,\“轻度受损\”,“中度受损”,或“严重受损”。
结果:共收集了超过9年的15514例单药病例。89%为男性,中位年龄为34岁。此外,3684例年龄和性别分布相似,未检测到药物,作为参考组。对于乙醇和苯二氮卓类药物,从较低到较高浓度窗口,临床受损病例的百分比显着增加。乙醇从60%到97%,苯二氮卓类药物从38%到76%。安非他明和四氢大麻酚的相应增幅不大,苯丙胺从43%到58%,四氢大麻酚从41%到55%。乙醇的药物浓度与损伤程度之间的相关性很高(Spearman'srho=0.548,p<0.001),苯二氮卓类药物的相关性相对较高(Spearman'srho=0.377,p<0.001),但苯丙胺(斯皮尔曼的rho=0.078,p<0.001)和THC(斯皮尔曼的rho=0.100,p<0.001)低。
结论:所有四种药物的受损驾驶员百分比随血液药物浓度的增加而增加,乙醇和苯二氮卓类药物最明显,苯丙胺和四氢大麻酚更少。随着乙醇和苯二氮卓类药物损害程度的增加,血液药物浓度中位数增加,而安非他明和四氢大麻酚则不那么明显。药物浓度的范围,然而,通过单独的临床检查评估,在所有损害类别中,所有四种药物类别都很广泛。
OBJECTIVE: The aim of the present study was to investigate the relationship between blood concentrations of four different drug classes; ethanol, benzodiazepines, amphetamines and tetrahydrocannabinol (THC) and driver
impairment as assessed by a clinical test of
impairment (CTI).
METHODS: Data was retrieved from a national database on CTI assessments and accompanying blood drug concentrations from apprehended drivers. All drug concentrations in blood were quantified using Liquid Chromatography Tandem Mass Spectrometry (LC-MS/MS), and compared to the results of the CTI which were categorized as either \"not impaired\", \"mildly impaired\", \"moderately impaired\", or \"considerably impaired\".
RESULTS: A total number of 15 514 individual mono drug-cases collected over 9 years was included. 89 % were men and the median age was 34 years. In addition, 3 684 individual cases with similar age and gender distribution where no drugs were detected, were included as a reference group. For ethanol and benzodiazepines the percentage of clinically impaired cases increased markedly from lower to higher concentration windows, from 60 % to 97 % for ethanol and from 38 % to 76 % for benzodiazepines. The corresponding increase for amphetamines and THC was modest, from 43 % to 58 % for amphetamines and from 41 % to 55 % for THC. The correlation between drug concentration and degree of
impairment was high for ethanol (Spearman´s rho=0.548, p<0.001) and relatively high for benzodiazepines (Spearman´s rho=0.377, p<0.001), but low for amphetamines (Spearman´s rho=0.078, p<0.001) and THC (Spearman´s rho=0.100, p<0.001).
CONCLUSIONS: The percentage of impaired drivers increased with increasing blood drug concentration for all four drug classes, most pronounced for ethanol and benzodiazepines and much less for amphetamines and THC. The median blood drug concentration increased with increasing magnitude of
impairment for ethanol and benzodiazepines, while this was much less pronounced for amphetamines and THC. The ranges of drug concentrations, however, were wide for all four drug classes in all
impairment categories as assessed by individual clinical examination.