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Cited by 28Forensic Toxicology and Drug AnalysisTraffic and Road SafetySubstance Abuse Treatment and Outcomes

Driving under the influence of drugs: Correlation between blood psychoactive drug concentrations and cognitive impairment. A narrative review taking into account forensic issues

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Blandino, Alberto, Cotroneo, Rosy, Tambuzzi, Stefano, Di Candia, Domenico, Genovese, Umberto, Zoja, Riccardo·2022·Forensic Science International: Synergy
DOI 10.1016/j.fsisyn.2022.100224PMC PMC8938866
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Abstract

Driving under the influence of alcohol has been shown to increase the risk of involvement in road traffic collisions (RTCs) however, less is known about the effects of illicit drugs, and a clear correlation between drug concentrations and RTC risk is still debated. The goal of this narrative review is to assess the current literature regarding the most detected psychoactive drugs in RTC (ethanol, amphetamines, cannabis, opioids and cocaine), in relation to driving performance. Evidence on impaired driving due to psychoactive substances, forensic issues relating to the assessment of the impact of drugs, blood cut-off values proposed to date as well as scientific basis for proposed legislative limits are discussed. At present there is no unequivocal evidence demonstrating a clear dose/concentration dependent impairment in many substances. Per se and zero tolerance approaches seem to have negative effect on drugged driving fatalities. However, the weight of these approaches needs further investigation.

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  • Psychoactive substances (including alcohol, cannabis, tramadol, cocaine, amphetamines, and sometimes tobacco and coffee) are commonly used by drivers despite their negative effects.

    “These include alcohol, cannabis, tramadol, cocaine, amphetamines, and, in some cases, tobacco and coffee; these, substances are commonly used by drivers despite their negative effects [8, 9].”

    From Road safety threats and occupational health risk associated with psychoactive substance use and dependence risk among commercial drivers: WHO ASSIST evidence from Ghana (2026) · cites this paper as [9]

    The Introduction (page not provided) describes driving under the influence of psychoactive substances as widespread and links alcohol, amphetamines, cannabis, opioids and cocaine to impaired driving and crash risk. It does not specifically identify tramadol or address tobacco and coffee; searches for those terms found no supporting passage in our copy. (LLM, conf=0.87)

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Cited by

Sorted by citations

Authors
Blandino, A., Cotroneo, R., Tambuzzi, S., Di Candia, D., Genovese, U., & Zoja, R.
Affiliations
University of Milan (IT)
Corresponding author
Blandino, Alberto
ORCID
Venue
Forensic Science International: Synergy
Publisher
Elsevier BV
Published
2022
Volume
4
Pages
100224
ISSN
2589-871X (ISSN-L)
DOI
10.1016/j.fsisyn.2022.100224
PMC
PMC8938866
OpenAlex
W4220847184
Cited by
28
References
4
Citations by year
2026: 6 · 2025: 11 · 2024: 6 · 2023: 4 · 2022: 1
FWCI
1.01
Type
journal article
Language
en
Open access
Licence
Locations
  • Forensic Science International Synergy (publishedVersion, cc-by-nc-nd)
  • PubMed Central (publishedVersion, cc-by-nc-nd)
  • PubMed (publishedVersion)
  • Archivio Istituzionale della Ricerca - Università Vita-Salute San Raffaele (submittedVersion, cc-by-nc-nd)
  • Archivio Istituzionale della Ricerca (Universita Degli Studi Di Milano) (submittedVersion, other-oa)
  • DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion, cc-by-sa)
Funders
Istituto Nazionale per l'Assicurazione Contro Gli Infortuni sul Lavoro
Topics
  • Life Sciences › Pharmacology, Toxicology and Pharmaceutics › Toxicology › Forensic Toxicology and Drug Analysis
  • Physical Sciences › Engineering › Safety, Risk, Reliability and Quality › Traffic and Road Safety
  • Health Sciences › Medicine › Epidemiology › Substance Abuse Treatment and Outcomes
Keywords
drug-impaired driving, psychoactive substances, plasma drug concentration, cognitive impairment, traffic accidents, ethanol, amphetamine, cannabis, opioids, cocaine, legislative limits, forensic toxicology, driving performance

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