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  • When most people hear the phrase “driving under the influence of drugs,” they think of alcohol. Indeed, according to the National Highway Traffic Safety Administration (NHTSA), drunk driving causes about 32 fatalities in the United States every day.

    However, alcohol is not the only drug with a high fatal crash risk. In the last decade, polydrug use has become more common among drivers, making the roadways extra dangerous.

    The Growing Problem Of Polydrug Use Among Drivers

    Over the years, the prevalence of impaired driving has gradually increased. 

    In 2007, the NHTSA’s National Roadside Survey (NRS) found that 8.6% of weekend nighttime drivers tested positive for marijuana. In the 2013-2014 survey, that percentage jumped to 12.6%, a 48% increase in under a decade.

    By 2020, more than 1 in 10 of all drivers reported driving under the influence of alcohol or other drugs, according to the Substance Abuse and Mental Health Services Administration’s (SAMHSA) National Survey on Drug Use and Health (NSDUH).

    One Or More Drugs On The Road

    The most commonly reported drug was alcohol at 7.2%, followed by marijuana (cannabis) at 4.5%. Other drugs included:

    • illegal drugs, including the opioid heroin, stimulants like cocaine and methamphetamine, and hallucinogens like LSD and psilocybin mushrooms
    • prescription drugs, including prescription opioids (such as OxyContin and Vicodin), prescription amphetamines (such as Adderall and Dexedrine), benzodiazepines (such as Xanax and Klonopin), and antidepressants
    • over-the-counter drugs, including allergy medications and sleep aids

    In 2021, 13.5 million people aged 16 and older reported driving under the influence of alcohol, while 11.7 million reported driving under the influence of illicit drugs.

    While some of these drivers only used one drug at a time, many engaged in polydrug use. Polydrug use occurs when someone uses more than one drug at once. For example, many people combine alcohol with marijuana. This behavior poses serious risks, especially among drivers. 

    Effects Of Polydrug Use Among Drivers

    Drivers who use multiple drugs face a high risk of fatal crash. According to the Governors Highway Safety Association, 43.6% of fatally injured drivers in 2016 had used drugs, and over half had used two or more drugs. 

    Increased Crash Risk

    Polydrug use often causes motor vehicle crashes because many drugs have side effects that disrupt your ability to drive. 

    For example, alcohol can impair your coordination, reaction time, and judgment. Marijuana can have these same effects due to its main psychoactive ingredient, which is a cannabinoid (cannabis compound) called delta-9 tetrahydrocannabinol (THC). 

    Other drugs can also hinder skills needed for safe driving. 

    For instance, depressant medications like opioids and benzodiazepines can make you too dizzy and drowsy to drive. They may also impair your thinking and judgment. According to the National Institute on Drug Abuse (NIDA), driving under the influence of opioids can double your crash risk. 

    In addition, stimulant drugs like cocaine and methamphetamine can make you an unsafe driver by causing irritability, aggression, and recklessness.


    In 2022, the National Transportation Safety Board (NTSB) recommended new initiatives to reduce drug-impaired driving. These initiatives include changes to warning labels, driving laws, and drug testing.

    Warning Labels

    The NTSB recommends that all cannabis products include a warning label that highlights the link between marijuana use and increased risk of motor vehicle crash. 

    It also urges the Food and Drug Administration (FDA) to explore ways to enhance user compliance with driving-related warnings on over-the-counter and prescription medications. 

    Driving Laws

    The threat of a DUI (driving under the influence) charge stops many people from driving while impaired. 

    Currently, law enforcement officers can arrest impaired drivers with a blood alcohol concentration (BAC) above a certain limit. That limit is 0.08% in all states except Utah, where it’s 0.05%. 

    These laws help decrease alcohol-impaired driving. However, the NTSB recommends that policymakers improve drug-impaired driving laws and enforcement, especially in regards to polydrug use. 

    Some sates have zero-tolerance laws (also called “per se” laws) for impaired driving. 

    That means anyone who drives with any amount of a drug in their urine or blood sample may face a DUI charge. Other states plan to implement driving laws related to marijuana and other drugs once researchers determine which blood levels indicate a driver is dangerously impaired. 

    Drug Testing

    In many jurisdictions, law enforcement officers stop testing for drugs once a driver’s BAC reaches a certain limit. That means other drugs in the driver’s system could go undetected. 

    As a result, some drivers get referred to treatment for alcohol use disorder alone, even though they also have other substance use disorders. 

    Because these individuals receive inadequate treatment, they face a high risk of relapse. 

    That’s why the NTSB is asking the National Highway Traffic Safety Administration (NHTSA) to develop a common standard of practice for all drug toxicology testing. This standardization will help law enforcement detect drugs besides alcohol, allowing for more comprehensive treatment referrals. 

    If you feel unable to control your use of drugs, please reach out to an Ark Behavioral Health specialist. Our inpatient and outpatient treatment programs offer medical detox, mental health counseling, and other evidence-based services to help you or your loved one stay drug-free.

    Written by Ark Behavioral Health Editorial Team
    ©2023 Ark National Holdings, LLC. | All Rights Reserved.
    This page does not provide medical advice.
    Article Sources

    Centers for Disease Control and Prevention - What You Need to Know about Substance Use and Driving – Including Marijuana
    National Highway Traffic Safety Administration - Drug-Impaired Driving
    National Highway Traffic Safety Administration - Drunk Driving
    National Institute on Drug Abuse - Drugged Driving DrugFacts
    National Transportation Safety Board - Alcohol, Other Drug, and Multiple Drug Use Among Drivers

    Medically Reviewed by
    Manish Mishra, MBBS
    on March 29, 2023
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