Driving under the influence of alcohol and/or drugs constitutes a main cause of road casualties. It is estimated that between 20% and 25% of all road fatalities in Europe are alcohol related (GRSP, 2007; ERSO, 2006). The role of drugs other than alcohol, though less well documented, should not be underestimated. According to a report of the OECD and the International Transport Forum (ITF), the overall incidence of drugs among drivers injured or killed in motor vehicle crashes ranges between 14% and 17% (OECD and ITF, 2010). In Europe, experts from the DRUID project (Driving under the Influence of Drugs, Alcohol and Medicines; homepage: http://www.druid-project.eu) consider drink-driving as a more problematic issue than drug-driving (Schulze et al., 2012, Meesmann et al., 2011). According to the DRUID roadside surveys conducted in 13 different European countries between 2007 and 2009, 3.9% of the drivers were under the influence of alcohol (3.5% only alcohol and 0.4% in combination with drugs), 1.9% had consumed illegal drugs, 1.4% medicinal drugs and 0.4% were under the influence of a combination of drugs (Houwing et al., 2011 in Meesmann et al., 2011). In the USA, a roadside survey conducted in the years 2013 and 2014 shows that the proportion of drivers under the influence of drugs exceeds that of drivers under the influence of alcohol (Berning, Compton & Wochinger, 2015). Compared to drink-driving, drug-driving is a far more complex issue. Drink-driving is a problem which has been studied for several decades. The consumption of alcohol leads to increased reaction time, lower vigilance, poor judgement, and impairs some visual functions. Drivers who have consumed alcohol therefore have a higher risk of being involved in crashes and this risk rises with an increasing blood alcohol concentration (BAC). Drugs (illegal as well as prescription or over-the-counter drugs) comprise a great variety of psychoactive substances that may impair the driving ability. Depending on the type of substance, alertness and perception are affected, impulsiveness is stimulated, reaction times are slowing, etc. (OECD and ITF, 2010). Another point is that drug presence does not necessarily result in impairment. Moreover, the relationship between concentrations of drugs and driver performance is difficult to establish (Berning, Compton & Wochinger, 2015). The role of medicines in road accidents is not clear as they can influence the capacity of driving positively or negatively (on the one hand they suppress or mitigate the manifestations of an illness, on the other hand they may have undesirable side effects). If a driver is under the influence of a combination of alcohol and drugs, the risk of being involved in crashes further increases. In the DRUID project, the estimates of the relative risk of getting seriously injured or getting killed in a road accident while positive for alcohol and drugs, respectively positive for a combination of drugs, is substantially increased, ranging from 5 to 200x (Hels et al., 2011). According to OECD and ITF, the predominant substance is cannabis, followed by benzodiazepines (OECD and ITF, 2010). Between 2001 and 2013/2014, in Europe, the number of road deaths attributed to alcohol has decreased even more significantly than the total number of road deaths (ETSC, 2015). Changing public attitudes towards drink-driving, the adoption of legal measures and enhanced enforcement have certainly contributed to the decrease of road deaths attributed to alcohol. The trends are, however, quite different from country to country. In order to better understand the reasons for these disparities, projects like SARTRE (Social Attitudes to Road Traffic Risk) in Europe and later on ESRA (European Survey of Road users’ safety Attitudes) were launched. SARTRE was realised four times (1991, 1996, 2002 and 2010) and ESRA once (2015). Thanks to these projects, it is possible to study and compare the opinions and attitudes and reported behaviour of the road users in different countries. (Author/publisher)
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