What interventions actually work to prevent drugged driving?

A systematic review of 28 studies found that cannabis packaging warnings, roadside drug testing, and motivational interviewing showed the strongest evidence for preventing drugged driving, while state-level legal sanctions showed little effect on drug-related fatalities.

Razaghizad, Amir et al.·American journal of preventive medicine·2021·Moderate EvidenceSystematic Review
RTHC-03448Systematic ReviewModerate Evidence2021RETHINKTHC RESEARCH DATABASErethinkthc.com/research

Quick Facts

Study Type
Systematic Review
Evidence
Moderate Evidence
Sample
N=33,711

What This Study Found

Cannabis packaging with health warnings increases knowledge about drugged driving effects (high certainty). Roadside drug testing can reduce drugged driving among cannabis users (moderate certainty). For youth, motivational interviewing can prevent drugged driving and driver education increases knowledge (moderate certainty). State sanctions, including criminalization and per-se laws, showed little or no effect on drug-related fatalities (very low to low certainty).

Key Numbers

11 RCTs + 17 nonrandomized studies; 33,711 youth participants; packaging warnings: high certainty; roadside testing: moderate certainty; motivational interviewing: moderate certainty; legal sanctions: very low to low certainty

How They Did This

Systematic review searching MEDLINE, PsycINFO, Web of Science, Embase, and other databases through May 2020. Included 11 RCTs and 17 nonrandomized studies (predominantly youth aged 15-25, n=33,711). Evidence certainty rated using GRADE guidelines.

Why This Research Matters

As cannabis legalization expands, preventing drugged driving becomes urgent. This review reveals that punitive legal approaches may be the least effective strategy, while information-based and behavioral interventions show more promise.

The Bigger Picture

The finding that legal sanctions have little impact on drug-related fatalities is striking and challenges the assumption that tougher laws automatically improve road safety. Education, testing, and behavioral interventions appear more effective, suggesting a public health rather than criminal justice approach may be warranted.

What This Study Doesn't Tell Us

Most studies focused on youth; applicability to older adults unclear. Heterogeneous interventions and outcome measures. Limited evidence on actual crash and fatality outcomes. Most studies measured knowledge and attitudes rather than behavior change.

Questions This Raises

  • ?Why do legal sanctions fail to reduce drug-related fatalities?
  • ?Would combining interventions (e.g., roadside testing with education) be more effective than single approaches?
  • ?How can motivational interviewing be scaled for broader populations?

Trust & Context

Key Stat:
Legal sanctions: little effect on fatalities
Evidence Grade:
Systematic review with GRADE certainty ratings. Evidence strength varied by intervention type, with the strongest evidence for packaging warnings.
Study Age:
Published in 2021; drugged driving prevention research is rapidly evolving with cannabis legalization.
Original Title:
Interventions to Prevent Drugged Driving: A Systematic Review.
Published In:
American journal of preventive medicine, 61(2), 267-280 (2021)
Database ID:
RTHC-03448

Evidence Hierarchy

Meta-Analysis / Systematic ReviewCombines many studies into one answer
This study
Randomized Controlled Trial
Cohort / Case-Control
Cross-Sectional / Observational
Case Report / Animal Study

Analyzes all available research on a topic using a structured method.

What do these levels mean? →

Frequently Asked Questions

Do tough laws prevent drugged driving?

This review found very low to low certainty evidence that legal sanctions, including criminalization and per-se THC limits, have little or no effect on drug-related fatalities or injuries.

What actually works?

The strongest evidence supports cannabis packaging with health warnings (high certainty), roadside drug testing (moderate certainty), and motivational interviewing for youth (moderate certainty).

Read More on RethinkTHC

Cite This Study

RTHC-03448·https://rethinkthc.com/research/RTHC-03448

APA

Razaghizad, Amir; Windle, Sarah B; Gore, Genevieve; Benedetti, Andrea; Ells, Carolyn; Grad, Roland; Filion, Kristian B; Eisenberg, Mark J. (2021). Interventions to Prevent Drugged Driving: A Systematic Review.. American journal of preventive medicine, 61(2), 267-280. https://doi.org/10.1016/j.amepre.2021.03.012

MLA

Razaghizad, Amir, et al. "Interventions to Prevent Drugged Driving: A Systematic Review.." American journal of preventive medicine, 2021. https://doi.org/10.1016/j.amepre.2021.03.012

RethinkTHC

RethinkTHC Research Database. "Interventions to Prevent Drugged Driving: A Systematic Revie..." RTHC-03448. Retrieved from https://rethinkthc.com/research/razaghizad-2021-interventions-to-prevent-drugged

Access the Original Study

Study data sourced from PubMed, a service of the U.S. National Library of Medicine, National Institutes of Health.

This study breakdown was produced by the RethinkTHC research team. We analyze and report published research findings without making health recommendations. All interpretations are based solely on the published abstract and study data.