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Study breakdown

About 1 in 4 injured young drivers in Arizona tested positive for alcohol, THC, or both

Retrospective CohortModerate evidence
The takeaway

Among 5,069 injured drivers aged 16-20 at Arizona trauma centers, 19% tested positive for alcohol and 30% tested positive for THC, with substance-positive drivers less likely to wear seat belts or helmets.

Traffic safety researchers, youth health advocates, and policymakers addressing impaired driving.

30% of tested injured young drivers were THC-positive

What the researchers found

Of drivers with BAC results, 19% tested positive (82% of those at or above 0.08 g/dL). Of drivers with THC results, 30% tested positive. American Indians had the highest THC-positive rates (38%) and highest dual positive rates (28%). Substance-positive drivers were less likely to wear seat belts or helmets.

Why it matters

The high rate of THC positivity (30%) among injured young drivers, combined with reduced safety behavior, suggests cannabis-impaired driving is a substantial contributor to youth traffic injuries.

The numbers in context

5,069 injured drivers. 19% BAC-positive (82% at 0.08+). 30% THC-positive. American Indians: 38% THC-positive, 28% dual positive. Annual injured drivers declined 41% over the study period.

How the study worked

Retrospective analysis of 5,069 injured drivers aged 16-20 evaluated at Arizona level 1 trauma centers (2008-2014) using the Arizona State Trauma Registry. Descriptive analysis of BAC and THC test results by demographics and safety behaviors.

What this study cannot tell us

Only injured drivers at level 1 trauma centers, not representative of all young drivers. Not all drivers were tested for both substances. THC presence indicates recent use but not necessarily impairment at time of crash.

How to read the evidence

Moderate: seven-year trauma registry data with biological testing, but limited to one state and level 1 trauma centers.

When this study was published

Published in 2019.

The bigger picture

While alcohol-impaired driving among youth has received decades of public health attention, THC-impaired driving is an emerging concern. The higher THC-positive rate (30%) than alcohol-positive rate (19%) among tested drivers is notable.

Questions still open

  • Are cannabis-positive crashes increasing over time? Do cannabis and alcohol have synergistic effects on crash risk? Would targeted prevention for high-risk populations (American Indian communities) reduce these disparities?

Common questions

Does THC-positive mean the driver was impaired?
Not necessarily. THC can remain detectable in blood for hours to days after use. However, the high rate among injured drivers compared to general population estimates suggests an association with crash risk.
Why were American Indian drivers disproportionately affected?
The study documented the disparity but did not investigate causes. Socioeconomic factors, access to treatment, and reservation-specific alcohol/drug policies may all contribute.

Read the original research

Alcohol and marijuana use among young injured drivers in Arizona, 2008-2014.

Traffic injury prevention, 20(1), 9-14

Citation

Shults, Ruth A; Jones, Jefferson M; Komatsu, Kenneth K; Sauber-Schatz, Erin K. (2019). Alcohol and marijuana use among young injured drivers in Arizona, 2008-2014.. Traffic injury prevention, 20(1), 9-14. https://doi.org/10.1080/15389588.2018.1527032