Alejandro Azofeifa, DDS1; Bárbara D. Rexach-Guzmán, MPH2; Abby N. Hagemeyer, PhD3; Rose A. Rudd, MSPH4; Erin K. Sauber-Schatz, PhD4 (View author affiliations)
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Summary
What is already known about this topic?
The use and co-use of alcohol and drugs has been associated with impairment of psychomotor and cognitive functions while driving.
What is added by this report?
During 2018, approximately 12 million (4.7%) U.S. residents aged ≥16 years reported driving under the influence of marijuana, and 2.3 million (0.9%) reported driving under the influence of illicit drugs other than marijuana during the past 12 months.
What are the implications for public health practice?
Development, evaluation, and further implementation of strategies to prevent alcohol-, drug-, and polysubstance-impaired driving coupled with standardized testing of impaired drivers and drivers involved in fatal crashes could advance understanding of drug- and polysubstance-impaired driving and assist states and communities with prevention efforts.
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In the United States, driving while impaired is illegal. Nonetheless, an estimated 10,511 alcohol-impaired driving deaths occurred in 2018.* The contribution of marijuana and other illicit drugs to these and other impaired driving deaths remains unknown. Data from the Substance Abuse and Mental Health Services Administration’s National Survey on Drug Use and Health (NSDUH) indicated that in the United States during 2014, 12.4% of all persons aged 16–25 years reported driving under the influence of alcohol, and 3.2% reported driving under the influence of marijuana (1). The impairing effects of alcohol are well established, but less is known about the effects of illicit substances or other psychoactive drugs (e.g., marijuana, cocaine, methamphetamines, and opioids, including heroin). This report provides the most recent national estimates of self-reported driving under the influence of marijuana and illicit drugs among persons aged ≥16 years, using 2018 public-use data from NSDUH. Prevalences of driving under the influence of marijuana and illicit drugs other than marijuana were assessed for persons aged ≥16 years by age group, sex, and race/ethnicity. During 2018, 12 million (4.7%) U.S. residents reported driving under the influence of marijuana in the past 12 months; 2.3 million (0.9%) reported driving under the influence of illicit drugs other than marijuana. Driving under the influence was more prevalent among males and among persons aged 16–34 years. Effective measures that deter driving under the influence of drugs are limited (2). Development, evaluation, and further implementation of strategies to prevent alcohol-impaired,† drug-impaired, and polysubstance-impaired driving, coupled with standardized testing of impaired drivers and drivers involved in fatal crashes, could advance understanding of drug- and polysubstance-impaired driving and support prevention efforts.
NSDUH annually collects information about the use of illicit drugs, alcohol, and tobacco among the noninstitutionalized U.S. civilian population aged ≥12 years via household face-to-face interviews using a computer-assisted personal interviewing system.§ Respondents aged <16 years were excluded from this analysis because they are typically too young to drive. Unweighted sample sizes for the 2018 survey cycle included 47,570 respondents aged ≥16 years. Driving under the influence of marijuana was defined as an affirmative response to the question “During the past 12 months, have you driven a vehicle while you were under the influence of marijuana?” Driving under the influence of illicit drugs other than marijuana was defined as an affirmative response to one or more of the questions (each asked separately) that asked about each illicit drug: “During the past 12 months, have you driven a vehicle while you were under the influence of (cocaine, hallucinogens, heroin, inhalants, methamphetamine)”? Public-use NSDUH data on driving under the influence of marijuana and illicit drugs other than marijuana were examined by sex, age group, and race/ethnicity. Data were weighted to provide nationally representative estimates. Statistical analyses were performed using SAS (version 9.4; SAS Institute). Prevalence measures and 95% confidence intervals (CIs) were determined for each response category.
During 2018, the overall prevalence of driving under the influence of marijuana (4.7%) exceeded that of driving under the influence of illicit drugs other than marijuana (0.9%) among persons aged ≥16 years (Table). This pattern persisted when the data were stratified by sex, race/ethnicity, and age group. The prevalences of driving under the influence of marijuana and driving under the influence of illicit drugs other than marijuana were higher among males (6.2%, 1.3%, respectively) than among females (3.2%, 0.5%, respectively). The prevalence of driving under the influence of marijuana was highest among non-Hispanic multiracial persons (9.2%). The prevalence of driving under the influence of marijuana ranged from 0.6% among persons aged ≥65 years to 12.4% among persons aged 21–25 years; the second highest prevalence (9.2%) was reported among persons aged 16–20 years (Figure). The highest reported prevalences of driving under the influence of illegal drugs other than marijuana were among persons aged 21–25 years (1.9%) and 26–34 years (1.9%).
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Discussion
Although 4.7% of the U.S. population aged ≥16 years reported driving under the influence of marijuana and 0.9% reported driving under the influence of illicit drugs other than marijuana, these estimates are lower than the 8.0% (20.5 million) who reported driving under the influence of alcohol in 2018 (NSDUH, unpublished data, 2019). The highest prevalence of driving under the influence of marijuana was among persons aged 21–25 years. The second highest was among the youngest drivers (those aged 16–20 years), who already have a heightened crash risk because of inexperience¶; thus, their substance use is of special concern. In a study of injured drivers aged 16–20 years evaluated at level 1 trauma centers in Arizona during 2008–2014 (3), 10% of tested drivers were simultaneously positive for both alcohol and tetrahydrocannabinol, the main psychoactive component of marijuana. Data from the 2018 NSDUH indicate a high prevalence (34.8%) of past-year marijuana use among young adults aged 18–25 years (4). Studies have reported that marijuana use among teenagers and young adults might alter perception, judgement, short-term memory, and cognitive abilities (5). Given these findings, states could consider developing, implementing, and evaluating targeted strategies to reduce marijuana use and potential subsequent impaired driving, especially among teenagers and young adults.
Research has determined that co-use of marijuana or illicit drugs with alcohol increases the risk for driving impairment (5,6). The use of these substances has been associated with impairment of psychomotor and cognitive functions while driving (6,7). In addition, previous research has demonstrated evidence of a statistical association between marijuana use and increased risk for motor vehicle crashes; however, methodologic limitations of studies limit inference of causation (8). Scientific studies have been unable to link blood tetrahydrocannabinol levels to driving impairment (8), and the effects of marijuana in drivers likely varies by dose, potency of the product consumed, means of consumption (e.g., smoking, eating, or vaping), length of use, and co-use of other substances, including alcohol. Additional data are needed to clarify the contribution of drug and polysubstance use to impaired driving prevalence and the resulting crashes, injuries, and deaths.
A national roadside survey using biochemical specimens among drivers aged ≥16 years found that during 2013–2014, the percentages of weekend nighttime drivers who tested positive for alcohol, marijuana (i.e., tetrahydrocannabinol) and illicit drugs were 8.3%, 12.6%, and 15.1%, respectively (9), although a positive test does not necessarily imply impairment. Collecting and testing biologic specimens (e.g., blood or oral fluids) currently required to test for drugs has challenges, including, in some circumstances, the need for a judge to order collection and testing (which can delay roadside testing, thus allowing drug levels to drop with time); variation in substances tested and methodology used by different toxicology laboratories; and the current state of development of oral fluid testing. The increased use of marijuana and some illicit drugs in the United States (4) along with the results of this report, point to the need for rapid and sensitive assessment tools to ascertain the presence of and impairment by marijuana and other illicit drugs. In addition, adoption and application of standards for toxicology testing and support for laboratories to implement recommendations are needed to improve understanding of the prevalence of drug- and polysubstance-impaired driving (10).
The findings in this report are subject to at least five limitations. First, because NSDUH data are self-reported, they are subject to recall and social desirability biases. Second, variations in laws and regulations among states and counties regarding marijuana could have resulted in negative responses to the NSDUH substance use survey questions for fear of legal consequences, leading to an underestimation of the prevalence of the use and driving under the influence in some jurisdictions. Third, the NSDUH questions are not limited to driving under the influence of marijuana only or each illegal substance only; therefore, persons might be driving under the influence of more than one substance at a given time. Fourth, self-reported data are subject to the respondents’ interpretations of being under the influence of a drug. Finally, NSDUH does not assess whether all respondents drive; therefore, reported percentages of impaired drivers might be underestimated.
Impaired driving is a serious public health concern that needs to be addressed to safeguard the health and safety of all who use the road, including drivers, passengers, pedestrians, bicyclists, and motorcyclists. Collaboration among public health, transportation safety, law enforcement, and federal and state officials is needed for the development, evaluation, and further implementation of strategies to prevent alcohol-, drug-, and polysubstance-impaired driving (2). In addition, standardized testing for alcohol and drugs among impaired drivers and drivers involved in fatal crashes could advance understanding of drug- and polysubstance-impaired driving and assist states and communities with targeted prevention efforts.
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Acknowledgments
Margaret E. Mattson, PhD, Division of Evaluation, Analysis and Quality, Center for Behavioral Health Statistics and Quality, Substance Abuse and Mental Health Services Administration, Rockville, Maryland; Applied Epidemiology Fellowship Program, Council of State and Territorial Epidemiologists, Atlanta, Georgia.
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Corresponding author: Erin K. Sauber-Schatz, ige7@cdc.gov, 770-488-0566.
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1Consultant, Washington, DC; 2Consultant, San Juan, Puerto Rico; 3Applied Epidemiology Fellowship, Council of State and Territorial Epidemiologists, Atlanta, Georgia; 4Division of Injury Prevention, National Center for Injury Prevention and Control, CDC.
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References
- Azofeifa A, Mattson ME, Lyerla R. Driving under the influence of alcohol, marijuana, and alcohol and marijuana combined among persons aged 16–25 years—United States, 2002–2014. MMWR Morb Mortal Wkly Rep 2015;64:1325–9. CrossRefexternal icon PubMedexternal icon
- Richard CM, Magee K, Bacon-Abdelmoteleb P, Brown JL. Countermeasures that work: a highway safety countermeasure guide for state highway safety offices. Washington, DC: US Department of Transportation, National Highway Traffic Safety Administration; 2018. https://www.nhtsa.gov/sites/nhtsa.dot.gov/files/documents/812478_countermeasures-that-work-a-highway-safety-countermeasures-guide-.pdfpdf iconexternal icon
- Shults RA, Jones JM, Komatsu KK, Sauber-Schatz EK. Alcohol and marijuana use among young injured drivers in Arizona, 2008–2014. Traffic Inj Prev 2019;20:9–14. CrossRefexternal icon PubMedexternal icon
- Center for Behavioral Health Statistics and Quality. Results from the 2018 National Survey on Drug Use and Health: detailed tables. Rockville, MD: US Department of Health and Human Services, Substance Abuse and Mental Health Services Administration; 2019. https://www.samhsa.gov/data/report/2018-nsduh-detailed-tablesexternal icon
- National Institute on Drug Abuse. Marijuana. Bethesda, MD: US Department of Health and Human Services, National Institutes of Health; 2018. https://d14rmgtrwzf5a.cloudfront.net/sites/default/files/1380-marijuana.pdfpdf iconexternal icon
- Busardo FP, Pichini S, Pellegrini M, et al. Correlation between blood and oral fluid psychoactive drug concentrations and cognitive impairment in driving under the influence of drugs. Curr Neuropharmacol 2018;16:84–96. PubMedexternal icon
- Hartman RL, Huestis MA. Cannabis effects on driving skills. Clin Chem 2013;59:478–92. CrossRefexternal icon PubMedexternal icon
- National Academies of Sciences, Engineering, and Medicine. The health effects of cannabis and cannabinoids: the current state of evidence and recommendations for research. Washington, DC: National Academies Press; 2017. https://www.nap.edu/read/24625/chapter/18external icon
- Berning A, Compton R, Wochinger K. Results of the 2013–14 National Roadside Survey of Alcohol and Drug Use by Drivers. Washington, DC: US Department of Transportation, National Highway Traffic Safety Administration; 2015. https://www.nhtsa.gov/behavioral-research/2013-14-national-roadside-study-alcohol-and-drug-use-driversexternal icon
- Logan BK, D’Orazio AL, Mohr ALA, et al. Recommendations for toxicological investigation of drug-impaired driving and motor vehicle fatalities—2017 update. J Anal Toxicol 2018;42:63–8. CrossRefexternal icon PubMedexternal icon
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Abbreviation: CI = confidence interval.
* Numbers and percentages are weighted to represent the 2018 U.S. civilian, noninstitutionalized population and are not mutually exclusive.
† Illicit drugs other than marijuana in this analysis are cocaine, hallucinogens, heroin, inhalants, and methamphetamines.
§ Whites, blacks, American Indian/Alaska Natives, Hawaiian/Other Pacific Islanders, Asians, and multiracial persons were non-Hispanic; Hispanic persons could be of any race.
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FIGURE. Percentage of all persons aged ≥16 years* who reported driving a vehicle under the influence of marijuana or illicit drugs other than marijuana†,§,¶ in the past year, by age group** — National Survey on Drug Use and Health, United States, 2018
* Percentages are weighted to represent the 2018 U.S. civilian, noninstitutionalized population.
† Illicit drugs other than marijuana in this analysis include cocaine, hallucinogens, heroin, inhalants, and methamphetamines.
§ Not mutually exclusive.
¶ Estimated percentage of adults aged ≥65 years who reported driving under the influence of illicit drugs other than marijuana was <0.02% and thus not shown.
** With 95% confidence intervals indicated by error bars.
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Suggested citation for this article: Azofeifa A, Rexach-Guzmán BD, Hagemeyer AN, Rudd RA, Sauber-Schatz EK. Driving Under the Influence of Marijuana and Illicit Drugs Among Persons Aged ≥16 Years — United States, 2018. MMWR Morb Mortal Wkly Rep 2019;68:1153–1157. DOI: http://dx.doi.org/10.15585/mmwr.mm6850a1external icon.
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FAQs
How much is the fine for drug driving UK? ›
an unlimited fine. up to 6 months in prison. a criminal record.
How long do the police have to charge you with drug driving UK? ›If a positive result is confirmed, a charge is likely to be brought – that of driving with excess (over the specified legal limit) drugs and the prosecuting authorities - the police and the CPS - have six months to charge you with an offence.
How long do the police have to prosecute for drug driving in Scotland? ›The Scottish Police Authority revealed 386 cases cannot be prosecuted as they have reached the statutory 12-month time limit.
What drugs can affect a person's driving ability? ›Alcohol, marijuana, and other drugs can impair the ability to drive because they slow coordination, judgment, and reaction times. Cocaine and methamphetamine can make drivers more aggressive and reckless.
What happens if found guilty of drug driving? ›A minimum 1 year driving ban. An unlimited fine. Up to 6 months in prison. A criminal record.
What's worse drunk or drug driving? ›The findings show that drink-driving is the generally most socially unacceptable driving conviction, but 38% of 18-24 year-olds surveyed thought driving under the influence of drugs was more unacceptable than driving under the influence of alcohol.
What is the maximum penalty for drug driving? ›? 5,000 fine and 6 months in prison. ? 5,000 fine and 6 months driving disqualification.
Can you get away with drug driving UK? ›You can be disqualified from driving for at least 1 year if you're found guilty of drug driving. Depending on your offence, you can also be fined or sent to prison. You must apply for a new licence before you can drive again.
Can I drive the next day after smoking? ›If you've smoked more than 35 mg, you need to wait longer. Wait at least 8 hours after eating or drinking marijuana containing less than 18 mg THC before driving, biking or performing other safety-sensitive activities.
Will I go to jail for drug driving? ›Drug driving codes
You may also face a minimum of a one-year driving ban alongside an unlimited fine, a community order or up to six months in prison. A DR60 is one of the most serious drug driving convictions. If you are found guilty, it is highly likely that you will face a prison sentence.
Can you go to America with a drug driving conviction? ›
Generally, any convictions for drug possession can result in a denial of entry. If the conviction was a while ago, you may have to contact the U.S. Embassy, Office of Consular Affairs in your country to obtain a waiver. Other misdemeanors may result in denial if they are recent.
Does drug driving show on DBS? ›It is a non recordable offence and will not show up on any level of criminal background check. If a more serious driving offence was committed at the same time, and it was not eligible for filtering, then driving without insurance would show up alongside it.
What are 3 impairing effects of drugs on driving? ›s slows the driver's reaction time s distorts driver's perceptions of distance and speed s greatly reduces ability to concentrate s decreases ability to coordinate appropriate reaction when driving s greatly increases the risk of having a crash.
How do drugs impact driving? ›The use of illicit drugs causes changes in the brain which can impair driving ability and increase crash risk. The effects of drug use depend on the type and concentration of the drug taken and vary widely between individuals.
Can you drive the day after taking drugs? ›It is not recommended to drive after having taken drugs as your driving might be affected, but it is now also illegal to drive with specified levels of certain drugs in your blood, if you have not been prescribed them or have not followed the advice given to you about how to take them.
How long can police keep you under investigation? ›There is no general time limit for how long a police investigation can stay open in England and Wales. For summary only offences, which are heard in the Magistrates' Court, the case must be heard within twelve months of the crime.
What type of offence is drug driving? ›The offence is a strict liability offence, which is committed once the specified limit for any of 17 specified controlled drugs is exceeded. The 17 drugs include both illegal drugs and drugs that may be medically prescribed.
Can you appeal drug driving ban? ›You can appeal your conviction, for starters, if you feel like the driving ban was unfairly imposed. Make sure that you have evidence to support your claims, as simply stating that you did not commit the offence will not suffice. You can also file your appeal based on the punishment that you received.
Is it safer to drive stoned or drunk? ›The higher the blood alcohol level, the worse a person's driving skills. Marijuana, meanwhile, actually made drivers slow down. But that didn't translate into safety: "High" drivers also had a harder time staying in their lane — akin to the effects of low blood alcohol levels.
Is driving stoned the same as driving drunk? ›Driving While Stoned Is Much Safer Than Driving Drunk, Says a New Study. Driving while stoned is not as dangerous as driving while drunk — in fact, according to a new report, it's about as safe as driving while sober once variables are adjusted for.
What evidence do police need for drink driving? ›
Usually the police will use a more complex breathalyser at the station to perform a more accurate test, and they may also take blood or urine samples as evidence that you have been drink driving.
Is a driving conviction a criminal conviction? ›If you are convicted of a motoring offence by the court, you will have a criminal record. This applies to all sentences available to the court, including fines, which are imposed by the court in respect of nearly all, if not all, motoring convictions.
How long does drug stay in your system chart? ›| Drug | In Blood | In Urine |
|---|---|---|
| Amphetamines | 12 hours | 1-3 days |
| Barbiturates | 1-2 days | 2-4 days |
| Benzodiazepines | 2-3 days | 3-6 weeks |
| Cannabis | 2 weeks | 7-30 days |
Penalty points stay on your licence record for three years.
How long does drug driving affect insurance? ›Impact on premiums
From an insurance perspective a drink or drug-driving conviction always impacts on insurance. You must tell insurers of your conviction for five years minimum. But the points on your licence might last longer, and that impact will last for years.
The medicinal drugs which will have limits based on scientific evidence are clonazepam; diazepam; flunitrazepam; lorazepam; methadone; morphine; oxazepam; and temazepam.
What convictions stop entry USA? ›In most cases, you will be denied a waiver where you have been convicted of a very serious offence. These are commonly referred to as crimes involving moral turpitude, (CIMTs), such as rape, kidnap, manslaughter, murder or forgery.
What countries can I move to with a criminal record? ›- Brazil.
- Cambodia.
- Chile.
- Egypt.
- Ethiopia.
- Hong Kong.
- Indonesia.
- Ireland.
USCIS's definition of aggravated felony includes many crimes that you would expect; such as rape, sexual abuse of a minor, drug trafficking, firearm trafficking, racketeering, running a prostitution business, child pornography, and fraud of $10,000 or more.
What will fail a DBS check? ›The number one way to fail a background check is if details of past convictions appear on a DBS certificate. Any criminal behaviour can show up on a DBS check, depending on the level of the check carried out – basic, standard, or enhanced.
Does your criminal record clear after 7 years UK? ›
Since 2006, the police retain details of all recordable offences until you reach 100 years of age. Your conviction will always show on your police records but the conviction may not show on your criminal record check that is used for employment vetting purposes.
What jobs can't you do with a criminal record UK? ›Crimes that include the likes of theft or fraud could stop someone from being hired for a job involving finance or cash handling. Employers at businesses are not legally allowed to discriminate against applicants because of spent convictions unless of course, the DBS check shows they are unsuitable for the role.
What happens if you are caught driving stoned UK? ›If there is sufficient evidence that you were under the influence of cannabis whilst driving, you could face an unlimited fine, disqualification, up to 6 months in prison and a criminal record. The conviction will be on your driving licence for up to 11 years.
What is the legal drug drive limit UK? ›| 'Illegal' drug driving limits ('accidental exposure' – zero tolerance approach) | Threshold limit in microgrammes per litre of blood (µg/L) |
|---|---|
| delta-9-tetrahydrocannabinol (cannabis) | 2µg/L |
| ketamine | 20µg/L |
| lysergic acid diethylamide | 1µg/L |
| methylamphetamine | 10µg/L |
A first time offender who is just over the legal limit would face a 12 – 16 month ban. A first time offender who is four times the legal limit would face a 29 – 36 month ban and prison sentence.
Does drug driving show on DBS? ›It is a non recordable offence and will not show up on any level of criminal background check. If a more serious driving offence was committed at the same time, and it was not eligible for filtering, then driving without insurance would show up alongside it.
How long does drug driving affect insurance? ›Impact on premiums
From an insurance perspective a drink or drug-driving conviction always impacts on insurance. You must tell insurers of your conviction for five years minimum. But the points on your licence might last longer, and that impact will last for years.
Facts about drug-impaired driving
Driving while high is a serious crime. Drivers can face immediate roadside penalties and criminal charges.
? 5,000 fine and 6 months in prison. ? 5,000 fine and 6 months driving disqualification.
Can you appeal a drug driving ban? ›You can appeal your conviction, for starters, if you feel like the driving ban was unfairly imposed. Make sure that you have evidence to support your claims, as simply stating that you did not commit the offence will not suffice. You can also file your appeal based on the punishment that you received.
How long does drug stay in your system chart? ›
| Drug | In Blood | In Urine |
|---|---|---|
| Amphetamines | 12 hours | 1-3 days |
| Barbiturates | 1-2 days | 2-4 days |
| Benzodiazepines | 2-3 days | 3-6 weeks |
| Cannabis | 2 weeks | 7-30 days |
The offence is a strict liability offence, which is committed once the specified limit for any of 17 specified controlled drugs is exceeded. The 17 drugs include both illegal drugs and drugs that may be medically prescribed.
How long can police keep you under investigation? ›There is no general time limit for how long a police investigation can stay open in England and Wales. For summary only offences, which are heard in the Magistrates' Court, the case must be heard within twelve months of the crime.
What court deals with drug driving? ›Causing Death by Dangerous Driving will be heard in the Crown Court. Causing Death by Careless Driving when under the influence of Drink or Drugs will also be heard in the Crown Court.
What will fail a DBS check? ›The number one way to fail a background check is if details of past convictions appear on a DBS certificate. Any criminal behaviour can show up on a DBS check, depending on the level of the check carried out – basic, standard, or enhanced.
What Offences put you on the barred list? ›- Rape.
- Murder.
- Sexual Assault.
- Ill-treatment of patients.
- Cruelty to persons under 16.
- Sexual intercourse with someone under 16.
- Possession or distribution of indecent images of children.
- Causing a child/vulnerable adult to die, or suffer serious physical harm.
Since 2006, the police retain details of all recordable offences until you reach 100 years of age. Your conviction will always show on your police records but the conviction may not show on your criminal record check that is used for employment vetting purposes.