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We found alcohol in 17.8% (15.6% to 20.1%) of drivers. Cannabis was the second most common recreational drug: cannabis metabolites were present in 12.6% (10.7% to 14.7%) of drivers and we detected \u0394-9-tetrahydrocannabinol (\u0394-9-THC) in 7.3% (5.9% to 9.0%), indicating recent use. Males and drivers aged under 30\u2005years were most likely to use cannabis. We detected cocaine in 2.8% (2.0% to 4.0%) of drivers and amphetamines in 1.2% (0.7% to 2.0%). We also found medications including benzodiazepines (4.0% (2.9% to 5.3%)), antidepressants (6.5% (5.2% to 8.1%)) and diphenhydramine (4.7% (3.5% to 6.2%)). Drivers aged over 50\u2005years and those requiring hospital admission were most likely to have used medications. Overall, 40.1% (37.2% to 43.0%) of drivers tested positive for alcohol or at least one impairing drug and 12.7% (10.7% to 14.7%) tested positive for more than one substance.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Alcohol, cannabis and a broad range of other impairing drugs are commonly detected in injured drivers. Alcohol is well known to cause crashes, but further research is needed to determine the impact of other drug use, including drug\u2013alcohol and drug\u2013drug combinations, on crash risk. In particular, more work is needed to understand the role of medications in causing crashes to guide driver education programmes and improve public safety.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1136\/bmjopen-2015-009278","type":"journal-article","created":{"date-parts":[[2016,3,10]],"date-time":"2016-03-10T22:33:55Z","timestamp":1457649235000},"page":"e009278","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":55,"title":["Prevalence of alcohol and drug use in injured British Columbia drivers"],"prefix":"10.1136","volume":"6","author":[{"given":"Jeffrey R","family":"Brubacher","sequence":"first","affiliation":[{"name":"Department of Emergency Medicine, University of British Columbia, Vancouver, British Columbia, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Herbert","family":"Chan","sequence":"additional","affiliation":[{"name":"Department of Emergency Medicine, University of British 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