{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,1,9]],"date-time":"2026-01-09T00:45:11Z","timestamp":1767919511347,"version":"3.49.0"},"reference-count":50,"publisher":"BMJ","license":[{"start":{"date-parts":[[2025,7,16]],"date-time":"2025-07-16T00:00:00Z","timestamp":1752624000000},"content-version":"unspecified","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"funder":[{"DOI":"10.13039\/100014613","name":"Public Safety Canada","doi-asserted-by":"publisher","award":["23191"],"award-info":[{"award-number":["23191"]}],"id":[{"id":"10.13039\/100014613","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100014615","name":"Transport Canada","doi-asserted-by":"publisher","award":["164246"],"award-info":[{"award-number":["164246"]}],"id":[{"id":"10.13039\/100014615","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100000008","name":"Health Canada","doi-asserted-by":"publisher","award":["1920-HQ-000008"],"award-info":[{"award-number":["1920-HQ-000008"]}],"id":[{"id":"10.13039\/501100000008","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["Inj Prev"],"accepted":{"date-parts":[[2025,5,8]]},"abstract":"<jats:sec>\n                  <jats:title>Background<\/jats:title>\n                  <jats:p>Alcohol and delta-9-tetrahydrocannabinol (THC) (main impairing ingredient of cannabis) are both crash contributors that interfere with motor vehicle operation. However, the relationship between drug concentration and crash injury severity is unclear for either drug. We aim to clarify the relationship between blood alcohol concentration (BAC) and crash injury severity, based on healthcare system utilisation, with and without THC.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Methods<\/jats:title>\n                  <jats:p>The National Drug Driving Study is an ongoing prospective study involving 17 Canadian trauma centres. Eligible subjects included drivers aged 16+ who visited a participating trauma centre and had blood drawn as part of routine care within 6\u2009hours of a crash. Deidentified blood samples were tested for alcohol and THC using gas chromatography-flame ionisation detection and liquid chromatography\/tandem mass spectrometry. Study outcomes included admission to hospital and admitted patients\u2019 length of hospital stay.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Results<\/jats:title>\n                  <jats:p>10\u2009322 injured drivers visited a participating trauma centre between 2018 and 2023. 1649 (16.0%), 1716 (16.6%) and 463 (4.5%) drivers had detectable levels of alcohol, THC or both, respectively. Compared with sober drivers (BAC=0), drivers with 0%&lt;BAC&lt;0.08% had increased odds of admission (aOR=1.69, 95%\u2009CI=1.31 to 2.19), as did drivers with BAC\u22650.08% (aOR=1.36, 95%\u2009CI=1.16 to 1.60). THC did not modify the relationship between alcohol and admission. Neither alcohol nor THC predicted were associated with length of stay following admission.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Interpretation<\/jats:title>\n                  <jats:p>Alcohol increases hospital admissions after crashes but does not have a dose\u2013response relationship with admission or length of stay. THC does not moderate this relationship.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1136\/ip-2025-045642","type":"journal-article","created":{"date-parts":[[2025,7,16]],"date-time":"2025-07-16T21:40:18Z","timestamp":1752702018000},"page":"ip-2025-045642","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":1,"title":["Influence of cannabis and alcohol on motor vehicle injury severity in Canadian trauma centres: a prospective study"],"prefix":"10.1136","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-7705-0271","authenticated-orcid":false,"given":"Sarah M","family":"Simmons","sequence":"first","affiliation":[{"name":"Department of Emergency Medicine, The University of British Columbia, Vancouver, British Columbia, Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Madison","family":"Donoghue","sequence":"additional","affiliation":[{"name":"School of Medicine, University of Calgary Cumming, Calgary, 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Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9900-4594","authenticated-orcid":false,"given":"Paul","family":"Atkinson","sequence":"additional","affiliation":[{"name":"Dalhousie Medicine New Brunswick, Saint John, New Brunswick, Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Floyd","family":"Besserer","sequence":"additional","affiliation":[{"name":"Department of Emergency Medicine, The University of British Columbia, Vancouver, British Columbia, Canada"},{"name":"Division of Medical Sciences, University of Northern British Columbia, Prince George, British Columbia, Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"David B","family":"Clarke","sequence":"additional","affiliation":[{"name":"Neurosurgery, Department of Surgery, Dalhousie University, Halifax, Nova Scotia, 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Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jacques S","family":"Lee","sequence":"additional","affiliation":[{"name":"Department of Emergency Medicine, University of Toronto, Toronto, Ontario, Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Andrew","family":"MacPherson","sequence":"additional","affiliation":[{"name":"Department of Emergency Medicine, The University of British Columbia, Vancouver, British Columbia, Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kirk","family":"Magee","sequence":"additional","affiliation":[{"name":"Department of Emergency Medicine, Dalhousie University, Halifax, Nova Scotia, Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4365-2220","authenticated-orcid":false,"given":"Eric","family":"Mercier","sequence":"additional","affiliation":[{"name":"Department of Emergency Medicine, Universite Laval, Qu\u00e9bec, Qu\u00e9bec, 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