{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,1]],"date-time":"2026-07-01T14:53:37Z","timestamp":1782917617193,"version":"3.54.5"},"reference-count":58,"publisher":"SAGE Publications","license":[{"start":{"date-parts":[[2026,6,29]],"date-time":"2026-06-29T00:00:00Z","timestamp":1782691200000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Substance Use &amp; Addiction Journal"],"abstract":"<jats:sec>\n                    <jats:title>Background:<\/jats:title>\n                    <jats:p>Motor vehicle accidents (MVAs) are a major cause of unintentional injury deaths in the United States. Substance use, particularly alcohol and cannabis, is a well-established contributor to impaired driving and fatal MVAs. This study aimed to analyze mortality trends from MVAs associated with substance use from 1999 to 2020 in the United States.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods:<\/jats:title>\n                    <jats:p>We conducted a retrospective analysis using the CDC WONDER database, examining death certificates from 1999 to 2020 that recorded both MVAs and substance use in individuals aged \u226515\u2009years. Data were stratified by sex, age group (15-64 and \u226565), race (white and black), and US census region. Age-adjusted mortality rates (AAMRs) were calculated, and temporal trends were analyzed using the Mann-Kendall trend test. Jointpoint regression analysis was used to calculate Average Annual Percentage Change (AAPC).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>\n                      A total 24\u2009152 deaths were recorded, with an overall AAMR of 0.46\u2009per 100\u2009000 population. While overall trends were stable, a significant increase in AAMR was observed among women (AAPC: 3.04% increase;\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      \u2009=\u2009.002), particularly white women (+4.3%) and women in the West (+2.0%). Older men (\u226565) also experienced a significant rise (\u03c4: 0.63;\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      \u2009&lt;\u2009.001). Men consistently had higher mortality than women across all demographics (\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      \u2009&lt;\u2009.001). Regionally, men in the Northeast experienced a significant decline (\u03c4: \u22120.57).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion:<\/jats:title>\n                    <jats:p>While total substance-related MVA mortality remained stable, the rising mortality among women, older men, and certain subgroups highlights shifting risk profiles. These findings underscore the need for targeted, demographically inclusive public health strategies and equitable resource allocation to reduce preventable deaths.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/29767342261452632","type":"journal-article","created":{"date-parts":[[2026,6,29]],"date-time":"2026-06-29T10:36:07Z","timestamp":1782729367000},"update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":0,"title":["Substance Use and Motor Vehicle Accident Mortality in the United States: A 22-Year National Analysis"],"prefix":"10.1177","author":[{"ORCID":"https:\/\/orcid.org\/0009-0001-1167-8867","authenticated-orcid":false,"given":"Abdullah","family":"Ahmad","sequence":"first","affiliation":[{"name":"Department of Medicine, CMH Lahore Medical College, Pakistan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Muhammad Ahmad","family":"Nadeem","sequence":"additional","affiliation":[{"name":"Department of Liver Transplant Surgery, Digestive Diseases and Surgery Institute, Cleveland Clinic, OH, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Asad Gul","family":"Rao","sequence":"additional","affiliation":[{"name":"Department of Medicine, Dow Medical College, Karachi, Pakistan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6411-8759","authenticated-orcid":false,"given":"Abdul Rafeh","family":"Awan","sequence":"additional","affiliation":[{"name":"Department of Surgery, Nishtar Medical University, Multan, Pakistan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Abdullah","family":"Khan","sequence":"additional","affiliation":[{"name":"Department of Vascular Surgery, Heart, Vascular and Thoracic Institute, Cleveland Clinic, OH, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2619-9962","authenticated-orcid":false,"given":"Ahsan Raza","family":"Raja","sequence":"additional","affiliation":[{"name":"Department of Medicine, Medical College, Aga Khan University, Karachi, Pakistan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Arlin A.","family":"Bustillos","sequence":"additional","affiliation":[{"name":"School of Medicine HSC, University of New Mexico, Alburquerque, NM, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mohammed A.","family":"Quazi","sequence":"additional","affiliation":[{"name":"Department of Family and Community Health, West Virginia University, Morgantown, WV, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jibran","family":"Ikram","sequence":"additional","affiliation":[{"name":"Department of Outcomes Research, Cleveland Clinic, OH, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Asad","family":"Ullah","sequence":"additional","affiliation":[{"name":"Department of Pathology, Texas Technical University Health Sciences Center TTUHSC, Lubbock, TX, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Abu Baker","family":"Sheikh","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine, University of New Mexico, Albuquerque, NM, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Amir Humza","family":"Sohail","sequence":"additional","affiliation":[{"name":"Department of Surgical Oncology, University of New Mexico, Albuquerque, NM, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2026,6,29]]},"reference":[{"key":"e_1_3_3_2_2","doi-asserted-by":"publisher","DOI":"10.15620\/cdc:101759"},{"key":"e_1_3_3_3_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.amepre.2019.12.015"},{"key":"e_1_3_3_4_2","doi-asserted-by":"publisher","DOI":"10.1373\/clinchem.2012.194381"},{"key":"e_1_3_3_5_2","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.e536"},{"key":"e_1_3_3_6_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.drugalcdep.2003.10.008"},{"key":"e_1_3_3_7_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.drugalcdep.2015.06.015"},{"key":"e_1_3_3_8_2","doi-asserted-by":"publisher","DOI":"10.1373\/clinchem.2015.238287"},{"key":"e_1_3_3_9_2","doi-asserted-by":"publisher","DOI":"10.1080\/00952990.2019.1669626"},{"key":"e_1_3_3_10_2","unstructured":"Substance Abuse and Mental Health Services Administration (SAMHSA). 2017 National Survey on Drug Use and Health (NSDUH) Releases | CBHSQ Data. 2017. 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