The consumption of alcohol and cocaine among drunk-drivers: retrospective data analysis of a protocol for driving license regranting program

AUTORI

ABSTRACT

Introduction: alcohol and cocaine are frequently used together; this co-abuse compromises the physical and mental requirements included in the assessment of fitness to drive. The assessment for the issuing of the certificate of fitness to drive is released by Local Medical Commissions after clinical examination and toxicological analysis. The aim of this paper is to estimate the prevalence of cocaine use among drunk-drivers during a specific driving regranting protocol, in order to assess the usefulness of the inclusion of cocaine metabolites in hair analysis in this category of subjects.
Methods: according to the toxicological protocol at the Regional Reference toxicological laboratory of the “Liguria Levante” in Sarzana (La Spezia) at San Bartolomeo Hospital, in addition to the quantification of carbohydrate-deficient transferrin (CDT) in serum by HPLC and Ethylglucuronide (ETG) in keratin matrix, also cocaine and its metabolites, especially Coca-ethylene (CE) has been tested in hair by LC-MS/MS. The protocol has been applied on biological samples collected from 2 215 drunk-drivers.
Results: the 6.6% of the 2 215 hair samples analyzed were classified as non-moderate alcohol users (ETG >30 pg/mg). Among these 0.1% were cocaine users and 0.9% consumed together alcohol and cocaine, as highlighted by the presence of CE. Out of the 94.4% of the 2 215 hair samples with ETG <30 pg/mg, 3.9% and 6.1% were positive for cocaine, and CE respectively.
Conclusion: This study demonstrates the importance of toxicological analysis of drugs of abuse in hair and the need to include the analysis in specific protocols for driving regranting, such as the one here adopted.

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