Urine Prevalence of Psychoactive Substances, Nicotine Exposure and Associated Factors Among Commercial Drivers. An Exploratory Study

Earlier studies have documented psychoactive substance use and nicotine exposure among commercial drivers in Ghana. However, those studies relied solely on self-reported questionnaires, which are prone to recall and response bias. This study aimed to provide a more accurate estimate by using a chromatographic immunoassay urine drug test. This exploratory cross-sectional study was conducted between January and August 2024 in the Tamale metropolitan area of Ghana. The study included 70 consenting commercial drivers aged from 26 to 78 years. Sociodemographic, anthropometric and occupational factors were collected using a semi-structured questionnaire. Urine samples were then obtained from the participants and tested for Amphetamine (AMP), Barbiturates (BAR), Benzodiazepines (BZO), Cocaine (COC), Tetrahydrocannabinol (THC), Morphine (MOP), Opiates (OPI), nicotine exposure using Cotinine (COT), Tramadol (TML), and Tricyclic Antidepressants (TCA) using the 10-panel Multi-Drug One Step chromatographic immunoassay test kit. The total urine prevalence of psychoactive substances and nicotine exposure was 61.4%, consisting of COT (37.1%), THC (24.3%), BZO (11.4%), Tramadol (5.7%) and AMP (2.9%). While the self-reported smoking prevalence was 10%, the urine cotinine prevalence was 37.1%. In addition, 14(20%) of the urine samples tested positive for two substances. Contrary to expectations, commercial drivers with no history of accident were more likely to test positive for TML [AOR = 8.667(95%CI: 1.025-73.249)], or two substances [AOR = 5.000(95%CI: 1.051-23.789)]. The urine samples of commercial drivers tested positive for psychoactive substances and nicotine exposure. However, positivity for a psychoactive substance or nicotine exposure may not be associated with a history of road traffic accidents. Further studies are recommended.