Recommendations of EU-project DRUID (Driving under influence of Drugs, Alcohol and Medicines)

The objective was to provide evidence based recommendations to EU policy concerning combating driving under the influence. 37 organizations from 19 European countries took part in the project according to a uniform study design. The study topics involved e.g. epidemiological and experimental studies, enforcement, classification/labeling of medicines, licence withdrawal, rehabilitation and prevention to reveal recommended “best practice” models. When combating alcohol and drugs in traffic, the target groups are 1) Young male drivers (drugs and alcohol) 2) Male drivers above 50 years of age (alcohol) 3) Drivers addicted to alcohol /drugs and misusers 4) Drivers with combined consumption of alcohol and drugs or multi drugs users. In case of psychoactive medicines the target groups are 1) Health care providers and patients, 2) Female drivers above 50 years; 3) Especially drivers using benzodiazepines and medicinal opiates. The legal limit of BAC 0.5 g/L is reasonable as the injury risk of drivers below that is rather low. Countries that have established lower legal limits have lower prevalence rates of drunken drivers in the general driving population. Nevertheless injured drivers with high alcohol concentration are still a problem. The establishment of lower legal limit, e.g. BAC 0.0 g/L for novice/inexperienced drivers and for combined consumption should be imposed. Mandatory alcohol testing for drivers involved in accidents should be introduced. Implementing the standardized DRUID classification and labeling system for medicines is recommended especially in view of aging societies. Driver assessment and rehabilitation should be harmonized according to defined criteria. Alcohol and drug offenders should be treated in separate groups as well as non-addicts and addicts as they require different interventions or treatments. Multiple offenders and offenders with a BAC ≥ 1.6 g/L should undergo an examination to preclude addiction. An alcohol interlock use should be combined with rehabilitation/treatment and close monitoring. Driver rehabilitation should be an integrated part of driving license withdrawal.