Amphetamine, cocaine and cannabinoids use among truck drivers on the roads in the State of Sao Paulo, Brazil

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Abstract

Drugs are important risk factors for traffic accidents. In Brazil, truck drivers report using amphetamines to maintain their extensive work schedule and stay awake. These drugs can be obtained without prescription easily on Brazilian roads. The use of these stimulants can result in health problems and can be associated with traffic accidents. There are Brazilian studies that show that drivers use drugs. However, these studies are questionnaire-based and do not always reflect real-life situations. The purpose of this study was to demonstrate the prevalence of drug use by truck drivers on the roads of Sao Paulo State, Brazil, during 2009. Drivers of large trucks were randomly stopped by police officers on the interstate roads during morning hours. After being informed of the goals of the study, the drivers gave written informed consent before providing a urine sample. In addition, a questionnaire concerning sociodemographic characteristics and health information was administered. Urine samples were screened for amphetamines, cocaine, and cannabinoids by immunoassay and the confirmation was performed using gas chromatography–mass spectrometry (GC–MS). Of the 488 drivers stopped, 456 (93.4%) provided urine samples, and 9.3% of them (n = 42) tested positive for drugs. Amphetamines were the most commonly found (n = 26) drug, representing 61.9% of the positive samples. Ten cases tested positive for cocaine (23.8%), and five for cannabinoids (11.9%). All drivers were male with a mean age of 40 ± 10.8 years, and 29.3% of them reported some health problem (diabetes, high blood pressure and/or stress). A high incidence of truck drivers who tested positive for drug use was found, among other reported health problems. Thus, there is an evident need to promote a healthier lifestyle among professional drivers and a need for preventive measures aimed at controlling the use of drugs by truck drivers in Brazil.

Introduction

In Brazil, traffic accidents are responsible for 35,000 deaths each year [1]. The traffic fatality rate increased from 17.5 per 100,000 inhabitants in 1994 to 20.3 per 100,000 in 2004, which demonstrates that the traffic accident burden in the country is an increasing public health issue [2]. The average cost of a traffic accident is estimated as US$5167, rising to US$52,942 in accidents resulting in injuries and as high as US$247,647 in those resulting in death [1]. Many factors are believed to contribute to road traffic accidents, including drug and alcohol abuse, fatigue and speed [3], [4]. Basic psychomotor and cognitive skills relevant to driving performance are impaired by most drugs of abuse. Freight transportation in Brazil is carried out predominantly on highways, which accounts for approximately 1,700,000 km of Brazilian roads [5]. Those transport routes are concentrated mainly in the southeastern region of the country where Sao Paulo, the largest and most developed state, is located. Approximately 93% of all final goods and services are transported along its 200,000 km of roads, which are also essential routes for the northern and southern regions, as well as for other Latin American countries [6]. To stay awake and maintain their extensive work schedule, Brazilian truck drivers report the use of amphetamines. Furthermore, they also point out that marijuana and cocaine are consumed during their workday [7]. For instance, amphetamines are easily obtained without prescription on Brazilian roads, and the consumption of these stimulants has been associated with serious health problems and traffic accidents. Although the consumption of psychoactive drugs by truck drivers is considered a great cause of concern in Brazil, the scientific evidence on this issue is still scarce. As such, an epidemiological study focused on these subjects that is based on toxicological analysis is a necessity.

Section snippets

Methods

The study was conducted on different highways in the State of Sao Paulo between March and November 2009. No specific day of the week was selected to collect samples. Large trucks (over 30 t) were randomly stopped by police officers on interstate roads during the morning. Out of 481 truck drivers stopped, 452 (94%) agreed to participate and provided urine samples after being informed of the goals of the study and signing a consent form. Additionally, they answered a simple questionnaire

Results

Among the 452 drivers who provided urine samples, 9.3% (n = 42) tested positive for drugs. Amphetamine was present in 5.8% (n = 26) of the total samples, cocaine in 2.2% (n = 10) and cannabis in 1.1% (n = 5). There was just one case with a combination of drugs, amphetamine and cocaine (0.2%) (Fig. 1). Methamphetamine was not detected in any sample.

When asked about the use of amphetamines to stay awake, 7.5% (n = 34) reported regular consumption (1–5 times per week) of amphetamine-based medicines, and

Discussion

The present study revealed a high consumption of psychoactive substances by truck drivers (9.3% positive samples), with values of 5.8% for amphetamines, 2.2% for cocaine and 1.1% for cannabis. These results were higher than those obtained by Silva et al., who stopped 728 truck drivers in three out of five of the major Brazilian geographical regions. These authors found 6.0% positive results in the Brazilian southeast region, where Sao Paulo state is located: 5.0% for amphetamines, 0.4% for

Conclusion

Unfortunately, epidemiological studies focused on drug abuse among drivers based on toxicological analysis are still scarce in Brazil. A higher frequency of positive test results for drugs of abuse was observed compared with a previously published similar study [12]. Truck drivers were also found to suffer from a number of health problems. Thus, there is a need to promote a healthier lifestyle among professional drivers, as well as a need for preventive measures aimed at controlling the use of

Acknowledgments

This study was supported by University of Sao Paulo Medical School (LIM 40/HCFMUSP) and by Brazilian Department of Federal Highway Police. The authors wish to thank Inspectors Sérgio Max Bastos Lins and João Bosco Ribeiro, as well as all the police officers involved in this study.

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