Five-year trend analysis of drug use among individuals 16 years of age and older injured in non-fatal motor vehicle crashes in the US.

Objective: To examine the prevalence of drug use among individuals (age 16+) injured in non-fatal motor vehicle crashes (MVCs) from 2019 to 2023 and assess regional differences based on US Census regions (i.e., West, Midwest, Northeast, and South), and thereby contribute to a comprehensive understanding of drug-related MVCs.

Methods: We examined emergency medical services data from 19 US states (January 2019 to December 2023) to determine the annual mean drug use prevalence among individuals (age 16+) injured in non-fatal MVCs. Differences in drug use prevalence were assessed using ANOVA with the Tukey-Kramer test for year-to-year comparisons. Adjusted Poisson regression models with random effect for states were used to compare trends to the baseline (i.e., 2019) and to assess regional differences.

Results: Among individuals (age 16+) injured in non-fatal MVCs, 62,310 had reported drug use. ANOVA results showed significant year-to-year differences in the prevalence of drug use among individuals injured in non-fatal MVCs, with an increase from 2019 to 2020 and a subsequent decrease from 2020 to 2023 (p < 0.05). Compared to the baseline year of 2019, the prevalence in 2020 was 1.34 times (95% confidence interval [CI]: 1.12, 1.61) the prevalence in 2019. The prevalence in 2022 and 2023 were similar to the 2019 prevalence. Although no significant associations were found between US regions and the overall mean prevalence from 2019 to 2023; there was a difference in the average annual rate of change in prevalence by region, with a 4.0% lower rate in the Midwest compared to the Northeast (p < 0.001). This signifies a need to monitor future trends for potential regional differences.

Conclusions: Drug use prevalence among individuals (age 16+) injured in non-fatal MVCs increased from 2019 to 2020; then decreased to levels reflecting baseline prevalence in 2019; with no significant regional differences in the overall mean crash-related drug use prevalence. These findings highlight the need for continuous surveillance across the US over an extended period. They also underscore the potential impact of environmental risk factors, such as the COVID-19 pandemic, and the necessity to monitor how drug use prevalence related to non-fatal MVCs changes in the coming years.