Marijuana and alcohol use among injured drivers evaluated at level I trauma centers in Arizona, 2008–2014

Proportion of Injured Drivers Evaluated at Level I Trauma Centers Testing Positive for Marijuana — Arizona, 2008–2014 (N = 2590) [Display omitted] •During 2008–2014 in Arizona, 30,083 drivers were treated at level I trauma centers•14,710 had marijuana test results and 2590 were positive for marijuana•23,186 had alcohol results and 5266 drivers exceeded legal limit•Among marijuana-positive drivers, 42% tested positive for alcohol•Medical marijuana legalization associated with increase in marijuana positivity We examined marijuana and alcohol use trends among drivers aged ≥16 years evaluated at Level I trauma centers before and after Arizona legalized medical marijuana in April 2011. We conducted interrupted time series (ITS) analysis of urine drug screens for marijuana metabolites and blood alcohol concentration (BAC) data from the 2008–2014 Arizona State Trauma Registry. Among 30,083 injured drivers, 14,710 had marijuana test results, and 2590 were positive for marijuana; of these, 1087 (42%) also tested positive for alcohol. Among 23,186 drivers with BAC results, 5266 exceeded the legal limit for their age. Compared with prelaw trends (models if law had not been enacted), postlaw models showed small but significant annual increases in the proportions of drivers testing positive for either substance. By the end of 2014, the proportion of drivers testing positive for marijuana was 9.6% versus a projected 5.6% if the law had not been enacted, and the proportion of drivers with illegal BACs was 15.7% versus a projected 8.2%. When ITS was restricted to only substance-tested drivers, no significant differences were detected. Despite the small annual postlaw increases in the proportion of marijuana-positive drivers compared with the prelaw trend, alcohol-impaired driving remains a more prevalent threat to road safety in Arizona.