Objectives To carry out comprehensive analysis of available Road Traffic Crash data from various sources to estimate alcohol and psychoactive substance related Road Traffic Injuries in Pakistan and to analyse Police road traffic accident recording system to know constrains which lead to underreporting of alcohol and psychoactive substance related Road Traffic Injuries in Pakistan

Methods Road Traffic Accident Data of National Highways and Motorways Police and Road Traffic Injury Research and Prevention Centre was used for estimating alcohol and psychoactive substance related Road Traffic Injuries in Pakistan and injury surveillance system of National Highways and Motorways Police was analysed to know the constrains which result in underreporting of alcohol and psychoactive related road traffic crashes in Pakistan.

Result Surprising, alcohol or any psychoactive substance has not been attributed as a cause of road traffic crash in both the dataset, which shows high level of underreporting mainly due to absence of relevant field in the road accident reporting system, restrictions in prosecuting drunk and psychoactive drivers and deficient Police training and capability to check drunk or driving under influence of psychoactive substance.

Conclusion There is either little or no understanding of issue of alcohol or psychoactive active related road traffic injuries in Pakistan due to which drunk or drugged driving has not been reported by National Highways and Motorways Police or Road Traffic Injury Research and Prevention Centre.