RT Journal Article SR Electronic T1 Prescription medication use as a risk factor for motor vehicle collisions: a responsibility study JF Injury Prevention JO Inj Prev FD BMJ Publishing Group Ltd SP 324 OP 330 DO 10.1136/injuryprev-2020-043840 VO 27 IS 4 A1 Mark Asbridge A1 Kathleen Macnabb A1 Herbert Chan A1 Shannon Erdelyi A1 Maria Wilson A1 Jeffrey R Brubacher YR 2021 UL http://injuryprevention.bmj.com/content/27/4/324.abstract AB Introduction Previous studies on the effect of prescription medications on MVCs are sparse, not readily applicable to real-world driving and/or subject to strong selection bias. This study examines whether the presence of prescription medication in drivers’ blood is associated with being responsible for MVC.Methods This modified case–control study with responsibility analysis compares MVC responsibility rates among drivers with detectable levels of six classes of prescription medications (anticonvulsants, antidepressants, antihistamines, antipsychotics, benzodiazepines, opioids) versus those without. Data were collected between January 2010 and July 2016 from emergency departments in British Columbia, Canada. Collision responsibility was assessed using a validated and automated scoring of police collision reports. Multivariable logistic regression was used to determine OR of responsibility (analysed in 2018–2019).Results Unadjusted regression models show a significant association between anticonvulsants (OR 1.92; 95% CI 1.20 to 3.09; p=0.007), antipsychotics (OR 5.00; 95% CI 1.16 to 21.63; p=0.03) and benzodiazepines (OR 2.99; 95% CI 1.56 to 5.75; p=0.001) with collision responsibility. Fully adjusted models show a significant association between benzodiazepines with collision responsibility (aOR 2.29; 95% CI 1.16 to 4.53; p=0.02) after controlling for driver characteristics, blood alcohol and Δ−9-tetrahydrocannabinol concentrations, and the presence of other prescription medications. Antidepressants, antihistamines and opioids exhibited no significant associations.Conclusion There is a moderate increase in the risk of a responsible collision among drivers with detectable levels of benzodiazepines in blood. Physicians and pharmacists should consider collision risk when prescribing or dispensing benzodiazepines. Public education about benzodiazepine use and driving and change to traffic policy and enforcement measures are warranted.Data are available on reasonable request.