Alcohol, illici d ugs and medicinal d ugs in a ally inju ed d i e s
in Spain be ween 1991and 2000
M. Ca men del Rı
´o
a
, Jose ina Go
´mez
b
, Manuel Sancho
b
,
F. Ja ie Al a ez
a,*
a
D ugs and Alcohol Resea ch G oup, Depa men o Pha macology and The apeu ics, Facul y o Medicine,
Uni e si y o Valladolid, 47005 Valladolid, Spain
b
Na ional Toxicological Cen e, Ins i u o Nacional de Toxicologı
´a, Mad id, Spain
Recei ed 9 Oc obe 2001; ecei ed in e ised o m 24 Ma ch 2002; accep ed 12 Ap il 2002
Abs ac
The aim o his s udy was o assess he p esence o alcohol, illici d ugs and medicinal d ugs among Spanish d i e s in ol ed
in a al oad acciden s be ween 1991 and 2000. Samples we e ob ained o 5745 d i e s killed in oad acciden s om Janua y
1991 o Decembe 2000. O he samples, 91.7% ep esen ed males and 8.3% emales; 40.7% we e unde 30 yea s o age, 31.9%
we e unde 31–50 yea s o age, 19.5% we e o e 51 yea s o age, and o 7.9% he age was unknown. Be ween 1991 and 2000,
some ype o psychoac i e subs ance was de ec ed among 50.1% o hose d i e s killed in oad acciden s, his being mainly
alcohol (43.8%) and, less equen ly, illici d ugs (8.8%) and medicinal d ugs (4.7%). In all he cases, in which alcohol was
de ec ed, combined use wi h o he subs ances accoun ed o only 12.5%, whils in he case o illici and medicinal d ugs, igu es
ep esen ing combined use wi h o he subs ances we e 75.6% o he o me and 65.8% o he la e . Fo one in e e y h ee cases
(32.0%), a blood alcohol le el o e 0.8 g/l was eco ded; cocaine (5.2%), opia es (3.2%) and cannabis (2.2%) we e he h ee
illici d ugs mos equen ly de ec ed. Among medicinal d ugs, we e benzodiazepines (3.4%), an i-dep essan d ugs (0.6%) and
analgesics (0.4%). The esul s show he equen p esence o psychoac i e subs ances, pa icula ly alcohol, among Spanish
mo o ehicle use s in ol ed in a al oad acciden s. I should be poin ed ou ha illici and medicinal d ugs in combina ion wi h
o he subs ances we e a common ea u e. #2002 Else ie Science I eland L d. All igh s ese ed.
Keywo ds: Alcohol; D ugs; Fa al inju ies; Medicinal d ugs; Road a ic acciden s; Spain
1. In oduc ion
Resea ch has shown ha alcohol impai s d i ing skills
and inc eases c ash isk [1]. Wi hin he Eu opean Union,
a e age yea ly oad a ic acciden s be ween 1991 and 1998
in ol ed 10,000 (21.3%), ou o he 47,000 a al acciden s,
ela ed o alcohol [2]. In he las yea s, esea ch has shown
ha illici d ugs and ce ain medicinal d ugs also impai
d i ing skills and can inc ease c ash isk [3,4]. The e o e, as
d ink-d i ing is dec easing in some coun ies, he ole
played by illici and medicinal d ugs has become he objec
o inc easing in e es [5,6].
In a ecen e iew [7,8], i was shown ha he p esence o
alcohol and d ugs among inju ed d i e s (36 and 19%,
espec i ely) and d i e s killed on he oads (31.7 and
16.3%, espec i ely) was a common ea u e. In he s udy
conduc ed by Gie [9] o he Pompidou G oup, Council o
Eu ope, and based on 13 Eu opean coun ies, ce ain in e -
es ing indings we e ob ained. Among he gene al d i e
popula ion, he p e alence o illici d ug use was in he ange
o 1–5%, while ha o medicinal d ugs ep esen ed 5–15%.
Among hose d i e s suspec ed o d i ing unde he in lu-
ence o d ugs, a high p e alence o medicinal d ugs was
epo ed (14–74%), while he p e alence o illici d ugs was
lowe (9–57% o cannabis, 8–42% o opia es and 1–20%
o amphe amines). Rega ding collision-in ol ed d i e s,
he p e alence o illici d ugs anged om 10 o 25% (in
a al oad acciden s) and, in he case o medicinal d ugs,
Fo ensic Science In e na ional 127 (2002) 63–70
*
Co esponding au ho . Tel.: þ34-983-423077;
ax: þ34-983-423022.
E-mail add ess: [email p o ec ed] a.es (F.J. Al a ez).
0379-0738/02/$ – see on ma e #2002 Else ie Science I eland L d. All igh s ese ed.
PII: S 0379-0738(02)00116-0
om 6 o 21%. The au ho [9] also poin ed ou he di i-
cul ies encoun e ed when compa ing he di e en s udies.
The e idence a ailable in Spain indica es ha alcohol
consump ion and use o o he psychoac i e subs ances a e
equen among mo o ehicle use s, and ha d i ing unde
he in luence o hese subs ances is equally cus oma y
[10,11]. Only in he las ew yea s has in o ma ion begun
o be a ailable abou he in ol emen o psychoac i e sub-
s ances in he incidence o a ic acciden s [12–14].
Cu en legisla ion in Spain s a es ha one may no d i e
unde he in luence o psychoac i e subs ances (illici d ugs
and medicinal d ugs) ha may al e he physical o men al
s a e in which one is i o d i e wi hou dange (Royal
Dec ee 13/1992). Likewise, maximum pe missible blood
alcohol le els among mo o ehicle use s ha e been es ab-
lished o se e al decades. On 7 May 1999, Royal Dec ee
2282/1998 became e ec i e, es ablishing blood alcohol
concen a ions and o malising es s on mo o ehicle use s,
as well as modi ying he legisla ion which had been in e ec
un il ha ime unde he Gene al D i ing Regula ions (Royal
Dec ee 13/1992). In acco dance wi h he new legisla ion,
mo o ehicle use s a e no allowed o d i e i hei blood
alcohol concen a ion is g ea e han 0.5 g/l (o 0.25 mg/l in
exhaled ai ). These limi s a e 0.3 g/l (0.15 mg/l in exhaled
ai ) o use s o ehicles in ended o anspo ing goods,
passenge s/school child en, haza dous goods, special ans-
po a ion, e c. as well as o any ope a o in he i s 2 yea s
a e ob aining a d i e ’s licence o pe mi [12,13].
In his s udy, we analyse he da a om he Na ional
Toxicological Cen e ega ding he p esence o subs ances
in mo o ehicle d i e s killed in oad acciden s. The aim is
o de e mine he ole ha alcohol, illici d ugs and medicinal
d ugs play in he incidence o a ic acciden s, as well as o
analyse hei e olu ion o e he las 10 yea s (1991–2000). A
p elimina y e sion was p esen ed a he ICADTS Con e -
ence in S ockholm [14].
2. Ma e ial and me hods
Samples om 5745 d i e s killed in oad acciden , om
Janua y 1991 o Decembe 2000, we e ob ained. Sample
dis ibu ion acco ding o yea was as ollows: 1991, 259;
1992, 250; 1993, 199; 1994, 244; 1995, 279; 1996, 383;
1997, 487; 1998, 1090; 1999, 1191; 2000, 1363. A o al o
91.7% (n¼5266) o he samples we e om males and 8.3%
(n¼479) om emales. As ega ds age ange, 10.0% (n¼
575) we e unde 20 yea s o age; 30.7% (n¼1763) we e
aged 21–30 yea s; 19.3% (n¼1107) we e aged 31–40 yea s;
12.6% (n¼726) we e aged 41–50 yea s; 8.9% (n¼511)
we e aged 51–60 yea s; 10.6% (n¼611) we e o e 60 yea s
o age; in he es o he cases 7.9% (n¼452), he age was
unknown.
The cases co espond o samples e e ed o he Na ional
Toxicological Cen e (Ins i u o Nacional de Toxicologı
´a) by
o ensic doc o s o as ins uc ed by he judge.
Blood samples we e analysed o alcohol (e hanol) by
Head-Space Gas ch oma og aphy) [12–14]. All samples
we e also sc eened o he p esence o d ugs o he han
alcohol (medicines and illici d ugs) by immunological o
ch oma og aphic me hods when app op ia e. The cu -o
le els o he i s sc eening we e: opia es 300 ng/ml; cocaine
me aboli e 150 ng/ml; cannabinoids 20 ng/ml; amphe a-
mines 300 ng/ml; benzodiazepines 200 ng/ml.
Posi i e esul s a e sc eening we e con i med by means o
gas ch oma og aphy–mass spec ome y (GC–MS), and con-
cen a ions o psychoac i e d ugs o me aboli es we e de e -
mined [12–14]. In he case o opia es, amphe amines and
cocaine, he cu -o le els o he GC–MS con i ma ion es
we e in he selec ed ion moni o ing mode (SIM) 50 ng/ml,
and 10 ng/ml in he case o cannabis. Posi i e esul s we e
con i med by GC–ni ogen–phospho us lame-ionisa ion
de ec ion (GC–NPFID) o benzodiazepines (cu -o 0.1 mg/
ml) and o he analgesic d ug dipy one (cu -o 1 mg/ml).
Subs ances o he han alcohol we e classi ied in wo
g oups: illici d ugs and medicines. In he i s g oup,
ca ego isa ion in o he ollowing g oups was es ablished:
opia es, cocaine, cannabis, amphe amines, syn he ic d ugs
(ecs asy) and hallucinogenic d ugs. In he second g oup,
di e en sub-g oups we e es ablished, in acco dance wi h
he Ana omical The apeu ic Chemical classi ica ion sys em.
The analy ical esul s we e exp essed as ollows: (i) no
subs ance de ec ed, o (ii) some ype o subs ance de ec ed.
Once a subs ance had been de ec ed, samples we e classi ied
in he ollowing g oups: (i) alcohol alone, (ii) alcohol plus
medicinal d ugs, (iii) alcohol plus illici d ugs, (i ) alcohol
plus medicinal d ugs plus illici d ugs, ( i) illici d ugs alone,
( ii) medicinal d ugs alone, ( iii) illici d ugs plus medicinal
d ugs.
Calcula ion was made o he pe cen age e e ing o he
cases in which alcohol, medicinal d ugs and illici d ugs, as
well as hei possible combina ions, we e ound. Fo alcohol,
cases in which blood alcohol concen a ion was equal o, o
o e 0.8 g/l, and equal o, o o e 0.5 g/l o 1999 and 2000,
we e shown.
Be ween 1991 and 2000, 59,071 people we e killed in
oad acciden s in Spain (Fig. 1). The smalles numbe o
dea hs occu ed in 1996 (5483) and he la ges numbe in
1991 (6797). Wi hin ha pe iod o ime, he Spanish popula-
ion changed om 38.9 million inhabi an s in 1991 o 39.5
million inhabi an s in 2000. As shown in Fig. 1, he numbe
o d i e s in hose yea s inc eased g adually om 16.9
million in 1991 o 21.4 million in 2000. This was due o
he g adual inc ease in he numbe o women ob aining a
d i ing licence. Consequen ly, in 1991, 31 ou o e e y 100
d i e s we e women, whe eas, in 2000, he numbe was 35
ou o e e y 100.
Da a analysis was conduc ed in he Da a P ocessing
Cen e a Valladolid Uni e si y. S a is ic analysis was by
means o SAS so wa e e sion 6.12 (SAS Ins i u e SAS).
An analysis o a iance es (ANOVA) was employed. P-
alues <0.05 we e conside ed o be signi ican di e ences.
64 M. Ca men del Rı
´o e al. / Fo ensic Science In e na ional 127 (2002) 63–70
3. Resul s
A o al o 5745 blood samples we e aken om he 59,071
d i e s killed in oad acciden s be ween 1991 and 2000. Tha
is o say ha he p esence o subs ances was analysed in only
9.7% o a al oad acciden cases. Howe e , his pe cen age
inc eased g adually om 3.8% in 1991 o 23.8% in 2000
(Fig. 1).
As demons a ed in Fig. 2, in 50.1% o cases some psy-
choac i e subs ance, mainly alcohol (43.8%), was de ec ed
and, o a lesse ex en , illegal d ugs (8.8%) and medicines
(4.7%). These h ee pe cen ages exceeded 100%, since
se e al o hese subs ances could be ound in jus one case.
The mean o subs ances de ec ed in posi i e cases is 1:19 
0:52 (mean S:D:), a ying acco ding o he p esence o
alcohol, illici d ugs o medicinal d ugs (F¼720:62,
P<0:0001).
3.1. Alcohol
In alcohol-de ec ed cases (n¼2517, 43.8%, Fig. 2),
alcohol alone was p esen in he majo i y (n¼2195,
38.2%, Fig. 2; 87.5% o all alcohol-de ec ed cases). Alcohol
combined wi h d ugs was much less common (n¼230,
Fig. 1. E olu ion o he numbe o d i e s, o oad acciden ic ims, and analyses o a ali ies in Spain be ween 1991 and 2000.
Fig. 2. P esence o subs ances among d i e s in ol ed in a al oad acciden s, Spain, 1991–2000.
M. Ca men del Rı
´o e al. / Fo ensic Science In e na ional 127 (2002) 63–70 65
4.0%), ollowed by alcohol and medicinal d ugs (n¼68,
1.2%), and alcohol, d ugs and medicinal d ugs (n¼24,
0.4%). The mean o subs ances de ec ed in hose cases in
which alcohol was p esen was 1:13 0:37 (mean S:D:).
Be ween 1991 and 2000, in 32.0% (n¼1836) o all
cases, blood concen a ion was highe han 0.8 g/l ( he legal
limi un il 6 May 1999); in o he wo ds, in nea ly one in
e e y h ee cases he concen a ion le el was highe han ha
pe mi ed by law. In 1999 and 2000, in 29.8% (n¼355) and
32.6% (n¼444) o he cases, espec i ely, blood concen-
a ion was ound o be o e 0.5 g/l ( he legal limi es ab-
lished om 7 May 1999).
3.2. Illegal d ugs
Be ween 1991 and 2000, a leas one illegal d ug was
de ec ed in 8.8% (n¼504) o he people killed in oad
acciden s. In mos cases, illegal d ugs and subs ances o he
han alcohol we e de ec ed: in 4.0% (n¼230) oge he wi h
alcohol, in 1.2% (n¼67) wi h medicinal d ugs, and in 0.4%
(n¼24) wi h alcohol and medicinal d ugs (Fig. 2). Tha is o
say, ha in 63.7% (321 ou o 504) o all he cases in which
an illegal d ug was de ec ed, alcohol and/o medicinal d ugs
we e also p esen . Mo eo e , wi h ega d o he cases in
which only illegal d ugs we e ound (n¼183; 3.2%), a
leas wo illici d ugs we e de ec ed in combined use in 60 o
he 183 cases. In o he wo ds, wo o mo e subs ances we e
ac ually p esen in 75.6% (381 ou o 504) o he cases in
which illici d ugs we e ound. The mean o subs ances
de ec ed in cases in which one illegal d ug appea ed was
1:86 0:62, and his was highe han when alcohol was
de ec ed (F¼1236:15, P<0:001) o medicinal d ugs
(F¼6:21, P<0:01).
An analysis o he d ugs de ec ed shows ha cocaine was
he mos common (n¼300, 5.2%) ollowed by opia es
(n¼186, 3.2%), cannabis (n¼127, 2.2%), amphe amines
(n¼67, 1.2%) and designe d ugs (n¼33, 0.6%).
We analysed in g ea e de ail he cases in which cocaine
was de ec ed (n¼300), as i happened o be he mos
common d ug ound. As shown in Fig. 3, in 82% o he
cases, cocaine was p esen wi h some o he subs ance. In
mo e han hal o he cases cocaine was de ec ed oge he
wi h alcohol (54.3%). Besides, cocaine was commonly
ound wi h o he illici d ugs (39.7%). The p esence o
cocaine wi h medicinal d ugs was less equen (17.3%).
Thei possible combina ions appea in Fig. 3.
3.3. Medicines
Be ween 1991 and 2000, medicines we e de ec ed in
4.7% (n¼269) o he cases. As o he p esence o o he
subs ances in combina ion wi h medicines, in 59.1% (159
ou o 269) o he cases in which medicines we e ound,
alcohol and/o illegal d ugs we e p esen (Fig. 2). In 18 ou
o he 110 cases in which only medicines we e de ec ed, wo
o mo e medicines we e p esen . Tha is o say, ha in eali y
Fig. 3. P esence o cocaine among Spanish d i e s in ol ed in a al oad acciden s, Spain, 1991–2000.
66 M. Ca men del Rı
´o e al. / Fo ensic Science In e na ional 127 (2002) 63–70
wo o mo e subs ances we e de ec ed in 65.8% (177 om
269) o he cases in which some medicine was ound. The
mean o subs ances de ec ed in cases in ol ing some med-
icinal d ug was 1:74 0:60, g ea e han when alcohol was
de ec ed (F¼564:96, P<0:001) and lowe when illici
d ugs we e ound (F¼6:21, P<0:01), as was men ioned
abo e.
Benzodiazepines ep esen ed he mos commonly
de ec ed g oup o medicines (n¼196, 3.4%), ollowed in
dec easing o de by an i-dep essan s (n¼33, 0.6%), analge-
sics (n¼26, 0.4%), an i-epilep ic d ugs (n¼18, 0.3%),
ba bi u a es (n¼15, 0.3%), H-1 an i-his amines (n¼15,
0.3%), asodila o s (n¼9, 0.15%), calcium an agonis s
(n¼8, 0.14%), an i-heme ic d ugs (n¼1, 0.01%) and
an i-psycho ic d ugs (n¼1, 0.01%).
As in he case o illegal d ugs, we ha e analysed mo e
ca e ully he cases in which benzodiazepines we e de ec ed
(n¼196), as his d ug was he one mos commonly aced.
As may be obse ed in Fig. 4, in 72.4% o cases, benzo-
diazepines we e de ec ed oge he wi h some o he sub-
s ance, mainly illegal d ugs (41.3%) and alcohol (33.7%),
and less equen ly, wi h o he medicines (14.8%).
4. Discussion
This s udy shows ha he p esence o subs ances (50.1%)
in Spanish d i e s killed in a ic acciden s and om whom
blood samples we e aken and analysed o alcohol and o he
d ugs is by no means negligible. Al hough alcohol is he
mos commonly de ec ed subs ance, he p esence o illici
and medicinal d ugs canno be igno ed ei he . Rega ding
alcohol, i should be poin ed ou ha i was equen ly
de ec ed (43.8%), and ha i was o en o e 0.8 g/l
(32.0%). In cases in which illegal d ugs (8.8%) and med-
icinal d ugs (4.7%) we e de ec ed, i is no ewo hy ha in
mos cases hese we e ound alongside o he subs ances
(75.6 and 65.8%, espec i ely), wi h cocaine (5.2%) and
benzodiazepines (3.4%) being he subs ances mos com-
monly aced in ela ion o illici and medicinal d ugs.
In a p e ious s udy [12,13], conduc ed on 259 Spanish
d i e s killed in a ic acciden s be ween 1994 and 1996
( andomly selec ed and o no legal pu pose), a leas one
ype o subs ance was de ec ed in 60.0% o he cases,
alcohol in 50.5% (0.8 g/l in 35.4%), illici d ugs in
10.2% and medicinal d ugs in 9.1%. These igu es a e
highe han hose obse ed in he p esen s udy be ween
1991 and 2000.
Ou indings show a high le el o psychoac i e sub-
s ances in oad acciden ic ims. Ne e heless, we belie e
ha hese igu es mus be iewed wi h cau ion, since he
numbe o d i e s killed in whom subs ances we e de ec ed
is e y low (9.7% o oad dea hs). How can his be
explained? Up o 1996 (B.O.E. 23/XII/1996, pp. 38203–
38221) es ing o alcohol (o o he d ugs) was no a o mal
equi emen in Spain. As a esul , he numbe o oad
Fig. 4. P esence o benzodiazepines among Spanish d i e s in ol ed in a al oad acciden s, Spain, 1991–2000.
M. Ca men del Rı
´o e al. / Fo ensic Science In e na ional 127 (2002) 63–70 67

acciden ic ims analysed o alcohol (o o he d ugs) was
e y low. In ac , his si ua ion was e e ed o colloquially
as he ‘widow synd ome’: ha is o say, no in e es was
shown as o whe he he ic im was unde he in luence o
alcoholo no ;i wasp e e ed ha heinsu ancecompa-
nies paid he amilies o he ic ims and he inciden s we e
o go en. Consequen ly, he e was always he suspicion
ha ha es s o blood alcohol (and o he d ugs) concen-
a ion we e ca ied ou only in cases in which he ic im
showed clea signs o being unde he e ec o alcohol.
Since 1996, he yea in which he law came ou , es ing o
alcohol has inc eased signi ican ly(3.8%in1991asagains
23.8% in 2000), which enhances he us wo hiness o
hese indings.
Conce ning alcohol, al hough compa ison wi h da a om
o he coun ies should be ca e ully conduc ed, he igu es
obse ed in ou s udy we e among he highes . In he UK
[15], da a accumula ed om 1990 o 1994 e ealed ha in
45.5% o dea hs alcohol was de ec ed, and ha his exceeded
0.8 g/l in 20.25% o he ic ims. Recen da a om 1997 [16]
e eals ha alcohol o e 0.8 g/l was de ec ed in 23% o all
ic ims. Alcohol has been equen ly de ec ed in I aly
(49.0%) [17], in F ance (45:7%>0:7 g/l) [18] and in Bel-
gium (28% o e 0.49 g/l) [19], whils igu es o he No dic
coun ies (Sweden: 27% [20] and 20.3% [21], No way:
28.3% [22]) a e conside ably lowe , pe haps as a esul o
he ac ha in hese coun ies he e exis s a e y s ic policy
wi h ega d o d inking and d i ing. High igu es ha e also
been eco ded o Canada (48%) [23] and some a eas o he
USA (46%) [24–27], whe eas in Aus alia igu es a e lowe
(36%) [28]. Dec easing ends o d inking and d i ing ha e
been obse ed in some indus ialised coun ies like he USA
[27].
The p esence o illici d ugs (8.8%) and medicinal d ugs
(4.7%; 11.9% i we conside he p esence o bo h illici and
medicinal d ugs), is lowe han ha men ioned in p e ious
e iews [7–9] analysing published s udies on oad acciden
ic ims. He e igu es o 16.3% [7,8] ha e been quo ed when
conside ing a combina ion o illici and medicinal d ugs, 10–
25% o illici d ugs, and 6–21% in he case o medicinal
d ugs [9]. Al hough he p esence o illici and medicinal
d ugs is much less common han ha o alcohol, hei
impo ance should no be unde es ima ed [5,6].
As ega ds he di e en kinds o illegal d ugs encoun-
e ed, in s udies ca ied ou in a ious coun ies [7,8], he
mos commonly ound d ugs ha e been cannabis (7.6%),
ollowed by opia es (3.1%), amphe amines (1.8%) and
cocaine (0.5%). The si ua ion among Spanish d i e s killed
in oad acciden s is comple ely di e en : cocaine is he mos
equen ly de ec ed d ug (5.2%), 10.5 imes mo e common
han he mean de ec ed in o he s udies [7,8], whils cannabis
was ound 3.45 imes less equen ly (2.2%). As ega ds
opia es (3.2%) and amphe amines (1.2%; 1.8% i hey a e
conside ed alongside designe d ugs), equencies a e simi-
la . We can ind no explana ion o his g ea e equency o
cocaine wi h espec o cannabis. Al hough consump ion
equency o he di e en d ugs may a y be ween coun ies,
d ug- aking pa e ns a e no so di e en among Spania ds
han among o he Eu opean Union ci izens o hese changes
o be accoun ed o . Cannabis is he mos equen ly used
subs ance in he Eu opean Union [29].
Benzodiazepines we e he mos commonly de ec ed med-
icinal d ugs (3.4%), albei wi h no ably less equency, and
his—despi e he ac ha he use o benzodiazepines is
pa icula ly common in ou coun y in ela ion o o he
indus ialised coun ies [30]—co esponds wi h p e ious
s udies (8.5%) [7,8].
An impo an poin is ha in mos cases in ol ing
de ec ion o illici d ugs (75.6%) and medicinal d ugs
(65.8%), a leas one o he subs ance was ound alongside
hem; howe e , alcohol was de ec ed oge he wi h ano he
subs ance in only 12.5% o cases. This accoun s o he
high a e age o subs ances de ec ed in cases in which some
ype o illegal d ug (1.86) and medicinal d ug (1.74) was
ound in ela ion o alcohol (1.13). The p e alence o
mul iple subs ances (alcohol, illici d ugs, medicinal d ugs)
used in combina ion is equen ly epo ed in mos o he
s udies [7–9,21,23,24]. The combina ion o a ious sub-
s ances may b ing abou an inc eased isk o in ol emen in
oad acciden s [5,6].
D i e, c ash and inju y cha ac e is ics among alcohol
and/o d ug posi i e cases in oad a ic ic ims has been
analysed in p e ious s udies [21,22]. D i e s who es ed
posi i e o alcohol and/o d ugs we e mo e likely o be
in ol ed in single ehicle c ash han hose who es ed
nega i e. In he p esen s udy, in o ma ion ega ding c ash
cha ac e is ics was no a ailable. We assume ha he p esen
esul s ep esen an unspeci ied combina ion o single and
mul iple ehicle acciden s.
The igu es obse ed in his s udy be ween 1991 and 2000
e eal ha subs ances a e egula ly ound in ic ims o oad
acciden s in Spain. Se e al ecen epo s ha e made a
de ailed analysis o possible in e en ion and ecommenda-
ions bo h in he a ea o d inking and d i ing [6,31–33] and
in ha o d ugs (illici and/o medicinal) and d i ing
[5,6,34,35]. D ink-d i ing and d ugs-d i ing ha e o be
ackled in an in eg a ed and mul idisciplina y way, wi h
he inclusion o a leas s ic e en o cemen , oughe punish-
men , ehabili a ion schemes, and con inuous public educa-
ion and publici y.
In ou coun y, d inking alcohol o ms pa o many
people’s daily and social li e, and g ea ole ance and
pe missi eness exis wi h ega d o alcohol, he eby making
in e en ion in his a ea a he di icul . Howe e , a g ea
e o is being made wi h ega d o p e en i e policies,
including, as men ioned ea lie , he educ ion o he legal
limi .
The p esen s udy shows how widesp ead alcohol con-
sump ion is and e eals he high concen a ion le el o his
subs ance in he blood o a ally inju ed d i e s. Al hough
he p esence o illici and medicinal d ugs is less equen ,
hey should, none heless, no be dismissed as unimpo an .
68 M. Ca men del Rı
´o e al. / Fo ensic Science In e na ional 127 (2002) 63–70
Cocaine and benzodiazepines a e, espec i ely, he mos
equen illici and medicinal d ugs de ec ed. As epo ed
p e iously [12], alcohol is he main p oblem in a ic
a ali ies in Spain, he eby making i necessa y o in ensi y
e o s and o se up speci ic p og ams o educe d inking and
d i ing, while also cla i ying he ole o d ugs o he han
alcohol in a ic acciden s.
Acknowledgemen s
Suppo o his s udy was p o ided by he Na ional Plan
on D ugs (Delegacio
´n del Gobie no pa a el Plan Nacional
sob e D ogas) and he Na ional T a ic Agency (Di eccio
´n
Gene al de T a
´ ico), Home O ice (Minis e io del In e io ),
Mad id, Spain, as well as he Conseje ı
´adeSanidady
Bienes a Social, Jun a de Cas illa y Leo
´n, Valladolid,
Spain. We also hank Inmaculada Fie o o he echnical
suppo .
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