Risky driving behaviours among stimulant drug users and the role of aggression: findings from a national survey

Background and Aims Stimulant drug users have a greater prevalence of risky driving behaviour. This study aimed to assess how far this association remains after adjusting for aggressiveness. Design Cross‐sectional interview study assessing associations between measures of risky driving behaviours as outcomes, measures of stimulant drug use as predictors and a measure of aggressiveness as a covariate. Setting United States. Participants Data were drawn from wave 3 (2012–13) of the National Epidemiological Survey on Alcohol and Related Conditions (NESARC‐III) ( n  = 36 309 aged ≥ 18 years). Measurements Stimulant drug use, past‐year DSM‐5 stimulant use disorder, aggression and measures of risky driving were assessed using face‐to‐face interviews conducted using the Alcohol Use Disorder and Associated Disabilities Interview Schedule (AUDADIS‐5) and the Diagnostic and Statistical Manual of Mental Disorders, 5th edition (DSM‐5). Findings Overall, 2714 (8.3%) respondents indicated life‐time stimulant use, and 112 (0.3%) met criteria for past‐year DSM‐5 stimulant use disorder. More than 10% of ongoing stimulant users and one‐third of respondents with DSM‐5 stimulant use disorder reported stimulant‐specific driving under the influence of drugs (DUID) in the past‐year (both P  < 0.0001). Adjusted for demographics and independent of aggression, life‐time stimulant users reported increased likelihood of driving [adjusted odds ratio (aOR) = 3.00, 95% confidence interval (CI) = 2.63–3.42] or speeding under the influence of drugs (aOR = 3.39, 95% CI = 3.01–3.82) and licence revocation (aOR = 2.16, 95% CI = 1.87–2.50) (all P  < 0.0001). Past‐year DSM‐5 stimulant use disorder was associated with all outcomes (aOR = 5.48, 95% CI = 2.95–10.18 and aOR = 3.87, 95% CI = 2.23–6.70, respectively, all P  < 0.0001), except licence revocation (aOR = 1.72). Conclusions Stimulant use appears to be positively associated with risky driving behaviours after adjusting for aggressiveness.