Drug-Related Car Crashes Not Affected by Rising Opioid Use in Maryland

Despite the fact that Maryland is facing a growing opioid epidemic, this has not translated to an increase in drug-related car crash fatalities involving drivers who have drugs in their system. This is according to a new report examining data from the state medical examiner. This means that the number of deaths remained roughly the same, despite an increase in opioid-addicted individuals.

“The fact that opioid crashes in Maryland over the last 10 years have been more or less steady was a surprise,” said Johnathon P. Ehsani, one of the report’s authors. “That is striking because Maryland is one of those states that has been quite severely affected by the overall opioid epidemic.”

The state medical examiner in Baltimore carried out the study with the help of researchers from Johns Hopkins Bloomberg School of Public Health and the University of Buffalo.

The study was made a bit more complicated by the fact that emergency crews often administered opioids, making it difficult to tell whether drivers already had opioids in their system before the crash. Autopsies, therefore, detected opioids in the systems of those who have died of their injuries. One of the most common opioids used by emergency personnel is the powerful painkiller Fentanyl.

In order to filter out those cases, the researchers had to focus on a smaller sample: a group of drivers who died at the scene. “In such cases, the likelihood of pain management is likely to be considerably lower than those who died hours or days following the crash,” the report said.

In 2017, the United States recorded more than 70,000 drug overdose deaths. Opioid overdoses made up nearly 68 percent of those. Maryland was among the 23 states singled out by the Centers for Disease Control as having statistically significant increases that year.

Ehsani says that their study is merely a part of a much bigger picture, and that is why opioid-related crashes have not increased significantly despite overall deaths being up in the state. “Our study is a single data point in a national phenomenon that we’re looking at.”

He suggests that there could be a number of factors involved. “It could be a number of things — and all of them are clouds,” he said. “It could be that a number of people who are impaired by opioids choose not to drive. It could be that there is some self-selection going on in that population or it could be that some of those who are most seriously impaired are unable to or don’t have access to a vehicle to drive.”

Ehsani said that earlier studies suggested that opioid-related crashes were increasing in many different parts of the country.

“We applied a stricter definition than our other colleagues did,” he said. “We were more conservative in our case definition. But my caution is to say that the jury is still out. We need to keep looking at this question and analyzing the data, and see truly in Maryland whether things are stable, and even if they are, how we can keep them that way.”

According to the report, the average person killed in an opioid-related crash in Maryland is white, male, and between the ages of 50 and 55. Meanwhile, women, African Americans, Asians, and Latinos are far less likely to be involved in such crashes. It also determined that people living in rural counties, such as on Maryland’s Eastern Shore, were more likely to die in opioid-involved crashes.

Ehsani emphasized that “in none of our crash deaths can we say that people were impaired. The definition is that opioids were present in their blood when a sample was taken.”

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