Isabelle Richer

Driving under the influence of cannabis: Links with dangerous driving, psychological predictors, and accident involvement

Driving under the influence of cannabis (DUIC) has become a growing concern. Studies investigating the impact of DUIC on traffic safety have shown evidence that, during the acute period of cannabis intoxication, cannabis diminishes driving faculties and is associated with an elevated risk of collision. However, DUIC drivers seem to exhibit a general reckless driving style that may contribute to an over-estimation of DUIC-related collisions among this group. In this study, we investigated DUIC drivers with respect to self-reported dangerous driving habits (e.g., risky driving, aggressive driving and negative emotional driving), behaviours observed in a driving simulator, psychological predictors and crash involvement. Results suggest that DUIC is associated with self-reported and observed risky driving and negative emotional driving. We also found that sensation seeking and impulsivity are independent psychological predictors of DUIC. Finally, a trend suggests that self-reported DUIC is associated with an increased risk of being involved in a car accident, after controlling for dangerous driving and demographic variables. Implications for interventions are discussed.

Differentiating risky and aggressive driving: Further support of the internal validity of the Dula Dangerous Driving Index

The Dula Dangerous Driving Index (DDDI) is a cross-cultural validated instrument that measures simultaneously various manifestations of behaviours, cognitions, and affects associated with dangerous driving. The aims of the study were to translate the DDDI into French and then to verify the validity and reliability of the French version of the scale by means of observed behaviours on a driving simulator, and of self-reported measures of driving behaviours, personality and sociodemographic characteristics. A first sample of 395 drivers completed self-reported questionnaires and a second sample of 75 male drivers also completed tasks on a driving simulator. A confirmatory factorial analysis supported the internal validity of the scale. Findings also show that the French version of the DDDI yields good internal consistency, concomitant and convergent validity for each subscale (risky driving, negative cognitive/emotional driving and aggressive driving) and total score. The scale was useful to differentiate sociodemographic and psychological profiles associated with each subscale.

Temporal changes in risk factors associated with Hiv seroconversion among injection drug users in eastern central Canada

Objectives:To investigate temporal trends in HIV incidence rates and to assess changes over time in associated risk factors. Methods:Since 1995, the SurvUDI network has conducted surveillance among IDUs recruited in harm reduction programmes in eastern central Canada. Among the 11 731 participants, 2903 repeaters were initially HIV-negative. HIV incidence was calculated and compared for two time periods (1995–2002 vs. 2003–2009). Multivariate Cox proportional hazard models with time-dependent covariates were used to assess risk factors associated with HIV seroconversion. Interactions between covariates and time periods were examined. Results:The overall HIV incidence rate was 2.7 per 100 person-years [95% confidence interval (CI) 2.4–3.1]. It significantly decreased from 3.1 per 100 person-years in 1995–2002 to 2.2 person-years in 2003–2009. Sex, needle borrowing, and cocaine as most often injected drug were independent and stable determinants of HIV seroconversion. Age, daily injection, sex work and being recruited in an urban area showed significant interactions with time. Being aged 25 years and older, injecting daily and being recruited in an urban area predicted HIV incidence in 1995–2002 but were no longer risk factors in 2003–2009. HIV incidence increased significantly among younger IDUs and sex work emerged as a new determinant of HIV incidence in 2003–2009. Conclusion:HIV incidence has decreased over time but remains high among IDUs in eastern central Canada. Associations between risk factors and HIV incidence have changed. Further research is needed to better understand HIV transmission among younger IDUs and IDU sex workers.

Assessing Covariates of Drug Use Trajectories Among Adolescents Admitted to a Drug Addiction Center: Mental Health Problems, Therapeutic Alliance, and Treatment Persistence

This study aimed to assess covariates of drug use trajectories among 102 adolescents admitted to a drug user treatment program between November 2005 and November 2006 in Québec, Canada. The influences of mental health, therapeutic alliance, and treatment persistence were examined. The Addiction Severity Index was used to measure drug use severity and mental health problems; the California Psychotherapy Alliance Scales was used for therapeutic alliance. latent growth curve analysis showed associations between (1) mental health and initial drug use severity; (2) therapeutic alliance and initial drug use severity; and (3) number of post-treatment sessions attended and drug use severity over time.

A prospective cohort study of non-fatal accidental overdose among street youth: The link with suicidal ideation

INTRODUCTION AND AIMS Drug overdose and suicide are the two leading causes of death among street youth. The literature discusses the two faces of drug overdose: accidental act and suicide attempt. Some authors have stated that accidental overdoses may be a hidden expression of suicidal ideation. This study longitudinally examined the relationship between recent suicidal ideations and non-fatal accidental drug overdoses among street youth. DESIGN AND METHODS Between July 2001 and December 2005, 858 street youth (14-23 years old) were recruited for a prospective cohort study. Youth were eligible if, in the previous year, they had been without a place to sleep more than once or had used the services of street youth agencies on a regular basis (≥3). Participants completed baseline questionnaires and follow-up interviews were carried out every 6 months. Mixed-effect logistic regression models were conducted. Apart from suicidal ideation and accidental drug overdose, variables considered in the model were age, sex, problematic alcohol use, homelessness, injection drug use and polydrug use (≥3 drugs). RESULTS Accidental drug overdose was significantly associated with suicidal ideation (adjusted odds ratio 1.88; 95% confidence interval 1.23-2.54). Homelessness, injection drug use and polydrug use were also significant in the final model. DISCUSSION AND CONCLUSIONS Results show that, during follow up, suicidal ideation independently increased risks of accidental overdose. They also underscore the need for interventions beyond educational prevention. Primary care practitioners should investigate suicidal ideations and behaviours of street youth in treatment for accidental overdose.