Аннотация:
Introduction. In Russia there is no legal regulation that allows the evaluation of the alcoholic intoxication as a result of the use of medications which have a warning about the possible effect on the ability to operate vehicles or mechanisms". Meanwhile, the judicial practice of rendering these decisions on the subject (presence or absence) of alcoholic intoxication is quite contradictory. The primary condition for such a judicial decision on the state of alcoholic intoxication are the established clinical indicators of intoxication, but the causal link between the latter and the possible side effects specified in the instructions for the use of the medicinal product detected in the biological object of the driver is not determined.
Relevance. The results of the study will give basis for evidence-based recommendations for subsequent use in the establishing of regulations to determine drivers’ alcoholic intoxication as a result of the use of medicinal products.
Aim is to determine the reliability of clinical indicators of drunkenness detected in drivers as part of the medical examination for alcoholic intoxication.
Methods. Epidemiological statistical solid survey of reports of medical examination for intoxication, drawn up in the medical examination room of the Moscow Research and Practical Centre of the Department of Public Health. Given the selection criteria, the study included 867 reports of "sober" drivers with negative breath tests for alcohol level and biological objects for psychoactive substances, including medicinal products. To conduct a study a form was developed containing the results data from the medical examination as well as information about the doctor who drew up the report. Double data input by independent operators was used to fill out the forms, which made it possible to create a statistically accurate database. Statistical analysis was performed using licensed IBM SPSS 25.0 software.
Results. Of the 867 sober drivers, only 9.7% were considered as not having signs of intoxication. In the vast majority of cases (90.3%), "sober" drivers were rated as having a moderate (76%) to significant (14.3%) alcohol intoxication profile. Accordingly, the reliability of detectable indicators of alcoholic intoxication in the terms of medical examination for the state of intoxication was less than 10%. The results of the analysis of the distribution in the reports of 17 clinical signs of intoxication specified in the order of the Ministry of Health of Russia from 18.12.2015 indicate that 3 or more of them are present in 739 acts (82.5%), which allows us to predict the driver’s license suspension for 85% of drivers whose biological samples will contain medicinal products with "possible effects on the ability to operate vehicles and mechanisms".
Discussion. The results of the study demonstrate that the suggested procedure for detecting the state of drunkenness in drivers as a result of the use of medications should contain legal, rather than clinical, criteria for drunkenness.
Conclusion. Performing further analysis of the database created in this study will highlight the sociodemographic characteristics of "sober" drivers as well as the evidence of possible patterns of distribution of alcohol intoxication indicators, taking into account the available data on doctors.
Ключевые слова:
medical examination, state of drunkenness, alcohol intoxication, narcotic intoxication, toxic drunkenness, driver intoxication, vehicle, medicinal product.