The prevention of repeated driving while intoxicated: the opinion of narcologists on the effectiveness of indicators for assessing the condition of drivers during mandatory medical examinations

Introduction. Practicing narcologists point to the need to modernize the existing procedure for mandatory medical examination of drivers. The purpose of the study: identification of indicators (parameters) significant for a psychiatrist-narcologist to assess the condition of drivers during a mandatory medical examination related to the restoration of the right to drive a vehicle. Materials and methods. A survey of 120 psychiatrists and narcologists working in narcological dispensaries in Moscow. The results were processed using descriptive statistics methods. Results. Objective methods for diagnosing alcohol abuse are the most effective for a doctor to decide whether a driver is fit to drive a vehicle. The results of the chemical and toxicological examination and the data of the objective medical history are significant. Conclusion. In order to increase the effectiveness of the procedure for assessing the suitability of drivers to drive a vehicle, additional external inspection criteria must be introduced into the Procedure. The fact that a driver who had previously driven a vehicle while intoxicated voluntarily completed thematic preventive rehabilitation programs may become an additional tool for a doctor when making an expert decision based on the results of the mandatory medical examination procedure. 

1. Road Traffic Accidents in the Russian Federation in 2023: An Information and Analytical Review / K. S. Bakanov, P. V. Lyakhov, A. S. Aisanov, et al. – Moscow: FKU “National Center for Road Safety of the Ministry of Internal Affairs of Russia,” 2024–154 p.

2. Road Traffic Accidents in the Russian Federation in 2022: Information and Analytical Review / K. S. Bakanov, P. V. Lyakhov, A. S. Aisanov et al. – Moscow, FKU “National Center for Road Safety, Ministry of Internal Affairs, 2023– 150 p.

3. Masjakin A.V., Bedina I. A., Khartonenkova E.Yu., Sazonova A. S. and Bedina I. D. (2024). “Features of the Procedure for Assessing the Fitness to Drive a Vehicle of Drivers Who Were Previously Deprived of Their Rights for Driving While Intoxicated: A Qualitative Study.” Public Health, 2(4), 32–40, doi: 10.2104/2782 1676 2024 4 2 32 40.

4. Bedina I.A., Burtsev A. A., Kochetova T. V. (2022). Basic models of medical and psychological work to prevent repeated driving under the influence of alcohol (international experience). Psychology and Law, 12(1), 2–14. https://doi.org/10.17759/psylaw.2022120101

5. Burtsev A.A., Bakanov K. S., Bedina I. A. (2020). Review of world experience in vehicle licensing (Spain, Croatia). Narcology, 19(8), 56–63. https://doi.org/10.25557/1682–8313.2020.08.56–63.

6. Shport S.V., Klimenko T. V. Problematic aspects of mandatory medical examination to establish the presence (absence) of medical contraindications related to the use of psychoactive substances to driving a vehicle. Road safety. 2024; 4: 25–29.

7. Baggio S., Trächsel B., Rousson V. et al. Identifying an accurate self-reported screening tool for alcohol use disorder: evidence from a Swiss, male population-based assessment. Addiction. 2020; 115(3): 426–436. DOI: 10.1111/add.14864.

8. Fiorelli D. et al. Carbohydrate-Deficient Transferrin (CDT) as a Biomarker of Alcohol Abuse: A Retrospective Study of the Italian Drinking Trend among Drivers from 2016 to 2022. Toxics. 2023; 11(11):914. DOI: 10.3390/toxics11110914.

9. Porpiglia N.M. et al. New evidence of high association between carbohydrate deficient transferrin (CDT) and alcohol-related road traffic accidents. A retrospective study on 929 injured drivers. Forensic Sci Int. 2022; 340:111438. DOI: 10.1016/j.forsciint.2022.111438.

10. Porpiglia N.M., Bortolotti F. et al. CDT vs. GGT for the certification of the fitness to hold the driving license. A comparison based on the association of incremented values with the occurrence of alcohol-related road traffic accidents. Drug Alcohol Depend. 2021; 1;228:109088. DOI: 10.1016/j.drugalcdep.2021.109088.

11. De Bejczy A. Phosphatidylethanol (B-PEth) and other direct and indirect biomarkers of alcohol consumption. Int. Rev. Neurobiol. 2024; 175:313–344. DOI: 10.1016/bs.irn.2024.03.004.