A recent investigation indicates that the methods used for drug screening might not align with their possible effects on reporting to the RMV.
In 2010, Massachusetts revised its Safe Driving Law, which urged healthcare professionals to notify the state Registry of Motor Vehicles (RMV) if they had “reasonable cause to believe that a driver is not physically or medically fit to safely operate a motor vehicle.” In light of this legislation, trauma physicians at two academic medical centers in Boston established a reporting policy. This policy mandates that if a patient is admitted due to a serious car accident potentially linked to impaired driving, the attending trauma physician must report them to the RMV for possible license suspension.
A study conducted by researchers from Boston University Chobanian & Avedisian School of Medicine, Boston Medical Center, Tufts Medical Center, and UMass Memorial Medical Center has revealed that there may be inconsistencies in drug screening practices, which could impact RMV reporting.
Neil Singh Bedi, a fourth-year medical student at Boston University and the study’s corresponding author, states, “This inconsistency raises concerns about fairness and effectiveness in preventing impaired driving and highlights disparities in policy implementation. There is a clear need for standardized and equitable reporting procedures across hospitals.”
The team analyzed data from two major trauma centers to determine how frequently alcohol and drug screenings occurred following serious vehicle crashes. They linked hospital records with the Massachusetts RMV database to see if those reported had their licenses suspended. They then compared suspension rates among different groups to identify any inconsistencies or disparities.
The study found significant differences in toxicology and ethanol (EtOH) screening rates across trauma centers. Overall, 11.5% of patients did not undergo either urine or serum toxicology screenings, while 47% only had EtOH screening performed. Both screenings were conducted in 41% of patients, and only 1% had toxicology screening alone. While the rates of different screenings varied, there were no racial differences in the likelihood of receiving any screening, whether EtOH or toxicology.
Researchers suggest that all patients involved in serious motor vehicle collisions should have blood samples taken, and that serum EtOH and toxicology screenings should be included as standard practice, even if urine samples are not collected right away. “The significant variations in screening practices related to EtOH and toxicology pose challenges for analysis and present opportunities for improving initial trauma evaluations and emergency room screening,” Bedi notes.
These results have been published online in the journal Academic Emergency Medicine.
