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Experts say bicycling under the influence can result in serious injury. Henrik Trygg/Getty Images
  • Researchers are calling drug-related bicycle accidents a “significant public health issue.”
  • They report that cyclists in these crashes tend to have more serious injuries.
  • The most common drug detected in these accidents was methamphetamine, followed by cannabis.
  • Experts say prevention programs are needed to educate cyclists about the use of drugs and bicycle safety.

The potential dangers of driving under the influence of alcohol or drugs have been the target of public service announcements for years.

But what about bicycling under the influence? Chances are you haven’t heard as much about that, even though there are indications it may be a bigger problem than you think.

A study published today in the Journal of Studies on Alcohol and Drugs concludes that “drug-related bicycle injuries are a significant public health issue.”

Researchers at the University of Arkansas looked at data from the National Electronic Injury Surveillance System for 2019-2020. Of the people treated in emergency departments in the United States for bicycle injuries, the researchers found that more than 11,000 had been using drugs. That’s more than 2% of the total number of people treated for bike injuries in that time period.

The researchers say those cyclists also tended to have more serious injuries. The majority were fractures or internal organ injuries. Nearly a third had to be admitted to the hospital.

The most common drug detected in the crash victims was methamphetamine (36%), followed by cannabis (30%) and opioids (18%).

The researchers noted that nearly a quarter of the injured cyclists had alcohol in their system.

They said the injured cyclists were mostly white, male, and between ages 25 and 44. The injured were less likely to be cycling for exercise. Some may have lost their license because of a previous DUI conviction and couldn’t drive a car.

“In the context of the population most affected by these injuries, they likely have substance use disorder, may be more likely to be homeless, and may not have access to other forms of transportation,” said Bart Hammig, PhD, MPH, a study co-author and a professor of public health at the University of Arkansas at Fayetteville.

“This is an often overlooked and ignored population when addressing serious injuries related to bicycle crashes,” Dr. Hammig told Healthline.

“I think it’s an interesting study. I’m glad someone’s paying attention to this” said Dr. Sherry Yafai, an emergency medicine physician at Saint John’s Physician Partners Urgent Care in Santa Monica, California.

However, she says most of the conclusions are not that surprising.

Yafai notes that methamphetamine use is surging among homeless populations.

And she says doctors see the role alcohol plays in these crashes.

“We do see a lot of alcohol-related accidents. That’s across the board for almost all these types of injuries, more than isolated marijuana,” she told Healthline.

Yafai says it wasn’t clear if the crash victims were using alcohol along with the drugs. It also wasn’t clear whether the people using marijuana were in states that allow recreational use.

As a cannabis provider, Yafai says her patients are those who are usually seriously ill, most too ill to drive or ride a bicycle, and she instructs them on usage.

“Patients who come seeking my assistance are not using it for recreational purposes. About 99 percent have cancer, dementia, Parkinson’s, cerebral palsy, autism, or developmental delays,” she explained. “They are often in wheelchairs or really severe situations. We talk about dose, frequency, and intoxication.”

The researchers concluded that prevention is needed but might prove difficult. It’s something they will investigate further.

“Better and easier access to transportation for persons who may use bicycles as their main mode of transportation is needed in order to aid in the prevention of injuries among the population,” Hammig said.

He said the efforts to get people into treatment need to start in the emergency department.

“In addition to the treatment of injuries, drug referral systems need to be readily accessible in emergency departments,” he noted.

“This is workable. Screening for substance use disorders can take place in the [emergency department] and may help prevent repeat visits for similar or other injuries associated with drug use or abuse” Hammig explained.

But Yafai said making referrals from the emergency room may not be that simple.

“If they’re actively intoxicated and you give them directions on how to stop using or abusing, it’s not very often met with any sort of consideration,” she said.

“Most of those patients were treated and released, which means your opportunity to educate is actually very little,” she added. “And if people aren’t interested, then they’re gonna throw away your instructions before they even hit the door. That’s the reality.”

“That’s not where we’re gonna capture people’s attention” she added. “And you’re putting another level of responsibility on the emergency department and staff that are typically already overwhelmed and understaffed.”

Yafai suggests that public awareness campaigns like those for drunk driving might help.

“‘Buzzed driving is drunk driving… That’s a great campaign and it made a good point. We could do some things along that line” she added.