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

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

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

A study published today in the Journal of Alcohol and Drug Studies concludes that “drug-related cycling injuries are an important public health problem”.

Researchers at the University of Arkansas reviewed data from the National Electronic Injury Surveillance System for 2019-2020. Of those treated in emergency departments across the United States for bicycle injuries, researchers found that more than 11,000 had used drugs. This is more than 2% of the total number of people treated for cycling injuries during this period.

The researchers say these cyclists also tended to have more serious injuries. The majority were fractures or damage to internal organs. Nearly a third had to be hospitalized.

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

Researchers noted that almost a quarter of injured cyclists had alcohol in their system.

They said the injured cyclists were mostly white males and between the ages of 25 and 44. The injured were less likely to cycle for exercise. Some may have lost their license due to a previous impaired driving conviction and could not 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, study co-author and professor of public health at the University of Arkansas at Fayetteville.

“This is a population that is often overlooked and ignored when it comes to serious injuries from bicycle crashes,” Dr. Hammig told Healthline.

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

However, she says most of the findings aren’t that surprising.

Yafai notes that methamphetamine use is increasing among homeless populations.

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

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

Yafai said it was unclear whether the crash victims were using alcohol in addition to drugs. It was also unclear whether the people using marijuana were in states that allow recreational use.

As a cannabis supplier, Yafai says her patients are usually seriously ill, most too sick to drive or ride a bike, and she gives them instructions on how to use it.

“Patients who come to seek my help do not use it for recreational purposes. About 99% of them have cancer, dementia, Parkinson’s disease, cerebral palsy, autism or developmental delays,” she explained. “They are often in wheelchairs or in very serious situations. We are talking about dose, frequency and intoxication.

The researchers concluded that prevention is necessary, but could prove difficult. This is something they will investigate further.

“Better and easier access to transportation for people who use bicycles as their primary mode of transportation is needed to help prevent injuries in the population,” Hammig said.

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

“In addition to injury treatment, medication referral systems should be easily accessible in emergency departments,” he noted.

” It’s doable. Screening for substance use disorders can take place in [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 so simple.

“If they’re actively intoxicated and you’re giving them instructions on how to stop using or abusing, that’s not taken into account very often,” she said.

“Most of these patients have been treated and discharged, which means your opportunity to educate is actually very small,” she added. “And if people aren’t interested, then they’ll throw away your instructions before they even walk through the door. It is reality.

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

Yafai suggests that public awareness campaigns like those on drunk driving could be helpful.

“’Driving while buzzing is drunk driving…It’s a great campaign and it made a good point. We could do some things in that direction,” she added.