Evaluating the Trends and Impact of COVID-19 on Illicit Drug and Benzodiazepine Use in Drivers: A Retrospective Large-Scale Study Based on Oral Fluid Testing

The COVID-19 pandemic disrupted global drug markets, but consumption soon returned to pre-pandemic levels. Continuous monitoring of drug use trends is essential for effective public health responses. A total of 29,397 oral fluid specimens from roadside drug tests across Spain (January 2019–July 2024) were sent to the Toxicology Laboratory of the Institute of Forensic Sciences, University of Santiago de Compostela, for LC-MS/MS confirmation of on-site positives. Results were stratified into five periods to assess drug use trends and the impact of COVID-19. Over 90% of drivers were male, and 85% were under 45 years old. Overall, 69.9% of samples were positive for cannabis, 64.9% for cocaine, 13.7% for amphetamines, 10.6% for opiates, 6.5% for ketamine, 5.4% for methadone and 6.6% for benzodiazepines/zolpidem; 56.3% showed poly-drug use. Cannabis use was higher in men, while amphetamines and benzodiazepines were more frequent in women (p29000 drug-positive driver oral fluid samples was performed • Drug trends and patterns from 2019–2024 were analyzed, focusing on COVID-19 impact • Cannabis and cocaine were predominant, with simultaneous use of multiple drugs common • Cannabis, amphetamines and notably ketamine increased compared to prepandemic levels • Other drugs decreased over time, reaching their lowest frequency in the last period