Kazakhstani Drivers and Substance Abuse During COVID-19: A Study of Patterns and Disaster Readiness

<b>Background/Objectives</b>: The COVID-19 pandemic has significantly affected public health and social behavior, contributing to increased psychoactive substance (PAS) use due to social isolation, economic stress, and uncertainty. This study aims to assess the impact of the pandemic on alcohol, cannabinoid, and opioid consumption among drivers involved in road traffic accidents (RTAs) in Kazakhstan. Understanding these patterns is essential for improving public health policies and road safety measures during crises. <b>Methods</b>: This retrospective cross-sectional study analyzed medical records from the Digital System of Medical Examination, a national database of drivers involved in traffic accidents in Kazakhstan. This study included 157,490 anonymized records from 1 January 2019, to 31 December 2020, categorizing cases into pre-COVID-19 and COVID-19 groups on the basis of the first nationwide lockdown on 16 March 2020. Statistical analyses, including prevalence rates and relative changes, were conducted via SPSS 20, while spatial distributions were visualized via QGIS software. <b>Results</b>: An analysis of all the records revealed a 12.9% decline in traffic accidents during the pandemic, with male drivers predominating during both periods. The mean age of the drivers in the compared groups was 36. Alcohol and cannabinoid use significantly increased during the COVID-19 period by 3.71% and 11.51%, respectively. In contrast, opioid use declined by 10.00%, but the difference was not statistically significant. The greatest increase in positive alcohol tests among drivers was observed in the Atyrau (94.80%), Pavlodar (35.43%), and North Kazakhstan (31.02%) regions, and Atyrau also presented the greatest increase in cannabinoid-positive cases. <b>Conclusions</b>: The results indicate that the COVID-19 pandemic and related lockdown measures have affected PAS consumption patterns among drivers. These findings are crucial for informing policies and developing strategies to improve road safety during future public health emergencies.