Background: Road traffic crashes RTC  are the leading injury-related cause of death among people aged 15-44 years. A clear dose-effect relationship has been demonstrated for drugs and/or alcohol use and (RTC).
Aim:The objective of this study was to estimate the prevalence of drug and/or alcohol use in cases admitted for RTC to emergency departments in Port-said general hospitals.
Methods: In this study, conducted between January to December 2014, where 1200 cases of road traffic crashes of both sexes and their age were form  18 to 65 years were examined. Toxicological  screening  urine test was used to detect drugs by the emergency department staff using  enzyme linked Immunosorbent assay ELISA . Alcohol  and drug of abuse concentration was confirmed  from  blood samples at the central laboratory using Gas Chromatography Mass Spectrometry GC-MS .
Results: Most of the cases were males, drivers and under 40 years of age. It was found that 70% of RTC occurred during winter, 34% at the weekend; Friday and most  crashes (68%)  were caused by trucks. At the time of crashes alcohol was positive in 18.3% of cases, cannabis positive in 27.5%, tramadol in 47.5%, amphetamine in 8 %, cocaine in 1.25% ,while sedative hypnotics drugs were positive in only 1.92%.
Conclusion: The risk of road traffic crashes is greatly increased among  drivers who tested positive for alcohol, in particular, those who had also ingested tramadol  or more psychoactive drugs .
Recommendations: Planning and implementing a national RTC risk management  strategy for  prevention of mortalities and morbidities due to driving under the influence of drugs. Toxicological screening  should be done by immunoassay method  followed by confirmation by GC-MS method