Alcohol, Drugs, and Impaired Driving

Forensic Science and Law Enforcement Issues

A. Wayne Jones, Jorg Morland, Ray H. Liu, A. Wayne Jones, Jorg Gustav Morland, Ray H. Liu

• Publisher: CRC Press
• Year: 2020
• ISBN:
  9781000048643
• Edition: 1
• Topic: Medicina
• Subtopic: Toxicología

Alcohol, Drugs, and Impaired Driving addresses many theoretical and practical issues related to the role played by alcohol and other psychoactive drugs on driving performance, road-traffic safety, and public health. Several key forensic issues are involved in the enforcement of laws regulating driving under the influence of alcohol and/or other drugs, including analytical toxicology, pharmacology of drug action, as well as the relationships between dose taken, concentration levels in the body, and impairment of performance and behavior. Our knowledge of drunken driving is much more comprehensive than drugged driving, so a large part of this book is devoted to alcohol impairment, as well as impairment caused by use of drugs other than alcohol.

For convenience, the book is divided into four main sections. The first section gives some historical background about measuring alcohol in blood and breath as evidence for the prosecution of traffic offenders. The important role of the Breathalyzer instrument in traffic-law enforcement, especially in Australia, Canada, and the USA is presented along with a biographical sketch of its inventor (Professor Robert F. Borkenstein of Indiana University) with focus on the man, his work and his impact. The second section discusses several issues related to forensic blood and breath-alcohol alcohol analysis as evidence for prosecution of traffic offenders. This includes how the results should be interpreted in relation to impairment and an evaluation of common defense challenges. Because most countries have adopted concentration per se laws, the main thrust of the prosecution case is the suspect's measured blood- or breath-alcohol concentration. This legal framework necessitates that the analytical methods used are "fit for purpose" and are subjected to rigorous quality assurance procedures. The third section gives a broad overview of the current state of knowledge about driving under the influence of non-alcohol drugs in various countries. This includes adoption of zero-tolerance laws, concentration per se statutes, and clinical evidence of driver impairment based on field sobriety tests and drug recognition expert evidence. The fourth section deals with epidemiology, enforcement, and countermeasures aimed at reducing the threat of drunken and drugged driving.

All articles have appeared previously in the international journal Forensic Science Review, but all are completely updated with current data, references, and the latest research on developments since the articles were published. This book contains a convenient collection of the best articles covering recommendations for blood and breath testing methods, public policy relating to such methods, and forensic and legal implications of the enforcement of measures to counter driving under the influence.

Use of Non-alcohol Drugs and Impaired Driving

IV

Driving Under the Influence of Non-alcohol Drugs Review of Earlier Studies^*

10

JØRG G. MØRLAND

Contents

10.1 Introduction

10.2 Methodological Issues

10.2.1 Controlled Experimental Studies

10.2.2 Analytical Epidemiological Studies (Allowing Traffic Accident Risk Evaluation)

10.2.3 Survey Studies (Descriptive Epidemiological Studies)

10.3 What Do We Know about Different Groups of Drugs and Traffic Safety?

10.3.1 Benzodiazepines and Related Drugs

10.3.1.1 Controlled Experimental Studies

10.3.1.2 Analytical Epidemiological Studies

10.3.1.3 Descriptive Epidemiological Studies

10.3.1.4 Conclusions

10.3.2 Cannabis

10.3.2.1 Controlled Experimental Studies

10.3.2.2 Analytical Epidemiological Studies

10.3.2.3 Descriptive Epidemiological Studies

10.3.2.4 Conclusions

10.3.3 Opioids

10.3.3.1 Controlled Experimental Studies

10.3.3.2 Analytical Epidemiological Studies

10.3.3.3 Descriptive Epidemiological Studies

10.3.3.4 Conclusions

10.3.4 Amphetamine and Related Drugs

10.3.4.1 Controlled Experimental Studies

10.3.4.2 Analytical Epidemiological Studies

10.3.4.3 Descriptive Epidemiological Studies

10.3.4.4 Conclusions

10.3.5 Antihistamines

10.3.5.1 Controlled Experimental Studies

10.3.5.2 Analytical Epidemiological Studies

10.3.5.3 Descriptive Epidemiological Studies

10.3.5.4 Conclusions

10.3.6 Antidepressants

10.3.6.1 Controlled Experimental Studies

10.3.6.2 Analytical Epidemiological Studies

10.3.6.3 Descriptive Epidemiological Studies

10.3.6.4 Conclusion

10.3.7 Summary

10.4 The Assessment of Drug Impairment

10.5 Roadside Detection of Non-alcohol Drugged Driving

10.5.1 Observation of Behavior

10.5.2 Drug Screening

10.6 Legislation

10.7 Non-alcohol Drugged Driving in Norway

10.8 Prevention

10.9 Further Research

10.10 Conclusions

Acknowledgments

References

10.1 Introduction

The negative role of alcohol in vehicular traffic has been recognized for a long time, as documented by epidemiological and experimental research in several countries (Borkenstein et al. 1974; Simpson 1986; Kerr and Hindmarch 1998). In spite of legal and other countermeasures to combat drunken driving, it still persists at an almost unacceptable level as demonstrated, for example, by a high recidivism rate for convicted drunken drivers in many countries (Brewer et al. 1994; Wells-Parker et al. 1995), and by high percentages of alcohol involvement in fatal crashes. In fact, the US National Highway Traffic Safety Administration estimated that 44% of fatal crashes in 1993 involved alcohol use (US National Highway Traffic Safety Administration 1994). The risk of causing a fatal car accident for a driver with a high blood alcohol level has been demonstrated to be greatly increased (Perrine et al. 1971; Borkenstein et al. 1974; Klebelsberg 1988; Sleet et al. 1989; Robertson and Drummer 1994).

During recent years, the problem of drugged driving (i.e., driving under the influence of non-alcohol drugs) has received considerable attention. In many countries the first studies in this field dealt with possible dangerous side effects which could occur during treatment with medicinal drugs in therapeutic doses (Seppala et al. 1979). As drug abuse and drug dependence problems developed in the United States and Europe, interest on illicit drug and abuse of medicinal drugs and traffic safety has increased. The Pompidou group of the European Council this year (1999) arranged a seminar on “Road traffic and illicit drugs.” In this seminar as well as from several reviews of the literature published in recent years (Hindmarch et al. 1991; Ferrara 1987; Albery et al. 1998; Moskowitz 1976; Seppala et al. 1979), it has been stated that our knowledge about drugged driving is less comprehensive than about drunken driving. Two main questions have frequently been discussed as the most important ones for any non-alcohol drug:

• To what extent will the use of a particular drug constitute a risk to traffic safety?

• To what extent do drivers on the roads use a particular drug which might constitute a traffic hazard?

In the following review I will first briefly discuss the methods available to answer these questions in Section 10.2. Then some results will be presented for the groups of drugs which have been studied, to an extent allowing some answers to the two main questions, in Section 10.3. This will be followed by sections briefly discussing assessment of drug impairment in practice, problems connected with the detection of potentially dangerous drugged driving and some legal issues. Finally, a short description of the situation in Norway, which has a very high detection rate of drugged drivers, will be given in addition to a discussion of prevention and future research issues in this field.

10.2 Methodological Issues

The information obtained with relevance to the first of the two main questions, “To what extent will the use of a particular drug constitute a risk to traffic safety?,” has originated from two major sources (Simpson and Vingilis 1992): (a) Controlled experimental studies and (b) Analytical epidemiological investigations.

10.2.1 Controlled Experimental Studies

This type of study comprises a series of different performance tests thought to be of importance for various aspects of the process of operating a car, as well as simulated driving and real driving under controlled conditions (Table 10.1). The idea behind the performance tests is that they should represent important mental and behavioral functions relevant to driving. Particular emphasis has been put on tests that measure sedation and drowsiness, divided attention, continuous perceptual-motor co-ordination, speed and accuracy of decision making, vigilance and short-term memory, to mention a few (de Gier and Vermeeren 1995; Vermeeren et al. 1993). It has also been pointed out that a battery of tests which are mutually independent should be used to characterize the effects of the drugs tested (Zacny 1995). Many drugs have so far been tested in experiments with single or combinations of various performance tests. Simulated driving experiments have not been conducted to the same extent. Simulators can be of two major types, interactive (wherein the driver has control of the speed and the path of the vehicle) and non-interactive (wherein the driver is only capable of making decisions, but cannot actually control the vehicle) (Irving 1988). Various levels of sophistication with respect to computer interface, robotics, and virtual reality applications a...