Drug‐Impaired Driving

Abstract

Driving is a very complex task, requiring the cooperation of several different cognitive and psychomotor functions at once. Experimental studies have shown that drugs can have a detrimental influence on capacities that are essential for driving. Cannabis, for example, can acutely reduce some cognitive and psychomotor skills, and these effects are mostly dose dependent. Some deleterious effects of cannabis appear to be additive or even synergistic with those of alcohol, and the combination of both substances results in a prolongation as well as enhancement of their effects. Epidemiological studies have shown that drugs are prevalent in 1–12% of the general driving population, in 6–50% of drivers who are injured or killed in traffic crashes, and in 55–99% of drivers who are suspected of driving under the influence of drugs. The most prevalent drug in most of these studies is cannabis. Drivers who are under the influence of drugs have a higher risk of being involved in or being responsible for a crash. Responsibility analyses show that driving under the influence of cannabis increases the risk of being responsible for an accident, and that this risk increases with increasing cannabis concentration in the blood, indicating a causal relationship between cannabis and crashes. Two major types of driving‐under‐the‐influence of drugs (DUID) legislation exist: “impairment” legislation and “ per se ” legislation. In impairment legislation, the prosecution must demonstrate that the driver was impaired, not fit to drive, or “under the influence”. A “ per se ” law prohibits driving if drugs are present in blood, serum, plasma, or oral fluid above a certain threshold concentration. Since the prosecution does not have to prove that the driver was impaired, this kind of legislation facilitates enforcement. In recent years, the interest in the use of oral fluid as biological matrix for roadside drug screening has increased significantly, as this matrix displays some particularly interesting properties. However the currently available on‐site oral fluid drug testing devices are not reliable enough to be recommended for roadside screening for drivers. Recent methods developed for confirmation analysis, either on blood or on oral fluid, use liquid chromatography (tandem) mass spectrometry (LC‐MS(MS)).

Drug Use and Road Traffic Injuries— Shots in the Dark

“…14,15 A comprehensive report by the European Monitoring Centre for Drugs and Drug Addiction (EMCDDA) estimated that 0.3%-1.3% of the general driving population drives a car under the influence of a combination of alcohol and drugs of abuse. 16 This is an alarming observation, Gayatri Bhatia 1 and Sahil Gupta 2…”

“…A comprehensive report by the European Monitoring Centre for Drugs and Drug Addiction (EMCDDA) estimated that 0.3%–1.3% of the general driving population drives a car under the influence of a combination of alcohol and drugs of abuse. 16 This is an alarming observation, since drivers who have used drugs are significantly more likely to be culpable for a fatal accident than nonusers, especially after using multiple drugs. 1 , 8 Possible factors contributing to increased reports of RTIs due to DRUID are a global increase in acceptance of recreational and experimental drug use, efficient identification by emergency services, and increased availability and usage of drug testing in hospital settings.…”

Detection of Some Drugs of Abuse From Fingerprints Using Liquid Chromatographymass Spectrometry

“…Screening test for the drugs of abuse was made using urine samples from all participants. The results of the urine screening tests appeared in the form of lines on the test cards (manufacture by abon biopharm company, China) to indicate the presence or absence of various substances (Raes and Verstraete, 2005).…”

The Effect of Lowering the Legal Drink‐Drive Limit on the Toxicological Findings in Driver Fatalities: A Comparison of Two Jurisdictions,

“…The role of alcohol as a major factor in motor vehicle crashes (MVCs) has been firmly established . Driving is a complex task, requiring the co‐operation of several different cognitive and psychomotor functions at once (psychomotor capability, physical space awareness, reaction times, etc. ), and drivers may be significantly impaired by the use of alcohol and/or other psychoactive substances .…”