risk of crashes increases also during the initial implementation of antidepressant medications and when dosing changes are initiated. To exacerbate the problem, many patients erroneously believe they are exempt from impaired driving laws when they are taking medications according to a physician’s prescription.
presence of impairing drugs in their bodies at the time of their crash. Of the subjects analyzed, over 27 percent showed the pres- ence of at least one impairing drug in their system. In addition, the Rocky Mountain High Intensity Drug Trafficking Area released a study in 2013 showing the ef- fects of “medical-marijuana” on Colorado’s impaired-driving fatality statistics. In 2013, Colorado voters passed a law permiting recreational marijuana, yet they had previ- ously permited medicinal marijuana for nearly a decade. During a nine-year period, traffic deaths experienced an overall decline of 16 percent, a feat few states can achieve. However, during this same period when traffic deaths were waning, the incidence of marijuana-impaired driving deaths increased by 114 percent.1
Similar results
should be anticipated for other states that relax prohibitions of marijuana among the driving population. But marijuana-impaired driving is not
the sole drug problem plaguing the safety of our nation’s highways. Some studies indicate benzodiazepine usage and driving can be even more dangerous. According to a study published in Accident Analysis and Prevention, the “motor vehicle crash risk for benzodiazepine users was 60–80 percent higher than for nonusers.”2
Te 22 datia focus
Tackling the Problem: the DRE Program Tese reports have atracted the atention of both NHTSA and the White House and have led to changes in highway safety fund- ing that trickles down to the states from the federal government. Drug-impaired driving has been identified at unacceptable levels, and, according to the Office of National Drug Control Policy strategy, “Preventing Drugged Driving Must Become a National Priority on Par with Preventing Drunk Driving.”3
Tere are many efforts employed
to prevent drug-impaired driving: the Drug Evaluation and Classification Program (DECP) spearheads these efforts by training law enforcement officers to detect and gath- er evidence to prosecute these offenders. Te DECP, oſten referred to as the Drug
Recognition Expert (DRE) program, was de- veloped in 1979 in Los Angeles in response to a growing trend in drug-impaired driving in that locale. Prior to the DECP, arrestees sus- pected of drug-impaired driving were brought to a medical professional for a diagnosis of drug intoxication. As most driving under the influence (DUI) cases tend to occur in the late night and early morning hours, the only medical facility available during the time of the arrest was an emergency room that oſten had higher priority life-saving measures to perform and might have litle time to help provide important evidence for a suspected drug-impaired driver. In addition, subsequent legal proceedings would also require court ap- pearances by the diagnosing medical profes- sionals. Consequently, though the service was noble, many physicians became reluctant to continue to provide these forms of diagnoses.
Te DUI enforcement officers and prosecu- tors had to contend with acquitals and the dismissal of charges for lack of evidence. Drug-impaired drivers were slipping through the system unscathed. Two officers from the Los Angeles Police
Department began to research the physi- ological signs and symptoms associated with impairment by particular drugs of abuse and compiling the clinical indica- tors that were commonly associated with impairment from these drugs. Drugs were filtered through their observable effects rather than through the ailments they were designed to remedy. A method was developed to adequately assess important physical atributes of potentially impaired subjects and render a valid opinion as to their sobriety and likely causes of impair- ment. Te research was a success.
Testing the Testers Two studies were conducted to assess the reliability of a law enforcement program that could identify drug impairment and classify a drug category as the likely culprit. First, a double-blind study was conducted at Johns Hopkins University, followed by a field study conducted in Los Angeles. Te Johns Hopkins study, conducted in 1984, was destined to carry the greatest cred- ibility in the clinical field. Subjects were provided a pill to be taken orally and were also to inhale 12 puffs of a marijuana ciga- rete. Participants received either a placebo (which could be both oral pills and/or marijuana cigaretes); a low or high dose of a stimulant; a low or high dose of a depres- sant; or a low or high dose of cannabis.4 Ethical considerations, however, limited the amount of drugs provided to the study participants. Furthermore, to adhere to the scientific method, DREs participating in the study had to perform a modified evalu- ation that minimized or eliminated rater subjectivity. Despite these hardships, DREs demonstrated remarkable accuracy in predicting impairment among high-dosed
summer 2014
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