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Powerful Connections This session on drug-impaired driving in the - - PDF document

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75TH ANNUAL JPs/Clerks Class: Justices of the Peace Drug-Impaired Driving and Constables Association Education Conference Isla Grand Beach Resort Thursday, June 27, 2019 South Padre Island June 24-28, 2019 3:15 5 p.m. Ms. Amber

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Powerful Connections

75TH ANNUAL

Justices of the Peace and Constables Association Education Conference

Isla Grand Beach Resort South Padre Island June 24-28, 2019

JPs/Clerks Class: Drug-Impaired Driving

Thursday, June 27, 2019 3:15–5 p.m.

  • Ms. Amber Trueblood

Assistant Research Scientist Texas A&M Transportation Institute Crash Analytics Program

This session on drug-impaired driving in the U.S. and Texas will provide an overview of the problem, including important statistics. In addition, the session will examine the most commonly detected drugs involved in fatal crashes.

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Dr. Amber Trueblood, Assistant Research Scientist, Texas A&M Transportation Institute, Crash Analytics Program, College Station

  • Dr. Amber Trueblood is trained and has experience

in environmental,

  • ccupational

and injury

  • epidemiology. She also has extensive experience in

project management, data management, data analysis and computing, and education and

  • utreach. Dr. Trueblood is involved in a multitude
  • f projects with a variety of tasks, ranging from

crash analyses to educational outreach efforts. Her interest areas are in injury prevention, specifically impaired driving crashes. She has a doctoral degree in epidemiology and environmental health, a master’s public health degree in behavioral science and health promotion and a bachelor’s in sociology.

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Drug-Impaired Driving in the United States and Texas

Amber Trueblood, DrPH,MPH Jena Prescott, MPSA

Presentation Foreword

  • The magnitude and effects of drugs on driving depends on:
  • Substance
  • Combination of substances
  • Dose
  • Extent of prior use
  • “A large enough dose of most drugs can impair. The purpose of

any drug is to affect physical or mental conditions in some way. Even prescription medications can impair driving.”- GHSA

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Drug-Impaired Driving Background

Drug-Impaired Driving: United States

  • Difficult to measure magnitude of drug-impaired driving
  • There is no good roadside test for drug levels
  • Police often do not test for drugs if there is enough evidence
  • f a DUI-alcohol
  • Polydrug use
  • Limited data available on drugged driving
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Drug-Impaired Driving: United States

  • 2013-2014 NHTSA Roadside Survey of Alcohol and Drug Use
  • Drugs present in 22% of drivers on weekend nights and

weekday days had drugs in their system

  • Weekend Surveys

Drug Category Percent of Samples 2013‐ 2014 Percent of Samples 2007 Difference Illegal Drugs 15.1% 12.4% 2.7% Marijuana 12.6% 8.6% 4.0% Medications 4.9% 3.9% 1.0%

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Drug-Impaired Driving: United States

  • 2013-2014 NHTSA Roadside Survey of Alcohol and Drug Use
  • 20% of drivers reported using a prescription drug within the

past 2 days

0.0% 0.5% 1.0% 1.5% 2.0% 2.5% 3.0% 3.5% 4.0% 4.5% 5.0% 5.5% 6.0% 6.5% 7.0% 7.5% 8.0% 8.5% Sedatives Antidpressants Narcotics Stimulants

Drug-Impaired Driving: United States

  • Fatality Analysis Reporting System (FARS)
  • Drugs present in 43% of fatally-injured drivers with a known

test result in 2015

  • There were 49,549 drivers who tested positive for a drug

from 2008-2015

5,422 5,500 5,946 6,096 6,572 6,540 6,640 6,833 1,000 2,000 3,000 4,000 5,000 6,000 7,000 8,000 2008 2009 2010 2011 2012 2013 2014 2015

Number of Drivers with Positive Drug Test, 2008‐2015

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Most Common Drug Types Detected: United States

Year Total Drivers Positive Drug Test Drug Type Cannabinoid Stimulant Depressant Narcotic

  • No. Of

Drivers (% of Total) With alcohol (%)

  • No. Of

Drivers (% of Total) With alcohol (%)

  • No. Of

Drivers (% of Total) With alcohol (%)

  • No. Of

Drivers (% of Total) With alcohol (%)

2008 5,422 1,982 (37%) 720 (36%) 1,310 (24%) 445 (34%) 1,138 (21%) 308 (27%) 1,065 (20%) 246 (23%) 2009 5,500 1,956 (36%) 748 (38%) 1,243 (23%) 421 (34%) 1,216 (22%) 324 (27%) 1,181 (21%) 254 (22%) 2010 5,946 2,110 (35%) 805 (38%) 1,254 (21%) 418 (33%) 1,452 (24%) 376 (26%) 1,307 (22%) 286 (22%) 2011 6,096 2,055 (34%) 742 (36%) 1,256 (21%) 384 (31%) 1,379 (23%) 339 (25%) 1,380 (23%) 275 (20%) 2012 6,572 2,369 (36%) 803 (34%) 1,324 (20%) 412 (31%) 1,404 (21%) 330 (24%) 1,400 (21%) 291 (21%) 2013 6,540 2,413 (37%) 848 (35%) 1,494 (23%) 422 (28%) 1,492 (23%) 377 (25%) 1,385 (21%) 274 (20%) 2014 6,640 2,577 (39%) 826 (32%) 1,512 (23%) 427 (28%) 1,422 (21%) 357 (25%) 1,321 (20%) 265 (20%) 2015 6,833 2,805 (41%) 828 (30%) 1,622 (24%) 389 (24%) 1,476 (22%) 321 (22%) 1,440 (21%) 254 (18%)

Drug-Impaired Driving: Texas

  • From 2010-2016, there were 4,953 fatalities due to drug-

impaired crashes in Texas

763 648 709 682 708 686 757 580 600 620 640 660 680 700 720 740 760 780 2010 2011 2012 2013 2014 2015 2016

Number of Fatalities Due to Drug‐Impaired Crashes, 2010‐2016

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Most Common Drug Types Detected: Texas

Year Stimulant Cannabinoid Depressant Narcotic 2010 275 271 241 115 2011 222 222 149 123 2012 255 273 174 121 2013 272 243 153 113 2014 280 256 135 102 2015 306 267 154 76 2016 376 309 164 111 Total 1,986 1,841 1,170 761

Stimulants and Driving

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Stimulants

  • Medicines or drugs that increase

alertness, attention, and energy

  • Amphetamines
  • Adderall
  • Methamphetamine
  • Cocaine
  • Methylphenidate
  • Ritalin

Stimulants

  • Effects
  • Increased alertness
  • Increased attention
  • Increased blood pressure
  • Increased heart rate
  • Increased breathing
  • Decreased ability to focus
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Stimulant Use

  • Adults are prescribed more stimulants than youth
  • Stimulant prescriptions in adults increased 6.4 fold from 1995

to 1998

  • Youth increased by 2.5 fold
  • Women take more stimulants compared to men

Stimulant’s Impact on Driving

Impacts motor and cognitive skills Reduces ability to focus Reduces balance and coordination Over‐ confidence in driving skills Increased risk taking

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Marijuana and Driving Marijuana

  • Marijuana or Cannabis are the dried leaves, flowers, and stems

from the Cannabis sativa and Cannabis indica plants

  • Delta-9-tetrahydocannabinol (THC)
  • Weed, Grass, Bud, Kush
  • Effects:
  • Problems with memory
  • Problems with learning
  • Distorted perception
  • Difficulty in thinking
  • Loss of coordination
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Legalization Status, By State

Marijuana Use

  • Marijuana is the most commonly used illicit drug in the United

States

  • Marijuana use is increasing over time
  • Marijuana use among drivers exceeds the rate of alcohol use

among drivers

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Marijuana’s Impact on Driving

  • Recent marijuana use approximately doubled one’s risk
  • f traffic crash
  • Marijuana use impairs:

Road tracking Brake latency Ability to gauge time and distance Recognition of lights Divided attention tasks Ability to pass Inhibitory control Ability to maintain headway

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FARS: United States Cannabinoid Positive Drivers, by Gender and Age

Year Total Gender Age Group Male Female 16 to 24 yrs. 25 to 34 yrs. 35 to 44 yrs. 55 yrs.

  • r
  • lder

2008 1,982 1,659 322 863 571 617 112 2009 1,956 1,636 320 853 556 636 131 2010 2,110 1,731 378 890 644 606 170 2011 2,055 1,728 327 866 638 640 176 2012 2,369 1,975 393 1,019 745 703 223 2013 2,413 2,009 402 947 825 712 255 2014 2,577 2,156 421 1,039 849 817 249 2015 2,805 2,350 454 1,094 987 836 313

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Depressants and Driving

Depressants

  • Psychoactive drugs that slow down the activity of the central

nervous system

  • Alcohol
  • Barbiturates (Barbs, Phennies, Birds, Reds)
  • Benzodiazepines (Bars, Candy, Downers, Tranks)
  • Sleep Medications (Ludes, Roofies)
  • Heroin
  • Inhalants
  • Ketamine
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Depressants

  • Effects
  • Feel relaxed
  • Reduced alertness
  • Reduced heart rate
  • Reduced breathing
  • Drowsiness
  • Dose and mixing more than one depressant can impact your

ability to move and breath.

Depressant Use

  • Limited Trend Data
  • Benzodiazepine
  • From 2006 to 2015 the annual dose per inhabitant per

day (DID) increased by 26%

  • 23.70 to 94.25 DID
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Depressant’s Impact on Driving

  • Depressant’s Impair:

Reaction Times Concentration Ability to Process Information Ability to Multitask

Opioids and Driving

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Opioids

  • Opioids are a class of drugs found in the opium poppy plant to

relax the body and relieve pain.

  • Effects:
  • Problems with memory
  • Problems with learning
  • Distorted perception
  • Difficulty in thinking
  • Loss of coordination

Opioid Use

  • Opioid prescription rate is three

times higher than it was in 1999

  • 58 opioid prescriptions per

100 Americans in 2017

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Opioid’s Impact on Driving

Impacts psychomotor and cognitive functioning Increases errors on driving tasks Drowsiness

Polydrug Use and Driving

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Polydrug Use

  • Using two or more drugs in combination
  • Using one drug to counteract the effects of another
  • Using drugs at different times over a short period of days or

weeks

  • Includes alcohol, illegal drugs, prescription drugs, and over-the-

counter medicines

  • Alcohol is the most common drug involved in polydrug use

Polydrug Use

  • 23.1% of people used three or

more prescriptions in the past 30 days in 2017

  • 11.9% of people used five or

more prescription drugs in the past 30 days in 2017

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Polydrug Use and Driving

Risk Level Relative Risk Drug Category Slightly increased risk 1‐3 Marijuana Medium increased risk 2‐10 Benzodiazepines Cocaine Opioid Highly increased risk 5‐30 Amphetamines Multiple drugs Extremely increased risk 20‐200 Alcohol together with drugs Extremely increased risk 40* Alcohol *adapted from Shulze et al., 2012; Griffiths, 2014; GHSA A Guide for States

Solutions and Summary

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Summary

  • While alcohol-impaired driving is decreasing, drug-impaired

driving crashes are increasing

  • Drugs can impact driving ability and increase crash risk
  • Effects of drugs vary widely across drug categories

Potential Solutions

  • High-visibility enforcement
  • Policies
  • Per Se Drug Laws
  • Zero Tolerance Laws
  • Alcohol and drug court
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FARS Limitations

  • Not all drivers involved in fatal crashes are drug tested
  • Reporting of toxicology results to FARS varies
  • Testing varies by state
  • A positive drug test result does not indicate the driver was

impaired at the time of the crash

  • FARS does not indicate that the number of fatal crashes

involving a driver positive for cannabinoids has increased, but instead supports the number of drivers who tested positive for cannabinoids reported to FARS has increased

Jena Prescott

J-Prescott@tti.tamu.edu 979-862-1525

Amber Trueblood

A-trueblood@tti.tamu.edu 979-845-7606

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Recommended Resources

  • NHTSA Drug-Impaired Driving
  • GHSA’s report Drug-Impaired Driving: Marijuana and Opioids

Raise Critical Issues for States

  • GHSA’s report Drug-Impaired Driving: A Guide for States, 2017

Update

  • Drugged Driving AAA Foundation
  • Countermeasures Against Prescription and Over-the-Counter

Drug-Impaired Driving

References

1. Adrian, M. (2015). What the History of Drugs Can Teach Us About the Current Cannabis Legalization Process: Unfinished Business. Substance use & misuse, 50(8-9), 990-1004. 2. Anderson, B. M., Rizzo, M., Block, R. I., Pearlson, G. D., & O'Leary, D. S. (2010). Sex differences in the effects of marijuana on simulated driving performance. Journal of psychoactive drugs, 42(1), 19-30. 3. Alcohol and Drug Foundation. Drugs and Driving. Available at: https://adf.org.au/insights/drugs-and- driving/ 4. Asbridge, M., Hayden, J. A., & Cartwright, J. L. (2012). Acute cannabis consumption and motor vehicle collision risk: systematic review of observational studies and meta-analysis. Bmj, 344, e536. 5. Asbridge, M., Poulin, C., & Donato, A. (2005). Motor vehicle collision risk and driving under the influence of cannabis: evidence from adolescents in Atlantic Canada. Accident Analysis & Prevention, 37(6), 1025-1034. 6. Attwood, D., Williams, R., McBurney, L., & Frecker, R. (1980). Cannabis, alcohol and driving: Effects on selected closed-course tasks. Alcohol, Drugs, and Traffic Safety, 3, 938-953. 7. Azofeifa, A., Mattson, M. E., & Lyerla, R. (2015). Driving under the influence of alcohol, marijuana, and alcohol and marijuana combined among persons aged 16–25 years: United States, 2002–2014. MMWR, 64(48), 1325-9. 8. Barnett, G., Licko, V., & Thompson, T. (1985). Behavioral pharmacokinetics of marijuana. Psychopharmacology, 85(1), 51-56. http://dx.doi.org/10.1007/bf00427321 9. Battistella, G., Fornari, E., Thomas, A., Mall, J. F., Chtioui, H., Appenzeller, M., ... & Giroud, C. (2013). Weed or wheel! FMRI, behavioural, and toxicological investigations of how cannabis smoking affects skills necessary for driving. PloS one, 8(1), e52545.

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References

11. Bech, P., Rafaelsen, L., & Rafaelsen, O. (1973). Cannabis and alcohol: Effects on estimation of time and

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12. Berning A., Compton R., Wochinger, K. Results of the 2013-2014 National Roadside Survey of Alcohol and Drug Use by Drivers; Available at: https://www.nhtsa.gov/sites/nhtsa.dot.gov/files/812118- roadside_survey_2014.pdf 13. Bosker, W. M., Kuypers, K. P., Theunissen, E. L., Surinx, A., Blankespoor, R. J., Skopp, G., . . . Ramaekers, J.

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17.

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18. Dott, A. B. (1972). Effect of marihuana on risk acceptance in a simulated passing task. 19. Fatality Analysis Reporting System. Available at: https://www.nhtsa.gov/research-data/fatality-analysis- reporting-system-fars 20. Fergusson, D. M., Horwood, L. J., & Boden, J. M. (2008). Is driving under the influence of cannabis becoming a greater risk to driver safety than drink driving? Findings from a longitudinal study. Accident Analysis & Prevention, 40(4), 1345-1350. 21. Galski, T., Williams, J. B., & Ehle, H. T. (2000). Effects of opioids on driving ability. Journal of pain and symptom management, 19(3), 200-208.

References

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https://www.ghsa.org/resources/DUID18

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https://www.ghsa.org/sites/default/files/2017-07/GHSA_DruggedDriving2017_FINAL_revised.pdf

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References

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33.

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34.

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staging.net/About-NHTSA/Traffic-Techs/current/Relative-Risk-Calculated-For-Driver-Fatalities-In-Alcohol%E2%80%93Related-Crashes 35. O'Kane, C. J., Tutt, D. C., & Bauer, L. A. (2002). Cannabis and driving: a new perspective. Emergency medicine, 14(3), 296-303. 36. Ramaekers, J., Moeller, M., van Ruitenbeek, P., Theunissen, E., Schneider, E., & Kauert, G. (2006). Cognition and motor control as a function of Δ9-THC concentration in serum and oral fluid: Limits of impairment. Drug And Alcohol Dependence, 85(2), 114-122. http://dx.doi.org/10.1016/j.drugalcdep.2006.03.015 37. Reed, J. (2016). Marijuana Legalization In Colorado: Early Findings. 38. Robbe, H. W. J. (1994). Influence of marijuana on driving (Doctoral dissertation, Maastricht university). 39. Romano, E., & Voas, R. B. (2011). Drug and Alcohol Involvement in Four Types of Fatal Crashes*. Journal of studies on alcohol and drugs, 72(4), 567-576. 40. Ronen, A., Chassidim, H. S., Gershon, P., Parmet, Y., Rabinovich, A., Bar-Hamburger, R., ... & Shinar, D. (2010). The effect of alcohol, THC and their combination on perceived effects, willingness to drive and performance of driving and non-driving tasks. Accident Analysis & Prevention, 42(6), 1855-1865. 41. Ronen, A., Gershon, P., Drobiner, H., Rabinovich, A., Bar-Hamburger, R., Mechoulam, R., ... & Shinar, D. (2008). Effects of THC on driving performance, physiological state and subjective feelings relative to alcohol. Accident Analysis & Prevention, 40(3), 926-934. 42. Safer, D. J. (2016). Recent trends in stimulant usage. Journal of attention disorders, 20(6), 471-477. 43.

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44. Scherer, M., Voas, R. B., & Furr-Holden, D. (2013). Marijuana as a predictor of concurrent substance use among motor vehicle

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45. Sexton, B. F., Tunbridge, R. J., Board, A., Jackson, P. G., Wright, K., Stark, M. M., & Engelhard, K. (2002). The influence of cannabis and alcohol on driving. 46. Smiley, A., Moskowitz, H. M., & Ziedman, K. (1985). EFFECTS OF DRUGS ON DRIVING. DRIVING SIMULATOR TESTS OF SECOBARBITAL, DIAZEPAM, MARIJUANA AND ALCOHOL (No. HS-040 208).

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