Stop Drugged Driving: Facing the Facts

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Stop Drugged Driving Facing the Facts

• Robert L. DuPont, M.D.
• President
• Institute for Behavior and Health, Inc.

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Extent of the Drugged Driving Problem Nationally

• 10.6 Million people drove under the influence of
  drugs in 2006, many of them repeatedly
• In the past two weeks 24 of high school seniors
  drove after using drugs or rode with a driver
  after he used drugs
• Compared to 16 driving or riding with someone
  after heavy drinking

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The Costs of Drugged Driving Each Year

• 20 of automobile crashes are estimated to be the
  result of drugged driving, resulting in
• 8,600 highway deaths
• 580,000 injuries from car crashes
• 33,000,000,000 in costs

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20 of Automobile Accidents are Drug-Related

• 20 is a conservative estimate based on
• J.M. Walshs finding that 50 of seriously
  injured drivers tested positive for drugs OTA
  (Walsh JM, Flegel R, et al Acc Anal Prev 37
  (2005) 894901)
• Barry Logans study showing 35 of
  fatally-injured drivers test positive for drugs
  (Schwilke, dos Santos, Logan, J For Sci, 2006)
• Barry Logans trucker drug-testing study which
  found 21 of truckers test positive for drugs
  (Couper, Logan. J For Sci, 2001)

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20 of Automobile Accidents are Drug-Related

• The CDC estimates 18 of traffic accidents are
  drug related (http//www.cdc.gov/ncipc/factsheets/
  drving.htm)
• NIDA estimates that drugs are used by 10 to 22
  of drivers in collisions (http//www.nida.nih.gov/
  infofacts/driving.html)
• NHTSA notes that, for fatally injured drivers,
  cannabis is detected in 7 to 37 with a mean of
  14. Each of five other drugs can be found in
  about 5 or less (http//www.nhtsa.dot.gov/people/
  injury/research/StateofKnwlegeDrugs/StateofKnwlege
  Drugs/pages/7Conclusions.html)

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Fatally Injured Drivers in Washington State -
2002Schwilke, dos Santos, Logan, J For Sci, 2006
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Extent of the Drugged Driving Problem In Maryland

• At a Shock-Trauma Unit in Baltimore
• 51 of drivers tested positive for drugs other
  than alcohol
• Of these, 31 were also positive for alcohol
• Alcohol was detected in 31 of sample
• Of these, 52 were also positive for drugs
• Among 16-20 year-olds
• 50 positive for marijuana
• 33 positive for alcohol
• All of these were also positive for marijuana

Walsh et al. 2005
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Among Drivers admitted to a Level-1 Trauma Center
in Baltimore

• 51 of drivers tested positive for drugs other
  than alcohol
• Alcohol was detected in 31 of sample
• Of these, 52 were also positive for drugs

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Extent of the Drugged Driving Problem In Maryland

• According to the 2004 Maryland Adolescent Survey
• Over 11 of licensed 12th graders drove under the
  influence of marijuana 1 or 2 times
• 14 of licensed 12th graders drove under the
  influence of marijuana 3 times or more
• Only 50 of 12th graders view driving after using
  marijuana as very dangerous
• 79 view driving after 5 drinks as very
  dangerous

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Consequences of Drugged Driving in Maryland

• 119 deaths
• 7,700 injuries
• Cost of drugged driving in Maryland
• 1,086,000,000
• Cost of drugged driving in Baltimore
• 511,000,000

AAA estimates automobile crashes cost each
person in Maryland 970 per year, 20 of which
are estimated to be the result of drugged driving
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Recommendations

• Maryland must have an enforceable per se standard
  for illegal drugs
• This standard has worked with little controversy
  for the U.S. Department of Transportation for 20
  years
• All drivers know the law and the consequences
• Police have incentive to test for illegal drugs
  in addition to alcohol

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Recommendations

• Penalties for drugged driving should be equal to
  those for drunk driving, including for repeat
  offenses
• Additional penalties should apply to those who
  test positive for BOTH drugs and alcohol making
  this an aggravated offense
• All student-drivers must learn of the impairing
  effects of drugs on driving and the consequences
  for driving drugged

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Recommendations

• Drug Testing should be done at all of the
  following opportunities
• At all sobriety checkpoints
• On drivers in accidents causing serious injuries,
  either at the scene of the crash or at the
  hospital/trauma center
• When drugs have been found in vehicles or on
  drivers
• When drivers admit to recent drug use
• When impaired drivers have BACs less than 0.08

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Recommendations

• Use urine, oral fluids, sweat and hair for drug
  testing in addition to blood
• Reduce barriers to successful prosecution by
  adopting the chain of custody procedures used by
  the U.S. Department of Transportation
• Test samples at approved commercial laboratories,
  not only at state laboratories

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Recommendations for the Convicted Drugged Driver

• All convicted drugged drivers must submit to
  repeated random drug testing for a year or longer
  as a condition of regaining and then maintaining
  their licenses
• Positive tests during monitoring should lead to
  additional penalties
• All convicted drugged drivers must undergo
  assessment for drug dependence with those in need
  of treatment required to get help

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The Per Se Necessity

• The per se standard makes any detectable
• level of illegal drugs a violation of the law

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Reasons for the Per Se Standard

• The per se standard for drug use has been the
  standard in the Federal workplace since 1986 and
  in safety-sensitive jobs since 1987
• Safety-sensitive jobs include commercial airline
  pilots, and drivers of all commercial vehicles
  including tractor-trailers, buses, and trains
• The per se standard has been adopted by 15 states
  and numerous countries including many in Western
  Europe plus Australia and New Zealand

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• If safety-sensitive jobs use the per se
• standard for drugs of abuse, WHY shouldnt
• all drivers be subject to this standard?

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Reasons for the Per Se Standard

• The per se standard eliminates the ambiguities of
  proving in each case the nexus between impairment
  and illegal drug use
• Since the combination of drugs and alcohol is
  especially impairing, there are no scientifically
  valid or enforceable cut-off levels other than
  zero for either drugs or alcohol when both are
  present

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The Task Forces Responsibilities

• The Task Force should not trim conclusions and
  recommendations to fit what is thought to be
  currently politically achievable or
  bureaucratically or budgetarily practical
• The Task Force, instead, should define the
  optimal responses to drugged (and drunk) driving
  that are in the best interests of the citizens of
  Maryland

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The Task Forces Responsibilities

• The Task Forces primary duty is to identify the
  full range of recommendations that will reduce
  the tragic toll of deaths, injuries and costs now
  exacted by drivers impaired by illegal drugs (as
  well as by alcohol)
• The Task Force must highlight the fact that
  drugged driving is now on a par with drunk
  driving and warrants responses on the same level

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Thank You!