Date post: | 05-Apr-2017 |
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Is my driving impaired?
Dr Richard EversSynergy Health Laboratory Services
SHLS
Laboratory Services division of Synergy Health•Based in Abergavenny, South Wales•Established in 1986•On-site Toxicology, Pathology and PCR suites
Services from SHLS
• Drug and Alcohol screening• Urine• Saliva• Hair• Breath Alcohol
• Drug and Alcohol sample collection services
• Clinical Pathology testing services
• Training services
What do we mean by “Impaired”
• Road Traffic Act (1988) Section 6B – CODE OF PRACTICE FOR PRELIMINARY
IMPAIRMENT TESTS (DfT 2004)• Designed to determine of you are unfit to
drive
Field Impairment Test
• Pupillary Examination – Look ahead– Keep eyes open– Pupil size– Rednes or watery
Modified Romberg Balance Test
• Stand to attention– Tilt head back and close eyes– Return head to upright and open eyes after 30
seconds– Note balance control and timing
Walk and Turn Test
• Stand still on a line– Nine heel-to-toe steps, turn and nine steps
back, counting out loud– Correct counting and steps– Deviation from line
One Leg Stand
• Stand still– Raise right foot 6-8 inches parallel to ground– Look ahead– Repeat for left foot– Record balance
Finger to nose test
• Hold both hands out in front with index fingers extended– Close eyes– Touch tip of the nose– Alternate hands on command– Record balance, missing nose
or using the wrong hand
Drink drive levels
• England and Wales– Blood 80mg/100mL– Breath 35µg/100mL– Urine 107mg/100mL
• Scotland– Blood 50mg/100mL– Breath 22µg/100mL– Urine 67mg/100mL
Drink drive stats 2013
• 683,631 tests– 71,675 positive (10.5%)
• 232,709 accidents (6,524 HGV)– 53% breathalysed (65% HGV)– 1.6% positive (0.4% HGV)
• 17% of deaths positive
DfT National Statistics (www.gov.uk)
Drink drive stats – Why test?
• Traffic offense (37%)– 6% Positive
• Collision (32.7%)– 8% Positive
• Suspicion (18.7%)– 18.7% Positive – 18.9% alcohol present below limit
DfT (www.gov.uk)
Drug drive stats
• 1132 convictions for drug driving (2012)– 19% of surveyed admit to driving while unfit– 7% due to illegal drugs
• 902 arrests March – May 2015– 45% of tests positive– 1 arrest every 2½ days– 1 test per day
IAM & Daily Mail
FOI requests
Is cannabis a problem?
• From US Data
Drug drive levels
DrugCutoff (µg/L) Drug
Cutoff (µg/L)
Amphetamine 250 LSD 1
Benzoylecgonine 50 Methadone 500
Clonazepam 50 Methamphetamine 10
Cocaine 10 Ecstasy 10
Cannabis 2 6-monoacetylmorphine 5
Diazepam 550 Morphine 80
Flunitrazepam 300 Oxazepam 300
Ketamine 20 Temazepam 1000
Lorazepam 100
DT5000
• Wide test menu – Cannabis– Cocaine– Opiates– Benzodiazepines
• Home Office Type Approved– Cannabis
Cannabis
• Legal Limit 2µg/L THC in blood• Driving Simulator
– Controlled cannabis use– Measured impairment
• 8µg/L THC gives similar impairment to 0.50‰ Alcohol
Long term cannabis use
• Cannabis users confined to a drug free R&D facility
• Daily blood cannabis levels• >2µg/L for 18 days
hangover• You do not have to have drugs in your system to
be impaired• Driving simulator with a hangover gives a similar
level of impairment to BAC 0.40‰• Longer sleep following drinking leads to less
impairment (!!!)• “chronic use of all illicit drugs is associated with
some cognitive and/or psychomotor impairment, and can lead to a decrease in driving performance even when the subject is no longer intoxicated” - EMCCDA
Amphetamine
• Controlled administration studies– Amphetamine no more harmful to cause
accident• Post-accident testing figures
– Amphetamine 6x more likely to cause death• Amphetamine increases risk taking• Dexedrine given to fighter pilots
San Francisco Bay Bridge, 2007• M/V Cosco Busan hit the
pier in fog• 53,500 gallons of fuel oil
spilt• $3.6 million repair bill• $70 million environmental
cleanup• Pilot tested BEFORE
accident and negative for SAMHSA 5 and alcohol
Stimulant/depressant mix• Pilot was taking:
– Lorazepam– Diazepam– Modafinil– Propoxyphene– Hydrocodone– Pentazocine (narcotic analgesic)
• Narcotics & sedatives – send you to sleep• Modafinil – wakes you up
• Similar patterns of use with amphetamines and benzodiazepines• Cocaine and heroin
Is my driving impaired?
• Alcohol – legal limit• Drugs – legal limit for some• Tiredness – limit on driving hours• Cold / ‘Flu – no law• Hangover – no law
Thank You