Third International Symposium on Drug-Impaired Driving
Lisbon, 23 October 2017
Mário Dias
Drug level and impairment – how do we measure this
National Institute of Legal Medicine and Forensic Sciences
Summary:
Introduction
Economic and Social Impact of Road Accidents
Prevalence of Cannabis use
DUID: Impairment vs Zero Tolerance
Rate of prosecutions
Conclusions
Lisbon, 23 October 2017
Third International Symposium on Drug-Impaired Driving
ECONOMIC AND SOCIAL IMPACT OF ROAD ACCIDENTS
0.00%
0.50%
1.00%
1.50%
2.00%
2.50%
3.00%
Cro
atia
Bu
lga
ria
Ro
man
ia
Hu
nga
ry
Slo
ven
ia
Au
stri
a
Latv
ia
Po
lan
d
Ge
rma
ny
Mal
ta
Cze
ch R
ep
ub
lic
Po
rtu
gal
Slo
vaki
a
Lith
uan
ia
Be
lgiu
m
Euro
pea
n U
nio
n
Ital
y
Gre
ece
Esto
nia
Cyp
rus
Fran
ce
Spai
n
Luxe
mb
ou
rg
Un
ite
d K
ingd
om
Swe
de
n
De
nm
ark
Ire
lan
d
Fin
lan
d
Ne
the
rla
nd
s
Estimate Cost / GDP (%)
Lisbon, 23 October 2017
Third International Symposium on Drug-Impaired Driving
1,1/%
0,90%
(Source: ANSR)
Lisbon, 23 October 2017
Third International Symposium on Drug-Impaired Driving
Drug level and impairment – how do we measure this Mário Dias
5.10%
7.80%
3.10%
6.20%
0.00%
2.00%
4.00%
6.00%
8.00%
10.00%
12.00%
14.00%
16.00%
15-34 35-74 15-34 35-74
Throughout life last 12 months last 30 days
2012 (n= 5355)
2016/17 (n=12033)
PREVALENCE OF CANNABIS IN THE GENERAL POPULATION
DISTRIBUTION BY AGE GROUPS
(Source: SICAD)
Lisbon, 23 October 2017
Third International Symposium on Drug-Impaired Driving
Drug level and impairment – how do we measure this Mário Dias
PREVALENCE OF CANNABIS AMONG INJURED DRIVERS
(Source: INMLCF)
73%
8.30%
9.50%
11.36%
12.74%
14.39%
12.74%
2011 2012 2013 2014 2015 2016(n= 1734) (n= 1646) (n= 1734) (n= 1711) (n= 1765) (n= 1765)
Lisbon, 23 October 2017
Third International Symposium on Drug-Impaired Driving
Drug level and impairment – how do we measure this Mário Dias
PREVALENCE OF CANNABIS AMONG INJURED DRIVERS
12.25%
10.79%
11.89%
13.35% 14.19%
2.46%
4.93%
1.71%
4.58%
6.72%
2011 2012 2013 2014 2015
Men Women
DISTRIBUTION BY GENDER
(Source: INMLCF)
Lisbon, 23 October 2017
Third International Symposium on Drug-Impaired Driving
Drug level and impairment – how do we measure this Mário Dias
PREVALENCE OF CANNABIS AMONG INJURED DRIVERS
37% 33%
22%
25%
21%
37%
44% 43% 45% 45%
18% 19%
30%
25%
28%
8%
4% 5%
3%
6%
2011 2012 2103 2014 2015
DISTRIBUTION BY AGE GROUPS
≥ 25 - 34
≥ 35 - 49
< 25
> 50
(Source: INMLCF)
- 25%
- 64%
+ 55%
+ 21%
Lisbon, 23 October 2017
Third International Symposium on Drug-Impaired Driving
Drug level and impairment – how do we measure this Mário Dias
Portaria 902-B/2007 Article 22
1 - The blood confirmation test is intended to identify the substance or substances and or its metabolites that in the screening test showed positive results.
The confirmation test is considered positive whenever reveals the presence of any psychotropic substances (Table 1 of Annex V) or other substance or product, with similar effect, able to disturb the physical, mental or psychological conditions for driving motor vehicle safely.
Article 23
Zero Tolerance
Lisbon, 23 October 2017
Third International Symposium on Drug-Impaired Driving
Drug level and impairment – how do we measure this Mário Dias
Código da Estrada
1 - If the same circumstances simultaneously constitute a criminal and administrative offense, the driver shall always be punished by way of crime, without prejudice to the application of the accessory penalty for the administrative offense.
Article 134
2 - Incurs in the same penalty who, at least negligently, drive a vehicle, with or without motor on public roads, not being able to do it safely for being under the influence of narcotic drugs, psychotropic substances or similar products with physical, mental or psychological disturbing effect on fitness to drive
Article 292 Código Penal
Impairment
How to interpret the analytical results in impairment approach?
Lisbon, 23 October 2017
Third International Symposium on Drug-Impaired Driving
Lisbon, 23 October 2017
Third International Symposium on Drug-Impaired Driving
Per-se approach can be based in three different type of limits:
The lowest limit of quantification or limit of detection (Zero Tolerance)
The lowest limit of impairment
The lower limit of risk
Lisbon, 23 October 2017
Third International Symposium on Drug-Impaired Driving
Drug level and impairment – how do we measure this Mário Dias
(Source: INMLCF)
0
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18[ng/mL]
[Mean = 2,5 ng/mL]
[Median = 1,7 ng/mL]
1 ng/mL
67 %
2 ng/mL
39 % 26 %
3 ng/mL
THC LEVEL IN BLOOD
Lisbon, 23 October 2017
Third International Symposium on Drug-Impaired Driving
Drug level and impairment – how do we measure this Mário Dias
(Source: INMLCF)
17.85% 18.42% 16.40%
7.14% 7.89% 10.15%
3.57% 3.51% 3.13%
0%
10%
20%
30%
40%
50%
60%
70%
80%
90%
100%
2011 2012 2013 2014 2015
≥ 10
5 to < 10
3 to < 5
2 to < 3
1 to < 2
< 1
[ng/mL]
THC LEVEL IN BLOOD
Lisbon, 23 October 2017
Third International Symposium on Drug-Impaired Driving
Drug level and impairment – how do we measure this Mário Dias
THC LEVEL IN BLOOD Prosecuted [Mean] = 2,81 [0,25 -17]
Not prosecuted [Mean] = 2,3 [0,25 - 10]
(Source: INMLCF)
67.00% 67.00% 70.00% 69.00% 66.00%
33.00% 33.00% 30.00% 31.00% 34.00%
< 0,5 0,5 - 0,99 1 - 1,99 2 - 2,99 > 3
Prosecuted as impaired Not prosecuted as impaired
Lisbon, 23 October 2017
Third International Symposium on Drug-Impaired Driving
Drug level and impairment – how do we measure this Mário Dias
KEY ISSUES
The presence of THC in blood affects the ability to drive
There is a relationship between the concentration of THC in the blood and the degree of impairment, the risk of accident and culpability
There is no agreement about the concentration of THC in blood that allows to distinguish the type of consumer and the moment of the last consume, despite several scientific studies
The approach to driving under the influence of drugs should be made in a road safety perspective
The consumption of illicit substances, being an individual option, has social and economic consequences for all road users and for the society
Increases the public perception of the likelihood that drug drivers would be convicted
Monitor the drug driving problem and updates the legal limits according to the scientific literature and guidelines