Developing a comprehensive response to the challenge of drug-impaired driving

Organized by the Government of the United States of America, the Canadian Centre on Substance Abuse, the European Monitoring Centre for Drugs and Drug Addiction and the New Zealand Drug Foundation.

Richard Baum , ONDCP, US

This is an important issue because it is a factor that affects people’ve lives in many ways. We’re all at consensus within drug policy that we want our families to be safe on the roads, so it’s good that we can come together and work on this issue collectively.

In the US, we have a problem with drug driving and an irony is that drunk driving is relatively less of a problem. In 2014 a survey found that 8 percent of people on the road had alcohol in their systems. 21 percent had three or more drugs in their system.

Youth are getting the message on safety around drinking and driving, but this is not the same with drugs.

Testing for marijuana while driving is a complicated question as there are issues around impairment.

In the US, we’re just at the start of the process of exploring how to best get the message out about drug-impaired driving.

Ross Bell, NZ Drug Foundation

We held the second international symposium on drugs and driving last year, building on the last one held in Canada. The reason we were able to hold this event is because the New Zealand government is beginning to put this on their agenda. Although we’re far away, we attracted over 100 researchers and policy experts to the symposium.

The themes of the two-day program were, among others:

  • Nature and magnitude
  • Legislation and policy
  • Detection, deterrence and enforcemetn
  • Public awareness, health promotion

This is a complex agenda because testing for substance use is not the same as for alcohol. Presence of a substance need not always result in impairment. Also, we need to factor in prescription medication. The technology to detect substances is still in its infancy, and its complex because we’re in a new world of NPS where we don’t really know what substances are on the market and what it means for road safety.

First we look at what is the size of the problem. It appears driving after drug use is a sizeable problem, but countries don’t take a standardised approach to this issue. There is a need for an updated research protocol that would facilitate international comparisons.

Driving after drug use is likely to be underreported, and when people do test they don’t test for a full range of substances, creating a gap in data. It’s importance for governments to describe and quantify the situation around drug driving.

In terms of law and policy, countries need to define the purpose of the law. There is a debate about whether drug driving laws should be a road safety or drug control measure. There is a need for evidence on effectiveness of basic legislative frameworks; zero tolerance, per se laws, behavioural impairment.

There are a number of different approaches being used for detection – random testing, field impairment testing, and Drug Evaluation and Classification (DEC) program.

There’s a need for greater enforcement capacity with specialised training.

A range of interventions and treatments are available such as drug and DWI courts; self-help groups, among others.

Public awareness campaigns should be well designed and targeted. For example, specific awareness campaigns for doctors so that people aren’t afraid to take their prescription medication.

Rita Notarandrea, Canadian Centre on Substance Abuse

We need to keep focused on technology as this will help us in terms of screening and detection. There was a good recent article in Time magazine that covers the issues we’re facing around drugs and driving.

In different countries we have different contexts. We need to look at health surveys, existing sources of data and so on. What is the problem that requires attention? There’s a need to review existing impaired driving laws and policies and determine the focus and objective of your approach – as Ross said, will it be drug control, or road safety?

Ultimately, you need to decide if what you’ve designed is enforceable. Can you actually implement the new policy effectively? It’s one thing to have a brilliant piece of legislation but if you can’t enforce it quickly, it’s relatively meaningless. Therefore, you need to develop enforcement tools and define the role of the police; are they stopping someone for suspicion, or making random stops?

What’s the capacity of toxicology labs to test the evidence? What’s the evidence that will be collected, and how will it be used to impose sanctions on those guilty of a drug driving offence?

There’s a need to provide more opportunities for the justice system to learn more about intricacies of drugs and driving investigations, and to establish sanctions comparable to those used for alcohol-impaired driving.

There must be consideration of substance misuse disorder, therefore there are opportunities in this scenario to implement health interventions such as drug courts, DWI courts, self-help groups, in-patient treatment.

Must develop and implement an awareness program to inform the public about the specifics of the law, enforcement practices and appropriate actions to ensure safety. Evidence-informed campaigns should be developed using principles from health communication research.

Paul Griffiths, EMCDDA

In our research it was found that there were an increasing number of countries in demand of technical assistance on this issue. There’s a recognition that drug driving is an issue of growing importance internationally and there’s a growing consensus on the role of drugs in accidents. There are gaps, though, in how much we really know about this role. There’s a need for WHO guidance which is currently being explored and developed.

The massive increase of road traffic use represents a potential burden on public health in light of substance use. There’s very much a need to be aware of different national contexts as people use different drugs depending on the market they’re in. This impacts on how and what tests are carried out.

There have been examples — UK and Japan — where specific incidents that caught the media’s attention of deaths by drug driving. This led to quick legislative action and it’s important that we’re able to properly advise policy makers on this issue so that laws aren’t rushed through, and that they’re designed properly.

We need to think about alcohol and drugs in proportion when it comes to impaired driving, and not dissuade prescription or use of essential medicines. We don’t have enough dialogue between the research community in the road safety and drugs area. This is an important relationship to foster.

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