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Price JM, Smith RC, Miles AK, Kayagil TA. Delays in blood collection and drug toxicology results among crash-involved drivers arrested for impaired driving. TRAFFIC INJURY PREVENTION 2024; 25:667-672. [PMID: 38648016 DOI: 10.1080/15389588.2024.2333918] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/16/2023] [Accepted: 03/19/2024] [Indexed: 04/25/2024]
Abstract
OBJECTIVE The concentration of drugs in a driver's system can change between an impaired driving arrest or crash and the collection of a biological specimen for drug testing. Accordingly, delays in specimen collection can result in the loss of critical information that has the potential to affect impaired driving prosecution. The objectives of the study were: (1) to identify factors that influence the time between impaired-driving violations and specimen collections (time-to-collection) among crash-involved drivers, and (2) to consider how such delays affect measured concentrations of drugs, particularly with respect to common drug per se limits. METHOD Study data included blood toxicology results and crash-related information from 8,923 drivers who were involved in crashes and arrested for impaired driving in Wisconsin between 2019 and 2021. Analyses examined how crash timing and severity influenced time-to-collection and the effects of delays in specimen collection on blood alcohol concentrations (BACs) and blood delta-9-tetrahydrocannabinol (THC) concentrations. RESULTS The mean time-to-collection for the entire sample was 1.80 h. Crash severity had a significant effect on time-to-collection with crashes involving a fatality having the longest duration ( M = 2.35 h) followed by injury crashes ( M = 2.06 h) and noninjury crashes ( M = 1.69 h). Time of day also affected time-to-collection; late night and early morning hours were associated with shorter durations. Both BAC (r = -0.11) and blood THC concentrations (r = -0.16) were significantly negatively correlated with time-to-collection. CONCLUSIONS Crash severity and the time of day at which a crash occurs can result in delays in the collection of blood specimens after impaired driving arrests. Because drugs often continue to be metabolized and eliminated between arrest and biological specimen collection, measured concentrations may not represent the concentrations of drugs that were present at the time of driving. This has the potential to affect drug-impaired driving prosecution, particularly in jurisdictions whose laws specify per se impairment thresholds.
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Affiliation(s)
- Jana M Price
- Office of Research and Engineering, National Transportation Safety Board, Washington, District of Columbia
| | - Ryan C Smith
- Office of Research and Engineering, National Transportation Safety Board, Washington, District of Columbia
| | - Amy K Miles
- Wisconsin State Laboratory of Hygiene, University of Wisconsin School of Medicine and Public Health, Madison, Wisconsin
| | - Turan A Kayagil
- Office of Research and Engineering, National Transportation Safety Board, Washington, District of Columbia
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2
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Brooks-Russell A, Wrobel J, Brown T, Bidwell LC, Wang GS, Steinhart B, Dooley G, Kosnett MJ. Effects of acute cannabis inhalation on reaction time, decision-making, and memory using a tablet-based application. J Cannabis Res 2024; 6:3. [PMID: 38308382 PMCID: PMC10837858 DOI: 10.1186/s42238-024-00215-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2023] [Accepted: 01/13/2024] [Indexed: 02/04/2024] Open
Abstract
BACKGROUND Acute cannabis use has been demonstrated to slow reaction time and affect decision-making and short-term memory. These effects may have utility in identifying impairment associated with recent use. However, these effects have not been widely investigated among individuals with a pattern of daily use, who may have acquired tolerance. The purpose of this study was to examine the impact of tolerance to cannabis on the acute effects as measured by reaction time, decision-making (gap acceptance), and short-term memory. METHODS Participants (ages 25-45) completed a tablet-based (iPad) test battery before and approximately 60 min after smoking cannabis flower. The change in performance from before to after cannabis use was compared across three groups of cannabis users: (1) occasional use (n = 23); (2) daily use (n = 31); or (3) no current use (n = 32). Participants in the occasional and daily use group self-administered ad libitum, by smoking or vaping, self-supplied cannabis flower with a high concentration of total THC (15-30%). RESULTS The occasional use group exhibited decrements in reaction time (slowed) and short-term memory (replicated fewer shapes) from before to after cannabis use, as compared to the no-use group. In the gap acceptance task, daily use participants took more time to complete the task post-smoking cannabis as compared to those with no use or occasional use; however, the level of accuracy did not significantly change. CONCLUSIONS The findings are consistent with acquired tolerance to certain acute psychomotor effects with daily cannabis use. The finding from the gap acceptance task which showed a decline in speed but not accuracy may indicate a prioritization of accuracy over response time. Cognitive and psychomotor assessments may have utility for identifying impairment associated with recent cannabis use.
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Affiliation(s)
- Ashley Brooks-Russell
- Injury and Violence Prevention Center, Colorado School of Public Health, University of Colorado Anschutz Medical Campus, 13001 E. 17Th Place, Aurora, CO, 80045, USA.
| | - Julia Wrobel
- Department of Biostatistics and Informatics, Colorado School of Public Health, University of Colorado Anschutz Medical Campus, Aurora, CO, USA
- Department of Biostatistics and Bioinformatics, Rollins School of Public Health, Emory University, Atlanta, GA, USA
| | - Tim Brown
- Driving Safety Research Institute, University of Iowa, Iowa City, IA, USA
| | - L Cinnamon Bidwell
- Institute of Cognitive Science, University of Colorado, Boulder, CO, USA
| | - George Sam Wang
- Department of Pediatrics, CU School of Medicine, University of Colorado Anschutz Medical Campus, Aurora, CO, USA
| | - Benjamin Steinhart
- Department of Biostatistics and Informatics, Colorado School of Public Health, University of Colorado Anschutz Medical Campus, Aurora, CO, USA
| | - Gregory Dooley
- Department of Environmental and Radiological Health Sciences, Colorado State University, Fort Collins, CO, USA
| | - Michael J Kosnett
- Department of Medicine, CU School of Medicine, University of Colorado Anschutz Medical Campus, Aurora, CO, USA
- Department of Environmental and Occupational Health, Colorado School of Public Health, University of Colorado Anschutz Medical Campus, Aurora, CO, USA
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Poetto AS, Catesini G, Dossetto P, Marchetti S, Addobbati R. Drug driving in Italy. The results of the first roadside drug testing service utilizing on-site confirmatory analysis between 2019 and 2022. Forensic Sci Int 2024; 355:111929. [PMID: 38262308 DOI: 10.1016/j.forsciint.2024.111929] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2023] [Revised: 12/18/2023] [Accepted: 01/06/2024] [Indexed: 01/25/2024]
Abstract
BACKGROUND Drug driving represents a public safety concern, and the size of this issue in Italy is not fully known. Drug testing is composed of two steps: 1) screening and 2) confirmatory analysis. The second step, and the associate medical examination to assess the state of impairment, usually are not performed right after the screening as they require specialized personnel and instrumental equipment that are not historically available at roadblocks. These pitfalls make this process both complicated and time-consuming. METHODS A mobile laboratory was set up in 2019 by the Forensic Lab Service S.r.l. (limited liability company) to improve roadblock timing, planning, as well as to shed light on the extent of the drug driving issue in Italy. Drug screenings were performed using DrugWipe® Saliva testing. Confirmatory analysis was performed on oral fluids by liquid chromatography coupled with tandem mass spectrometry. A dedicated room of the mobile laboratory was also designed for drug driving medical assessment. RESULT 2082 samples were collected during 88 road safety services held in different locations across Italy. In total, 9 % of the tested subjects were positive to both the screening and the confirmatory analysis. The most prevalent illicit drugs found in this study were THC (72 %), followed by cocaine (41 %). Drug drivers were mostly male (93 %) and younger than 30 years of age (58 %). CONCLUSIONS The prevalence of drivers testing positive for illicit drugs resulted to be higher compared to the results obtained in the DRUID project and to other surveys previously performed in Italy. These data demonstrate the need for control services to improve road safety in regards to drug driving.
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Affiliation(s)
| | - Giulio Catesini
- Forensic Lab Service Srl, Rome, Italy; Division of Metabolism, Bambino Gesù Children's Hospital, IRCCS, Rome, Italy
| | - Paolo Dossetto
- Forensic Lab Service Srl, Rome, Italy; Sciex, Milano, Italy
| | | | - Riccardo Addobbati
- Forensic Lab Service Srl, Rome, Italy; Institute for Maternal and Child Health-IRCCS Burlo Garofolo, 34137 Trieste, Italy
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Dutra LM, Gourdet C, Farrelly MC, Bradfield B. Perceived Safety, Not Perceived Legality, Mediates the Relationship Between Cannabis Legalization and Drugged Driving. HEALTH EDUCATION & BEHAVIOR 2023; 50:718-727. [PMID: 35822623 DOI: 10.1177/10901981221109137] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Cannabis legalization has rapidly spread throughout the United States and is associated with multiple public health outcomes, including driving under the influence of cannabis (DUIC). To improve understanding of the relationship between legalization and DUIC, we tested two potential mediators of this relationship: perceived safety and perceived legality of driving high. We analyzed data from 1,236 current (past 30-day) cannabis users who were recruited from states with recreational, medical only, or no legal cannabis between 2016 and 2017 using address-based and social media samples. Using a generalized linear model and adjusting for cannabis legalization, demographics, living in a state with a cannabis-specific drugged driving law, frequency of cannabis use, and weights, we found that perceived safety (risk ratio [RR] = 2.60, 95% CI [1.88, 3.58]), but not perceived legality (RR = 0.96, 95% CI [0.67, 1.37]), was significantly associated with DUIC. Perceived safety mediated the relationship between legalization and DUIC (Coeff: -0.12, 95% CI [-0.23, -0.01]). Models stratified by frequency of cannabis use yielded results consistent with those of pooled models except that, for frequent users, cannabis-specific driving laws were associated with a significantly lower risk of DUIC (RR = 0.64, 95% CI [0.44, 0.92]). Agencies developing cannabis-focused drugged driving educational campaigns should consider the potential role of perceived safety of driving high in DUIC campaigns.
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Affiliation(s)
- Lauren M Dutra
- RTI International, Research Triangle Park, NC, USA
- RTI International, Berkeley, CA, USA
| | - C Gourdet
- RTI International, Research Triangle Park, NC, USA
| | - M C Farrelly
- RTI International, Research Triangle Park, NC, USA
| | - B Bradfield
- RTI International, Research Triangle Park, NC, USA
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Gjerde H, Bogstrand ST, Jamt REG, Vindenes V. Crash-involved THC-positive drivers in Norway have a high frequency of polysubstance use. Drug Alcohol Depend 2023; 244:109800. [PMID: 36774807 DOI: 10.1016/j.drugalcdep.2023.109800] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/17/2022] [Revised: 01/25/2023] [Accepted: 01/26/2023] [Indexed: 02/11/2023]
Abstract
BACKGROUND Tetrahydrocannabinol (THC) is the most frequently detected drug in blood samples from apprehended drug driving suspects in Norway. This investigation aimed to study the extent of polysubstance use among apprehended crash-involved drivers with THC concentrations above the legal limit and explore the importance of THC in polysubstance cases. METHODS We selected all drug driving cases where blood samples had been submitted for forensic toxicology testing after involvement in road traffic crashes during 2013-2020, except drivers who were fatally injured. RESULTS Twenty percent (n = 2133) of the 10,520 apprehended crash-involved drivers had concentrations of THC in their blood above the legal limit of 1.3 ng/mL, and 84 % of those also had concentrations of alcohol or other drugs above the legal limits; 61 % for sedatives, 38 % for stimulants, 33 % for alcohol, and 10 % for opioids. The most frequent substance combination was cannabis together with sedatives and stimulants (22.9 %; n = 488). Polysubstance use was least common among drivers under 24 years. The proportion of drivers with THC > 5 ng/mL was highest if the blood sample was collected within 90 min after the crash, and when only THC was detected. There was a statistically significant inverse association between THC > 5 ng/mL and concentrations of alcohol or amphetamines at the highest sanction level. CONCLUSIONS Most apprehended crash-involved THC-positive drivers also tested positive for other psychoactive substances. Drivers with high blood THC concentrations had less often high concentrations of other substances; cannabis might then have been a more important contributor to impairment.
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Affiliation(s)
- Hallvard Gjerde
- Section of Drug Abuse Research, Department of Forensic Sciences, Oslo University Hospital, Oslo, Norway.
| | - Stig Tore Bogstrand
- Section of Drug Abuse Research, Department of Forensic Sciences, Oslo University Hospital, Oslo, Norway; Department of Public Health Science, Institute of Health and Society, Faculty of Medicine, University of Oslo, Oslo, Norway; Department of Nursing and Health Promotion, Acute and Critical Illness, Faculty of Health Sciences, OsloMet - Oslo Metropolitan University, Oslo, Norway
| | - Ragnhild Elén Gjulem Jamt
- Section of Drug Abuse Research, Department of Forensic Sciences, Oslo University Hospital, Oslo, Norway
| | - Vigdis Vindenes
- Section of Drug Abuse Research, Department of Forensic Sciences, Oslo University Hospital, Oslo, Norway; Department of Forensic Medicine, Institute of Clinical Medicine, Faculty of Medicine, University of Oslo, Oslo, Norway
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Karschner EL, Swortwood-Gates MJ, Huestis MA. Identifying and Quantifying Cannabinoids in Biological Matrices in the Medical and Legal Cannabis Era. Clin Chem 2020; 66:888-914. [DOI: 10.1093/clinchem/hvaa113] [Citation(s) in RCA: 24] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2020] [Accepted: 05/04/2020] [Indexed: 12/15/2022]
Abstract
AbstractBackgroundCannabinoid analyses generally included, until recently, the primary psychoactive cannabis compound, Δ9-tetrahydrocannabinol (THC), and/or its inactive metabolite, 11-nor-9-carboxy-THC, in blood, plasma, and urine. Technological advances revolutionized the analyses of major and minor phytocannabinoids in diverse biological fluids and tissues. An extensive literature search was conducted in PubMed for articles on cannabinoid analyses from 2000 through 2019. References in acquired manuscripts were also searched for additional articles.ContentThis article summarizes analytical methodologies for identification and quantification of multiple phytocannabinoids (including THC, cannabidiol, cannabigerol, and cannabichromene) and their precursors and/or metabolites in blood, plasma, serum, urine, oral fluid, hair, breath, sweat, dried blood spots, postmortem matrices, breast milk, meconium, and umbilical cord since the year 2000. Tables of nearly 200 studies outline parameters including analytes, specimen volume, instrumentation, and limits of quantification. Important diagnostic and interpretative challenges of cannabinoid analyses are also described. Medicalization and legalization of cannabis and the 2018 Agricultural Improvement Act increased demand for cannabinoid analyses for therapeutic drug monitoring, emergency toxicology, workplace and pain-management drug testing programs, and clinical and forensic toxicology applications. This demand is expected to intensify in the near future, with advances in instrumentation performance, increasing LC-MS/MS availability in clinical and forensic toxicology laboratories, and the ever-expanding knowledge of the potential therapeutic use and toxicity of phytocannabinoids.SummaryCannabinoid analyses and data interpretation are complex; however, major and minor phytocannabinoid detection windows and expected concentration ranges in diverse biological matrices improve the interpretation of cannabinoid test results.
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Affiliation(s)
- Erin L Karschner
- Armed Forces Medical Examiner System, Division of Forensic Toxicology, Dover Air Force Base, Dover, DE
| | | | - Marilyn A Huestis
- Institute of Emerging Health Professions, Thomas Jefferson University, Philadelphia, PA
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Hitchcock LN, Tracy BL, Bryan AD, Hutchison KE, Bidwell LC. Acute Effects of Cannabis Concentrate on Motor Control and Speed: Smartphone-Based Mobile Assessment. Front Psychiatry 2020; 11:623672. [PMID: 33551884 PMCID: PMC7862106 DOI: 10.3389/fpsyt.2020.623672] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/30/2020] [Accepted: 12/21/2020] [Indexed: 12/28/2022] Open
Abstract
Background: The use of cannabis concentrate is dramatically rising and sparking major safety concerns. Cannabis concentrate contains tetrahydrocannabinol (THC) potencies up to 90%, yet there has been little research on motor impairment after concentrate use (commonly referred to as "dabbing"). This study measured postural control and motor speed after the use of high potency concentrates in males and females. Methods: Experienced concentrate users (N = 65, Female: 46%, 17 ± 11 days/month of concentrate use) were assessed for motor performance in a mobile laboratory before, immediately after, and 1 h after ad-libitum cannabis concentrate use. Plasma levels of THC were obtained via venipuncture at each timepoint. We used a remotely deployable motor performance battery to assess arm and leg movement speed, index finger tapping rate, and balance. The sensors on a smart device (iPod Touch) attached to the participant provided quantitative measures of movement. Results: Arm speed slowed immediately after concentrate use and remained impaired after 1 h (p < 0.001), leg speed slowed 1 h after use (p = 0.033), and balance decreased immediately after concentrate use (eyes open: p = 0.017, eyes closed: p = 0.013) but not at 1 h post-use. These effects were not different between sexes and there was no effect of concentrate use on finger tapping speed. Acute changes in THC plasma levels after use of concentrates were minimally correlated with acute changes in balance performance. Conclusions: Use of cannabis concentrates in frequent users impairs movement speed and balance similarly in men and women. The motor impairment is largely uncorrelated with the change in THC plasma levels. These results warrant further refinement of cannabis impairment testing and encourage caution related to use of cannabis concentrates in work and driving settings.
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Affiliation(s)
- Leah N Hitchcock
- Institute of Cognitive Science, University of Colorado-Boulder, Boulder, CO, United States
| | - Brian L Tracy
- Department of Health and Exercise Science, Colorado State University, Fort Collins, CO, United States
| | - Angela D Bryan
- Institute of Cognitive Science, University of Colorado-Boulder, Boulder, CO, United States.,Department of Psychology and Neuroscience, University of Colorado-Boulder, Boulder, CO, United States
| | - Kent E Hutchison
- Institute of Cognitive Science, University of Colorado-Boulder, Boulder, CO, United States.,Department of Psychology and Neuroscience, University of Colorado-Boulder, Boulder, CO, United States
| | - L Cinnamon Bidwell
- Institute of Cognitive Science, University of Colorado-Boulder, Boulder, CO, United States.,Department of Psychology and Neuroscience, University of Colorado-Boulder, Boulder, CO, United States
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Romano E, Moore C, Kelley-Baker T, Torres-Saavedra PA. The utility of delta 9-tetrahydrocannabinol (THC) measures obtained from oral fluid samples in traffic safety. TRAFFIC INJURY PREVENTION 2019; 20:667-672. [PMID: 31356118 DOI: 10.1080/15389588.2019.1635690] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/16/2018] [Revised: 06/12/2019] [Accepted: 06/19/2019] [Indexed: 06/10/2023]
Abstract
Objective: Blood and/or urine are typical drug detection matrices used by law enforcement. There are some concerns about using oral fluid (OF) in the identification of drivers potentially impaired by cannabis, particularly regarding their accuracy when compared to blood. The study objectives were to (1) examine the accuracy of predicting delta 9-tetrahydrocannabinol (THC) in blood from THC measured in OF and (2) examine factors influencing prediction accuracy. Methods: Using data from the 2007 and 2013-2014 National Roadside Survey (NRS) of Alcohol and Drug Use, 7,517 drivers with known laboratory results in both OF and blood were included in this study. OF samples were collected using the Quantisal® device and analyzed at the same private laboratory in both the 2007 and 2013-2014 NRS. The Quantisal device has consistently shown to collect 1 mL ±10%. Descriptive statistical analyses were used to examine and compare the distribution of THC concentrations in OF and blood. A hurdle model was applied to examine factors influencing the accuracy of the THCblood predictions based on THCOF while accounting for the decisions of cannabis consumption. We estimated the number of true positives (TPs), false positives (FPs), true negatives (TNs), false negatives (FNs), sensitivity, specificity, and positive predicted value (PPV). Results: This study found that THC measured in OF (THCOF) is a good predictor of THC measured in blood (THCblood), in particular when THCOF > 0 ng/mL is used to predict being positive for THCblood (THCblood > 0 ng/mL). However, as blood and OF concentrations depart from 0 ng/mL, the proportion of TPs (sensitivity) decreases, which might be a concern for law enforcement. The likelihood of accurately predicting THCblood from THCOF is lower for drivers who were simultaneously using cannabis and other drugs. Conclusions: The findings of this study are based on THC measures obtained in a laboratory, which may not be the same as those conducted by police using point-of-care devices. However, this study is unique due to its large sample of drivers obtained in similar roadside locations and times to actual law enforcement activities. Though a positive THCOF may assist law enforcement in probable cause for a blood draw, efforts to develop reliable methods to detect drug impairment based on OF should continue.
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Affiliation(s)
- Eduardo Romano
- Pacific Institute for Research and Evaluation (PIRE) , Calverton , Maryland
| | | | | | - Pedro A Torres-Saavedra
- Department of Mathematical Sciences, University of Puerto Rico at Mayagüez , Mayagüez , Puerto Rico
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Gjerde H, Clausen GB, Andreassen E, Furuhaugen H. Evaluation of Dräger DrugTest 5000 in a Naturalistic Setting. J Anal Toxicol 2018; 42:248-254. [PMID: 29409046 DOI: 10.1093/jat/bky003] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2017] [Indexed: 12/15/2022] Open
Abstract
Reliable field testing devices for psychoactive drugs would be useful tools for the police for detecting drug-impaired drivers. The Norwegian Mobile Police Service (NMPS) started using Dräger DrugTest 5000 (DDT5000) in 2015 as an on-site screening instrument for drugs in samples of oral fluid. The aim of this study was to compare the results of field testing of DDT5000 with drug findings in blood and oral fluid samples taken from drivers suspected for driving under the influence of drugs (DUID). In total, 369 drivers were included in this field testing; blood samples were obtained from all of them, while oral fluid samples were collected with the Intercept device from 301 of them. The median time from field testing with DDT5000 and collection of blood and oral fluid samples was 50 min. The proportions of false positive results with DDT5000 compared to findings in blood samples above the Norwegian legal per se limits were for cannabis 14.5%, amphetamine 23.2%, methamphetamine 38.4%, cocaine 87.1%, opiates 65.9% and benzodiazepines 36.4%. The proportions of false negatives were for cannabis 13.4%, amphetamine 4.9%, methamphetamine 6.1%, cocaine 0.0%, opiates 0.0% and benzodiazepines 18.8%. Among drivers who had drug concentrations above the legal limits in blood, the proportion who tested positive using DDT5000 was 82.9% for THC, 90.8% for amphetamine, 75.7% for methamphetamine, 100.0% for cocaine, 100.0% for opiates and 37.2% for benzodiazepines. In cases with false-positive DDT5000 results compared to blood, traces of drugs were most often found in oral fluid. The DDT5000 did not absolutely correctly identify DUID offenders due to fairly large proportions of false-positive or false-negative results compared to drug concentrations in blood. The police reported that DDT5000 was still a valuable tool in identifying possible DUID offenders, resulting in more than doubling the number of apprehended DUID offenders.
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Affiliation(s)
- Hallvard Gjerde
- Department of Forensic Sciences, Oslo University Hospital, P.O. Box 4950 Nydalen, NO-0424 Oslo, Norway
| | | | | | - Håvard Furuhaugen
- Department of Forensic Sciences, Oslo University Hospital, P.O. Box 4950 Nydalen, NO-0424 Oslo, Norway
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Gjerde H, Romeo G, Mørland J. Challenges and common weaknesses in case-control studies on drug use and road traffic injury based on drug testing of biological samples. Ann Epidemiol 2018; 28:812-820. [PMID: 30217677 DOI: 10.1016/j.annepidem.2018.08.006] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2018] [Revised: 08/01/2018] [Accepted: 08/19/2018] [Indexed: 11/25/2022]
Abstract
PURPOSE To determine and discuss common weaknesses and errors in case-control studies on the association between drug use and road traffic crash injury among drivers and recommend improvements for future studies. METHODS A search for case-control studies published between 2000 and 2016 was performed using PubMed and other databases in addition to manual search. The used methodologies were compared with requirements and recommendations for case-control studies as well as current knowledge on the interpretation of drug concentrations in biological samples. RESULTS Seventeen studies were identified. The major difficulties in the studies were related to likely selection bias, information bias, and confounding. In some studies, the definition of drug exposure was different for controls than for cases, generating potentially serious errors in the odds ratio estimations. Other weaknesses include lacking explanation of the assessment of drug exposure, missing covariates, lacking description of statistical methods, and lack of discussion of bias and confounding. CONCLUSIONS Many of the observed challenges and weaknesses can be overcome or reduced. Recommendations for future studies are presented.
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Affiliation(s)
- Hallvard Gjerde
- Department of Forensic Sciences, Oslo University Hospital, Oslo, Norway.
| | - Giovanni Romeo
- Department of Biostatistics, Institute of Basic Medical Sciences, University of Oslo, Oslo, Norway
| | - Jørg Mørland
- Division of Health Data and Digitalization, Norwegian Institute of Public Health, Oslo, Norway; Institute of Clinical Medicine, University of Oslo, Oslo, Norway
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Aydelotte JD, Brown LH, Luftman KM, Mardock AL, Teixeira PGR, Coopwood B, Brown CVR. Crash Fatality Rates After Recreational Marijuana Legalization in Washington and Colorado. Am J Public Health 2017. [PMID: 28640679 DOI: 10.2105/ajph.2017.303848] [Citation(s) in RCA: 65] [Impact Index Per Article: 9.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
OBJECTIVES To evaluate motor vehicle crash fatality rates in the first 2 states with recreational marijuana legalization and compare them with motor vehicle crash fatality rates in similar states without recreational marijuana legalization. METHODS We used the US Fatality Analysis Reporting System to determine the annual numbers of motor vehicle crash fatalities between 2009 and 2015 in Washington, Colorado, and 8 control states. We compared year-over-year changes in motor vehicle crash fatality rates (per billion vehicle miles traveled) before and after recreational marijuana legalization with a difference-in-differences approach that controlled for underlying time trends and state-specific population, economic, and traffic characteristics. RESULTS Pre-recreational marijuana legalization annual changes in motor vehicle crash fatality rates for Washington and Colorado were similar to those for the control states. Post-recreational marijuana legalization changes in motor vehicle crash fatality rates for Washington and Colorado also did not significantly differ from those for the control states (adjusted difference-in-differences coefficient = +0.2 fatalities/billion vehicle miles traveled; 95% confidence interval = -0.4, +0.9). CONCLUSIONS Three years after recreational marijuana legalization, changes in motor vehicle crash fatality rates for Washington and Colorado were not statistically different from those in similar states without recreational marijuana legalization. Future studies over a longer time remain warranted.
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Affiliation(s)
- Jayson D Aydelotte
- Jayson D. Aydelotte, Kevin M. Luftman, Pedro G. R. Teixeira, Ben Coopwood, and Carlos V. R. Brown are with Trauma Service, Department of Surgery and Perioperative Care, Dell Medical School at the University of Texas-Austin. Lawrence H. Brown is with the Emergency Medicine Residency Program, Department of Surgery and Perioperative Care, Dell Medical School at the University of Texas-Austin. Alexandra L. Mardock is with Rice University, Houston, TX
| | - Lawrence H Brown
- Jayson D. Aydelotte, Kevin M. Luftman, Pedro G. R. Teixeira, Ben Coopwood, and Carlos V. R. Brown are with Trauma Service, Department of Surgery and Perioperative Care, Dell Medical School at the University of Texas-Austin. Lawrence H. Brown is with the Emergency Medicine Residency Program, Department of Surgery and Perioperative Care, Dell Medical School at the University of Texas-Austin. Alexandra L. Mardock is with Rice University, Houston, TX
| | - Kevin M Luftman
- Jayson D. Aydelotte, Kevin M. Luftman, Pedro G. R. Teixeira, Ben Coopwood, and Carlos V. R. Brown are with Trauma Service, Department of Surgery and Perioperative Care, Dell Medical School at the University of Texas-Austin. Lawrence H. Brown is with the Emergency Medicine Residency Program, Department of Surgery and Perioperative Care, Dell Medical School at the University of Texas-Austin. Alexandra L. Mardock is with Rice University, Houston, TX
| | - Alexandra L Mardock
- Jayson D. Aydelotte, Kevin M. Luftman, Pedro G. R. Teixeira, Ben Coopwood, and Carlos V. R. Brown are with Trauma Service, Department of Surgery and Perioperative Care, Dell Medical School at the University of Texas-Austin. Lawrence H. Brown is with the Emergency Medicine Residency Program, Department of Surgery and Perioperative Care, Dell Medical School at the University of Texas-Austin. Alexandra L. Mardock is with Rice University, Houston, TX
| | - Pedro G R Teixeira
- Jayson D. Aydelotte, Kevin M. Luftman, Pedro G. R. Teixeira, Ben Coopwood, and Carlos V. R. Brown are with Trauma Service, Department of Surgery and Perioperative Care, Dell Medical School at the University of Texas-Austin. Lawrence H. Brown is with the Emergency Medicine Residency Program, Department of Surgery and Perioperative Care, Dell Medical School at the University of Texas-Austin. Alexandra L. Mardock is with Rice University, Houston, TX
| | - Ben Coopwood
- Jayson D. Aydelotte, Kevin M. Luftman, Pedro G. R. Teixeira, Ben Coopwood, and Carlos V. R. Brown are with Trauma Service, Department of Surgery and Perioperative Care, Dell Medical School at the University of Texas-Austin. Lawrence H. Brown is with the Emergency Medicine Residency Program, Department of Surgery and Perioperative Care, Dell Medical School at the University of Texas-Austin. Alexandra L. Mardock is with Rice University, Houston, TX
| | - Carlos V R Brown
- Jayson D. Aydelotte, Kevin M. Luftman, Pedro G. R. Teixeira, Ben Coopwood, and Carlos V. R. Brown are with Trauma Service, Department of Surgery and Perioperative Care, Dell Medical School at the University of Texas-Austin. Lawrence H. Brown is with the Emergency Medicine Residency Program, Department of Surgery and Perioperative Care, Dell Medical School at the University of Texas-Austin. Alexandra L. Mardock is with Rice University, Houston, TX
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Doucette ML, Frattaroli S, Vernick JS. Oral fluid testing for marijuana intoxication: enhancing objectivity for roadside DUI testing. Inj Prev 2017; 24:78-80. [DOI: 10.1136/injuryprev-2016-042264] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2016] [Revised: 01/23/2017] [Accepted: 03/29/2017] [Indexed: 11/04/2022]
Abstract
Reducing marijuana-impaired driving is an important part of any strategy to prevent motor vehicle traffic injuries. In Colorado, the first of eight US states and the District of Columbia to legalise marijuana for recreational use, drivers with positive tests for the presence of marijuana accounted for a larger proportion of fatal MVCs after marijuana commercialisation. The use of blood tests to screen for marijuana intoxication, in Colorado and elsewhere in the USA, poses a number of challenges. Many high-income countries use oral fluid drug testing (OF) to provide roadside evidence of marijuana intoxication. A 2009 Belgium policy implementing OF roadside testing increased true positives and decreased false positives of suspected marijuana-related driving under the influence (DUI) arrests. US policy-makers should consider using roadside OF to increase objectivity and reliability for tests used in marijuana-related DUI arrests.
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Watson TM, Mann RE. International approaches to driving under the influence of cannabis: A review of evidence on impact. Drug Alcohol Depend 2016; 169:148-155. [PMID: 27810658 DOI: 10.1016/j.drugalcdep.2016.10.023] [Citation(s) in RCA: 29] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/29/2016] [Accepted: 10/18/2016] [Indexed: 11/29/2022]
Abstract
BACKGROUND There are knowledge gaps regarding the effectiveness of different approaches designed to prevent and deter driving under the influence of cannabis (DUIC). Policymakers are increasingly interested in evidence-based responses to DUIC as numerous jurisdictions worldwide have legally regulated cannabis or are debating such regulation. We contribute a comprehensive review of international literature on countermeasures that address DUIC, and identify where and how such measures have been evaluated. METHODS The following databases were systematically searched from 1995 to present: Medline, Embase, PsycINFO, CINAHL, Sociological Abstracts, and Criminal Justice Abstracts. Hand searching of relevant documents, internet searches for grey literature, and review of ongoing email alerts were conducted to capture any emerging literature and relevant trends. RESULTS Numerous international jurisdictions have introduced a variety of measures designed to deter DUIC. Much interest has been generated regarding non-zero per se laws that set fixed legal limits for tetrahydrocannabinol and/or its metabolites detected in drivers. Other approaches include behavioural impairment laws, zero-tolerance per se laws, roadside drug testing, graduated licensing system restrictions, and remedial programs. However, very few evaluations have appeared in the literature. CONCLUSIONS Although some promising results have been reported (e.g., roadside testing), it is premature to draw firm conclusions regarding the broader impacts of general deterrent approaches to DUIC. This review points to the need for a long-term commitment to rigorously evaluate, using multiple methods, the impact of general and specific deterrent DUIC countermeasures.
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Affiliation(s)
- Tara Marie Watson
- Institute for Mental Health Policy Research, Centre for Addiction and Mental Health, 33 Russell Street, Toronto, Ontario, M5S 2S1, Canada.
| | - Robert E Mann
- Institute for Mental Health Policy Research, Centre for Addiction and Mental Health, 33 Russell Street, Toronto, Ontario, M5S 2S1, Canada; Dalla Lana School of Public Health, University of Toronto, 155 College Street, Toronto, Ontario, M5T 3M7, Canada.
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14
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Lee JR, Choi J, Shultz TO, Wang SX. Small Molecule Detection in Saliva Facilitates Portable Tests of Marijuana Abuse. Anal Chem 2016; 88:7457-61. [PMID: 27434697 DOI: 10.1021/acs.analchem.6b01688] [Citation(s) in RCA: 40] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
As medical and recreational use of cannabis, or marijuana, becomes more prevalent, law enforcement needs a tool to evaluate whether drivers are operating vehicles under the influence of cannabis, specifically the psychoactive substance, tetrahydrocannabinol (THC). However, the cutoff concentration of THC that causes impairment is still controversial, and current on-site screening tools are not sensitive enough to detect trace amounts of THC in oral fluids. Here we present a novel sensing platform that employs giant magnetoresistive (GMR) biosensors integrated with a portable reader system and smartphone to detect THC in saliva using competitive assays. With a simple saliva collection scheme, we have optimized the assay to measure THC in the range from 0 to 50 ng/mL, covering most cutoff values proposed in previous studies. This work facilitates on-site screening for THC and shows potential for testing of other small molecule drugs and analytes in point-of-care (POC) settings.
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Affiliation(s)
- Jung-Rok Lee
- Department of Materials Science and Engineering, Stanford University , Stanford, California 94305, United States
| | - Joohong Choi
- Department of Electrical Engineering, Stanford University , Stanford, California 94305, United States
| | - Tyler O Shultz
- Department of Materials Science and Engineering, Stanford University , Stanford, California 94305, United States
| | - Shan X Wang
- Department of Materials Science and Engineering, Stanford University , Stanford, California 94305, United States.,Department of Electrical Engineering, Stanford University , Stanford, California 94305, United States
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15
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Wood E, Salomonsen-Sautel S. DUID prevalence in Colorado's DUI citations. JOURNAL OF SAFETY RESEARCH 2016; 57:33-38. [PMID: 27178077 DOI: 10.1016/j.jsr.2016.03.005] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/18/2015] [Revised: 02/29/2016] [Accepted: 03/10/2016] [Indexed: 06/05/2023]
Abstract
INTRODUCTION There are limited studies that measure the prevalence of driving under the influence of drugs (DUID) based upon impairment measures because most prevalence studies are based on drug tests. The aim of this study was to provide the first estimate of DUID prevalence in Colorado using data collected by Colorado law enforcement officers in vehicular homicide (VH) and vehicular assault (VA) cases, and reported in court records. METHODS The four research questions of this study were answered by completing independent t-tests or Mann-Whitney U tests, Pearson chi-square analyses or Fisher's exact tests, and Kruskal-Wallis tests. RESULTS Seventy percent (119 out of 170) of the cases involved alcohol only and 30% (51 out of 170) involved drugs. Of the latter cases, 32 cases involved a combination of alcohol and drugs and 19 cases identified drugs only, with no alcohol. Marijuana was the most commonly cited drug (23 cases); however, it was the sole impairing substance identified in only three cases. CONCLUSION Polydrug use was very common among DUID cases, which makes it difficult to identify which drug or drugs caused the impairment responsible for the Driving Under the Influence citation. This study revealed tha (a) drugged driving is a frequent cause of DUI citations in cases charged with VH or VA; (b) that polydrug use, rather than marijuana, is the most common cause of drugged driving in Colorado; and (c) that current warrant procedures render blood test results meaningless in cases of marijuana-impairment. PRACTICAL APPLICATION States should collect and analyze DUID data to ensure legislators focus on the right DUID problems to improve biological testing for drugs, adopt more appropriate roadside testing, and enact stronger DUID laws to protect the public.
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Affiliation(s)
- Ed Wood
- DUID Victim Voices, Morrison, CO, USA.
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