Drug-Impaired Driving in the UnitedStates and TexasTroy Walden, Ph.D.Center for Alcohol & Drug Education StudiesTexas A&M Transportation Institute- College Station, Texas1The magnitude and effects of drugs ondriving depends on:SubstanceCombinationofsubstancesDoseExtent ofprior usePresentationForeword“A large enough dose of most drugs canimpair. The purpose of any drug is to affectphysical or mental conditions in some way.Even prescription medications can impairdriving.”- GHSA2Drug-Impaired DrivingBackground31

Drug-ImpairedDriving: UnitedStates Difficult to measure magnitude of drugimpaired driving There is no good roadside test for drug levels Police often do not test for drugs if there isenough evidence of a DUI-alcohol Polydrug use Limited data available on drugged driving4Drug-Impaired Driving: United States 2013-2014 NHTSA Roadside Survey of Alcohol and Drug Use Drugs present in 22% of drivers on weekend nights and weekdaydays had drugs in their system Weekend SurveysDrug Category Percent ofPercent ofDifferenceSamples 2013- Samples 20072014Illegal ns4.9%3.9%1.0%58.5%Drug-ImpairedDriving: UnitedStates 2013-2014 NHTSA RoadsideSurvey of Alcohol and DrugUse 20% of drivers reportedusing a prescriptiondrug within the past oticsStimulants62

Number of Drivers with Positive Drug Test, 2008-20158,000Drug-ImpairedDriving: 201220136,6406,0965,9466,0005,000Fatality Analysis ReportingSystem (FARS)4,000 Drugs present in 43% offatally-injured drivers with aknown test result in 20153,000 There were 49,549 driverswho tested positive for adrug from 2008-20152,0001,000020102011201420157Most Common Drug Types Detected: UnitedStatesYearTotal DriversPositive DrugTestDrug TypeCannabinoidStimulantDepressantNarcoticNo. OfDrivers (% ofTotal)With alcohol(%)No. OfDrivers (% ofTotal)With alcohol(%)No. OfDrivers (% ofTotal)With alcohol(%)No. OfDrivers (% ofTotal)With alcohol(%)20085,4221,982 (37%)720 (36%)1,310 (24%)445 (34%)1,138 (21%)308 (27%)1,065 (20%)246 (23%)20095,5001,956 (36%)748 (38%)1,243 (23%)421 (34%)1,216 (22%)324 (27%)1,181 (21%)254 (22%)20105,9462,110 (35%)805 (38%)1,254 (21%)418 (33%)1,452 (24%)376 (26%)1,307 (22%)286 (22%)20116,0962,055 (34%)742 (36%)1,256 (21%)384 (31%)1,379 (23%)339 (25%)1,380 (23%)275 (20%)20126,5722,369 (36%)803 (34%)1,324 (20%)412 (31%)1,404 (21%)330 (24%)1,400 (21%)291 (21%)20136,5402,413 (37%)848 (35%)1,494 (23%)422 (28%)1,492 (23%)377 (25%)1,385 (21%)274 (20%)20146,6402,577 (39%)826 (32%)1,512 (23%)427 (28%)1,422 (21%)357 (25%)1,321 (20%)265 (20%)20156,8332,805 (41%)828 (30%)1,622 (24%)389 (24%)1,476 (22%)321 (22%)1,440 (21%)254 (18%)8Number of Fatalities Due to Drug-Impaired Crashes, 064062060058020102011Drug-Impaired Driving: Texas20122013201420152016 From 2010-2016, there were 4,953 fatalities due to drug-impairedcrashes in Texas93

Year Stimulant Cannabinoid Depressant 4762016376309164111Total1,9861,8411,170761Most Common Drug Types Detected: Texas10Stimulants and Driving11Stimulants Medicines or drugs that increasealertness, attention, and energy Amphetamines Adderall Methamphetamine Cocaine Methylphenidate Ritalin124

Effects Increased alertness Increased attention Increased blood pressure Increased heart rate Increased breathing Decreased ability to focusStimulants13Adults are prescribed morestimulants than youth Stimulant prescriptions in adultsincreased 6.4 fold from 1995 to1998 Youth increased by 2.5 foldStimulant UseWomen take morestimulants compared to men14Stimulant’s Impact on DrivingImpacts motorand cognitiveskillsReducesability to focusOverconfidence indriving skillsReducesbalance andcoordinationIncreased risktaking155

Marijuana and Driving16MarijuanaMarijuana or Cannabis are the dried leaves, flowers, and stems fromthe Cannabis sativa and Cannabis indica plants Delta-9-tetrahydocannabinol (THC) Weed, Grass, Bud, KushEffects: Problems with memoryProblems with learningDistorted perceptionDifficulty in thinkingLoss of coordination17Marijuana Use Marijuana is the most commonlyused illicit drug in the UnitedStates. Marijuana use is increasing overtime. Marijuana use among driversexceeds the rate of alcohol useamong drivers.186

19Marijuana’s Impact on Driving Recent marijuana use approximately double the risk of traffic crash. Marijuana use impairs:Road trackingBrake latencyAbility togauge timeand distanceRecognition oflightsDividedattentiontasksAbility to passAbility tomaintainheadwayInhibitorycontrol20FARS: United States Cannabinoid Positive Drivers, by Genderand AgeYearTotalGenderAge GroupMaleFemale 16 to24 yrs.25 to34 yrs.35 to44 yrs.55 17

Depressants and Driving22Psychoactive drugs that slow down the activity ofthe central nervous system Alcohol Barbiturates (Barbs, Phennies, Birds, Reds) Benzodiazepines (Bars, Candy, Downers,Tranks) Sleep Medications (Ludes, Roofies) Heroin Inhalants KetamineDepressants23EffectsDepressants Feel relaxed Reduced alertness Reduced heart rate Reduced breathing DrowsinessDose and mixing more than onedepressant can impact your abilityto move and breath.248

Depressant Use Limited Trend Data Benzodiazepine From 2006 to 2015 the annual dose per inhabitant per day(DID) increased by 26% 23.70 to 94.25 DID25Depressant’s Impact on DrivingDepressant’s Impair:ReactionTimesConcentrationAbility toProcessInformationAbility toMultitask26Opioids and Driving279

Opioids are a class of drugs found in theopium poppy plant to relax the body andrelieve learningDistortedperceptionDifficulty inthinkingLoss ofcoordination28Opioid Use Opioid prescription rate isthree times higher than itwas in 1999 58 opioid prescriptions per100 Americans in 201729Opioid’s Impact on DrivingImpactspsychomotor andcognitivefunctioningIncreases errors ondriving tasksDrowsiness3010

Polydrug Use and Driving31Polydrug UseUsing two or more drugs incombination Using one drug to counteract theeffects of another Using drugs at different times overa short period of days or weeksIncludes alcohol, illegal drugs,prescription drugs, and over-thecounter medicines Alcohol is the most common druginvolved in polydrug use32Polydrug Use 23.1% of people used threeor more prescriptions in thepast 30 days in 2017 11.9% of people used fiveor more prescription drugsin the past 30 days in 20173311

Polydrug Use and DrivingRisk LevelRelative RiskDrug CategorySlightly increased risk1-3MarijuanaMedium increased risk2-10BenzodiazepinesCocaineOpioidHighly increased risk5-30AmphetaminesMultiple drugsExtremely increased risk20-200Alcohol together with drugsExtremely increased risk40*Alcohol*adapted from Shulze et al., 2012; Griffiths, 2014; GHSAA Guide for States34Solutions and Summary35While alcohol-impaired driving isdecreasing, drug-impaired drivingcrashes are increasingSummaryDrugs can impact driving ability andincrease crash riskEffects of drugs vary widelyacross drug categories3612

High-visibility enforcement Policies Per Se Drug Laws Zero Tolerance Laws Alcohol and drug courtPotential Solutions37FARSLimitations Not all drivers involved in fatalcrashes are drug tested Reporting of toxicology results toFARS varies Testing varies by state A positive drug test result does notindicate the driver was impaired atthe time of the crash FARS does not indicate that thenumber of fatal crashes involving adriver positive for cannabinoids hasincreased, but instead supports thenumber of drivers who tested positivefor cannabinoids reported to FARS hasincreased38Troy [email protected]

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NHTSA Drug-Impaired Driving GHSA's report Drug-Impaired Driving: Marijuana and Opioids Raise Critical Issues for States GHSA's report Drug-Impaired Driving: A Guide for States, 2017 Update Drugged Driving AAA Foundation Countermeasures Against Prescription and Over-the-Counter Drug-Impaired Driving References 1. Adrian, M. (2015).