By Chuck Hayes, Patrol Operations Captain, Oregon State Police (Retired), Salem, Oregon; Drug Evaluation and Classification Program Regional Operations Coordinator, IACP
growing body of research is confirming what law enforcement officers and traffic safety experts have suspected for years: that many licit, illicit, and over-the-counter drugs impair a driver’s ability to operate a vehicle. Much of this research has involved laboratory or experimental studies using driving simulators, although some epidemiological studies have examined the effect of drugs on crash prevalence and risk. While data focusing on the danger of driving under the influence (DUI) caused by alcohol is readily available, and often cited, less is known or discussed about the dangers associated with DUI caused by drugs other than alcohol.
DUI is an issue that crosses all segments of society and endangers everyone using U.S. roadways. For many years traffic safety professionals throughout the United States have focused primarily on alcohol-impaired driving, which is responsible for an alarming percentage of traffic deaths each year. In recent years, great strides have been made to combat drunk driving and as a result, many lives have been saved. The National Highway Traffic Safety Administration (NHTSA) recently reported that U.S. alcohol-related fatalities once again declined 2.5 percent from 2010 to 2011;1 however, at the same time, drugs other than alcohol or mixed in combination with alcohol, have become more prevalent in impaired driving fatal crashes. In a recent study, researchers looked at four types of fatal crashes from 14 states and determined that approximately 25 percent of the drivers in those crashes tested positive for drugs.2 This study, which was one of the first to show the prevalence of drug use among fatally injured drivers, provides further evidence of a link between drug use and fatal crashes.
Many examples of the hazards of drugged driving illustrate this growing problem. In August 2011, a 54-year-old female driver
struck and killed three women leaving a church in New York.3 The driver claimed that her sandal wedged around the gas pedal causing her to accelerate uncontrollably prior to hitting the ladies. Toxicology tests, however, confirmed the presence of two prescription drugs in her system: Alprazolam (Xanax)—a medication that can cause drowsiness and dizziness, which is often prescribed for treating anxiety disorders—and Quetiapine (Seroquel), an antipsychotic drug that can also cause drowsiness and dizziness.
One month later in Salem, Oregon, a 29-year-old female driver hit three teenagers after they had exited a city bus, killing two and leaving a third in critical condition.4 Police suspected the driver was impaired although no alcohol was involved. A drug recognition expert (DRE) assisted with the investigation and determined that the driver was under the influence of drugs. Toxicology confirmed the presence of four prescription medications in her system: Lorazepam (Ativan); Cyclobenzaprine (Flexeril); Bupropion (Wellbutrin); and Hydroxybupropion, a metabolite of Bupropion, all Central Nervous System depressants with the potential of causing driving impairment.
On September 26, 2012, in Ventura, California, a school bus driver with 11 children on board her bus fatally struck a 75-year-old pedestrian.5 The investigating officers suspected she was under the influence of drugs at the time of the crash. The DRE who assisted in the investigation confirmed those suspicions, and the driver was charged with drugged driving.
On January 14, 2013, a 46-year-old man sped his vehicle recklessly through a Sayville, New York, business district hitting numerous vehicles until slamming head-on into another vehicle, killing the 82-year-old driver and seriously injuring his passenger. The driver was charged with driving under the influence of drugs (DUID).6
Incidents like these involving both legal and illegal drugs are occurring more frequently on U.S. roadways. In a November 2010 report on drug use by drivers involved in fatal crashes, NHTSA reported that postmortem test results showed an increase in the level of drug involvement among fatally injured drivers from 2005 to 2009. The report shows drug use among fatally injured drivers increased from 13 percent in 2005, to 15 percent in 2006, to 16 percent in 2007, and 18 percent in 2008.7
The report prompted NHTSA Administrator David Strickland to release the following statement: “Every driver on the road has a personal responsibility to operate his or her vehicle with full and uncompromised attention on the driving task and this report provides a warning signal that too many Americans are driving after having taken drugs, not realizing the potential for putting themselves and others on the highway at risk.”8
To help address the increasing incidents of drivers impaired by drugs, the International Association of Chiefs of Police (IACP), working together with NHTSA, continues to coordinate and manage the Drug Evaluation and Classification Program (DECP), also referred to as the DRE Program. As of December 2012, 49 states plus the District of Columbia were recognized by the IACP’s Highway Safety Committee as officially approved DECP states.9
The DECP trains officers as DREs who use their specialized training to detect and identify drivers suspected of drug impairment and to identify the drug category (or categories) likely causing the impairment. In the early days of DRE, the primary emphasis of the comprehensive training focused on illegal drugs, such as cocaine, marijuana, heroin, and methamphetamine. In recent years with the concerns of prescription drug use and abuse and new “designer” drugs being used, there is an increasing awareness of many of the potentially impairing prescription drugs, as well as the new synthetic substances that can impair a driver’s ability to operate a vehicle safely. As the drug culture changes, drugged-driving detection training must also change to keep up. The aim of DECP is to provide police officers with the most current training to detect both alcohol and drug impairment.
With the increases in drugged driving, the majority of states in the United States now include “any drug” or “any impairing substance” in their DUI statutes.10 However, a few states retain laws that only allow for certain drugs, that is, controlled substances. The DRE definition of a drug is, “Any substance that, when taken into the human body can impair the ability of the person to operate a vehicle safely.”11 State DUI statutes that do not include any drug or any impairing substance undoubtedly have impaired drivers’ being arrested but avoiding prosecution. Seventeen states have strict drugged-driving per se laws that also help to address the drugged-driving problem.12 However, efforts to establish more such laws have stalled. Drugged-driving per se laws can be effective when the impairing substance detected in the offending driver is an illegal substance; yet, if the impairing substance is determined to be a legal drug, the law may not always apply, and the impairment issue reverts to the arresting officer or a DRE involved in the investigation.
The drugged-driving problem appears unlikely to abate anytime soon and is drawing the attention of many groups and organizations. The U.S. Office of National Drug Control Policy (ONDCP) National Drug Control Strategy includes a goal of reducing drugged driving in the United States by 10 percent by the year 2015. Specifically, ONDCP aims to make preventing drugged driving a U.S. priority on par with preventing drunk driving. To work toward this goal, the strategy calls for states to adopt per se laws, collecting drugged-driving data, educating the communities and professionals of the hazards of drugged driving, and increasing the training to law enforcement on identifying drugged drivers.13
One ongoing issue that has helped fuel the drugged-driving problem is the rising use of illicit drugs in the United States. In 2012, 8.7 percent of U.S. citizens aged 12 and older—an estimated 21.8 million people—admitted using illicit drugs in the prior month—a 9 percent increase from previous years.14 The rise was driven largely by an increase in the use of marijuana, which has steadily increased through the years and continues to be the most commonly used illicit drug for persons 12 and older.15
Another factor is the growing number of elderly people using drugs, both legal and illegal. A recent report relates a dramatic increase in illicit drug use in adults age 50 and older, including an alarming rate of nonmedical use of prescription drugs among women age 60 to 64.16 The report also states that an estimated 4.7 percent of older adults (4.3 million) had used an illegal drug in the past year. The report also shows that men age 50 and older were almost twice as likely to use marijuana over the nonmedical use of prescription drugs. In those persons age 65 years or older, the use of nonmedical prescription drugs was found to be more common than marijuana use. These statistics, combined with the fact that the United States is expected to have over 92 million people above the age of 60 by 2030, is another cause for concern in the coming years.17
In a related study by LeRoy and Morse, researchers examine the association between multiple medication use and motor vehicle crashes among people age 50 and older. The study finds a large percentage of older people (64 percent) take medications that can potentially impair their driving, and those people taking three or more impairing medications were 87 percent more likely to be involved in a crash.18
As previously mentioned, DREs are now in 49 of the 50 states and the program has expanded to countries outside the United States. The IACP collects DRE-related data from each of the DECP states for the IACP’s DRE Section annual report. This report provides a state-by-state overview of the enforcement activities of the DREs for the previous calendar year. In 2011, more than 6,300 DREs nationwide conducted approximately 23,000 drug evaluations of suspected drug-impaired drivers—a figure that demonstrates the seriousness of U.S. drugged driving.19
In addition to the DRE data collected through the states’ annual reports, NHTSA has developed a national DRE database to collect and track DRE evaluations throughout the United States. As of March 1, 2013, over 245,000 drug evaluations of suspected drugged drivers had been entered into the national tracking system by DREs from 4,639 law enforcement agencies.20
Many states have strongly embraced the importance of drugged-driving recognition training for police officers, prosecutors, and toxicologists. Those efforts have resulted in increased DUID arrests. One example is in Arizona where DRE training is strongly emphasized and highly supported by the Governor’s Office of Highway Safety. In 2012, drugged-driving arrests increased by 11.9 percent from 2011 and by more than 40 percent from 2010.21 The same can be said for Pennsylvania, where DUID arrests have increased by 170 percent from 2004, the year they began training DREs, to 2011.22
In addition, a number of DECP states have seen significant decreases in traffic fatalities, which can be partially attributed to a number of traffic safety initiatives, including the active use of DREs and increased drugged-driving enforcement efforts. A good example is Oregon with a 26 percent decrease in drug-related traffic deaths from 2007 to 2011 and a 31 percent increase in DUID arrests during the same period. The only year Oregon experienced a spike in drug-related fatalities was the same year in which there was a noticeable decline in drugged-driving arrests and a decline of DRE drug evaluations.23
According to the IACP certification records through December 31, 2011, there were 6,837 DREs in 49 states and the District of Columbia. California leads the nation with 1,297 DREs and of those, 683 were within the highway patrol. The year-end national breakdown of DREs state-by-state and by law enforcement disciplines showed that 1,945 were state police or highway patrol officers, 3,659 were city police officers, 1,075 were employed by sheriff’s departments, and 158 were classified as “other” with affiliations with various state, county, and federal enforcement agencies.24
Most state police or highway patrol agencies have embraced the DECP and the benefits of having DREs. The New Jersey State Police and the Texas Department of Public Safety follow California with 99 and 94 state police or highway patrol DREs, respectively. The national average is 36 state police or highway patrol DREs per state; yet a number of states that have been in the program for at least three years have fewer than 10 state police or highway patrol DREs (Alabama, Alaska, Delaware, Illinois, Indiana, Kentucky, Louisiana, Maine, Mississippi, North Dakota, Rhode Island, Virginia, and Wisconsin).
DRE training consists of 72 hours of comprehensive classroom training and another 20–24 hours of hands-on certification training.25 Not all police officers can be or want to be DRE-trained, and it is unlikely that all law enforcement agencies can actively participate in the DECP. To assist those law enforcement agencies, NHTSA, working in conjunction with the IACP, developed the 16-hour Advanced Roadside Impaired Driving Enforcement (ARIDE) training program. This training bridges the gap between the standardized field sobriety test (SFST) and DRE training. The training is conducted by certified and IACP-credentialed DRE instructors and includes SFST proficiency as well as training on the basic impairment indicators associated with the DRE drug categories. The course does not replace the DRE or qualify officers to be DREs.
It is estimated that more than 12,000 police officers received ARIDE training during the past two years. Several state police agencies have completely embraced the training with some making it mandatory for their officers. The Montana Highway Patrol was the first state highway patrol agency to make ARIDE mandatory and completed the training in 2012. Other state police or highway patrol agencies have made the training mandatory, including the Ohio State Highway Patrol and the Tennessee Highway Patrol with more to follow. In 2013, states will have the option of conducting live ARIDE classroom training or using a new online ARIDE training version, or both.
With the increases in prescription drug use and abuse, combined with the increases in marijuana use, it is likely drugged driving will increase thereby creating additional dangers on U.S. roadways. It makes good sense to expand drugged-driving enforcement training for police officers, prosecutors, and toxicologists. ARIDE and DRE provide the necessary tools to assist officers in detecting drivers who are impaired by alcohol or drugs or a combination of the two. To learn more about DRE or the ARIDE training, contact the IACP at www.decp.org.
Strategies to Reduce Drugged Driving
The drugged-driving problem is arguably at its highest level in history. With the increasing usage of both legal and illegal drugs, effective strategies are needed. Law enforcement cannot stop the drugged-driving problem alone. The problem is much too large and demands collaborative efforts. Some strategies to combat drugged driving include, but are not limited to, the following:
- Expanding education and public awareness on the risks and hazards of potentially driver impairing (PDI) medications, particularly among high-risk groups.
- Expanding research of the most frequently implicated prescription drugs and over-the-counter substances involved in impaired-driving episodes and educating clinicians and health providers on their potential hazards.
- Expanding research on the adverse effects of new prescription drugs on driving performance.
- Encouraging all states to enact impaired-driving laws that include “any drug” or “any impairing substance” to help address issues caused by the increase in the creation of impairing substances.
- Increasing drugged-driving training and education for law enforcement, prosecutors, toxicologists, judges, and highway safety professionals.
- Expanding the DECP and mandating ARIDE training for all patrol officers.
- Implementing illegal per se drug laws nationally with a zero tolerance for illegal drugs.
- Expanding the research to better identify and understand the drugged-driving problem.
- Establishing uniform standards for laboratory drug toxicology testing throughout the United States.
- Expanding efforts to improve warning information regarding potential driving impairment for prescription and over-the-counter drugs that have impaired-driving risks.♦
1“State Motor Vehicle Fatalities and State Alcohol-Impaired Motor Vehicle Fatalities, 2011,” Traffic Safety Facts: Crash Stats, DOT HS 811 699 (National Highway Traffic Safety Administration, December 2012), http://www-nrd.nhtsa.dot.gov/Pubs/811699.pdf (accessed June 10, 2013).
2Eduardo Romano and Robert Voas, “Drug and Alcohol Involvement in Four Types of Fatal Crashes,” Journal of Studies on Alcohol and Drugs 72, no. 4 (July 2011): 567-576.
3“SUV Kills Three Pedestrians in Grisly N.Y. Wreck,” CBS News, August 10, 2011, http://www.cbsnews.com/2100-201_162-20090931.html (accessed June 10, 2013).
4“Salem Woman Convicted in Deaths, Injury of Pedestrians near Chemeketa Community College” Associated Press, April 18, 2012, http://www.oregonlive.com/pacific-northwest-news/index.ssf/2012/04/salem_woman_convicted_in_death.html (accessed June 10, 2013).
5Steve Chawkins, “School Bus Driver Fatally Hits 75-Year Old, Arrested on DUI,” L.A. Now, Los Angeles Times, September 27, 2012, http://latimesblogs.latimes.com/lanow/2012/09/school-bus-driver-arrested-in-fatality.html (accessed June 10, 2013).
6“Cops: Man High on Drugs in Fatal Sayville Crash,” News 12 – Long Island, January 14, 2013, http://longisland.news12.com/news/cops-man-high-on-drugs-in-fatal-sayville-crash-1.4444193?firstfree=yes (accessed June 10, 2013).
7Drug Testing and Drug-Involved Driving of Fatally Injured Drivers in the United States: 2005–2009, Office of National Drug Control Policy, Executive Office of the President (Washington, D.C.: Government Printing Office, October 2011), http://www.whitehouse.gov/sites/default/files/ondcp/issues-content/fars_report_october_2011.pdf (accessed June ).
8National Highway Traffic Safety Administration, “NHTSA Reports Drug Use among Fatally Injured Drivers Increased over Last Five Years,” press release, NHTSA 16-10, November 30, 2010, http://www.nhtsa.gov/PR/NHTSA-16-10 (accessed June 11, 2013).
9International Association of Chiefs of Police, “Drug Evaluation and Classification Program,” http://www.decp.org (accessed June 11, 2013).
10National Highway Traffic Safety Administration, Digest of Impaired Driving and Selected Beverage Control Laws, 26th ed., DOT HS 811 673 (October 2012) http://www.nhtsa.gov/staticfiles/nti/pdf/811673.pdf (accessed June 11, 2013).
11National Highway Traffic Safety Administration, Drug Evaluation and Classification Training: The Drug Recognition Expert School, January 2011 ed., DOT HS172. (Washington, D.C.: U.S. Department of Transportation, 2011).
12“Drug Impaired Driving Laws,” Governor’s Highway Safety Association, June 2013, http://www.ghsa.org/html/stateinfo/laws/dre_perse_laws.html (accessed June 11, 2013).
132012 National Drug Control Strategy, Office of National Drug Control Policy, Executive Office of the President (Washington D.C.: Government Printing Office), 43–44, http://www.whitehouse.gov/sites/default/files/ondcp/2012_ndcs.pdf (accessed June 11, 2013).
14U.S. Department of Health and Human Services, Substance Abuse and Mental Health Services Administration, Results from the 2009 National Survey on Drug Use and Health: Summary of National Findings vol. 1, NSDUH Series H-38A, HHS pub. no. SMA 10-4586 (Rockville, Md.: Office of Applied Studies, 2010), http://www.gmhc.org/files/editor/file/a_pa_nat_drug_use_survey.pdf (accessed June 11, 2013).
15U.S. Department of Health and Human Services, Substance Abuse and Mental Health Services Administration, Results from the 2011 National Survey on Drug Use and Health: Summary of National Findings, NSDUH Series H-44, HHS pub. no. SMA 12-4713 (Rockville, Md.: Center for Behavioral Health Statistics and Quality, 2012), http://www.samhsa.gov/data/NSDUH/2K11Results/NSDUHresults2011.pdf (accessed June 11, 2013).
16Older Adults’ Knowledge about Medications That Can Impact Driving (Washington, D.C.: AAA Foundation for Traffic Safety, August 2009), https://www.aaafoundation.org/sites/default/files/KnowledgeAboutMedicationsAndDrivingReport.pdf (accessed June 11, 2013).
17“Projected Future Growth of the Older Population,” Department of Health and Human Services, http://www.aoa.gov/aoaroot/aging_statistics/future_growth/future_growth.aspx (accessed June 11, 2013).
18Aida A. Leroy and M. Lee Morse, Multiple Medications and Vehicle Crashes: Analysis of Databases, DOT HS 810 858 (Washington D.C.: National Highway Traffic Safety Administration, May 2008).
19International Association of Chiefs of Police, The 2010 Annual Report: The Drug Recognition Expert Section (Alexandria, Va.: IACP, September 2011), http://www.decp.org/oversight/2010Annualreport.pdf (accessed June 11, 2013).
20NHTSA, DRE National Tracking System, www.sobrietytesting.org (accessed June 11, 2013).
21Kimberly Cheng, “Drugged Driving on the Rise, Arrests up in Arizona, Valley” East Valley Tribune, January 18, 2013, http://www.eastvalleytribune.com/local/cop_shop/article_258577dc-61c5-11e2-b3e1-001a4bcf887a.html (accessed June 11, 2013).
22Pennsylvania DUI Association, DRE data, February 2013.
23Oregon Department of Transportation, 2011 Traffic Safety Division Performance Plan (October 2010), http://www.oregon.gov/ODOT/TS/docs/publications/2011_pv_perf_plan_final_print.pdf (accessed June 11, 2013).
24State-by-State DRE database, International Association of Chiefs of Police, December 2012.
25International Association of Chiefs of Police, The International Standards of the Drug Evaluation and Classification Program, (DEC Standards Revision Subcommittee, October 2012), http://www.decp.org/coordinators/state/resources.htm (accessed June 12, 2013).
Please cite as:
Chuck Hayes, "Efforts Continue to Address Drugged Driving, But Is It Enough?" The Police Chief 80 (July 2013): 28–32.