Twelve cases of suspected impaired driving are discussed in which the drivers who subsequently tested positive for synthetic cannabinoid drugs underwent a psychophysical assessment. The attitude of the drivers was described as cooperative and relaxed, speech was slow and slurred and coordination was poor. Pulse and blood pressure were generally elevated. Horizontal gaze nystagmus was assessed in nine of the subjects, but was present in only two. The most consistent indicator was a marked lack of convergence. In all cases where a Drug Recognition Expert (DRE) officer evaluated and documented impairment (10 cases), it was attributed to the DRE cannabis category. Performance in field sobriety tests was variable, ranging from poor to minimal observable effect. Synthetic cannabinoid testing was performed by LC‐MS-MS. Positive results included: JWH-018 (n 5 4), 0.1‐1.1 ng/mL; JWH-081 (n 5 2) qualitative only; JWH-122 (n 5 3), 2.5 ng/mL; JWH-210 (n 5 4), 0.1 ng/mL; JWH250 (n 5 1), 0.38 ng/mL and AM-2201 (n 5 6), 0.43‐4.0 ng/mL. While there is good evidence of psychophysical impairment in these subjects, further structured data collection is needed to fully assess the relationship between synthetic cannabinoid use and psychomotor and cognitive impairment.

/pdf/blood-synthetic-cannabinoid-concentrations-in-cases-of-4w5sq3w46z.pdf

Blood Synthetic Cannabinoid Concentrations in Cases of Suspected Impaired Driving

An examination of the validity of the standardized field sobriety test in detecting drug impairment using data from the Drug Evaluation and Classification program.

http://www.madd.ca/media/docs/drug-impaired-tirf.pdf

Canada's New Drug-Impaired Driving Law: The Need to Consider Other Approaches

Motor vehicle accidents due to prescription drug impairment have increased in the past decade. Typically, impairment is associated with medications causing excessive drowsiness, such as opioids or benzodiazepines, but the scope of driving under the influence (DUI)-drug charges is reaching into medications that are not typically considered impairing, such as antipsychotics, antiepileptics, and mood stabilizers. Data associating medication use with driving impairment are growing, especially with agents not typically thought of as impairing. Forty-three states currently train drug recognition experts who employ a 12-step evaluation to detect the presence of drug impairment. Seventeen states have instituted “per se” laws, which make it illegal to drive with the presence of drugs or metabolites in the body. Pharmacists should recognize an ethical, professional, and perhaps legal responsibility to inform patients of the risk of impaired driving with prescription agents. Pharmacists should reconsider how they ar...

Driving Under the Influence, Public Policy, and Pharmacy Practice

The objective of this paper is to illustrate the accuracy with which police officers trained as Drug Recognition Experts (DREs) can identify the category of drug(s) ingested by persons suspected of being impaired as the result of drug use. The study examined 1,349 drug evaluations completed by DREs in Canada to determine the extent to which DRE opinions about the category of drug(s) used matched the results of toxicological analysis of fluid samples. The paper presents measures of sensitivity, specificity, the false alarm rate, and miss rate for all drug categories combined as well as for the most commonly found substances. The data demonstrate that the drug evaluations conducted by DREs in Canada are accurate.

Jacques Lecavalier

Papers

Evaluation of the Drug Evaluation and Classification program: a critical review of the evidence.

The Accuracy of Evaluations by Drug Recognition Experts in Canada