In an attempt to shift the culture and keep people safe, Utah has adopted the strictest DUI law in the country by dropping the national standard for legal alcohol intoxication from 0.08 percent to 0.05 percent. All told, more American drivers are dying in car crashes where drugs are detected than they are from those involving only alcohol. This makes it more likely the new law is really an effort to combat this fact – the challenges that come with roadside testing other substances complicates the picture. Expect other states to follow Utah’s path.

The Reality

Multi-drug misuse and abuse – albeit prescription, over-the-counter (OTC) or illicit in nature – is a huge problem (not just in overdose risk). Whether these substances are used alone or in combination, when you throw alcohol into the mix, people are impaired even more.

It is hard to test on the roadside for many drugs that can impair driving. These drugs are often used with alcohol. So making alcohol rules stricter also gives more opportunity to test for these drugs.

Increasing legalization of marijuana and the lack of accurate, swift roadside testing to determine level of influence for many of these substances creates the perfect storm for a public health threat – one with a number of challenges to overcome to ensure safety on the roads.

Drugged Driving on the Rise

According to a report by the Governors Highway Safety Association (GHSA) and the Foundation for Advancing Alcohol Responsibility, the ten-year trend shows drug-impaired driving has increased while driving under the influence of alcohol has decreased.

“Drugged driving” corrects many preconceptions including the notion substances must be illicit in nature to cause problems. Whether legally prescribed, over-the-counter or illegally obtained, certain medicines whether used properly or abused can impair a driver.

According to the American Automobile Association (AAA), “prescription drugs are the most prevalent of all drugs found in drugged drivers involved in fatal crashes (46.5%), and the percentage has continually increased since 2005.” They contend benzodiazepines and opiates are the most common prescription drugs found in fatal and seriously injured drivers. The former is typically used for anxiety or sleep disturbances, the latter for alleviating pain (read here).

The National Institute on Drug Abuse declares “prescription and OTC drugs are, after marijuana (and alcohol), the most commonly abused substances by Americans 14 and older.”

There is a misunderstanding that if a drug is over-the-counter (OTC) it must be safer than a prescription. Or, a prescription drug must be okay because it treats a medical illness or condition. The reality is dosing, type of medicine along with its possession of psychoactive or mind-altering properties, half-life or metabolic breakdown duration, polypharmacy or mixture with alcohol or illicit substances all can serve to impair a driver.

Congressional Hearing Held to Assess Disturbing Trend

In July, the U.S. House of Representatives Committee On Energy and Commerce held a Congressional hearing to clarify the extent of the issue and inform on how best to guide policy to counter this disturbing trend. They hoped to determine scope, suss out accurate data on the topic and methods to garner more information, learn what states are doing to address drug-impaired driving (e.g. law enforcement action and training, roadside detection capabilities, public education), and understand how the federal government was dealing with the ballooning predicament including examining the National Highway Traffic Safety Administration’s (NHTSA) new initiative, launched in January, to “combat drugged driving, a growing problem on U.S. roads.” (Review here to learn more about it).

The Challenges to Testing

There are innumerable drugs that can impair driving ranging from recreational to therapeutic. When it comes to drugged driving, benzodiazepines, opioids, and marijuana are the biggest culprits. Marijuana is the “illicit drug most frequently found in the blood of drivers who have been involved in vehicle crashes, including fatal ones.” It can slow response time, impede decision-making and impact coordination. Pairing with alcohol causes a double whammy in diminishing capacity.

Currently, aside from field sobriety tests or a breathalyzer for alcohol exposure there is no reliable, rapid roadside test for the host of other intoxicants. They cannot all be tested the same way. Drugs have different pathways and rates of metabolism, for instance, some require blood analysis. Though officers can readily assess that someone is impaired, they can’t determine the extent to which they are and have no means of testing that satisfies the court – legal thresholds can be tricky. Marijuana has a long half-life, so assessing when exactly a person last smoked can be difficult. A number of companies are trying to come up with a saliva or breathalyzer test, but progress has been disappointing. There are many variables to consider in determining an individual’s impairment as size, clinical status and multi-drug use all contribute to alterations in degrees of influence.

Their Bottom Line From The Hearing

Drug-impaired driving is a preventable misfortune that has many consequences, including but not limited to emotional anguish, suffering, short- and long-term disability or death, increased health care burdens and its accompanying costs. Policy suggestions have ranged from zero tolerance for those under age 21 (like the alcohol laws) especially given the strides in marijuana legalization to reducing the blood alcohol concentration limit.

Given the frequency of people’s use of alcohol mixed with drugs and its known testing capability, some have encouraged using its presence as a baseline for reflexively testing for other drugs. Imposing hefty penalties for poly drug users is another proposition. Improving officer training in field sobriety testing and recognizing an impaired driver are additional areas of concentration. Educating the public on the hazards of these behaviors is a no-brainer as part of prevention efforts. 

In the End 

Time will tell the influence of Utah’s new legislation and if it will have an impact on behavior. To learn more about the wide-ranging adverse consequences of driver distraction or impaired driving, read these pieces:

·         Much-Needed Congressional Hearing Examines Rise In Drug-Impaired Driving

·         'Drugged Driving' Not Just Tiger Woods' Issue

·         Polypharmacy Problems Go Beyond Tiger Woods

·         Please, Beto O’Rourke, Drive Safely