INTRODUCTION TO DRUGGED DRIVING PARTICIPANT S MANUAL HS 178A R2/06

Transcription

1 INTRODUCTION TO DRUGGED DRIVING PARTICIPANT S MANUAL HS 178A R2/06

2 INTRODUCTION TO DRUGGED DRIVING Upn successfully cmpleting this mdule f instructin, the participant will be able t: define the term "drug" in the cntext f DWI enfrcement. describe in apprximate, quantitative terms the incidence f drug invlvement in mtr vehicle crashes and in DWI enfrcement. name the majr categries f drugs. describe the bservable signs generally assciated with the majr drug categries. describe medical cnditins and ther situatins than can prduce similar signs. describe apprpriate prcedures fr dealing with drug-impaired r medically-impaired suspects. Cntent Segments Learning Activities A. Overview Instructr-Led Presentatins B. Eye Examinatins: Detecting Signs f Drug Influence Participant Practice C. Drug Categries and Their Observable Effects Vide Presentatins D. Cmbinatins f Drugs E. Demnstratins f Drug Influence (Vide/DVD) F. Dealing with Suspected Drug Influence r Medical Impairment HS 178A R2/06

3 A. OVERVIEW The purpse f this mdule is t acquaint yu with the infrmatin nw becming available n the recgnitin f individuals wh may be medically impaired r under the influence f drugs ther than alchl, and t assist yu in preparing t prsecute such cases. It is clear that plice fficers respnsible fr traffic law enfrcement will encunter drug-impaired drivers. The best available data suggest that tens f millins f Americans rutinely use drugs ther than alchl. And, sme f these peple at least smetimes drive when they are under the influence f thse drugs. Sme drug-impaired drivers lk and act very much like alchl-impaired drivers. Others lk and act very differently. All f them are dangerus, t themselves and t everyne else n the rad. 1. What is a "drug" The wrd "drug" means many things t many peple. The wrd is used in a number f different ways, by different peple, t cnvey sme very different ideas. Sme sample definitins frm dictinaries: "A drug is a substance used as a medicine r in making medicines." (Webster's Seventh New Cllegiate Dictinary, 1971) This definitin seems t exclude any substance that has n medicinal value. But there are many nn-medicinal substances that regularly are abused. Mdel airplane glue is ne such substance. "A drug is a narctic substance r preparatin." (Als frm Webster's). Webster's further defines a narctic as smething that "sthes, relieves r lulls". Clearly, nt all drugs that are f cncern t plice fficers are narctics. Ccaine, fr example, is very different frm a narctic. "A drug is a chemical substance administered t a persn r animal t prevent r cure disease r therwise t enhance physical r mental welfare." (Frm Randm Huse's Cllege Dictinary, 1982) Here again, anything that has n medicinal value apparently des nt fit the dictinary ntin f a "drug". HS 178A R2/06 1

4 Frm the perspective f traffic law enfrcement, a nn-medicinal cncept f "drug" is needed. The definitin we will use is adapted frm the Califrnia Vehicle Cde, Sectin 312: A drug is any substance, which when taken int the human bdy, can impair the ability f the persn t perate a vehicle safely. 2. Categries f drugs Within the simple, enfrcement-riented definitin f "drug" that we have adpted, there are seven brad categries. The categries differ frm ne t anther in terms f hw they affect peple and in terms f the bservable signs f impairment they prduce. Central Nervus System Depressants This categry includes a large number f different drugs, all f which slw dwn the peratin f the brain and ther parts f the central nervus system (CNS). The mst familiar drug f all--alchl--is a central nervus system depressant. Central Nervus System Stimulants This categry als includes a large number f drugs, all f which act quite differently frm the depressants. Central nervus system stimulants impair by "speeding up", r ver-stimulating the brain. Ccaine is an example f a CNS stimulant. Hallucingens This categry includes sme natural, rganic substances, and sme synthetic chemicals. All hallucingens impair the user's ability t perceive the wrld as it really is. Peyte (which cmes frm a particular variety f cactus) is a naturally-ccurring hallucingen. LSD is an example f a synthetic hallucingen. Dissciative Anesthetics This categry cnsists f the drug PCP and its varius analgs (r "chemical cusins") and Dextrmethrphan (DXM). Originally develped fr use as an anesthetic, PCP is a pwerful drug that in sme ways acts like a depressant, in ther ways like a stimulant, and in still ther ways like an hallucingen. Ketamine is an analg f PCP. Narctic Analgesics This categry includes the natural derivatives f pium, such as mrphine, herin, cdeine and many thers. The categry als includes many synthetic drugs, such as demerl, methadne and thers. All narctic analgesics relieve pain (that is what "analgesic" means) and prduce addictin. HS 178A R2/06 2

5 Inhalants This categry includes many familiar husehld materials such as paint, mdel airplane glue, aersl sprays, etc. Nne f these substances is manufactured fr use as a drug. Hwever, they prduce vlatile fumes that can prduce significant impairment, and they are abused by sme peple. Cannabis This is the categry that includes marijuana hashish, as well as synthetic cmpunds. Each categry f drugs prduces a distinct set f bservable effects. N tw categries affect peple in exactly the same way. 3. Frequency f drug use N ne knws with any appreciable degree f certainty hw many Americans use drugs, r hw frequently the varius drugs are used. Estimates f drug use vary widely, and the estimates apparently depend n the kinds f peple wh were surveyed, where they were surveyed and the methds used. But all estimates agree that an appreciable segment f this cuntry's ppulatin d use drugs. All available infrmatin shws that drug use and abuse are widespread amng large segments f the American public. A 2002 survey (Natinal Survey n Drug Use and Health) revealed that ne in seven Americans aged 12 years r lder (14.2 percent r 33.5 millin peple) admitted driving under the influence f alchl at least nce in the past year. The same survey als revealed that in 2003, an estimated 19.5 millin Americans, r 8.2 percent f the ppulatin aged 12 years r lder, were current illicit drug users, and that marijuana was the mst cmmnly used illicit drug, with a rate f 6.2 percent (14.6 millin) in In 2003, an estimated 11 millin peple reprted driving under the influence f an illicit drug during the past year. As many as 18 percent f 21 year-lds reprted having driven under the influence f drugs at least nce during the past year. (NSDUH Reprt: Drugged Driving, 2003 Update) HS 178A R2/06 3

6 B. EYE EXAMINATIONS: IMPORTANT CLUES OF DRUG INFLUENCE A suspect's eyes ften disclse sme very imprtant, and easy-t-bserve indicatrs f drug influence r medical impairment. Five eye examinatins are especially helpful: Resting Nystagmus Tracking Ability Pupil Size Hrizntal Gaze Nystagmus Vertical Nystagmus Resting Nystagmus is referred t as jerking as the eyes lk straight ahead. This cnditin is nt frequently seen. Its presence usually indicates a pathlgy r high dses f a drug such as PCP. NOTE: Resting Nystagmus may als be a medical prblem. Althugh this bservatin is an imprtant medical assessment, it is NOT an HGN administrative prcedure step. Tracking ability refers t the ability f the eyes t track tgether when the subject attempts t fllw an bject mving side-t-side. The test f tracking ability is cnducted in exactly the same fashin as the check fr "lack f smth pursuit" in the hrizntal gaze nystagmus test. If the tw eyes d nt track tgether, i.e., if ne mves smthly but the ther mves nly slightly, r in a very jerky fashin, r nt at all, the pssibility f a medical cnditin r injury exists. Pupil size is an imprtant indicatr f certain categries f drugs. Of curse, the size f a persn's pupils changes naturally, in respnse t changing light cnditins. Usually, the diameter f the pupils cnstricts in bright light, and dilates in dark cnditins. If the tw pupils are nticeably different in size, the suspect may have a glass eye, r be suffering frm an injury r medical cnditin. Subjects under the influence f narctic analgesics generally have cnstricted pupils. Subjects under the influence f CNS stimulants r hallucingens generally have dilated pupils. Cannabis generally causes pupil dilatin. Mst CNS Depressants, Dissciative Anesthetics and Inhalants generally leave pupil size within the nrmal range. HS 178A R2/06 4

7 It is nt necessary that a precise estimate f pupil size be btained. It is enugh t estimate whether the pupils are f equal size, and whether they lk nticeably small, abut nrmal, r nticeably large. Hrizntal Gaze Nystagmus generally ccurs with subjects under the influence f three categries f drugs (DID): CNS depressants (including alchl) Inhalants Dissciative Anesthetics The nystagmus generally will be present with a very early angle f nset. Resting nystagmus may be evident especially with high dses. That is a distinct jerking f the eyes even as the suspect stares straight ahead. Vertical Nystagmus is anther easy-t-administer test. Psitin the bject hrizntally, apprximately inches in frnt f the subject's nse. Instruct the subject t hld the head steady and fllw the stimulus with the eyes nly. Then, slwly and steadily raise the stimulus until the eyes are elevated as far as pssible. If the eyes can be bserved t jerk nticeably, vertical nystagmus is present. Vertical nystagmus usually ccurs with Dissciative Anesthetics, and may ccur with relatively high dses f CNS depressants r inhalants. C. SUMMARIES OF DRUG CATEGORIES AND THEIR OBSERVABLE EFFECTS 1. CNS Depressants Actin CNS depressants slw dwn the peratins f the brain. They usually depress the heartbeat, bld pressure, respiratin and many ther prcesses cntrlled by the brain. Examples Alchl Rhypnl Anti-Anxiety Tranquilizers (e.g., Valium, Xanax) Barbiturates Muscle Relaxants Many Others HS 178A R2/06 5

8 General Indicatrs "Drunken" behavir Uncrdinated Drwsy Sluggish Disriented Thick, Slurred Speech Eye Indicatrs Hrizntal Gaze Nystagmus generally present. Vertical Nystagmus pssibly present. Pupil size usually nrmal (except that the drug Methaqualne and Sma usually cause pupils t dilate). 2. CNS Stimulants Actin CNS stimulants accelerate the heart rate and respiratin, elevate the bld pressure, and "speed up" r ver-stimulate many ther prcesses f the bdy. Examples Ccaine The Amphetamines (e.g.,dextramphetamine, amphetamine sulfate, etc.) Methamphetamine General Indicatrs Restlessness Talkative Excitatin Euphria Exaggerated Reflexes Grinding Teeth (Bruxism) Redness t Nasal Area (if "snrting") Runny Nse (if "snrting") Bdy Tremrs Lss f Appetite Eye Indicatrs Nystagmus generally will nt be present. Pupils generally will be dilated. 3. Hallucingens Actin Hallucingens may cause hallucinatins, i.e., they cause the user t perceive things differently frm the way they really are. HS 178A R2/06 6

9 Examples Peyte (derives frm cactus) Psilcybin (derives frm mushrms) LSD MDA MDMA (Ecstasy) Many Others General Indicatrs Hallucinatins Dazed Appearance Bdy Tremrs Uncrdinated Perspiring Disrientatin Parania Difficulty in Speech Nausea Pilerectin (gse bumps) Eye Indicatrs Nystagmus generally will nt be present. Pupils generally will be dilated. 4. Dissciative Anesthetics Actin Dissciative Anesthetics are pwerful anesthetics. Hwever, they als cause bizarre and smetimes vilent behavir. General Indicatrs Perspiring Blank Stare Repetitive Speech Incmplete Verbal Respnses Cnfused Muscle Rigidity Pssibly Vilent and Cmbative Eye Indicatrs Hrizntal gaze nystagmus generally will be present, ften with early nset. Vertical nystagmus generally will be present. Pupil size generally nrmal. HS 178A R2/06 7

10 5. Narctic Analgesics Actin All narctic analgesics share three imprtant characteristics: they relieve pain; they prduce withdrawal signs and symptms when the drug is stpped after chrnic administratin; and, they suppress the withdrawal signs and symptms f chrnic mrphine administratin. Examples Mrphine Herin Cdeine Many Other Opium Derivatives General Indicatrs "On the Nd" Drpy Eyelids Depressed Reflexes Dry Muth Fentanyls Demerl Methadne OxyCntin Many Other Synthetic Opiates Facial Itching Lw, Raspy Speech Fresh Puncture Marks May Be Evident NOTE: A tlerant user wh has taken their "nrmal" dse f narctic analgesic may nt exhibit these general indicatrs. Eye Indicatrs Nystagmus generally will nt be present. Pupils generally will be cnstricted. 6. Inhalants Actin Sme inhalants include psychactive chemicals that prduce a variety f effects. Others exert their majr effect by blcking the passage f xygen t the brain. Examples Vlatile Substances (glue (tluene), paint, gasline, many thers) Aersls (hair sprays, insecticides, many thers) Anesthetics (nitrus xide, ether, chlrfrm, etc.) HS 178A R2/06 8

11 General Indicatrs Disrientatin Slurred Speech Cnfusin Pssible Nausea Pssible residue f substance n face, hands, clthing. Eye Indicatrs Hrizntal gaze nystagmus generally present. Vertical nystagmus pssibly present. Pupil size generally nrmal. 7. Cannabis Actin Marijuana and ther Cannabis prducts impair the attentin prcess. Ability t perfrm divided attentin tasks diminishes under the influence f Cannabis. Examples Marijuana Hashish Hash Oil Marinl Drnabinl General Indicatrs Reddening f Cnjunctiva Disriented Bdy Tremrs Relaxed inhibitins Odr f Marijuana Difficulty in Dividing Attentin Eye Indicatrs Nystagmus generally will nt be present. Pupil size will generally be dilated, but smetimes can be nrmal. D. DRUG COMBINATIONS Many substance abusers apparently rutinely use mre than ne drug at a time. Fr example, sme like t drink alchl while smking marijuana. Others prefer t use PCP by sprinkling it n marijuana cigarettes, r "jints". Sme prefer their herin mixed with ccaine. Plydrug use is defined as ingesting drugs frm tw r mre drug categries. The prefix "ply" derives frm the Greek wrd fr "many". Peple wh rutinely use tw r mre drugs in cmbinatin are plydrug users. HS 178A R2/06 9

12 Plydrug use appears t be very cmmn, at least amng peple invlved in impaired driving incidents. Fr example, the Natinal Highway Traffic Safety Administratin and the Ls Angeles Plice Department (LAPD) cnducted a careful study f bld samples drawn frm nearly 200 suspected drug-impaired drivers arrested in Ls Angeles. Nearly three-quarters f thse arrestees had tw r mre drugs in their systems. It is actually mre cmmn fr an fficer t encunter plydrug users than single drug users. In 1985, during the Ls Angeles field validatin study f the DRE prgram, 72% f the suspects had tw r mre drugs in them. Alchl was ften fund in cmbinatin with ne r mre ther drugs. But, if we discunt alchl, nearly half (45%) f the field study suspects had tw r mre ther drugs in them. In 1989, during DRE certificatin training in New Yrk City, tw thirds (67%) f the suspects evaluated had tw r mre drugs ther than alchl in their urine. Because plydrug use is s cmmn, it is highly likely that plice will encunter suspects wh are impaired by a cmbinatin f drugs, and wh use alchlic beverages t mask drug use. When plice cme in cntact with a plydrug user, a cmbinatin f effects may be bserved in the suspect. The effects may vary widely, depending n exactly which cmbinatin f drugs is invlved, hw much f each drug was ingested, and when they were ingested. In general, any cmbinatin f drugs may act tgether in fur general ways. 1. Null - Neither drug has an effect n the indicatr. Null Effect: The cmbinatin f n actin plus n actin equals n actin. EXAMPLE OF NULL EFFECTS: CNS Stimulant and Narctic Analgesic. Neither drug causes nystagmus, there-fre yu will nt see nystagmus with this cmbinatin. 2. Overlapping - Each drug may affect the suspect in sme different way. In cmbinatin, bth effects may appear. Overlapping Effect: Actin plus n actin equals actin. HS 178A R2/06 10

13 EXAMPLE OF OVERLAPPING EFFECTS: Dissciative Anesthetic and Narctic Analgesic. Dissciative Anesthetic will enhance nystagmus, while a Narctic Analgesic des nt cause nystagmus. There-fre, yu will see nystagmus. 3. Additive - The tw drugs may independently prduce sme similar effects. In cmbinatin, these effects may be enhanced. Additive Effect: Actin plus the same actin reinfrces the actin. EXAMPLE OF ADDITIVE EFFECTS: Stimulants and Hallucingens bth cause pupil dilatin. Pupils wuld be dilated. 4. Antagnistic - The tw drugs may prduce sme effects that are exactly ppsite. In cmbinatin, these effects may mask each ther. Antagnistic Effect: Actin versus ppsite actin can t predict the utcme. EXAMPLE OF ANTAGONIS-TIC EFFECTS: A CNS Stimulant usually causes pupil dilatin, a narctic usually causes cnstrictin. It is pssible that smene wh is simultaneusly under the influence f a stimulant and a narctic may have pupils that are nearly nrmal in size. It is als pssible that the suspect's pupils may be dilated at ne time, and then becme cnstricted, as the effects f ne drug diminish while the effects f the ther increase. E. DEALING WITH SUSPECTED DRUG INFLUENCE OR MEDICAL IMPAIRMENT Participants shuld becme familiar with their agency's plicies and prcedures fr handling drug- r medically-impaired subjects. HS 178A R2/06 11

14 F. TOPICS FOR STUDY Test yur knwledge f the subject matter cvered in this mdule by trying t answer the fllwing questins. Answers are given n the next page. 1. What is a "drug" as the term is used in this curse? 2. What are the seven majr categries f drugs? 3. What kind (categry) f drug is alchl? What abut ccaine? What abut herin? 4. Name the fur eye examinatins that prvide imprtant indicatrs f drug influence r medical impairment. 5. What kind (categry) f drug is PCP? What abut marijuana? What abut Valium? 6. What categry (r categries) f drug usually causes (r cause) the pupils t cnstrict? 7. What categry (r categries) f drug causes (r cause) the pupils t dilate? 8. What categries f drugs usually will nt induce hrizntal gaze nystagmus? 9. What kind (categry) f drug is methamphetamine? What abut LSD? What abut Peyte? 10. What des the term "plydrug use" mean? HS 178A R2/06 12

15 Answers T Review Questins 1. Fr purpses f this training, "a drug is any substance, which when taken int the human bdy, can impair the ability f the persn t perate a vehicle safely." 2. The seven categries are: Central Nervus System Depressants Central Nervus System Stimulants Hallucingens Dissciative Anesthetics Narctic Analgesics Inhalants Cannabis 3. Alchl is a CNS depressant. Ccaine is a CNS stimulant. Herin is a narctic analgesic. 4. The fur key eye examinatins include: Tracking Ability Pupil Size Hrizntal Gaze Nystagmus Vertical Nystagmus 5. PCP is a Dissciative Anesthetic; that categry cnsists nly f PCP and its varius analgs. Marijuana is Cannabis. Valium is a CNS depressant. 6. Narctic Analgesics usually cause the pupils t cnstrict. 7. CNS Stimulants, Hallucingens, and Cannabis usually cause the pupils t dilate. Smetimes Cannabis can leave pupils nrmal. 8. CNS Stimulants, Hallucingens, Narctic Analgesics and Cannabis d nt cause hrizntal gaze nystagmus. 9. Methamphetamine is a CNS stimulant. LSD and Peyte are Hallucingens. 10. "Plydrug use" is the practice f ingesting drugs frm tw r mre drug categries, i.e., cmbing drugs. HS 178A R2/06 13

16 CATEGORY Signs/ Symptms CNS Depressants CNS Stimulants Hallucingens Dissciative Anesthetic ACTION Slw dwn the peratins f the brain. Depress the heartbeat, bld pressure, respiratin and many ther prcesses cntrlled by the brain. Accelerate the heartrate and respiratin, elevate the bld pressure and "speed up" r verstimulate many ther prcesses f the bdy. They cause the user t perceive things differently frm what they really are and they may cause hallucinatins. Pwerful anesthetic. It als causes bizarre and smetimes vilent behavir. GENERAL INDICATORS "Drunken" behavir, Uncrdinated, Drwsy, Sluggish, Disriented, Thick, Slurred Speech Restlessness, Talkative, Excitatin, Euphria, Exaggerated Reflexes, Lss f Appetite, Grinding Teeth (Bruxism), Redness t Nasal Area (if "snrting"), Bdy Tremrs Hallucinatins, Dazed Appearance, Bdy Tremrs, Uncrdinated, Perspiring, Disrientatin, Parania, Difficulty in Speech, Nausea Perspiring, Repetitive Speech, Cnfused, Pssibly Vilent and Cmbative, Blank Stare, Incmplete Verbal Respnses, Muscle Rigidity EYE INDICATORS Nystagmus -Hrizntal Present Nt present Nt present Present, with early nset and very distinct jerking Nystagmus -Vertical May be present Nt present Nt present Present Pupil Size Nrmal (except that the drug Methaqualine Sma causes pupils t dilate) Will be dilated Will be dilated Is nrmal HS 178A R2/06 14

17 CATEGORY Signs/Symptms Narctic Analgesics Inhalants Cannabis ACTION All narctic analgesics share three imprtant characteristics: they will relieve pain, they will prduce withdrawal signs and symptms when the drug is stpped after chrnic administratin; and, they will suppress the withdrawal signs and symptms f chrnic mrphine administratin. Sme inhalants include psychactive chemicals that prduce a variety f effects. Others exert their majr effect by blcking the passage f xygen t the brain. Marijuana and ther Cannabis prducts apparently impair the attentin prcess. Ability t perfrm divided attentin tasks diminishes under the influence f Cannabis. GENERAL INDICATORS "On the Nd", Drpy Eyelids, Depressed Reflexes, Dry Muth, Facial Itching, Lw, Raspy Speech, Fresh Puncture Marks May be Evident Disrientatin, Cnfusin, Slurred Speech, Pssible Nausea, Pssible residue f substance n face, hands, clthing Reddening f Cnjunctiva, Bdy Tremrs, dr f Marijuana, Disriented, Relaxed Inhibitins, Difficulty in Dividing Attentin EYE INDICATORS Nystagmus - Hrizntal Nt present Will be present Nt present Nystagmus - Vertical Nt present May be present Nt present Pupil Size Will be cnstricted Is nrmal Will be dilated, but may be nrmal HS 178A R2/06 15