Impaired Driving Marijuana Legislation April 15, 2011

Transcription

1 Impaired Driving Marijuana Legislation April 15, 2011 Rebecca Sturdevant, APRN, C-SAPA Certified Substance Abuse Program Administrator Occupational Health Services,

2 Traffic Fatalities in Montana Total Rural Urban Impaired* *Alcohol-Impaired Driving Fatalities (BAC=.08+) FARS Fatality Analysis Reporting System

3 Montana Number 2 in US Marijuana and Alcohol Use in Fatal Crashes, FARS 2008 STATE # Drivers Number MJ % MJ % BAC >.08 New Hampshire % 18.8% Montana % 31.0% Alaska Vermont Washington % 4.3% % 11.4% % 22.6% California is #13 with %MJ 5.5% and %BAC 17.9% North Dakota is #1 for %BAC with 32.3% MT is #2 Crancer & Crancer, 2010, From NHTSA Fatality Analysis Reporting System

4 Court Monitoring Flathead County: Sturdevant 1095 DUI arrests from reviewed Sample was primarily litigated cases Convenience sample of cases found in district and justice courts in Flathead County Arrests made by FCSO, MHP, KPD Felony cases from other police departments Limited data available public access DMV data not included in this study Outcome data did not include use of Interlocks

5 Court Monitoring Flathead County: Sturdevant Event causing DUI arrest

6 Court Monitoring Flathead County: Sturdevant REFUSAL to Provide Specimen

7 Court Monitoring Flathead County: Sturdevant Outcome based on whether defendant was: Guilty of arrest charge % Guilty of alcohol related charge % Guilty of NON alcohol charge * % Charges dismissed 58 7% Data collection ongoing Cases still open Records unavailable *Such as Reckless driving or Negligent Endangerment

8 Driving a vehicle A momentary lapse of concentration may result in serious injury or death.

9 Impairment from Drugs Studies Laboratory based [animal & human] Physiologic [e.g, DSST, Critical tracking, Stop signal] Cognitive [e.g., Wechsler, Tower of London]

10 Impairment from Drugs Studies Simulated task [driving, machinery] Cars on a test course [knock over the cones] Computer based simulators

11 Impairment from Drugs Studies Epidemiologic [statistical study of humans] Drug use by driving population Drug use involved in fatal crashes Drugs found in fatal crash victims Drug use found in DUI arrested suspects

12 Impairment from Drugs Studies Epidemiologic Population crash/death/injury risk Odds Ratio = Relative Risk = chances of event happening in one group chances of event happening in another group probability of event happening in exposed group probability of event happening in control group RR=6.6= probability of driver + THC responsible for fatal crash probability of sober driver responsible for fatal crash

13 Odds Ratio Drummer, et.al., The involvement of drugs in drivers of motor vehicles killed in Australian road traffic crashes. Accident Analysis and Prevention 943(2003) Relative Risk of Death--Alcohol >0.2 Blood Alcohol Concentration

14 Relative Risk of Death Drivers Odds Ratio Drug & Alcohol Free 1704 (50%) 1 THC only 58 (1.7%) 2.7 THC only ( 5ng/ml) 49(1.4%) 6.6 THC 5ng/ml odds ratio similar to drivers with BAC 0.15% THC + BAC 0.05% odds ratio 2.8 times BAC 0.05% alone Drummer, et.al., 2003,The involvement of drugs in drivers of motor vehicles killed in Australian road traffic crashes. Accident Analysis and Prevention 943:1-10.

15 Responsibility for Death Alcohol & drug free THC 1 ng/ml Alcohol 0.05% All drivers Known responsibility Responsible Not responsiible Resp/not resp Alcohol and THC Biecheler, et.al., 2008, SAM Survey on Drugs and Fatal Accidents : Search of substances consumed and comparison between drivers involved under the influence of alcohol or cannabis. Traf Inj Prev 9:11-21

16 Montana Statistics Fatal vehicle crashes in % had drugs involved Up from 32% in % had alcohol involved Down from 36% in % had a mixture of drugs and alcohol involved Same as 2009 Montana Department of Justice/Forensic Science Division

17 Comparison of DUI Cases in Montana Involving Cannabis, CNS Depressant Drugs, or Alcohol

18 Montana Forensic DUI Specimens TOTAL cannabis Cannabis + alcohol Cannabis + fatal Cannabis + alcohol + fatal Courtesy of Sara J. Hansen, Forensic Toxicologist Montana Department of Justice, Forensic Science Division

19 DOLLARS NHTSA estimates value of a life lost in a traffic fatality=$6,000, deaths in 2010 = $312,000,000 Who pays?

20 Montana Forensic DUI Specimens 2008 Depressants (other than alcohol): Diazepam Meprobamate Nordiazepam Carisoprodol Alprazolam Diphenydramine Citalopram Zolpidem Fluoxetine 7-aminocitalopram Venlafaxine Lorazepam Trazodone Clonazepam Valproic Acid 7-aminoclonazepam Butalbital

21 Benzodiazepines & Driving Diazepam (Valium) & lorazepam (Ativan) Standard deviation of lateral position Effects with all doses were 0.05% BAC Lorazepam 2 mg > 0.2% BAC after 8 days On day one test aborted due to eyes closing SDLP correlates with RR crash Ramaekers, Vermeeren,etal. 2010, Effects of Drugs on Human Performance Robert F. Borkenstein course, Indiana University.

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23 Effects of THC in serum Significant effects found in THC levels: 2-5 ng/ml -- Only Critical Tracking impaired >5 ng/ml -- Stop signal & Tower of London impaired Critical tracking effects compared to alcohol First 2 hours equivalent to BAC > 1.0 mg/ml 2-6 hours equivalent to BAC > 0.05 mg/ml Stop signal and Tower of London tests do not show impairment with BAC <0.06 mg/ml Ramaekers, et.al., 2006, Cognition and Motor Control as a Function of Δ9-THC concentration in serum and oral fluid: Limits of Impairment. Drug and Alcohol Dependence 85:

24 Court Monitoring Flathead County: Sturdevant Marijuana impaired drivers with negative BAC and lab confirmed THC in blood THC level Other drugs Outcome 3 ng/ml Sleeping pills Careless (Haynes case) 7 ng/ml Clonazepam DUI-1 9 ng.m Clonazapam, Soma Negligent endangerment 3 ng/ml Clonazepam, methadone, benadryl Negligent homicide 3 ng/ml Methamphetamine Dismissed (towed vehicle) 4 ng/ml Methamphetamine, Soma, lorazepam FTA(6 yr old child in car)

25 Car which crushed his car driver had BAC 0.16 and THC 7 ng/ml

26 Driving a Boat 0.16 BAC Culture of tolerating, accepting, and embracing social drinking. When you are drinking you may not be counting % alcohol per drink volume of container free refills When you reach 0.06 BAC you no longer have good judgment Do things you would not do if you were sober Feel invincible Tragedy for all every person on the boat is a victim.

27 National Strategy to Stop Impaired Driving NHTSA Motorists reporting impaired drivers Uniform guidelines for state programs Highly visible enforcement Increased prosecution SBIRT Interlocks

28 Increased DUI enforcement Campaign to Eliminate Drunk Driving Sobriety checkpoints & saturation patrols Mandatory ignition interlocks for all convicted DUI offenders Develop advanced vehicle based technology Breath, transdermal, ocular, detect weaving Public support for these efforts Change the culture; change the laws Mothers Against Drunk Driving Making a Difference Daily

29 New Mexico DUIs 1.5 Interlocks Up...Drunk Driving Down (Correlation = -0.93) Z-scores of Interlock Installations and 3 Measures of DWI Richard Roth, PhD.; February 27, Interlocks A-I Crashes A-I Injuries A-I Fatalities

30 2011 HB 43 MJ & Employers Expands definition of employee in drug testing County and municipal employees Person who drives a motor vehicle Affecting public safety or public health Strengthens language in the WC law Impaired by marijuana may deny claim WC insurance doesn t pay for marijuana or pipes Use of marijuana can t expand partial disability

31 2011 SB 423 Registry cards issued to persons with debilitating medical condition MD must state activity limitations May not use electronic means no telemedicine Review of MDs who write more than 15/year Criminal penalty for MD who doesn t follow rules Registry cards issued to provider Background investigation, no criminals May not accept any compensation May not use marijuana

32 2011 SB 423 (DUI) (7) (a) A law enforcement officer who has reasonable cause to believe that a registered cardholder or provider is driving under the influence of marijuana may apply for a search warrant to require the person to provide a sample of the person's blood for testing pursuant to the provisions of A person with a tetrahydrocannabinol (THC) level of 3.5 ng/ml may be charged with a violation of (b) A registered cardholder or provider who violates subsection (1)(a) is subject to revocation of the person's registry identification card if the individual is convicted of or pleads guilty to any offense related to driving under the influence of alcohol or drugs

33 2011 SB 423 (Workplace) (4) Nothing in this section prevents the imposition of a civil penalty or a disciplinary action by a professional licensing board or the department of labor and industry if: (a) a registered cardholder's use of marijuana impairs the cardholder's job-related performance; or (5) Nothing in [sections 1 through 17] may be construed to: (a) prohibit an employer from including in any contract a provision prohibiting the use of marijuana for a debilitating medical condition; or (b) permit a cause of action against an employer for wrongful discharge pursuant to or discrimination pursuant to

34 Truck which crushed his car driver had BAC 0.16 On his way to a pharming party