Highway to Safety

13—Driving and Marijuana—A Dangerous Combination

February 15, 2014 | Posted in Drugged Driving, Podcast Episodes | By Traffic Safety Guy

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Chris Halsor, Colorado TSRP

For years individuals and organizations everywhere have talked about, and continue to work on combating, the dangers of alcohol-impaired driving. As a result, there has been a significant reduction in alcohol-impaired fatalities. However, impaired driving due to drugs other than alcohol, sometimes called “Drugged Driving,” is a growing concern across the United States and beyond. One of the most common drugs found in substance-impaired driving fatalities is marijuana.

Mr. Chris Halsor is the Traffic Safety Resource Prosecutor (TSRP) [1] in Colorado, where marijuana was first approved by state residents for medicinal use, and more recently for legal recreational use. [2] With the changes in the law, [3] Mr. Halsor has seen a troubling increase in drugged driving cases involving marijuana.

Impairment from Marijuana

Based on the science and the research, there is no question that marijuana impairs a person’s mental and physical? abilities. It is wrong to believe that marijuana use does not result in impaired driving. It is a scientific fact: Marijuana use increases the risk of being in a fatal crash.

Of significant concern is the public’s misunderstanding of the signs of marijuana impairment. Message after message has shown alcohol-impaired individuals with slurred speech, poor balance, and problems walking. Mental impairment is actually a greater issue because 1) driving is a complicated task requiring a person to focus on a number of critical factors simultaneously, and 2) alcohol affects a person’s mind and judgment before the physical signs are visible—meaning a person is already mentally impaired by the time the physical signs are observed. Mr. Halsor noted that the predominant marijuana-induced impairment affects a person’s judgment. The impairment is less about the physical response, but that does not make it any less dangerous than alcohol.

The increasing potency of Delta 9 THC is another concern when considering a person’s impairment. Delta 9 THC is the active impairing ingredient in marijuana. Several years ago the THC concentration was typically under 10%, even as low as 2-6% in a “joint.” Now, the potency is significantly higher and marijuana stores in Colorado advertise this increased potency. It is not uncommon to see ads for 20% potency or greater. It has become a race to the top, resulting in greater impairment.

Putting the THC concentrate into a variety of foods also creates problems. Adding the concentrate to food products results in delayed impairment. People consume these products, do not initially feel any effects and then drive, with the effects impacting them while driving.

Drugged Driving and Per Se Drug Laws

Many states have passed a ‘per se’ law, similar to the .08 breath alcohol concentration (BrAC) per se law for alcohol. Colorado passed a modified per se law that allows jurors to infer impairment if a person has 5 nanograms or greater of THC in their blood.

One argument against a per se law is that marijuana stays in the body for up to 30 days. However, Delta 9 THC is generally in the blood only 1 to 3 hours. The THC that is found in the body days later is THC-COOH, an inactive non-impairing metabolite.

Supplemental Material

Shortly after NTSB’s announcement of the NTSB Most Wanted List in January 2014, the Traffic Safety Guy was able to briefly speak with NTSB Board Member Dr. Mark Rosekind. I asked him about substance impaired driving and the issues marijuana is causing for safe driving. His response is part of this episode.

December is National Impaired Driving Prevention Month

On November 29^th, President Obama declared December 2013 to be National Impaired Driving Prevention Month. NHTSA will be extremely active in December working with its partners everywhere, promoting the messages of ‘Buzzed Driving is Drunk Driving’ and ‘Drive Sober or Get Pulled Over.’

In the United States, 760 people lost their lives from impaired driving during December of 2011, with a total of 4,169 in the December months from 2007 to 2011. While impaired driving happens all year ‘round, the holiday season is a particularly dangerous time. Because of these devastating facts, law enforcement will be out in force cracking down on impaired drivers from December 17, 2013 through January 1, 2014.

Impaired Driving from Other Drugs

Alcohol is not the only drug that causes impaired driving. Other drugs are playing an increasingly deadly role. From research done by NHTSA, of the drivers tested for alcohol and other drugs, nearly 16% were positive for a drug other than alcohol. This is not to say that everyone was using an illegal drug. Prescription and over-the-counter medications were found as well. It is essential to remember that impaired driving can also occur from medications, both prescription and over-the-counter. That is why we must understand how any medication may impact the person taking it or interact with other medication being taken.

Make Plans Beforehand

Even one drink can impair someone’s judgment and increase the risk of getting arrested for impaired driving, or worse, killing someone. That is why it is important to make plans before heading out for the evening. Easy plans include:

Designating a sober driver before the party begins
Planning to call a taxi or using public transportation
Making plans to stay where you are drinking

If hosting a party, stop serving alcohol as the evening wears on, and be responsible—friends don’t let friends drive after drinking.

Check out any SoberRides in your area

One option that more communities are developing is free cab rides home. Called SoberRide in the Washington, DC area, the program is typically funded through sponsors and donations, and works with local cab companies to provide impaired adults (over the age of 21) cab rides home. In many locations the ride is free. WRAP (Washington Regional Alcohol Program) organizes the DC SoberRide program. To see a list of programs nationwide, click here.

Celebrate the Holiday Season Safely

It is the Holiday Season, a time to celebrate with family and friends. It is not a time to stop thinking. It is not a time to drink and drive. Take the time to plan ahead. Decide where to go with family or friends. Choose which celebrations to attend. Then make plans on how to get home safely. It is the Holiday Season—a time to make plans to be safe, for one and all.

What plans have you made for a safe holiday season? Let me know in the comments below.

Drugged Driving and Prescription Medication

Prescription medication may cause drugged driving

When talking specifically about drugged driving, we need to recognize that it is often the result of prescription and over-the-counter medications. It is critical that we understand the consequences of taking medicine, and follow the instructions. For instance, drinking alcohol while on medication can result in serious unintended consequences. Drugged driving can also be a concern when someone is starting a newly prescribed medication or has recently increased the dosage of their usual prescription, or is concurrently taking several different drugs.

Drugged Driving and Illegally Obtained Drugs

According to Dr. DuPont, the more immediate and easier situation to address are those individuals who:

Use illegal drugs and then drive, or
Take prescription mediation that is not prescribed for them, or
Obtain prescriptions when there is no medical need.

Alcohol and Other Drugs: It is all substance impaired driving

Those intent on abusing prescription medications can obtain them through a variety of methods, such as the black-market or “pill mill” doctor, or by going to a doctor and convincing that doctor that the need is genuine. People that abuse drugs will lie about their symptoms, and at times it is hard for a doctor to determine the truth. That may require physicians to start drug testing all of their patients. As Dr. DuPont noted, while such a step may offend some patients, it is an important process to ensure the medication is being prescribed for a legitimate purpose. These routine drug tests would also serve to inform doctors about other medications the patient is taking.

Pill mill doctors are doctors who are not operating ethically, and typically provide pain medication under the guise of treating the person. The pharmaceutical chain CVS attempted to shut down this type of doctor by examining its prescription data. After finding that a few doctors had written an unusually large number of prescriptions, CVS declared that these doctors would no longer have dispensing privileges. And what is “an unusually large number of prescriptions?” One doctor whose privileges were suspended had prescribed more than 44,000 doses of high-risk drugs, compared to other doctors in his region who had prescribed 662 doses.

Recommendations by Dr. DuPont

In wrapping up, Dr. DuPont has two key recommendations to reduce drug impaired driving:

Regularly drug test everyone who is arrested and convicted for impaired driving, whether it is because of alcohol or other drugs, and
Every state must pass a ‘per se” law to address those who drive with illegal drugs or with prescription medication without a prescription. It is a law with a zero tolerance for illegal drugs. As he noted, this is similar to the ‘per se’ laws already in effect for alcohol nationwide.

In my closing comments I note the importance of parents talking to their children about drugged driving. ONDCP has developed a very useful tool kit with the facts on the dangers of teen and young adult drugged driving, and activities for effective prevention, a link can be found below.

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