04 – Drugged Driving: What is it and What Can We Do About It? A Conversation With Dr. Robert DuPont

Drugged Driving

October 24, 2013 | Posted in Drugged Driving, Podcast Episodes

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Robert DuPont

Dr. Robert DuPont

Dr. Robert DuPont, President of the Institute for Behavior and Health, provides a comprehensive perspective on preventing drugged driving.  As the first Director for the National Institute on Drug Abuse (NIDA) and the second White House Drug Chief, Dr. DuPont has been a leader in drug abuse prevention for decades.  In this episode Dr. DuPont and I talk about drugged driving and the steps that can be taken to reduce its pervasiveness.

The latest research demonstrates drugged driving is pervasive and widespread.  A 2007 national survey to determine the extent of drugs present found that of the drivers tested, nearly 16% tested positive for drugs – 11% illegal drugs, 4% prescription drugs and 1% both illegal and prescription.  In another national study, of the drivers killed in 2009 in motor vehicle crashes with known drug-test results, one-third tested positive for drugs.

According to Dr. DuPont and others, including the Centers for Disease Control (CDC) and the Office of National Drug Control Policy (ONDCP), drugged driving is at an epidemic status. Steps must be taken now to improve safety on our roads. For many years, the focus has been on alcohol-impaired driving, but it is no longer just about alcohol or just about other drugs.  It is not either/or, it is both.  We must look at the broader issue of “substance-impaired driving.”

Drugged Driving and Prescription Medication

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.
It is substance impaired driving

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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