Impairment based legislative limits and driving under the influence - PowerPoint PPT Presentation

Impairment based legislative limits and driving under the influence of alcohol and drugs in Norway Vigdis Vindenes, MD, PhD, Head of Research, Dep. of Forensic Sciences, Section of Drug Abuse Research Oslo University Hospital, University of Oslo Dublin 07.10.19

Outline of the presentation • Driving Under the Influence in Norway • The Norwegian Road Traffic Act • Legislative limits for non-alcohol drugs • Enforcement of the legislation for alcohol and drugs • Experiences and effects of this legislation • Cases with multiple drug findings

NORWAY Roadside studies Apprehended drivers

Driving under the influence of alcohol The problem of alcohol use in traffic was already identified at the turn of the century – First law prohibiting alcohol intoxication and driving in the beginning of 20 th century Norway was the first country to implement a legislative limit for alcohol in 1936 – Blood alcohol concentration (BAC) of 0.05% (reduced to 0.02% in 2001) – Extended to include impairment due to illicit or medicinal drugs in 1959 (but no concentration limits)

Driving Under the Influence in Norway ✓ ~ 10.000 drivers apprehended by the police annually for driving under the influence; (Signs & Symptoms Test, Saliva rapid test, Blood samples and Clinical Test of Impairment) ✓ All the blood samples are sent to our laboratory (around 40 different psychoactive drugs analysed) : Around 95% of the cases contain at least one drug ✓ ✓ Mean number of drugs in each case is almost 3 Almost 90% of the apprehended drivers are men ✓ ✓ Around 50% without a driving license Mainly drug addicts (high concentrations, illicit drugs, needle marks etc.) ✓

The Norwegian Road Traffic Act Legislative limits for alcohol: BAC > 0.02 % (fine of 1 monthly salary. Novice drivers (2 years/special conditions, min. 6 months driving ban) BAC > 0.05 % (fine of 1.5 monthly salary. Min. 1 year driving ban. Conditioned or unconditional sentence of imprisonment) BAC > 0.12 % (fine of 1.5 monthly salary and sentence of unconditioned imprisonment for 21 days. Min. 2 years driving ban) BAC = Blood Alcohol Concentrations – whole blood

Normal traffic in Norway Before 2012: Road side study 2008-2009: Alcohol 0.3 % Lack of legislative limits for non-alcohol drug: Narcotics 1.5 % (THC 0.7 %) Requests for a large number of Medicinal drugs 3.2 % expert witness reports; - individual evaluations - time consuming Around 10.000 oral fluid samples (Statsure) - high costs Refusal rate 5.8% - less severe sanctions compared to alcohol Gjerde H. et al 2012 (DRUID project)

The Norwegian Road Traffic Act Legislative limits for non-alcohol drugs from 2012 / revision in 2016 - harmonize the situation for alcohol and non-alcohol drugs - signal that drugs and driving are not compatible

Legislative limits for non-alcohol drugs ➢ Per se limits corresponding to BAC 0.02 % for 28 non-alcohol drugs Limits for graded sanctions corresponding to ➢ BAC 0.05 and 0.12 % for 22 of the 28 non-alcohol drugs Tolerance is not taken into account The regulation is not applied if the driver has a valid prescription

Enforcement of the legislation • The police have the power to "stop and control" drivers roadside without any reason • The police have the power to do alcohol breath screening test and rapid saliva screening test without any prior suspicion • If the test results or other circumstances give grounds for believing that a driver is impaired, the police may conduct Signs and Symptoms test for substance impairment • Drug- testing is conducted in “speeding” and “driving without seatbelt” cases • Targeted drug-controls are performed • Alcohol and drug cases are sent to court for conviction

Experiences and effects of the legislation

Suspected alcohol and drug impairment drivers - blood sample has been sent for analysis The police have only Alcohol and drugs are analyzed requested analysis of alcohol Gjerde H.

Alcohol positive cases – including breath testing Alcohol breath testing Alcohol blood samples

Drug findings among arrested drivers Gjerde H.

Follow-up road side study 2016-2017 2016-2017: Testing positive for cannabis was associated with having previous speeding tickets and being Alcohol THC Amphetamine/ Cocaine/ Benzo- Codeine Zopiclone involved in road methamph. benzoylec diazepines traffic crash Eastern part of Norway 5000 oral fluid samples Data from Furuhaugen H et al 2019, Traffic injury prevention 2018

Factors affecting driving under the influence of drugs and alcohol – Introduction of legal limits for 28 drugs – Introduction of automatic number plate recognition (ANPR) – Introduction of Dräger DrugTest 5000 (oral fluid rapid testing) – New regulations for prescription of psychoactive medicines to drivers – Vision Zero strategy

“Vision Zero” strategy “A future in which no-one will be killed or seriously injured in road traffic crashes using multiple strategies” Implemented in 2001 The National Transport Plan involves the entire transportation system: – Roads and traffic system – Vehicles – Promoting the safest modes of transportation – Road users – Injury treatment/rescue

Grethe B. Clausen, Police Superintendent, Central Mobile Force Service, Norway

Cases with multiple drug use • Legislative limits are defined for individual drug concentrations not for combinations • When more drugs are detected, the overall likelihood of impairment higher than the limits for graded sanctions (0.05 and 0.12%) are estimated based on the analytical results, Clinical Test of Impairment, Signs and Symptoms test and any prescription • Conversion factors for benzodiazepines and opioids; diazepam and morphine equivalents are summed

Expert witness reports • Produced by specialists in Clinical Pharmacology (MD) • More than 40% reduction in requests after introduction of legislative limits • Not necessary when one/more drug concentrations are > 0.12% limits. The analytical reports can be used in court (safety margins between 25-50%) • Requested cases: – No drugs detected in concentrations higher than the 0.12% limits 55398_137_04 MRM of 20 Channels ES+ 338.3 > 77 (RCS-4 N-5-OH-pentyl) 100 6.49e6 – Psychoactive substances without legislative limits % – One/more detected drugs are prescribed 3.61 0 Time – Analytical results are evaluated in relation to any prescription 0.00 0.25 0.50 0.75 1.00 1.25 1.50 1.75 2.00 2.25 2.50 2.75 3.00 3.25 3.50 3.75 4.00 4.25 4.50 4.75

Summary ➢ Legal limits for non-alcohol drugs have been introduced successfully in Norway with a harmonization of the legislation for alcohol ➢ The measured concentrations can be used in court ➢ Multiple drug cases are handled by individual evaluation of impairment based on all drug concentrations, prescriptions and clinical observations of impairment ➢ The number of apprehended drivers suspected of being under the influence of drugs has increased with around 40% after introducing legal limits ➢ The number of expert witness reports has been reduced with around 40%

Thank you for your attention! Vigdis Vindenes vigvin@ous-hf.no Oslo University Hospital Departement of Forensic Sciences