The percentage of fatally injured drivers testing positive for drugs increased over the last five years, according to data from the National Highway Traffic Safety Administration (NHTSA). Each year between 56% and 65% of drivers fatally injured in motor vehicle crashes were tested for the presence of drugs in their systems. In 2009, 33% of the 12,055 of drivers fatally injured in motor vehicle crashes with known test results tested positive* for at least one drug, compared to 28% in 2005 (see figure below). The drugs tested for included both illegal substances as well as over-the counter and prescription medications, (which may or may not have been misused). In 2009, marijuana was the most prevalent drug found in this population—approximately 28% of fatally injured drivers who tested positive were positive for marijuana1. The authors caution that “drug involvement rates among those with unavailable drug test results may be similar to those for whom results are available, or there may be a systematic bias that could influence the unavailable rates in a positive or negative direction.”

*Nicotine, aspirin, alcohol, and drugs administered after the crash are excluded. Testing positive for drugs only means that the drugs were found in the driver’s system and does not imply impairment or indicate that drug use was the cause of the crash or the fatality.

SOURCE: Adapted by CESAR from National Highway Traffic Safety Administration (NHTSA),
drug Involvement of Fatally Injured Drivers,” Traffic Safety Facts, November 2010.
Available online at http://www-nrd.nhtsa.dot.gov/Pubs/811415.pdf

Abstract

Delta (9)-tetrahydrocannabinol (THC), the most important psychoactive substance in cannabis, is frequently detected in blood from apprehended drivers suspected for drugged driving. Both experimental and epidemiological studies have demonstrated the negative effects of THC upon cognitive functions and psychomotor skills. These effects could last longer than a measurable concentration of THC in blood. Culpability studies have recently demonstrated an increased risk of becoming responsible in fatal or injurious traffic accidents, even with low blood concentrations of THC. It has also been demonstrated that there is a correlation between the degree of impairment, the drug dose and the THC blood concentration. It is very important to focus on the negative effect of cannabis on fitness to drive in order to prevent injuries and loss of human life and to avoid large economic consequences to the society.

Source:  Tidsskr Nor Laegeforen. 2007 Mar 1;127(5):583-4.

1. 12/17 states (including DC) with “medical” marijuana” have 20% + traffic fatalities involving drugs
70.6% of states with MMJ laws have driver fatalities testing positive for drugs of 20% or greater

2. 13/17 states with “medical” marijuana” has 19% + traffic fatalities involving drugs (Arizona)
76% of states with MMJ have driver fatalities testing positive for drugs of 19% or higher

3. 3/17 states with “medical” marijuana” laws that have low rates of driver fatalities also have low rates of testing for drugs (Oregon, Rhode Island, Maine: not tested 79%, 41%, 100% ).

4. 1/17 states with “medical” marijuana”, New Mexico, tests all, but has anomalous 1% positive tests (an outlier, along with Mississippi, North Carolina).
Drug testing of drivers in fatal accidents should be 100%!

STATES WITHOUT “MEDICAL MARIJUANA” LAWS HAVE LOWER PREVALENCE OF DRIVER FATALITIES INVOLVING DRUGS: 27%

1. 24/33 states with no “medical” marijuana” laws have fewer than 20% of driver fatalities involving drugs
73% of states with no “medical marijuana” laws have fewer than 20% driver fatalities testing positive for drug.

2. 9/33 states with no “medical” marijuana” approval have 20% or more driver fatalities involving drugs.
27% of states with no “medical marijuana” laws have 20% or more of driver fatalities involving drugs

3. Ct, state with highest number of fatalities also has highest rate of testing, 99%
Prevalence of driver fatalities involving drugs is three times higher, on average, in states with approved “medical marijuana” laws.

Source: Bertha Madras PhD Harvard Medical School Dec. 2010

R. Gil Kerlikowske, Director of the Office of National Drug Control Policy, this week called attention to the high percentage of fatalities on USA roadways involving drivers who had drugs in their system and called on communities to continue to prevent drug use before it starts. Kerlikowske’s announcement was shared in light of a new traffic fatality analysis released by the National Highway Transportation Safety Administration.

According to the inaugural analysis of drug involvement from NHTSA’s Fatal Accident Reporting System census, one in three motor vehicle fatalities (33 percent) with known drug test results tested positive for drugs in 2009. Additionally, according to the new analysis, the involvement of drugs in fatal crashes has increased by five percent over the past five years, even as the overall number of drivers killed in motor vehicle crashes in the United States has declined.

Kerlikowske said campaigns against drunk driving have been effective and should continue, but more emphasis should be placed on ‘drugged driving.’

In a news release, Kerlikowske said, “It is critical that communities across the nation address the threat of drugged driving as we redouble our efforts to make America’s roadways safer by increasing public awareness, employing more targeted enforcement, and developing better tools to detect the presence of drugs among drivers.”

According to a 2007 NHTSA Roadside Survey of Alcohol and Drug Use by Drivers, 1 in 8 nighttime weekend drivers tested positive for an illicit drug. The most recent Monitoring the Future survey revealed that one in 10 high school seniors reported that in the two weeks prior to the survey they had driven after smoking marijuana.

Source: www.CADCA.org Dec.2010

Even mild alcohol intoxication can seriously impair drinkers’ visual acuity, according to a study from the University of Washington.
Researchers found that test subjects who consumed just enough alcohol to reach half the legal alcohol intoxication level in the U.S. performed poorly on tests of their ability to notice an unexpected visual object when they were performing another simple task. Researchers said this was the first study to demonstrate that alcohol can cause such “inattentional blindness.”
“We rely on our ability to perceive a multitude of information when we drive (speed limit, road signs, other cars, etc.),” said study lead author Seema Clifasefi. “If even a mild dose of alcohol compromises our ability to take in some of this information, in other words, limits our attention span, then it seems likely that our driving ability may also be compromised.”
The study was published in the July 2006 issue of the journal Applied Cognitive Psychology.
Reference:
Clifasefi, S. L., Takarangi, M. K. T., Bergman, J. S. (2006) Blind drunk: the effects of alcohol on inattentional blindness. Applied Cognitive Psychology, 20(5): 697-704.

Source:Reported in Medical News Today July 7, 2006

J. Michael Walsh, Ph.D.
October 12, 2010
The consumption of illegal psychoactive drugs (e.g. amphetamines, cocaine, marijuana, opiates, etc.) is a problem of growing concern in many countries around the world, as these substances are increasingly detected in impaired and injured drivers. Drugged driving is a serious public health concern because it puts not only the user at risk, but all others who share the road. Despite the mounting evidence that drugged driving is common, the American public seems unaware of this fact. Perhaps this is because drugged drivers are less frequently detected, prosecuted, or referred to treatment, compared to drunk drivers.
Other than alcohol, Marijuana is the most prevalent drug detected in impaired and injured drivers. Marijuana affects areas of the brain that control the body’s movements, balance, coordination, memory, and judgment abilities, and its effects last for hours after the drug is used. Evidence from both on-the-road and simulated driving studies indicate marijuana can negatively influence a driver’s attentiveness, perception of time and speed, and the ability to draw on information obtained through past experiences.
Driving is a complex task that requires continuous information processing and coordinated responses to ever-changing traffic, while operating a multi-ton vehicle. Clearly, illegal drugs like marijuana that alter a driver’s normal brain functioning can create an extremely dangerous situation.

Source: www.ofSubstance.gov/blogs Tuesday, October 12, 2010

Marijuana used for medical purposes has the same long term effect on the user as marijuana used for recreation. Marijuana use can cause impairment of short-term memory, attention, motor skills, reaction time, and the organization and integration of complex information.

Marijuana use alters perceptions and creates time distortion and can cause drowsiness and lethargy. Heavy marijuana use can cause apathy, decreased motivation, and impair cognitive performance and can cause mental health problems.

Employees who use marijuana off-duty are still effected by it. Impaired cognition that can cause lapses in judgement can remain for a long period. Memory defects can last as long as six weeks. See: Abbie Crites-Leoni, Medicinal Use of Marijuana: Is the Debate a Smoke Screen for Movement Toward Legalization? 19 J. Legal Med. 273, 280 (1998) (citing Schwartz, et al., Short- Term Memory Impairment in Cannabis-Dependent Adolescents, 143 Am. J. Dis. Child. 1214 (1989)

Employers may be liable for the actions of employee who use marijuana especially those employees in safety sensitive positions. The more chronic the use of “medical” marijuana the higher the risk.

VIOLATIONS OF FEDERAL LAW

Will employers have to accommodate marijuana use that violates federal law? Marijuana, remains illegal under federal law because of its “high potential for abuse,” its lack of any “currently accepted medical use in treatment in the United States,” and its “lack of accepted safety for use … under medical supervision.”Gonzales v. Raich, 545 U.S. 1 (2005); United States v. Oakland Cannabis Buyers’ Cooperative, 532 U.S. 483 (2001)

IF THIS BILL PASSES “MEDICAL” MARIJUANA WILL RESULT IN MORE MARIJUANA USE AMONG EMPLOYEES

As consumers we all pay for lost productivity and job-related accidents in the final costs of the produced goods and higher insurance premiums due to workplace accidents. Drug using employees are not as safe. They are 3.6 times more likely to be involved in a work-related accident than their non-using employee, and 5 times more likely to file workers’ compensation claims. As many as 50% of all workers’ compensation claims may involve substance abuse.[FN1]

The U.S. Postal Service did a study that showed that substance abusers have 55% more accidents, experience 85% more on-the-job injuries, and have a 78% higher rate of absenteeism when compared to non-substance abusing employees.[FN2] A report by the National Safety Council claimed that 80% of those injured in serious drug-related work accidents are not the drug using employees, but innocent employees and others.[FN3]

Drug using employees commit workplace crimes. There is a very significant statistical correlation between drug use and criminal conduct.[FN4]

Substance abuse also causes:
Domestic and financial difficulties for employees;
Poor judgment in employment decision making;
Potential embarrassment to the employer as a result of off-duty conduct, which may be publicized, including criminal charges, diversion of supervisory and managerial time;
Damage to company property; and
Time devoted to discipline and grievance matters.[FN5]

While the studies vary somewhat, it is clear that there is substantial substance abuse in the workplace and it has a powerful negative impact on our economy and productivity. The increased use of “medical” marijuana will magnify all these problems.

References

[FN1] Current, The Truth About Drug Testing: Answers to the Questions Everyone Is Asking, p. 3 (1st Ed., Fort Lauderdale, FL, 1998).

[FN2] “Pre-employment Drug Testing: Association with EAP, Disciplinary, and Medical Claims Information” U.S. Postal Service, Personnel Research and Development Branch, Office of Selection and Evaluation, July 1992.

[FN3] Wisotsky, The Ideology of Drug Testing [Ideology of Drug Testing], 11 Nova L Rev 763, 768 (1987).

[FN4] See Stewart, Proof Positive of Drug Link to Crime, Wall St J, May 28, 1987, at 26, col 3.

[FN5]Alcohol & Drugs in the Workplace: Costs, Control and Controversies, A BNA Special Report [Costs, Control and Controversies], 7 (Bureau of National Affairs, Washington, D.C. 1986)

Source: David Evans sent to DFAF May 2010

Neuropharmacologists ran clinical trials to find that a drug called topiramate is an effective therapeutic medication for decreasing heavy drinking and diminishing the physical and psychosocial harm caused by alcohol dependence.

The drug works by blocking the right amount of the feel good effects of alcohol (brought on by increased levels of dopamine), making drinking less enjoyable and thus reducing cravings and helping to stop heavy drinking.

Topiramate was also found to lower blood pressure and cholesterol levels which may lead to a decrease in heart disease in alcohol dependent patients.

Alcoholism affects over 17 million people. Without proper treatment, it’s a devastating disease that can ruin lives and relationships. A new therapy that comes in a pill is bringing new hope to alcoholics.

There was a time in Christine Flemming’s life when alcohol came before her kids.
“I can’t remember when my daughter was very little, because I was drinking so much,” said Flemming. “That affected me a lot.”

Flemming needed help, but traditional treatment methods didn’t work. Now she’s on a new kind of therapy in the form of a pill called topiramate. It has changed her life. “I can tell you that it cuts my cravings, and I don’t feel like I have to drink,” Flemming said. “I don’t feel like that’s something I need in my life and I have to do.”

Alcohol increases levels of dopamine, a chemical in the brain that makes us feel good. The drug works by blocking the right amount of the feel-good effects from alcohol to reduce cravings and help stop heavy drinking. During clinical trials, neuropharmacologists were surprised to learn it also lowers blood pressure and cholesterol levels, which may lead to a decrease in heart disease in alcohol dependent patients.

“Most of the morbidity due to alcoholism is caused by secondary effects of all these other systems, so to have a drug that begins to correct all those other physical abnormalities is extremely helpful,” said Bankhole Johnson, Ph.D., a Neuropharmacologist at the University of Virginia in Charlottesville, Va.

The drug helped improve Fleming’s health and end her dependence on alcohol. She cut her drinking from 15 beers a day to just three, so time with her kids is now a priority.
“It’s made a big difference,” Flemming said. “It’s made a really big difference, and I feel like I’m actually there for my family.”

Qualifying patients can find out how to receive the drug by contacting their primary care doctors.

WHAT IS TOPIRAMATE? Topiramate is a drug originally discovered in 1979. It is prescribed as an epilepsy medication and for migraine headaches. It is also used for a number of other purposes, including as a treatment for people with alcoholism.

Researchers believe that topiramate works in two ways. First, it reduces the release of dopamine that follows the consumption of alcohol. This reduces the positive feeling that people receive from alcohol, and thus reduce the incentive to drink. Second, topiramate interferes with the protein glutamate which normally excites dopamine neurons and again, lessening the ýfeel goodý effect of dopamine from alcohol.

WHAT IS ALCOHOL? Alcohol is created through the natural process of fermentation. This happens when yeast and sugar from vegetables and grains change the sugar into alcohol. When you drink alcohol, it is absorbed into your bloodstream, where it can affect the central nervous system, which is the control center for your entire body.

Alcohol slows down this control center with its sedative effect. In moderation it can reduce anxiety, but it also blocks some of the commands the brain sends to other parts of the body, so it alters your senses. That’s why, when drunk, people often have trouble walking, talking, and some may even “black out,” forgetting what they said or did. Drinking an excessive amount of alcohol can even be fatal.

Source www.ScienceDaily June 2010

California data on drivers involved in passenger vehicle fatal crashes using Marijuana were analyzed to determine the impact on traffic safety and to provide information on the possible impact of an initiative, the Tax and Regulate Cannabis Initiative or “TC2010” which is on the California ballot in November 2010 to reform and partially legalize Marijuana.

A total of 1240 persons were killed in the last five years in fatal motor vehicle crashes involving Marijuana. 230 were killed in 2008. Use has increase steadily in the last ten years and is now at 5.5% in fatal passenger vehicle crashes. The use in single vehicle fatal crashes where most drivers are tested shows an involvement rate of 8.3%.

The largest increases occurred in the 5 years following the establishment of the Medical Marijuana Program in January 2004. For the five years following legalization there were 1240 fatalities in fatal crashes, compared to the 631 fatalities for the five years prior, for an increase of almost 100%.

In 2008 there were 8 counties where more than 16% of the drivers in fatal crashes tested positive for Marijuana. Five of the 8 counties had rates over 20% Based on this experience, a use rate of 16% to 20% is very likely. A rate increase to only 16%, would result in 670
fatalities, and at 20% we would have about 840 fatalities annually. The 20% level would be more than triple the present level of 230 fatalities in 2008. At these levels, Marijuana would rival alcohol at 17.9%, as the top cause of traffic fatalities.

If “TC2010” passes, tax income on Marijuana is estimated at $1.4 billion annually compared to an estimated $4 billion or more economic loss from Marijuana related fatal crashes.
Over 80% of the Marijuana drivers are male, with a median age of 25. In addition, about half (48%) of the drivers using Marijuana also were legally intoxicated. About 75% of the drivers that used Marijuana did not use any other drug. About 1.2 fatalities were reported for each Marijuana involved driver.

Authors: Alfred Crancer and Alan Crancer

Source: -Received June 2010 from Drug Free America Foundation

Steroids are linked to manic episodes, depression, suicide, psychotic episodes and increased aggression and hostility, occasionally triggering violent behavior, including murder.

Researchers at Uppsala University in Sweden studied the relationship between crime and steroid use in 1,440 Swedish residents tested for the drugs between 1995 and 2001 from clinics, including substance abuse facilities, as well as police and customs stations.

Of those involved in the study, 241 tested positive, with an average age of about 20.
The research team found those who tested positive for steroid use were roughly twice as likely to have been convicted of a weapons offense and one-and-a-half times as likely to have been convicted of fraud.

When the researchers excluded people from substance abuse facilities from their analysis the connection with armed crime remained, but the link between steroid use and fraud disappeared.
While steroids are linked with outbursts of uncontrolled violence known as “‘roid rage,” they did not appear to be connected with sexual offenses, violent crimes such as murder, assault and robbery, or crimes against property such as theft.

This investigation instead reveals that steroid use may be linked with premeditated crimes—those involving preparation and advance planning.
One explanation the researchers suggest for the findings is that criminals involved in serious crimes such as armed robbery or the collection of crime-related debts might benefit from the muscularity, heavy build and increase in aggression that comes with steroid use.

The scientists report their findings in the November issue of the Archives of General Psychiatry.

Source: Fox News Live Science Monday , November 06, 2006

Abstract
California data on drivers involved in passenger vehicle fatal crashes using Marijuana were analyzed to determine the impact on traffic safety and to provide information on the possible impact of an initiative, the Tax and Regulate Cannabis Initiative or “TC2010” which is on the California ballot in November 2010 to reform and partially legalize Marijuana.

A total of 1240 persons were killed in the last five years in fatal motor vehicle crashes involving Marijuana. 230 were killed in 2008. Use has increase steadily in the last ten years and is now at 5.5% in fatal passenger vehicle crashes. The use in single vehicle fatal crashes where most drivers are tested shows an involvement rate of 8.3%.

The largest increases occurred in the 5 years following the legalization of Medical Marijuana in January 2004. For the five years following legalization there were 1240 fatalities in fatal crashes, compared to the 631 fatalities for the five years prior, for an increase of almost 100%. In 2008 there were 8 counties where more than 16% of the drivers in fatal crashes
tested positive for Marijuana. Five of the 8 counties had rates over 20%

Based on this experience, a use rate of 16% to 20% is very likely. A rate increase to only 16%, would result in 670 fatalities, and at 20% we would have about 840 fatalities annually. The 20% level would be more than triple the present level of 230 fatalities in 2008. At these levels, Marijuana would rival alcohol at 17.9%, as the top cause of traffic fatalities.

If “TC2010” passes, tax income on Marijuana is estimated at $1.4 billion annually compared to an estimated $4 billion or more economic loss from Marijuana related fatal crashes.
Over 80% of the Marijuana drivers are male, with a median age of 25. In addition, about half (48%) of the drivers using Marijuana also were legally intoxicated. About 75% of the drivers that used Marijuana did not use any other drug. About 1.2 fatalities were reported for each Marijuana involved driver.

Source: Sent by Ronald E. Brooks Northern California High Intensity Drug Trafficking Area June 2010

Recent research has clarified a number of important questions concerning adverse effects of cannabis on health.

A causal role of acute cannabis intoxication in motor vehicle and other accidents has now been shown by the presence of measurable levels of Δ9-tetrahydrocannabinol (THC) in the blood of injured drivers in the absence of alcohol or other drugs, by surveys of driving under the influence of cannabis, and by significantly higher accident culpability risk of drivers using cannabis.

Chronic inflammatory and precancerous changes in the airways have been demonstrated in cannabis smokers, and the most recent case-control study shows an increased risk of airways cancer that is proportional to the amount of cannabis use.

Several different studies indicate that the epidemiological link between cannabis use and schizophrenia probably represents a causal role of cannabis in precipitating the onset or relapse of schizophrenia.

A weaker but significant link between cannabis and depression has been found in various cohort studies, but the nature of the link is not yet clear. A large body of evidence now demonstrates that cannabis dependence, both behavioral and physical, does occur in about 7–10% of regular users, and that early onset of use, and especially of weekly or daily use, is a strong predictor of future dependence.

Cognitive impairments of various types are readily demonstrable during acute cannabis intoxication, but there is no suitable evidence yet available to permit a decision as to whether long-lasting or permanent functional losses can result from chronic heavy use in adults. However, a small but growing body of evidence indicates subtle but apparently permanent effects on memory, information processing, and executive functions, in the offspring of women who used cannabis during pregnancy. In total, the evidence indicates that regular heavy use of cannabis carries significant risks for the individual user and for the health care system.

Source: Progress in Neuro-Psychopharmacology and Biological Psychiatry, Volume 28, Issue 5, August 2004, Pages 849-863

Scientists at Melbourne’s Howard Florey Institute have discovered a system in the brain that stops an alcoholic’s craving for alcohol, as well as prevent relapse once they have recovered from alcohol addiction.
________________________________________
The ‘Orexin’ system is a group of cells in a part of the brain called the hypothalamus. These cells produce Orexin, which was originally implicated in the regulation of feeding, but it soon became apparent that Orexin was also involved in the ‘high’ felt after drinking alcohol or taking illicit drugs.

In studies conducted with rats, Dr Andrew Lawrence and his Florey colleagues used a drug that blocked Orexin’s euphoric effects in the brain and the results were remarkable.
“In one experiment, rats that had alcohol freely available to them stopped drinking it after receiving the Orexin blocker.” Dr Lawrence said. “In another experiment, rats that had gone through a detox program and were then given the Orexin blocking drug, did not relapse into alcohol addiction when they were reintroduced to an environment in which they had been conditioned to associate with alcohol use.

“Orexin reinforces the euphoria felt when drinking alcohol, so if a drug can be developed to block the Orexin system in humans, we should be able to stop an alcoholic’s craving for alcohol, as well as preventing relapse once the alcoholic has recovered,” he said.
Dr Lawrence said that this research could also lead to treatments for eating disorders, such chronic over-eating, which leads to obesity. “Our research shows that alcohol addiction and eating disorders set off common triggers in the brain, so further investigations may uncover drug targets in the Orexin system to treat both conditions,” Dr Lawrence said.

The Florey scientists are now conducting multiple experiments to discover the precise circumstances that activate the Orexin system. “To explore this discovery further we are now investigating how different experimental paradigms and environmental situations impact on the Orexin system, which will hopefully pinpoint therapeutic drug targets,” Dr Lawrence said.
“Before a therapeutic Orexin-blocking drug can be developed, we need to ensure that it will be safe to use in the long-term and that issues surrounding a person’s compliance in taking the drug are considered,” he said.

According to the World Health Organisation, alcohol is one of the most widely used and abused substances in the world and causes as much, if not more death and disability as measles, malaria, tobacco, or illegal drugs.
Dr Lawrence and his colleagues were the first in the world to demonstrate the Orexin system’s involvement in alcohol addiction and their research paper was recently published in the prestigious British Journal of Pharmacology. Dr Lawrence’s paper was downloaded 658 times by researchers from around the world in the first three months of its publication, making it the most downloaded research paper in that issue and supporting the research’s importance.
The Howard Florey Institute is Australia’s leading brain research centre. Its scientists undertake clinical and applied research that can be developed into treatments to combat brain disorders, and new medical practices. Their discoveries will improve the lives of those directly, and indirectly, affected by brain and mind disorders in Australia, and around the world. The Florey’s research areas cover a variety of brain and mind disorders including Parkinson’s disease, stroke, motor neuron disease, addiction, epilepsy, multiple sclerosis, autism and dementia.

Source: ScienceDaily. Retrieved March 28, 2010 Howard Florey Institute (2006, December 13).
.
________________________________________

Driving under the influence of cannabis almost doubles the risk of a fatal road crash, finds a study published online by the British Medical Journal. However its share in fatal crashes is significantly lower than those involving alcohol.The study took place in France and involved 10,748 drivers who were involved in fatal crashes from October 2001 to September 2003. All drivers underwent compulsory tests for drugs and alcohol.

A total of 681 drivers tested positive for cannabis (7%) and 2096 for alcohol (21.4%), including 285 for both (2.9%). Men were more often involved in crashes than women, and were also more often positive for both cannabis and alcohol, as were the youngest drivers, and users of mopeds and motorcycles.

The risk of being responsible for a fatal crash increased as the blood concentration of cannabis increased (known as a dose effect). The odds increased from 1.9 at a concentration of 0-1 ng/ml to 3.1 at or above 5 ng/ml. These effects were adjusted for alcohol and remained significant when also adjusted for other factors.

These results give credence to a causal relationship between cannabis and crashes, say the authors.

Samples show that the prevalence of cannabis (2.9%) within the driving population is similar to that for alcohol (2.7%) at or above 0.5 g/l, they add. However, in France, its share in fatal crashes is significantly lower than that associated with alcohol (2.5% compared with 29% for alcohol).

Source: BMJ-British Medical Journal (2005, December 5). Cannabis Almost Doubles Risk Of Fatal Crashes. ScienceDaily. Retrieved October 5, 2009, from http://www.sciencedaily.com­ /releases/2005/12/051205115540.htm

The State Government figures show that out of 4619 drivers pulled over, one in 73 tested positive to either cannabis or methamphetamines. This compared to an average of one in 250 drivers testing positive for alcohol. The results surprised police.The  results come just two days after research by the National Drug and Alcohol Research Centre showed 57 per cent of clubbers admitted driving under the influence of alcohol and 52 per cent under the influence of cannabis. The VicRoads-commissioned study reported that just under half of those surveyed admitted driving soon after taking other drugs.

43% said they had taken ecstasy and 42 % speed.

Source:  Minister for Police & Emergency Services. Victoria. Australia. April 15 2005

Driving under the influence of cannabis almost doubles the risk of a fatal road crash, finds a study published online by the British Medical Journal. However its share in fatal crashes is significantly lower than those involving alcohol.

The study took place in France and involved 10,748 drivers who were involved in fatal crashes from October 2001 to September 2003. All drivers underwent compulsory tests for drugs and alcohol.
A total of 681 drivers tested positive for cannabis (7%) and 2096 for alcohol (21.4%), including 285 for both (2.9%). Men were more often involved in crashes than women, and were also more often positive for both cannabis and alcohol, as were the youngest drivers, and users of mopeds and motorcycles.
The risk of being responsible for a fatal crash increased as the blood concentration of cannabis increased (known as a dose effect). The odds increased from 1.9 at a concentration of 0-1 ng/ml to 3.1 at or above 5 ng/ml. These effects were adjusted for alcohol and remained significant when also adjusted for other factors.
These results give credence to a causal relationship between cannabis and crashes, say the authors.
Samples show that the prevalence of cannabis (2.9%) within the driving population is similar to that for alcohol (2.7%) at or above 0.5 g/l, they add. However, in France, its share in fatal crashes is significantly lower than that associated with alcohol (2.5% compared with 29% for alcohol).

Source:  BMJ-British Medical Journal (2005, December 5). ScienceDaily. Retrieved March 29, 2009

Since states began setting the legal drinking age to 21, the National Highway Traffic Safety Administration estimates over 26,000 lives have been saved. And as one of the most studied public health laws in history, the scientific research from 46 high-quality studies all found that the 21 Law saves lives.² In addition, studies show that the 21 Law reduces causes those under the age of 21 to drink less and to continue to drink less throughout their 20s.³ Of the 5,000 total alcohol-related deaths among 18-24 year-olds, 80 percent, or 4,000, were alcohol-related traffic deaths.4
“Lowering the minimum drinking age to 18 is both misguided and dangerous,” said IACP former President Ronald Ruecker, Director of Public Safety in Sherwood, Oregon. “The worst thing any police officer has to do is knock on a door in the dead of night to tell parents that their child will not be coming home because he or she is a victim of impaired driving. Lowering the national drinking age would inevitably lead to more tragedies for more families.”
The public strongly disagrees with efforts to lower the drinking age. According to a 2008 survey by Nationwide Insurance, 78 percent of adults support 21 as the minimum drinking age and 72 percent believe lowering the drinking age would make alcohol more accessible to youth.
Bill Windsor, Associate Vice President of Safety for Nationwide, said, “While advocates argue a lower drinking age will curb teen binge drinking, our survey shows only 14 percent of Americans agree and 47 percent believe it will actually make a huge problem worse. Americans feel so strongly about teen binge drinking more than half say they are less likely to vote for a politician who supports lowering the legal limit or to send their child to a known ‘party school.’”
Parents are crucial in addressing this problem and can do more by talking and listening to their son or daughter about the many challenges they will face in college. In fact, research shows that parents should educate children before they reach middle school about the dangers of alcohol. We do not want to pass the problem on to high school principals. Parents need to ask themselves whether they want their kids to have more or less access to alcohol. When searching for the right college, parents should ask questions about the college’s policies on alcohol and what the consequences are for underage drinking while on campus. MADD strongly believes parents should be notified if their son or daughter is disciplined or arrested for alcohol.
Dean-Mooney said, “Underage drinking is not just a youth problem, but an adult problem.” Parents and other adults are the key to reducing underage drinking. MADD is developing a program for parents that will give them proven-effective tools for communicating to their teens about this issue.
Source: February 23, 2009 Mothers Against Drunk Driving (MADD)

The Transport Research Laboratory published studies in 1993 and produced a
follow-up study in 2001 that found that, over a period of nearly ten years, there had been a steep rise in the number of drivers killed in road accidents with drugs in their system. The results from 1,184 cases in the 2001 study show that illicit drug taking (mainly cannabis) had increased by a factor of six since the earlier study. At least one medicinal or illicit drug was detected in 24 percent of the casualties – in other words, nearly one in four drivers. Illicit drugs were significantly more prevalent.

The University of Glasgow conducted research in 2001 and 2002, as part of the
European project ‘Impaired Motorists, Methods of Roadside Testing and
Assessment for Licensing’ (IMMORTAL), and was required to analyse 1,396 oral
fluid samples collected from drivers for a wide range of drugs. The study group
included drivers who were stopped at random and participation was entirely
voluntary. The results showed that out of the 1,396 samples tested, 16.8% were
positive for at least one drug. This study demonstrated that a significant number of the driving population is positive for at least one drug.

Research from the Norwegian Institute of Public Health presented at the
European Traffic Police Network (TISPOL)’s conference in Harrogate in October
2008 comprised a representative selection of 10,835 drivers who were tested for drugs and alcohol. TISPOL estimated that if the results from that study were
applied to the UK, the number of journeys taken by drivers unfit to drive because of drugs would be equivalent to around one million car journeys.

In Australia’s State of Victoria, data collected from more than 70,000 roadside drug tests indicated a clear trend. Over a four-year period of roadside testing and educational drug-driving campaigns, drug driving in the State has decreased by almost 50 percent from one driver in 44 (2004 figures) to one driver in 76 (2008 figures).

Similar studies from other countries, including Italy, which has been conducting
roadside testing since a change in legislation in 2002, show that the availability of a greater depth of evidentiary data supports the revision and implementation of
related legislation and strategies to reduce the risks of drug driving in these
countries

Australian Roadside Case Study
Concateno has been working with the Australian police since 2004 to introduce random roadside testing. The State of Victoria, which is at the forefront of road safety initiatives, was the first in the world to effect a change in legislation and allow random testing, other Australian states have subsequently followed, including Queensland, New South Wales, Western Australia, South Australia and Tasmania.

Since the introduction of this testing regime, a clear trend can be seen, with a reduction in the numbers of drivers that were confirmed as positive. In 2004 it was 1:445, whereas by the end of 2008 it has dropped to 1:76. This means that fewer drivers are driving while taking drugs, indicating that a regime such as the one adopted by Australia is effective in reducing drug driving and contributing to safer roads. Most recently, on July 14 2009, Australia’s Transport Accident Commission announced a new campaign targeting those who drive while under the influence of cannabis

Source: July 14, 2009 Response from Concateno plc to ‘A Safer Way’ Consultation, Department for Transport

According to a study from the Institute of Environmental Science and Research (ESR) in New Zealand, more than one in five drivers who died on the roads 1995-1997 had been smoking cannabis in the-hours before they crashed. The study found 82 of a sample of 386 drivers had cannabis in their bloodstreams and 54 per cent of the cannabis smokers were over the legal alcohol limit.

 In 2000, an estimated 310,000 people were injured in crashes where police reported that alcohol was present — an average of one person injured approximately every 2 minutes.

A University of Tennessee study reveals extensive alcohol and other drug problems among emergency-room patients, but most go undiagnosed.
The study, led by Dr. Ian Rockett, included 1,502 adults seeking emergency care at seven hospitals throughout Tennessee from June 1996 to January 1997. Patients were interviewed and underwent saliva and urine screenings. The research team found that 27 percent of the patients needed addiction treatment. However, a diagnosis of a drug-related problem was recorded in the charts of only 1.1 percent of the patients.On a larger scale, the researchers determined that 22 million patients, or one in every four entering emergency rooms in Tennessee, are dependent on drugs.

“I think people who work in emergency rooms are well aware that many patients have drug problems,” said Rockett, who is now with West Virginia University. “But I don’t think they are truly aware of the extent of it.”

Tests Driving Drug-Affected Motorists Off The Road 

Victoria’s world-first random roadside saliva tests have highlighted an alarming rate of drug use among drivers, the Minister for Police & Emergency Services, Tim Holding, said today.

Mr Holding said independent laboratory analysis had shown drug driving was more than three times as prevalent as drink driving, with one in every 73 drivers testing positive for cannabis or methamphetamine-based drugs. This compares to an average of one in every 250 drivers who are breathalysed testing positive for alcohol.

“Drug driving tests have been an outstanding success in reliably identifying drivers whose capacity to drive is dangerously compromised,” Mr Holding said. “There can be no mistake that driving under the influence of illicit drugs is just as dangerous as driving while affected by alcohol and is a major contributor to death and trauma on Victoria’s roads.

“The first four months of the saliva drug testing program have identified a worrying level of substance use among drivers that will not be tolerated.” Mr Holding said a three-step process ensured the integrity of the tests. Drivers are initially asked to provide a saliva sample by placing a small absorbent pad on their tongue for a few seconds.

Drivers who return a positive test are then asked to accompany police into a drug bus, similar to a booze bus, for two further saliva samples – one to be kept by the driver and the other for further on-the-spot analysis. If this indicates a positive result, the sample is sent to a laboratory for verification. Motorists who return positive laboratory results for cannabis or methamphetamines are fined $307 and lose three demerit points, or are prosecuted in court. If the offence progresses to court, the maximum penalty for a first offence is $614 and three months’ licence cancellation. Subsequent convictions can result in fines of up to $1227 and up to six months’ licence cancellation.

Mr Holding said in the four months to 17 March 2005, a total of 4619 drivers were tested, with 63 drivers testing positive for drugs. He said 21 drivers tested positive for cannabis and methamphetamine-based drugs. Five drivers tested positive for only cannabis, with 37 testing positive to only methamphetamine-based drugs.

Of the 3488 car drivers tested, 47 returned a positive result. Sixteen out of 1131 truck drivers tested positive for drugs. Eight preliminary tests were not confirmed by the drug bus.

Mr Holding said test handling procedures had been reviewed after three drivers’ final tests ultimately came up negative in the very early stages of the program. “Independent laboratory tests since have conclusively verified the accuracy of saliva drug testing,” Mr Holding said.

Aims To investigate the relationship between marijuana use prior to driving, habitual marijuana use and car crash injury

Design and setting Population based case control study in Auckland, New Zealand.

Participants Case vehicles were all cars involved in crashes in which at least one occupant was hospitalized or killed anywhere in the Auckland region, and control vehicles were a random sample of cars driving on Auckland roads. The drivers of 571 case and 588 control vehicles completed a structured interview.

Measurements Self reported marijuana use in the 3 hours prior to the crash/survey and habitual marijuana use over the previous 12 months were recorded, along with a range of other variables potentially related to crash risk. The main outcome measure was hospitalization or death of a vehicle occupant due to car crash injury.

Findings Acute marijuana use was significantly associated with car crash injury, after controlling for the confounders age, gender, ethnicity, education level, passenger carriage, driving exposure and time of day (OR 3.9, 95% CI 1.2 12.9). However, after adjustment for these confounders plus other risky driving at the time of the crash (blood alcohol concentration, seat-belt use, travelling speed and sleepiness score), the effect of acute marijuana intake was no longer significant (OR 0.8, 95% CI 0.2 3.3). There was a strong significant association between habitual use and car crash injury after adjustment for all the above confounders plus acute use prior to driving (OR 9.5, 95% CI 2.8 32.3).

Conclusions This population-based case control study indicates that habitual use of marijuana is strongly associated with car crash injury. The nature of the relationship between marijuana use and risk-taking is unclear and needs further research. The prevalence of marijuana use in this driving population was low, and acute use was associated with habitual marijuana use, suggesting that intervention strategies may be more effective if they are targeted towards high use groups.

Alcohol-related injury deaths and drunk driving both increased among college students over the past few years, according to a new report from the National Institute on Alcohol Abuse and Alcoholism (NIAAA).

More than 1,700 college students ages 18-24 died in 2001 as the result of alcohol-related injuries, up from about 1,500 in 1988. Moreover, according to NIAAA, an estimated 2.8 million drove while under the influence of alcohol in 2001, compared to 2.3 million in 1998.

The study authors said that the problems could be mitigated through greater enforcement of drinking-age and zero-tolerance laws, increases in alcohol taxes, wider implementation of screening and counseling programs, and comprehensive community interventions.

Researchers from Boston University and Harvard University analyzed data from the National Highway Traffic Safety Administration, the Centers for Disease Control and Prevention, the National Household Survey on Drug Abuse, and the Harvard College Alcohol Survey, as well as other reports.

“In both 1998 and 2001 more than 500,000 students were unintentionally injured because of drinking and more than 600,000 were assaulted by another student who had been drinking,” said lead study author Ralph W. Hingson, Sc.D, a professor at the Boston University School of Public Health and Center to Prevent Alcohol Problems Among Young People. “We must remember, however, that since the 18-to-24-year-old non-college population vastly outnumbers the college population, they actually account for more alcohol-related problems than do college students. For example, while 2.8 million college students drove under the influence of alcohol in 2001, so too did 4.5 million college-aged persons who were not in college.”

“The magnitude of problems posed by excessive drinking among college students should stimulate both improved measurement of these problems and efforts to reduce them,” added Hingson.

By Antony Stone, PA News

A teenage boy knocked down and killed by an express train was probably under the influence of cannabis at the time, an inquest jury heard today.

Phillip Francis, 18, from West Wales, turned his back on the speeding train and walked down the track as its driver sounded the horn. Within seconds he was hit by the 415-ton First Great Western high-speed train heading to London Paddington from Carmarthen at 7.58am on May 6.

An inquest jury in Llanelli heard today how the parents and friends of the teenage labourer, of Randall Square, Pembrey, had been devastated by his death. Driver Michael Jonah said he had already been slowing the train from 75mph to 65mph as he approached Pembrey station from a mile away.

He saw the teenager walk out from the side of Talybank Bridge, Pembrey, and continue on to the track. He just continued to walk on the running lines and turned his back. He made no acknowledgement of the horn.

He said that he appeared to raise both of his arms to shoulder height in the moment before being struck. The front of the driver’s cab then struck this young person and he disappeared from view below the train, Mr Jonah added.

David Emmott, a British Transport Police investigator, said Phillip had been at a sleepover at a friend’s home in Burry Port that night. He said his parents were aware that he had been using cannabis for about one year but had been unable to stop him taking it.

He had left no suicide note, did not suffer from depression and was seen as pleasant and well-balanced by all who knew him. “It seems most likely that his death is the result of disorientation as a result of his use of the drug,” Mr Emmott said.

Pauline Mainwaring, deputy coroner for Llanelli, said a post-mortem report had concluded the teenager had died of multiple injuries.

Toxicology tests confirmed that he had taken cannabis not long before the accident. It was likely that he was experiencing one or more of the psychological effects associated with the drug at the time of his death. These include disturbances of memory and judgment, anxiety and panic attacks, irritability and hallucinations. The jury recorded a verdict of accidental death

Research SummaryResearchers from the University of Michigan Health System tested 443 patients ages 14-17 who entered the emergency room at the school’s hospital for treatment of severe injuries. They found that 29 percent tested positive for opiates, 11.2 percent tested positive for alcohol, and 20 percent tested positive for marijuana.

“The two major preventable health issues facing adolescents are injuries that result in death or disability, and lifestyle choices that have long-term, adverse health consequences,” said lead researcher Peter Ehrlich. “To help alter this risk-taking behavior, it is essential that drug testing and brief substance-abuse intervention programs be included in the treatment of all injured adolescents.”

Ehrlich called for comprehensive drug screening in emergency rooms.

The research was published in the Journal of Pediatric Surgery.

Reference:

Ehrlich PF, Brown JK, Drongowski R. (2006) Characterization of the drug-positive adolescent trauma population: should we, do we, and does it make a difference if we test? Journal of Pediatric Surgery, 41(5): 927-930.

Marijuana Impairs Driving-Related Skills and Workplace Performance.Marijuana use impairs driving-related functions and is linked to a pattern of behaviors that leads to poor job performance, according to two NIDA-supported studies on the effects of marijuana on human performance. Findings from the studies were presented at NIDA’s first National Conference on Marijuana Use.
At NIDA ‘s National Conference on Marijuana Use, Dr. Stephen Heishman presented data from laboratory studies showing that marijuana impairs functions important to driving. Figures from previous studies of automobile accident victims show that from 6 to 12 percent of nonfatally injured drivers and 4 to 16 percent of fatally injured drivers had tetrahydrocannabinol (THC), the psychoactive ingredient in marijuana, in their bloodstream. One study showed that 32 percent of drivers in a shock trauma unit in Baltimore had marijuana in their bloodstream. However, in most of these studies, the majority of subjects who tested positive for THC also tested positive for alcohol, making it difficult to single out THC’s effect on driving.
In a laboratory study at NIDAs Addiction Research Center in Baltimore that controlled for alcohol’s confounding effect, Dr.Stephen Heishiman,a research psycologist in clinical pharmocology, tested marijuana’s effects on the functional components of driving. Study subjects smoked a marijuana cigarette, waited 10 minutes. then smoked another cigarette. Both cigarettes contained either 0. 1.8. or 3.6 percent THC. Twenty minutes after smoking the cigarettes. the subjects were given a standard sobriety test similar to a roadside sobriety test. The test showed that marijuana significantly impaired their ability to stand on one leg for 30 seconds or touch their finger to their nose. As the dose of THC increased, the subjects swayed more, raised their arms, and had to put their feet down in an attempt to maintain their balance. Subjects also committed 2.5 times more errors when they attempted to touch their nose with their finger.
The data from these laboratory studies show that marijuana impairs balance and coordination – functional components important to driving – in a dose-related way, said Dr. Heishman. These effects may be related to reported marijuana-induced impairment of automobile driving, he stated.
Highway and urban driving studies conducted in the Netherlands show less impact on actual driving. However. these driving studies used very low doses of marijuana for safety reasons, Dr. Heishman said. Future research using appropriate safety measures should test the effect of higher doses of marijuana on driving as well as the combined effect of marijuana and alcohol on driving, he concluded.

Dr. Wayne Lehman of Texas Christian University looked at how marijuana affects job performance. A series of surveys he conducted among 4,600 municipal employees in four cities in the Southwest indicated that 8 percent of employees had smoked marijuana in the past year, and a large percentage of these users had smoked marijuana in the past month, Dr. Lehman said.
‘Employees who report marijuana use are different from nonusers,” said Dr. Lehman. They are much more likely than nonusers to have arrest histories, low self-esteem, high rates of depression, and friends who are deviant. Many marijuana smokers also have alcohol-related problems. One-third of marijuana users in the suneys reported they drank frequently. one-half said they got drunk, and 60 percent reported a problem with alcohol use, according to Dr. Lehman.
This behavioral pattern in the personal backgrounds of marijuana-smoking employees was associated with negative attitudes toward work and job performance, Dr. Lehman said. The surveys found that marijuana users were less likely than nonusers to commit to the organization. had less faith in management, and experienced low job satisfaction. These workers reported more absenteeism, tardiness, accidents, workers’ compensation claims, and job turnover than workers who had not used marijuana. They were also more likely to report to work with a hangover, miss work because of a hangover, and be drunk or use drugs at work.
These data indicate that marijuana use is strongly associated with problematic alcohol use and a pattern of general deviance that leads to impaired behaviors and poor workplace performance, Dr. Lehman concluded.

DRUG misuse is leading more young people than ever before to show up at hospital A&E departments with chest pain.

While chest pain is perceived as being associated with older generations, the increase in heroin and cocaine abuse is becoming more and more evident in hospitals as large numbers of young people present with symptoms mimicking heart related illnesses as a direct consequence of drug misuse.

“We are seeing a big increase in the abuse of cocaine and heroin and we are now also seeing it show up in our hospitals,” said Tony Barden, regional drugs co-ordination with the HSE South East.

“Young people are now coming in with chest pains association with drug misuse. This is an indication of heart and lung damage but we are just in our infancy where damage is concerned. The picture of just how serious the problem is will become a lot clearer over the next 18 months or so.”

Tony Barden says that serious health problems associated with cocaine and heroin abuse will only get worse and lead to more heart and lung complaints among those who use drugs.

“A lot of people are going out and having seven or eight, even 10 pints, and then mixing it with cocaine,” he said. “We need to be moving towards a scenario where we are working on testing for drugs as well as alcohol among motorists.”

The recently published Drugs Misuse Report 2005 showed that while the numbers coming forward for alcohol abuse treatment had dipped, there had been a marked increase in those seeking help for heroin and cocaine.

Data from the Liaison Officer at WRH, contained in the report, showed that 409 people admitted to the hospital after collapsing, hurting themselves or suffering serious ill-health, were then referred onto addiction services.
Source: Waterford News & Star 2nd June 2006

Published: Monday, 20-Feb-2006

A fifth of young adults whose blood vessels ruptured inside their brain abused drugs and more than 40% had malformed blood vessels, according to a study reported Feb. 17 at the American Stroke Association’s International Stroke Conference 2006 in Kissimmee, FL.

The study included 307 patients with intracerebral hemorrhage (ICH) — a stroke caused by a blood vessel bursting inside the brain. Of the 75 patients 49-years-old or younger, 20% had drugs in their system.

“The dominant drug of abuse was cocaine, long recognized as a risk factor for ICH,” said Michael Hoffmann, MD, lead author of the study and director of the stroke program at the University of South Florida-Tampa General Hospital. “Marijuana was another frequently abused drug and is beginning to emerge as a risk factor for stroke. Amphetamines also were commonly abused.”

How these drugs make brain blood vessels prone to rupture is not clear, but is being studied, Dr. Hoffmann said.

The study analyzed the causes and outcomes of ICH patients. 24% of ICH patients in a registry at Tampa General Hospital were ages 18 to 49. Half were women, about two thirds were Caucasian, 15% were black and 12% were Hispanic.

ICH is often linked with high blood pressure in people over age 50, and in this study, 57% of those age 50 and older had it. Only 33% of ICH patients ages 18 to 49 had high blood pressure.

Of the younger patients in the study, 41% had malformed blood vessels, known as arteriovenous malformations, aneurysms or other vascular disorders. Cerebral arteriovenous malformation occurs when blood vessels in the brain develop in an abnormal tangle in which the arteries connect directly to the veins without the normal capillaries between them. A cerebral aneurysm is the bulging of the wall of an artery in the brain. Both these conditions weaken blood vessels and increase the risk of a hemorrhagic (bleeding) stroke.

The good news is that patients under age 50 who experience this vessel rupture inside the brain have better outcomes than older patients.

“Surprisingly, our study showed a low mortality rate compared to population studies,” said Dr. Hoffmann, professor of neurology at USF.

The 30-day mortality was 14.6% for the younger group, significantly lower than for older patients, whose mortality rate was 21%, he said. Previously, national population studies have found a high 30-day mortality rate for stroke patients with ICH. Some epidemiological data have suggested a 45% to 50% mortality rate, Dr. Hoffmann said.

ICH has traditionally been associated with older age groups and higher mortality rates.

Dr. Hoffmann attributes the low mortality rate in younger ICH patients to intensive neurocritical care management at Tampa General. The protocol includes decreasing intracranial pressure and using drains to prevent hydrocephalus, mechanical ventilation, sepsis control, blood pressure control and cooling.

The younger patients came into the emergency room, then were rapidly transferred to a neurocritical care unit within six hours. Typically, patients are hospitalized in the neurocritical care unit for one to eight weeks. Patients were evaluated by MRI, CT and angiography.

“This new way of thinking about how to manage patients with ICH is an important approach, and patients are reaping benefits,” Dr. Hoffmann said.

Most of the younger patients were able to live independently three to six months after their ICH, with only mild to moderate cognitive impairment that tends to improve over time, he said.

Dr. Hoffmann said the degree and nature of disability at six months is now the focus of the extension of this study.

“Intensive neurocritical care is the key to successful outcome,” Dr. Hoffmann said. “Good medical care can salvage a high quality of life after a stroke.”

The study was funded by USF Health and the Tampa General Hospital Stroke Registry. Co-author is Ali Malek, MD, USF assistant professor of neurology.
Source: http://www.hsc.usf.edu ; News-medical.net

(The Substance Abuse and Mental Health Services Administration’s Drug Abuse Warning Network ( DAWN ) found that the most common single-drug suicide deaths involved opiates, followed by antidepressants and then cocaine, sedatives and anti-anxiety medications.

DAWN information showed that 7 out of 10 of the suicide deaths involved multiple drugs. The highest rates included combinations of alcohol and antidepressants, anti-anxiety medications and opiates, alcohol and opiates, and then antidepressants with opiates. One quarter of the overall deaths in the metropolitan areas and states involved multiple antidepressants.

“What this data shows is what we teach in our education presentations,” comments a supervisor at Narconon Arrowhead, which is one of the nation’s largest and most successful drug rehabilitation and education programs, “that all drugs are basically poisons and that enough of any drug can cause extreme adverse reactions and even death.”

The DAWN study of 32 metropolitan areas and six states also looked for mortality rates for drug abuse. Of the cities that were examined, Baltimore and Albuquerque had the highest rates with more than 200 deaths per million people. Another 14 metropolitan areas had drug misuse death rates that exceeded 100 per 1,000,000.

In the six states, the number of deaths related to drug misuse or abuse ranged from 74 to 697. After adjusting for population differences, the rates of drug misuse/abuse deaths ranged from 88 deaths per 1,000,000 in Maine and New Hampshire to 162 deaths per million in New Mexico.

The Drug Abuse Warning Network is a public health surveillance system that monitors drug-related hospital emergency department visits and drug-related deaths to track the impact of drug use, misuse, and abuse in the U.S.

This survey did not include any deaths from adverse reactions to drugs. Such cases would include the consequences of using a prescription or over-the-counter pharmaceutical for therapeutic purposes and include deaths related to adverse drug reactions, side effects, drug-drug interactions, and drug-alcohol interactions.

Source: I-Newswire.com Jan.2006

A little light relief in amongst all the serious data – there are occasionally sections – which although still serious – can bring a smile to one’s face. One such is this extract from the book ‘Marijuana – Deceptive Weed’ by Professor Gabriel Nahas.

Experiments carried out in Germany by Luff (1972) indicate that driving under the effects of Cannabis intoxication induced by active material is hazardous. Twelve young volunteers Ingested 3.2 gr. of a potent preparation, and were tested under actual driving conditions. They passed through 35 stop signs, ignored three red lights, made 233 parking mistakes, ran through l9 pedestrian crossings, demolished a simulated wall of plastic blocks and ran over a large stuffed lion. The dose of delta-9-THC these volunteers absorbed was certainly elevated (60 – 100 mg) but the results are nevertheless sobering.

Source: ‘Marijuana – Deceptive Weed’ by Professor Gabriel Nahas, O.B.E., Ph.D. Published Raven press NY 1975.

Much of the push toward drug testing has come from the federal government. In 1982, the Navy began the first broad-scale random drug testing after an aircraft accident aboard the USS Nimitz uncovered widespread drug use about the ship. The practice soon spread to other branches of the military. Then drug testing was introduced in safety-sensitive government agencies such as the Nuclear Regulatory Commission, and mandated for government contractors with contracts worth more than $25,OOO.

Several horrific accidents spurred drug testing in the transportation industry. In 1987, two trains collided in Chase, Md., causing 16 deaths, and it was later revealed that one of the trains engineers had been smoking marijuana before the collision. And in 1991, eight people were killed in a New York subway train crash; the train’s driver later tested positive for alcohol.

These incidents led to the passage of the Omnibus Transportation Employee Testing Act of 1991 which required the Department of Transportation to mandate drug and alcohol  testing of employees in safety-sensitive transportation positions in private companies.

A snapshot of how drug testing works comes from Tom Warner, president of three D.C-based plumbing, heating and air conditioning companies that together employ 92 workers.  He wasn’t pushed to his drug-testing policy because of any big disaster. Instead, it was little things such as recurring minor accidents and foolish mistakes.  He remembers one experienced technician, for example, who had used his bare hands on a sewer-contaminated piece of machinery, rather than use his gloves. “It wasn’t something a rational person would do” he recalled thinking at the time.

Warner decided to introduce drug testing, and the first results startled him.  About half of a group of new trainees failed. as did the worker who had failed to use his safety gloves. Some drug users quit rather than be tested. Warner decided to clean out the problem workers by simply firing people who tested positive for drug use.  They are invited to reapply after one year and will be rehired if they pledge to remain drug-free.  Few drug users either apply or reapply now, Warner said. “It’s known we’re a drug-free company,”  he said. “People who do drugs want to do drugs — and want to be in a place where they can.” The percentage of major firms requiring employee drug tests has escalated in the past decade, … and the percentage of employees who test positive has declined significantly.

Construction workers are among the category of employees reporting the highest usage rate of Illegal drugs. Percentage of employees, 18-49, reporting use of illicit drugs in the past month :-
 

At the Department of forensic Medicine in Stockholm various studies on drug-related mortality are carried out. One important object is to create a register of deaths related to illicit drug use in the Stockholm area. This register includes users of heavy drugs chiefly amphetamine and heroin.

However, in recent years a number of cases were found with tetrahydrocannabinol but no other illicit drugs, in blood or cannabinoids in urine.
At closer investigation, it appeared that manners of death among the cannabis users were unexpectedly violent compared to the ways of death among other drug addicts. The proportion of suicides, 10 out of 24, was particularly high. This finding was remarkable, since cannabis use is not generally associated with violence.
The literature contains several descriptions of delusional states, paranoid symptoms and personality disturbances in cannabis users . These abnormal mental states are of comparatively short duration, usually lasting for just a few hours. Even first-time users may be affected.

These so-called cannabis psychoses are not very frequent and are often induced by long periods of intensive cannabis use. It is uncertain whether or not these psychoses can be separated from schizophrenia or other known paranoid states . The entity distinguishing cannabis psychosis from other mental disorders is the significant subsidence of the symptoms after some days or a few weeks. In most cases, the patient recovers totally but remains at risk for relapse in connection with repeated cannabis use. In case studies of cannabis psychoses, it is not uncommon to see descriptions of violent and destructive outbursts, suicide attempts and assaults on other persons, often with major violence. In a Swedish follow-up study of conscripts with a history of cannabis use, an excess mortality was noted 15 years after conscription. The excess mortality from suicides was particularly high, and the share of suicides increased in proportion to the magnitude of the cannabis abuse.

During these four years, a total of 13,417 medico-legal autopsies were made on males and females of all ages (about 26% after violent deaths). A total of 1.9 million people resided in the service area in 1987; of these, about 1.6 million lived in Stockholm county and 668,810 in the city of Stockholm. Information about deceased persons was obtained from police reports and was, when possible, supplemented with information from clinical journals, families and friends as well as from social workers. Complete autopsies were carried out, with few exceptions, when the blood tests analyses concerning HIV-infection were positive The autopsies were supplemented with histological investigations. Toxicological analyses were made, with the purpose of disclosing the presence of alcohol, barbiturates, tranquilizers, opiates, central stimulants and cannabis, as suggested by autopsy findings, past history, police records, or circumstances of death. Toxicological analyses were also carried out when insufficient information about the circumstances of death was at hand, for instance in cases of violent death, or when the postmortem findings were inconclusive, and also when information about unusual behaviour or symptoms was available.

RESULTS
During the four-year period of 1987-1990, cannabis was found to be the only narcotic drug in postmortem samples in 24 cases; in 8 of these, cannabis was the only finding, while alcohol, alcohol and medicinal drugs, or only medicinal drugs was demonstrated together with cannabis in 10, 5 and 1 instance, respectively. The number of deaths among these 24 cannabis users during the study period is shown in Figure 1.

There were 23 males and 1 female, 20-43 years of age (mean age 29.6 years). About two thirds (15) of the persons in this series were, at the time of death, under the influence of alcohol.

Manners of death among 24 cannabis users in comparison to the same number randomly selected alcohol users, amphetamine and heroin users’ deaths. N = Natural deaths. A = Accidental deaths. S = Suicides. H = Homicides. U = Undetermined deaths.
Among the 24 cannabis users, only one died from a non-violent cause, while the remaining 23 (96%) died as a result of violence, compared to a total of 26% of the entire number of 13,417 investigated postmortems during the same period (Table I). No stigmata which could be indicative of cannabis use were noted at the postmortems. None of the cannabis users had blood tests that were positive for HIV.

CAUSE AND MANNER OF DEATH AMONG 25 CANNABIS-ASSOCIATED DEATHS DURING THE FOUR YEAR PERIOD 1987-1990

The manners of death among 24 cannabis users were compared with those in the same number of users of alcohol, amphetamine and heroin (Figure 2); a similar distribution for alcohol users and amphetamine users was noted. There were obvious differences between cannabis users and heroin users, with suicides dominating for cannabis users, while deaths of undetermined origin, following collapse in connection with intravenous drug administration, predominated among heroin users.

Accidental deaths
Eight of the 24 cannabis users died in accidents, 7 males and one female, ranging in age from 22 to 43 years (mean 32.5 years). Two users died of alcohol intoxication. At the time of death, the concentrations of THC in the blood were only 0.8 and 2.0 ng/g. One male with 0.5 ng THC/g blood and 2.7 g ethanol/l blood died from drowning after suddenly loosing his balance and falling into the water. Five cannabis users died in traffic accidents, 3 as drivers of motor vehicles, and 2 as passengers with cannabis-influenced drivers. One of the deceased car drivers had 30 ng THC/g blood (and no other drug), while the remaining 4 traffic accident victims had 1-4 ng THC/g blood in combination with alcohol (0.3, 0.9, 2.8 and 3.2 g/1), in two cases also with low concentrations of chlormezanon and paracetamol. In one of the automobile accidents, high speed ( 3 times exceeding the speed limit through central Stockholm) preceded collision with another car; in another, the cannabis influenced driver passed another car, at twice the speed limit, and just continued to drive on the left side of the road until he collided with a car coming from the opposite direction. In the two others, the drivers were not able to keep their cars on the road in a minor curve; and in yet another, the car was simply driven into a ditch.

The operator of the Baltimore Light Rail train that ploughed into a steel barrier at Baltimore Washington International Airport on Feb 13, injuring 22 passengers, tested positive for cocaine after the crash, transportation officials said yesterday: Sam Epps, who had worked for the Maryland Mass Transit Administration for 25-years, was fired Feb 17. He told investigators he was under the influence of prescription drugs at the time of the crash, MTA officials said. The next day, agency officials said, they received the drug test results that showed Epps was under the influence of cocaine.

Source: Reported in Washington post Feb 24th 2000

People who abuse both alcohol and other drugs have the highest risk of injury. The association among alcohol and other drug use and injury is well documented. Alcohol alone is known to be a factor in 60 to 70 percent of homicides, 40 percent of suicides, 40 to 50 percent of fatal motor vehicle crashes, 60 percent of fatal burn injuries, 60 percent of drownings, and 40 percent of fatal falls. Miller and his co-authors examined medical claims data from a database for 1.5 million people with health care coverage provided by 70 large corporations. Specifically, they analysed the injury-claims histories during a three-year period of people who were treated for an alcohol-or drug-related diagnosis.

“We included all medically treated non-work injuries except alcohol and drug poisonings,” said Miller. “This included falls, car crash injuries, assaults, suicide attempts, near-drownings, suffocations, poisonings that were not substance-abuse related, injury deaths in the hospital, among many others. We excluded medical misadventures that resulted in injury. We also excluded injuries treated at the same time that someone was admitted to the hospital primarily for substance-abuse treatment, because some of those injuries might not have been treated in the absence of the substance-abuse treatment. This latter decision considerably lowered our injury counts for substance abusers, making them conservative.’ Despite the conservatism of their injury findings, the researchers found a notable difference in the risk of injury between those who abused alcohol and other drugs and those who did not. Those individuals clinically identified as substance abusers had an elevated risk of injury. Alcohol-and-drug abusers had the highest risk of injury (58%), followed by drug-only abusers (49%), alcohol-only abusers (46%), and those who did not abuse any drugs (38%). Compared to those without a diagnosed substance-abuse problem, said Miller, alcohol abusers were twice as likely, drug abusers were three times as likely, and alcohol-and-drug abusers were almost four times as likely to be hospitalized for an injury during the three years examined.

“This study provides important evidence regarding the extent of substance abuse disorders and injuries in a population of people who are employed and receive insurance coverage through their employers, said Linda C. Degutis, assistant professor of surgery and public health at Yale University. Each year, she added, substance abuse costs businesses at least $10 billion in absenteeism, injuries, medical liability and health care costs.

Investment in treatment is an effective strategy to reduce these costs,’ said Degutis “Research shows that, following substance abuse treatment, absenteeism, disability days and disciplinary actions all decrease by more than 50%. Adults who complete inpatient alcohol treatment have significantly lower health care utilization than they had prior to treatment. Their use of medical services is cut in half, while they use 60 percent fewer psychiatric services, have a third fewer emergency admissions, and show a 75% reduction in detoxification admissions. However, in order for treatment to occur, the problems must first be identified.”

Both Miller and Degutis noted that health care practitioners – particularly family physicians and trauma personnel – have an invaluable, yet often overlooked, role in detecting, intervening on the behalf of, and referring substance-abusing patients to the appropriate care. Miller said that family physicians have an especially important role in helping older, female substance abusers. “Addiction is a brain disease,” she said “Too often, addiction is treated as a moral issue, or a ‘defect’ in someone’s personality or behaviour or judgement. There are many things that can place someone at risk for developing an addiction, and we now know that it can have a genetic basis, It is a chronic disease, just like heart disease, diabetes, and other diseases. Unfortunately, there is still a great deal of stigma related to addiction and substance abuse, In fact, the very term ‘substance abuse’ somehow implies that the person with an addiction is responsible for the problem. We should not be reluctant to discuss these issues, and should bring them out into the open, just as we have done with diseases such as breast cancer, prostate cancer, and heart disease.”

Source: Miller et al at Pacific Institute for Research and Education Dec 2000

The number of people killed in road construction zones around Illinois has varied from year to year, but been relentless:
17 in 1999
38 in 2000
36 in 2001
31 in 2002
according to the Illinois Department of Transportation.
Police have been doing a fine job making DUI arrests. Legislators have been doing a fine job passing stricter laws against DUI offenders. Some judges, however, have fallen short when it comes to enforcing those laws. That deserves far more scrutiny than it has received.

Source: http://www.chicagotribune.com

Drunken driving has pushed Alabama’s highway death toll up to its highest point in four years.

Forty percent of all highway fatalities last year were alcohol-related and most of those wrecks happened Sunday mornings. The critical time was between 1am and 3am on Sundays – about the time most bars close. Alabama alcohol-related highway fatalities increased 10 percent in 2002 over the previous year. They rose from 374 in 2001 to 413 in 2002, according to the Fatality Analysis Reporting System of the National Highways Safety Administration.

Source: http://www.al.com

In June 1997, the Department published preliminary results from the first 7 months of a new 3 year study into the incidence of drugs in road accident fatalities. At that time the Department committed itself to publishing a further report on the study  when at least 12 months data were available.

This report summarises the findings from the first 15 months of the study (up to 7 January 1998), and reports on the findings from 619 road user fatalities. As before, these include drivers, riders of two-wheeled vehicles (21 of them cyclists), passengers in vehicles and pedestrians.

Table 1 gives the percentage of those testing positive for medicinal and illicit drugs by road user groups. The figures for medicinal drugs include those cases where more than one such drug was found; those for illicit drugs are shown separately. This table is directly comparable to that published in the report issued in June 1997 (based on 301 fatalities).

The figures released on drugs and driving indicate that the scale of illicit drug use among people who have been killed in road accidents has increased considerably over the last decade. They show that among all road users, medicinal drugs were present in six per cent of fatalities. Illicit drugs (mainly cannabis) in 16 per cent, and alcohol in 34 per cent (23 per cent over 80 mg per 100ml) Among drivers alone four percent of those killed had taken medicinal drugs, 18 per cent illicit drugs and 30 per cent, (22 per cent over 80mg per 100 ml) alcohol. All these figures indicate a considerable increase in drug taking compared with the previous 1985-87 study.

Speaking at the PACTS (Parliamentary Advisory Committee on Transport Safety) conference, Keith Hellawell, the UK Anti-Drugs Co-ordinator said: “These figures do not allow simplistic conclusions but they do show that illicit drug use may be a significant factor on road fatalities. In my new role as UK Anti Drugs Co-ordinator I am drawing up a strategy to deal with drugs and the harm they can cause. I look forward to working with colleagues in a wide range of agencies as we learn more about this problem.”

Interim results of survey, January 1998. Published DETR.