Driving - drugs and driving
February 2008
The BMA is concerned at the influence of drugs (both illegal and prescribed) on driving skills and calls on the Government to:
- undertake a campaign to educate the public that the side effects of illegal and certain prescribed drugs can affect their ability to drive, and
- ensure speedier and more specific and co-ordinated research to establish appropriate drug testing devices.
The negative influence of alcohol on the ability to drive safely is proven. National campaigns educating the public of the risks posed by drink driving are generally accepted as being successful. The BMA recognises that a similar problem now exists in relation to drug driving.
People generally accept that they should not drink and drive but probably are unaware of the effects of drugs - illegal and prescribed drugs - on their driving ability. Millions of people regularly take drugs such as anti-depressants, painkillers, anti-histamines and cough mixtures, all of which can have a sedative effect, and yet most of these people probably think it is totally safe for them to drive.
Whilst current research does not yet provide definitive answers, drug driving is a recognised concern in research and by motoring bodies.
The BMA believes that the Government should raise the awareness of this issue with the public and educate them as to the potential impact of drugs on driving ability.
The legal position
Many people lack knowledge with regard to the legal position in relation to drug driving Reference 1 In law, “drug driving” is considered just as serious an offence as drink driving. Section four of the Road Traffic Act 1988, states that “a person who, when driving or attempting to drive a motor vehicle on the road or a public place is unfit to drive through drink or drugs is guilty of an offence”. The law makes no distinction between illegal and prescribed drugs, and does not state any legal limit for drugs as it does for alcohol.
New powers were introduced on roadside testing in September 2003 Reference 2 which amend section 6 of the Road Traffic Act. In its place, schedule 7 contains six new sections giving new powers for the police to administer three preliminary tests including an impairment test to indicate whether a person is unfit to drive due to drugs ('field impairment test') and a test for the presence of drugs in a person's body ('drug screening test'). These new powers require suitable equipment for drug testing - see section on testing devices below.
A new Code of Practice introduced in December 2004 details the tests to be undertaken, how they should be administered, the kind of observations that may be made and the inferences that may be drawn. It also deals with the training for officers and their authorisation by Chief Constables. The tests are a range of tasks including a pupilliary examination, the walk and turn test and the one-leg stand. Other training helps officers to recognise the outward signs of drug recognition. Refusal to participate is an offence in the same way as failure to provide a breath test.
The BMA welcomes the new powers on roadside testing which will help tackle the dangers of drug and drink driving.
Increasing use of drugs
The use of illegal drugs by the younger generation has been found to be frequent and increasing Reference 3. Nearly half of 16 to 24 year olds in England and Wales are reported as using cannabis at least once. Furthermore, 39% reported having taken hallucinogens, with other drugs being taken by fewer 16 to 24 year olds Reference 4. In a separate survey of club-goers in Scotland, 69% had taken cannabis and 85% had at some time driven after using illegal drugs Reference 5.
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The problem of drug driving is not merely related to drug misuse in terms of illegal drugs. The impact of some prescribed drugs and treatments (e.g. sedatives, anti-depressants Reference 6 and eye drops) are also relevant. Although patients are warned of the side effects (e.g. drowsiness, impaired vision), research has shown that they tend to ignore the advice given to them by doctors and pharmacists, and in information leaflets Reference 7
The BMA believes that the general public needs to be made more aware that the side effects of certain prescribed drugs can affect the ability to drive Reference 8, and Reference 9
Implications of drug taking on driving
The wider implications of this behaviour are beginning to emerge. Recent research indicates an increasing incidence of road traffic accidents where people have tested positive for drugs ie drugs which may have been a contributory factor to the cause of the crash Reference 10. The Transport Research Laboratory carried out tests to detect alcohol and drug levels in people involved in fatal collisions between 1985 and 1987, and then again between 1996 and 1999. The results show a six fold increase in the percentage of people testing positive for illegal drugs (with detection of cannabis increasing from 2.6% to 11.9%). Over the same period, the incidence of medicinal drugs and alcohol remained very similar. Drug taking overall, increased by a factor of three, and the proportion of those testing positive for multiple drugs increased dramatically.
The known effects of cannabis are that it can impair co-ordination, visual perception, tracking and vigilance. Impairment is also shown when subjects are tested under simulated driving conditions. Studies report that the majority of fatal cases with detected levels of cannabis are confounded by alcohol. Alcohol alone or in combination with cannabis, increases impairment, accident rate and accident responsibility Reference 11. Therefore, the consequences of mixing alcohol with drugs must also be explored as the side effects of each substance are often exaggerated Reference 12.
The BMA believes that the Government should ensure speedier and more specific and co-ordinated research in order to establish appropriate drug testing devices.
BMA web resource/research
In order to assist debate and raise awareness about this issue the BMA has produced a website outlining the current legal situation, the implications of drug taking on driving and the need to develop an effective drug driving test. The site also supplies links to numerous organisations working in this area. Read more here
In terms of prescribed drugs, the impact on impairment is evident. However, for the spectrum of illegal drugs, such as cannabinoids, current evidence of their effect on driving skills and road safety is inconclusive Reference 13.
Current research continues to investigate the broad spectrum of issues that require investigation if the detection of drugs whilst driving is to be addressed. These range from how to detect levels of drugs in the body Reference 14 , how to detect impairment Reference 15, the level of each drug that can effect driving performanceReference 16, and the timescale over which each drug remains in the body.
Testing devices
The complexity of developing reliable testing devices for drugs is an onerous task. Unlike tests to detect impairment from alcohol that are based on clinical understanding of the metabolic rate and excretion from the body as well as dose related neuropsychological impairment, comparable tests to detect drug levels in the body remain elusive. This is due to the differing effects on the body, and the length of time remaining in the body, of the diverse assortment of drugs that are taken illegally and legally by drivers.
In the Second Review of the Road Safety Strategy, published 26/2/07, the Government announced a consultation 'to establish whether the current process of police enforcement for drug impairment could be made more effective'. The Home Office is working on a specification for a (non-evidential) machine that could screen oral fluid samples.
For further information, please contact the parliamentary unit:
E-mail: parliamentaryunit@bma.org.uk.
References
- Neale, J et al. (2000) Recreational drugs and driving: a qualitative study. Scottish Executive Central Research Unit, research findings 102.
- Railways and Transport Safety Act 2003
- United Kingdom Drug Situation 2000. Report to the European Monitoring Centre for Drugs and Drug Addiction by the Reitox national focal point of United Kingdom, Drugscope.
- United Kingdom Drug Situation 2000. Report to the European Monitoring Centre for Drugs and Drug Addiction by the Reitox national focal point of United Kingdom, Drugscope.
- Neale, J et al. (2000) Recreational drugs and driving: a qualitative study. Scottish Executive Central Research Unit, research findings 102.
- DTLR. Road safety compendium 2000/2001
- Eirpharm
- Accident prevention report 2000: Medicines that can impair driving. Royal Pharmaceutical Society.
- DTLR. Over-the-counter medicines and the potential for unwanted sleepiness in drivers: a review
- Tunbridge, R. J. et al. (2000) The Incidence of drugs and alcohol in road traffic accident fatalities. TRL report 495
- Ward, N. and Dyer, L. (1999) Cannabis and driving: a literature review and commentary. DTLR research report 12.
- Robbe, H. (1998) Marijuana’s impairing effects on driving are moderate when taken alone but severe when combined with alcohol. Human Psychopharmacology: Clinical and experimental Vol 13 (S2) S70 – S78
- Neale, J et al. (2000) Recreational drugs and driving: a qualitative study. Scottish Executive Central Research Unit, research findings 102.
- Rosita
- Tunbridge, R. J. et al. (2000) Recognising drug use and drug related impairment in drivers. TRL report 464.
- Sexton, B. et al. (2000) The influence of cannabis on driving. TRL report 477.