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DRUGS and DRIVING: a Research Review

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DRUGS and DRIVING: a Research Review DOT HS-802 189 DRUGS AND DRIVING: A Research Review Contract No. DOT-HS-4-00994 January 1977 Final Report PREPARED FOR: U.S. DEPARTMENT OF TRANSPORTATION NATIONAL HIGHWAY TRAFFIC SAFETY ADMINISTRATION WASHINGTON, D.C. 20590 Document is available to the public through the National Technical Information Service, Springfield, Virginia 22161 This document is disseminated under the sponsorship of the Department of Transportation in the interest of information exchange. The United States Govern­ ment assumes no liability for its contents or use thereof. Technical Report Docuoeetatioe Pays 1. Report No. 2. Go..res.nt Accession No. 3. Recipient's Catalog No. DOT HS-802 189 4. Title and Subtit. S. Report D.•2 January 1977 DRUGS AND DRIVING: A RESEARCH REVIEW 6. Perlonaing Organization cod. S. Perfonming Organization Report No. 7. 'kr'*-"a) Kent B. Joscelyn and Roger P. Maickel, DOT-HS-4-00994-2 Principal Investigators 9. Performing Organisation N. and Address 10. Work Unit No. (TRAIS) 53-175-47 Indiana University 11. Contract or Gant No. Bloomington, Indiana 47401 DOT-HS-4-00994 13. Type of Report and Period Covered 12. Sponsoring Agency N. and Address Final Report U.S. Department of Transportation National Highway Traffic Safety Administration June 74-Oct. 75 400 Seventh Street , S.W. 14. Sponsoring Agency Cod. Washington, D.C. 20590 15. Suppl.rm.ntory Not.s T6. Abstract This final report presents the results of a study of the relationship between drugs (other than alcohol alone) and highway safety. The state of the art of current research is examined. Conclusions and recommendations for future action and research are made. Topics examined include epidemiological studies, experimental studies, analytical methods for measurement of drug presence, measurement of drug effects on behavior, and legal constraints on drug/driving research and countermeasure development. Other reports produced under the contract include: Drugs and Driving: A Selected Bibliography and A Report of an International Symposium on Drugs and Driving. 17. Key Words 18, Oistribution statement Drugs, Drugs and Driving, Drug Effects, Drug Document is available to the public Measurement, Legal Constraints on Drug Re- through the National Technical Inf mation Service, Springfield, VA search, Use of Human Subjects 22161 19. Sacvrity Cl.ssif. (.f this report) 2a. Security Classif. (of this page) 21• No. of Popes 22. Price Unclassified Unclassified 107 F.s DOT F 1700.7 (8-72) Rpreirction of completed peg. authorized 1 * U. S. GOVERNMENT PRINTING OFFICE : 1973 725-504/32B METRIC CONVERSION FACTORS Approximate Conversions to Metric Measures Approximate Conversions from Metric Measures N Symbol When You Know Multiply by To Find Symbol Symbol When You Know Multiply by To Find Symbol N LENGTH LENGTH mm millimeters 0.04 inches in em centimeters 0.4 inches in m meters 3.3 feet ft i n i nches '2.5 centimeters cm * ao m meters 1.1 yards yd it feet 30 centimeters cm J km kilometers 0.6 miles mi yd yards 0.9 meters m mi miles 1.6 kilometers km r- AREA AREA cm2 square centimeters 0.16 square inches in2 6.5 in2 square inches square centimeters cm2 m2 square meters 1.2 square yards yd2 0.09 ft2 square feet square meters m2 km2 square kilometers 0.4 square miles mt2 yd2 square yards 0.8 square meters m2 he hectares (10,000 m2) 2.5 acres mil square miles 2.6 square kilometers km2 acres 0.4 hectares ha C, MASS (weight MASS (weight) g grams 0.035 ounces or or ounces 28 grams kg kilograms 2.2 pounds 11) lb pounds 0.45 kilograms kg t tonnes (1000 kg) 1.1 short tons short tons 0.9 tonnes t (2000 lb) VOLUME VOLUME a, tsp teaspoons 5 milliliters ml ml milliliters 0.03 fluid ounces fl or m Tbsp tablespoons 15 milliliters ml 1 liters 2.1 pints pt fl on fluid ounces 30 milliliters ml I liters 1.06 quarts qt c cups 0.24 liters 1 liters 0.26 gallons gal pt pints 0.47 liters m3 cubic meters 35 cubic feet tt3 qt quarts 0.95 liters m3 cubic meters 1.3 cubic yards yd3 gal gallons 3.8 liters ft3 cubic teat 0.03 cubic meters m3 yd3 cubic yards 0.76 cubic meters m3 TEMPERATURE (exact) TEMPERATURE (exact) C Celsius 9/5 (then Fahrenheit temperature add 321 temperature OF Fahrenheit 5/9 (alter Celsius C en temperature subtracting temperature of 32) 98.6 212 N OF 32 -40 0 { 40 90 120 160 2001 r"TTI 1 m 2.54 le Kactly), t, nther eoar:t u:nveisern> ane more ler,c Io l able-, xe NBS MOO . Pubs. 25$, 60 90 000 Umis of Weryhts and Measures, Price $2.25, SO Cat-Icy No. C13.10:2e6. -40 -20 0 20 40 S E a e0 37 * ACKNOWLEDGMENT This report is the product of a multidisciplinary research effort and represents the contributions of many individuals and organizations. The principal investigators thank all those who assisted. Special recognition must be given to: The Symposium participants, who gave unhesitatingly of their time to make a contribution to the field. Gerald Milner, M.D., Melbourne, Australia, and Reginald Smart, Ph.D., To­ ronto, Canada, who shared scholarly insights and provided unusual support in accessing the international literature. James L. Nichols, Ph.D., the Contract Technical Manager, and Gary T. Butler, assistant Contract Technical Manager, NHTSA, Washington, D.C. Judith A. Riggs, who served as project administrator and Symposium Coordina­ tor. Our colleagues, Talmadge R. Bosin, Ralph K. Jones, and Joseph E. Zabik, who participated in the analyses of the literature and the development of the project. Frances E. Komoroske (candidate for the J.D./M.P.A. degrees, 1977) and Ger­ ald J. Longa (candidate for the M.D./M.S. degrees, 1977), who served as the principal graduate assistants for this project. Sandra R. Smith, who supervised the report production process, and James E. Haney, who served as technical editor. John S. Merritt, Jr. and John R. Treat, who provided administrative support throughout the project. Rex G. Bickers, Alan R. Buckpitt, E. Jane Hixson, and William C. Kimberling, who served as recorders for the Symposium. The librarians and staff of the NHTSA Reference Library, The Addiction Re­ search Foundation, the University of Michigan Highway Safety Research Insti­ tute, the National Safety Council, and the Indiana University Institute for Re­ search in Public Safety. Kent B. Joscelyn, J.D. Roger P. Maickel, Ph.D. Principal Investigator Principal Investigator iii TABLE OF CONTENTS ACKNOWLEDGMENT SYNOPSIS .................................................. 1 INTRODUCTION ............................................. 10 1.1 Background ............................................. 10 1.2 Literature Search .......................................... 10 1.3 Symposium .............................................. 13 1.4 Technical Report-Scope and Approach .......................... 13 2.0 15 It UNDERSTANDING DRUG EFFECTS .......................... 2.1 Definition of a "Drug„ ...................................... 15 2.2 Pharmacological Action of Drugs ............................... 15 2.3 Drug Interactions .......................................... 21 2.4 Side Effects ............................................. 23 2.5 Residual Effects .......................................... 23 2.6 Individual States .......................................... 24 2.7 Alcohol as a Unique Drug .................................... 24 2.8 Summary ............................................... 25 3.0 DRUG USAGE IN UNITED STATES ........................... 26 3.1 Background ............................................. 26 3.2 Literature Limitations ....................................... 27 3.3 Prescription Drugs ......................................... 28 3.4 Over-the-Counter (OTC) Drugs ................................ 29 3.5 Illicit Drugs ............................................. 29 3.6 "Non-Drug" Drugs ........................................ 30 3.7 An Overview Study ........................................ 31 3.8 Summary ............................................... 32 4.0 DETECTION AND MEASUREMENT OF DRUGS .................. 35 4.1 Current "State of the Art " ................................... 35 4.2 The Overall Assay Procedure ................................. 37 4.3 Characteristics Demanded of Assay Procedures ..................... 39 4.4 The Need for Coordinated Information Storage and Retrieval ........................................... 41 4.5 The Need for Chemical Information and Substances .................. 42 4.6 Summary ............................................... 42 5.0 MEASUREMENT OF DRUG EFFECTS ......................... 43 5.1 Driving Task Analysis ...................................... 43 5.2 Development of Test Methods ................................. 44 5.3 Summary ............................................... 46 6.0 LEGAL AND ETHICAL CONSTRAINTS ........................ 48 6.1 Basic Legal Issues ......................................... 48 6.2 Experimental Studies ....................................... 49 6.3 Field Studies .............................................. 50 6.4 Summary ............................................... 51 7.0 EXPERIMENTAL STUDIES ................................. 53 7.1 Experimental Research Issues ................................. 53 7.2 Reported Findings ......................................... 57 v 7.3 Relevance of Experimental Research Studies ....................... 71 8.0 EPIDEMIOLOGICAL STUDIES ............................... 81 8.1 Epidemiological Research Issues ............................... 81 8.2 Epidemiological Research Findings .............................. 84 8.3 Relevance of Epidemiological Studies ...........................
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