Fatigue and beyond: Patterns of, and motivations for illicit drug use among long haul truck drivers Naomi Richards BPsych (Hons) This thesis is submitted for the degree of Masters of Applied Science (Research) within the Centre for Accident Research and Road Safety-Queensland (CARRS-Q), School of Psychology and Counselling, Queensland University of Technology 2004 Key words Drug use Drug use career Illicit drug use Road safety Truck drivers Abstract Long distance truck drivers are considered a special interest group in terms of drug driving research and policy due to high rates of use, involvement of drugs in truck accidents and the link between drug use and work related fatigue. Qualitative interview data was collected from 35 long haul truck drivers in South East Queensland and analysed using NVivo 2.0. High rates of licit and illicit drug use (particularly amphetamines) were reported. However, unlike previous studies which focus on fatigue, this research found overlapping and changing motivations for drug use during individual lifetimes. Using Becker’s model of a drug use ‘career’ it was revealed that some drivers begin illicit drug use before they begin truck driving. As well as fatigue, powerful motives such as peer pressure, wanting to fit the trucking ‘image’, socialisation, relaxation and addiction were reported. These may need to be considered along side fatigue in the development of effective drug prevention or cessation policies for truck drivers. Contents Page 1. Introduction 1 2. Literature Review 5 2.1. Drugs of concern to road safety 5 2.1.1. Cannabis 6 2.1.1.1. Effects of cannabis on driving performance 7 2.1.2. Central Nervous System stimulants 9 2.1.2.1. Amphetamine/Methamphetamine (Speed) 9 2.1.2.2. Ecstasy 11 2.1.2.3 Cocaine 12 2.1.2.4. Stimulant pharmaceuticals (phentermine, ephedrine, pseudoephedrine, modafinil) 12 2.1.2.5. Effects of CNS stimulants on driving performance 14 2.2. Prevalence of drug driving and the contribution of drug driving to traffic accidents 15 2.3. Drug driving in the road transport industry: Prevalence and crash risk 18 2.4. Drug use as a fatigue countermeasure in the road transport industry 20 2.4.1. Fatigue and truck driving 20 2.4.2. Fatigue countermeasures in the road transport industry 23 2.4.3. Educational programs and behavioural fatigue countermeasures 24 2.4.4. Driving hours restrictions 25 2.5. Enforcement of driving hours and drug driving legislation 32 2.5.1. Chain of Responsibility 32 2.5.2. Drug testing of truck drivers 33 2.6. Why do people use drugs? Risk factors for drug use in the general population 35 2.6.1. Risk factors for drug use in the workplace 36 2.6.2. Social and situational risk factors for illicit drug use 36 2.6.3. Personality types 37 2.6.4. Dependence 37 2.7. A theoretical stance - Becker (1963) 38 2.7.1. Deviant groups: ‘Outsiders’ 38 2.7.2. Becoming a drug user: Stages of a drug use career 40 2.7.2.1. Learning the technique 40 2.7.2.2. Learning to perceive the effects 40 2.7.2.3. Learning to enjoy the effects 41 2.7.3. Social control: 41 2.7.3.1. Supply 42 2.7.3.2. Secrecy 42 2.7.3.3. Morality 43 2.8. Aims 43 3. Method 45 3.1. Participants 45 3.2. Materials 48 3.2.1. Demographic items 48 3.2.2. Peer report drug usage 48 3.2.3. Self report drug usage 49 3.2.4. Career paths in drug use 49 3.3. Procedure 50 4. Results 52 4.1. Demographic items 52 4.2. Self report illicit drug use status 52 4.3. Self report licit drug use status 54 4.4. Peer report licit drug use 55 4.5. Peer report illicit drug use 59 4.6. Addressing the problem of illicit drug use in the road transport industry 67 4.7. Becker’s theory of a drug use career 75 4.7.1. Becoming a drug user - past users 75 4.7.2. Becoming a drug user - current users 77 4.7.3. Becoming a drug user - opinions of those that have never used 82 4.7.4. Supply 84 4.7.5. Secrecy 85 4.7.6. Morality 90 5. Discussion 95 5.1. Drug use prevalence and patterns 95 5.2. Drug use as a fatigue countermeasure 96 5.3. Drug use for reasons other than fatigue 97 5.4. Drug use careers (Becker) 99 5.4.1. Past users 99 5.4.2. Current users 99 5.5. Social controls 101 5.5.1. Supply 101 5.5.2. Secrecy 101 5.5.3. Morality 102 5.5. Addressing the problem of illicit drug use among long haul truck drivers 103 6. Conclusion 105 6.1. Implications of this research 105 6.2. Limitations of this research 106 6.3. Recommendations for future research 107 Glossary of terms 108 References 111 Appendix A. Recruitment advertisement 122 Appendix B. Interview format 123 Appendix C. Information and consent form 131 Tables Page Table 1: Drugs (other than alcohol) recognised as potential crash risk (Drummer, 1995) 6 Table 2: Driving and rest schedules allowable under the Standard Hours regime 26 Table 3: Self reported usage rates of illicit drug types 53 Table 4: Self reported usage rates of legal drug types 54 Table 5: Respondents who had never used illicit drugs (n=15): Perceived reasons why truck drivers use illicit drugs 61 Table 6: Respondents who have used illicit drugs in the past (n=6): Perceived reasons why truck drivers use illicit drugs 62 Table 7: Respondents who currently use illicit drugs (n=14): Perceived reasons why truck drivers use illicit drugs 62 Statement of original ownership The work as presented in this thesis is, to the best of my knowledge, original except as acknowledged in the text. I hereby declare that I have not submitted this material - either in whole or in part - for a degree at this or any other institution. Naomi Richards ii Acknowledgements I wish to thank CARRS-Q and in particular, Dr. Jeremy Davey for the opportunity to undertake this project. Dr. Davey’s guidance, supervision and friendship has been invaluable. Also, I am grateful to Queensland Police for the provision of my scholarship. Finally, sincere thanks to all the truck drivers that were involved in this project. Their willingness to give their time and divulge their personal stories is to be greatly admired. 1. Introduction Whilst drink driving has long been considered a social problem worthy of substantial research and campaign efforts, it is only relatively recently that increasing attention has been given to the issue of drug driving. Statistics are emerging which demonstrate the extent of the problem of drug driving within the community - including the types of drugs used whilst driving, how these affect performance and the types of people that are likely to be high risk. Regarding this issue, long haul truck drivers are generally considered a special interest group. There is considerable evidence of high rates of both illicit and licit substance use among truck drivers both in Australia and internationally and a general consensus that drug taking for truck drivers is a means of alleviating work related fatigue. Whether or not this is the case, this behaviour has been linked to accident culpability and consequently several legislative measures to combat the problem have been enforced. Most notably, at the end of the 1980’s tighter controls were placed on stimulant pharmaceuticals (such as the prescription amphetamine based weight loss drug Duromine) that truck drivers were commonly obtaining illegally. However truck drivers argued that at the same time the issue of fatigue was ignored, so many truck drivers turned to illicitly manufactured stimulants (most notably speed) instead. More recently, driving hours restrictions (such as the Fatigue Management Program) have been enforced in order to reduce the problem of truck drivers working whilst fatigued. This effort has been coupled with the introduction of drug testing and a penalty structure for drug taking or breaches of driving hours that includes those in the supply chain beyond the driver (the ‘Chain of Responsibility’). These policies have been met with mixed responses, some industry representatives arguing that driving hours restrictions are inappropriate or difficult to adhere to in the real world. Most research on the issue of truck drivers and illicit drug use focuses on accident culpability, drug usage rates and/or fatigue. Very little if any research to date allows the drivers to tell their stories, to describe their motives for use and transitions from non- users to users (and possibly addicts). In order to do just that, the current research used qualitative interviews to provide a thorough insight into the lives of these men. It was thought that a better understanding of their lifestyle may prove useful in promoting abstinence or rehabilitation from drug use. To structure the interviews, Becker’s (1963) theory of a ‘career path’ in drug use was used. Drivers described their initiation, experiences as a beginner and motivations for continued use over time. Becker (1963) described ‘Outsiders’ as deviant groups that are somewhat removed from mainstream society - and the drug using truck drivers interviewed conveyed this concept regarding their own lives. Importantly, it was found that the theme of fatigue was interwoven with other powerful motivations that have seemingly been overlooked in research on this problem. The issues of social use, recreation and relaxation, peer pressure to use (fitting the trucking image) and addiction were repeatedly mentioned.