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Driving while impaired by drugs – whether licit or illicit – has emerged as an important road safety issue. This report provides a state-of-the-art review of the role and impact of drugs in road accident risk. It reviews the legislation, deterrence and roadside detection practices in member countries as well as preventative measures to combat drug use while driving.
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On the heels of several decades of successful efforts to understand and reduce the magnitude of the problems associated with driving after consuming alcohol, driving while impaired by other psychoactive substances has emerged as a road safety issue of its own. There are a wide variety of substances that have the potential to adversely affect the cognitive and behavioural skills required to operate a vehicle safely. The list of substances includes many illegal drugs (e.g. cannabis, ecstasy), psychotropic medications (e.g. benzodiazepines, opiates), and some over-the-counter preparations (e.g. antihistamines, cough and cold remedies). Despite the apparent similarity with the problem of alcohol use and driving, drug-driving1 presents a whole new array of challenges for research, policy, and programmes.
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Following almost three decades of intensive efforts to reduce the magnitude of the alcohol-crash problem, safety advocates, policy makers, legislators, and enforcement agencies have begun to express greater concern about the use of drugs by drivers. Although the misuse of drugs has long been considered a major social problem, the acute and devastating consequences of driving while impaired by psychoactive substances other than, or in addition to, alcohol has only recently become a recognised road safety issue of its own.
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This chapter discusses the scientific evidence that provides the basis for our understanding of drug effects on driving performance. The evidence on the drug effects on driving skills will be assessed across three domains: strategic/analytic (i.e. higher-order cognitive functions such as planning, judgement); manoeuvring (e.g. lane-changing, merging, speed adjustments); and, vehicle control (e.g. tracking, reaction time). It also provides an assessment of the pharmacological effects in relation to driving skills and documents the relationship between blood toxicology findings and impairment.
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This chapter presents the evidence from studies that have examined the frequency of driving after drug use and the incidence of drugs among drivers involved in crashes. This includes population-level data on drug and alcohol use (including data from the survey conducted as part of this project), self-report surveys in which drivers are asked to describe their own practices of driving after using drugs, roadside surveys in which objective measures of drug use are usually obtained from drivers, and studies that seek to measure the type and extent of drugs among drivers who come to the attention of authorities as a result of arrest or crash involvement.
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The studies reviewed in this chapter attempt to establish the contributory role of drugs to crashes and/or the risks associated with driving after using drugs. Studies include casecontrol studies, in which the incidence of drug use is compared between drivers who are or are not involved in crashes, and crash responsibility/culpability studies, in which the incidence of drug use is compared between drivers who are and are not responsible/culpable for the crashes in which they are involved.
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This section provides a review and discussion of legislative and enforcement policies and practices in OECD/ITF countries. In particular, it examines the two primary legislative approaches to controlling drug use by drivers – per se and behavioural/impairment – and provides practical examples of the implementation of these laws in Australia. In addition, this section will review approaches to enforcement (e.g. targeted, random), drug testing (e.g. oral fluid, urine, blood), and the distinction (if any) made between the use of illicit substances and prescription medications. A discussion of primary prevention initiatives is also provided.
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This chapter draws conclusions about the role of drugs in traffic and identifies leading practices for controlling/preventing the behaviour based on the evidence presented. The overall purpose is to identify evidence-informed practices to guide the development of effective policies to reduce drug-related traffic casualties.
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