Drugged driving arrests in Norway before and after the implementation of per se law
Introduction
Driving under the influence of alcohol has for a long time been recognized as a risk factor for involvement in a road traffic crash [1]; the risk increases as a function of the blood alcohol concentrations (BACs) [1], [2]. During the last decades there has been an increased focus on the risk of traffic accidents when driving under the influence of non-alcohol drugs (DUID) [3], [4], [5], [6]. In Norway there has been focused on this issue for many years, both from forensic toxicologists [7], [8], [9], [10] and the authorities. Compared to most other countries all over the world, the number of samples from DUID cases collected over the last decade, has been quite high [11], [12], [13].
During the period 2000–2010, about 10,000 drivers (out of a population close to 5 million people) were annually apprehended by the police on suspicion of drunken or drugged driving in Norway. Blood samples were taken from about 4400 drivers suspected for DUID, in addition, blood samples were taken for only alcohol analysis from about 3200 drivers and about 2100 additional drivers were subject to evidential breath testing for alcohol [14]. A study performed in 2008–2009 investigating the prevalence of alcohol and psychoactive drugs in oral fluid samples from random drivers in normal road traffic in Norway revealed that alcohol was detected in concentrations in oral fluid, above the legal limit corresponding to 0.02% in whole blood, in samples from 0.2% of the drivers [15]. The prevalence was thus very low compared to most other European countries [16]. The prevalence of any illicit and/or medicinal drugs in oral fluid was, however, much higher, and reported to be around 4.5% [15].
Norway has practiced a per se law for driving under the influence of alcohol in whole blood since 1936. Initially the legal limit was 0.05%, but it was reduced to 0.02% in 2001. Graded sanctions are given; drivers are sentenced to conditioned imprisonment for driving with BACs between 0.05% and 0.12% and unconditioned imprisonment for BACs above 0.12%.
The Norwegian Road Traffic Act was extended to also include impairment due to illicit or medicinal drugs in 1959. The judicial process required a statement from a clinical pharmacologist as expert witness to evaluate the driver's impairment and to compare the estimated impairment with corresponding BACs to be able to compare it to sentencing policies for alcohol. The role of the expert witness was to determine the concentrations of the detected drugs at the time of the driving and to assess the degree of impairment taking in consideration the result of a clinical test for impairment that was performed by a physician in conjugation with the blood sampling. Information about drug use by the suspect, and tolerance for the drug effects had to be taken into account; thus, habitual or frequent drug use or abuse could lead to a more lenient handling compared with naïve drug users. This procedure was in contrast to the cases of driving under the influence of alcohol, where the legislation allowed the court to convict the offender and determine the level of penalty based on the measured BAC only, without evaluating possible tolerance.
Per se limits corresponding to BACs of 0.02% were established for 20 illicit and medicinal drugs in February 2012 [17] as well as limits for graded sanctions corresponding to BACs of 0.05% and 0.12% for 13 of these drugs. The limits made it possible for the court to sentence the driver to conditioned or unconditioned prison based on the results from the blood samples alone, similar to the situation for alcohol. The new system should, however, not be applied on individuals with valid prescriptions for medicinal drugs. The prescribed drugs are expected to have beneficial effects on the underlying conditions, and daily ingestion of stable doses leads to a more pronounced degree of tolerance compared to ingestion of higher doses to induce euphoria. There are, however, strict regulation regarding the use of prescribed psychoactive drugs and holding a driving licence, and the use of combinations of prescribed psychoactive drugs is rarely approved. If a person is suspected of impaired driving, and uses prescribed drugs, an individual assessment of impairment is performed.
Since all blood samples from drivers suspected of DUID in Norway are sent to the Norwegian Institute of Public Health (NIPH) for analysis, it is possible to study if the changes in the law have caused changes in the enforcement. The aim of this study was to investigate if the implementation of legislative limits for drugs affected the number of blood samples taken from suspected drugged drivers, drugs findings and the number of expert witness statement requests.
Section snippets
Study population
The police requests mandatory blood samples for drug testing if a driver is suspected of DUID. All blood samples are sent to NIPH for alcohol and drug testing. We selected all such blood samples received by NIPH for drug analysis from the years 2010–2013. We did not include earlier years due to significant changes in the applied analytical techniques, changes in drug screening programs (immunology versus chromatography) and changes in cut-off concentrations, making a detailed comparison between
Trends in alcohol and drug findings
The number of blood samples taken from suspected drugged drivers during each of the studied years is presented in Table 2, together with the number of alcohol and drug findings above the legislative limits and the limits for graded sanctions that were implemented February 1st, 2012. The number of blood samples submitted for drug analysis increased by about 20% from 2010 to 2013. The number of drug findings above the legislative limits increased by about 17%. The largest increase in positive
Discussion
We have in this study investigated drivers apprehended by the police suspected of DUIDs, before and after the implementation of per se limits for 20 medicinal and illicit drugs in Norway. The main finding was an increase in the number of samples submitted from the police for drug testing and a decrease in the number of expert witness statements. The prevalence of positive drug findings was similar over the four-year period studied, but the introduction of safety margins reduced the number of
Conclusion
The introduction of legislative per se limits for drugged driving and legislative limits corresponding to BACs at 0.02%, 0.05% and 0.12% has been successful, and the experience is that alcohol and non-alcohol drugs can be handled similarly. The DUI legislation now signals that driving under the influence of psychoactive drugs is not compatible with safe driving, in the same way as for alcohol. It is likely that the new legislation leads to more convictions in court. The deterrent effect of the
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