1
|
Whitehurst LN, Morehouse A, Mednick SC. Can stimulants make you smarter, despite stealing your sleep? Trends Cogn Sci 2024:S1364-6613(24)00102-5. [PMID: 38763802 DOI: 10.1016/j.tics.2024.04.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2023] [Revised: 04/16/2024] [Accepted: 04/17/2024] [Indexed: 05/21/2024]
Abstract
Nonmedical use of psychostimulants for cognitive enhancement is widespread and growing in neurotypical individuals, despite mixed scientific evidence of their effectiveness. Sleep benefits cognition, yet the interaction between stimulants, sleep, and cognition in neurotypical adults has received little attention. We propose that one effect of psychostimulants, namely decreased sleep, may play an important and unconsidered role in the effect of stimulants on cognition. We discuss the role of sleep in cognition, the alerting effects of stimulants in the context of sleep loss, and the conflicting findings of stimulants for complex cognitive processes. Finally, we hypothesize that sleep may be one unconsidered factor in the mythology of stimulants as cognitive enhancers and propose a methodological approach to systematically assess this relation.
Collapse
Affiliation(s)
- Lauren N Whitehurst
- Department of Psychology, University of Kentucky, Lexington, KY, USA, 40508.
| | - Allison Morehouse
- Department of Cognitive Science, University of California, Irvine, Irvine, CA, USA, 92617
| | - Sara C Mednick
- Department of Cognitive Science, University of California, Irvine, Irvine, CA, USA, 92617.
| |
Collapse
|
2
|
Blandino A, Cotroneo R, Tambuzzi S, Di Candia D, Genovese U, Zoja R. Driving under the influence of drugs: Correlation between blood psychoactive drug concentrations and cognitive impairment. A narrative review taking into account forensic issues. Forensic Sci Int Synerg 2022; 4:100224. [PMID: 35330981 PMCID: PMC8938866 DOI: 10.1016/j.fsisyn.2022.100224] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2021] [Revised: 03/11/2022] [Accepted: 03/14/2022] [Indexed: 12/05/2022]
Abstract
Driving under the influence of alcohol has been shown to increase the risk of involvement in road traffic collisions (RTCs) however, less is known about the effects of illicit drugs, and a clear correlation between drug concentrations and RTC risk is still debated. The goal of this narrative review is to assess the current literature regarding the most detected psychoactive drugs in RTC (ethanol, amphetamines, cannabis, opioids and cocaine), in relation to driving performance. Evidence on impaired driving due to psychoactive substances, forensic issues relating to the assessment of the impact of drugs, blood cut-off values proposed to date as well as scientific basis for proposed legislative limits are discussed. At present there is no unequivocal evidence demonstrating a clear dose/concentration dependent impairment in many substances. Per se and zero tolerance approaches seem to have negative effect on drugged driving fatalities. However, the weight of these approaches needs further investigation. Driving under the influence of psychotropic substances has become a widespread phenomenon. Only a few substances have been reported to have a clear dose/concentration dependent impairment. Statistically significant differences should not be considered as clinically significant per se There is wide variability in legislative cut-offs. Detection limits seems to be the most public safety-oriented legislative approach.
Collapse
|
3
|
Amphetamine-induced alteration to gaze parameters: A novel conceptual pathway and implications for naturalistic behavior. Prog Neurobiol 2020; 199:101929. [PMID: 33091542 DOI: 10.1016/j.pneurobio.2020.101929] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2020] [Revised: 09/03/2020] [Accepted: 10/08/2020] [Indexed: 12/25/2022]
Abstract
Amphetamine produces a multiplicity of well-documented end-order biochemical, pharmacological and biobehavioural effects. Mechanistically, amphetamine downregulates presynaptic and postsynaptic striatal monoamine (primarily dopaminergic) systems, producing alterations to key brain regions which manifest as stereotyped ridged behaviour which occurs under both acute and chronic dosing schedules and persists beyond detoxification. Despite evidence of amphetamine-induced visual attentional dysfunction, no conceptual synthesis has yet captured how characteristic pharmaco-behavioural processes are critically implicated via these pathways, nor described the potential implications for safety-sensitive behaviours. Drawing on known pathomechanisms, we propose a cross-disciplinary, novel conceptual functional system framework for delineating the biobehavioural consequences of amphetamine use on visual attentional capacity and discuss the implications for functional and behavioural outcomes. Specifically, we highlight the manifest implications for behaviours that are conceptually driven and highly dependent on visual information processing for timely execution of visually-guided movements. Following this, we highlight the potential impact on safety-sensitive, but common behaviours, such as driving a motor vehicle. The close pathophysiological relationship between oculomotor control and higher-order cognitive processes further suggests that dynamic measurement of movement related to the motion of the eye (gaze behaviour) may be a simple, effective and direct measure of behavioural performance capabilities in naturalistic settings. Consequently, we discuss the potential efficacy of ocular monitoring for the detection and monitoring of driver states for this drug user group, and potential wider application. Significance statement: We propose a novel biochemical-physiological-behavioural pathway which delineates how amphetamine use critically alters oculomotor function, visual-attentional performance and information processing capabilities. Given the manifest implications for behaviours that are conceptually driven and highly dependent on these processes, we recommend oculography as a novel means of detecting and monitoring gaze behaviours during naturalistic tasks such as driving. Real-word examination of gaze behaviour therefore present as an effective means to detect driver impairment and prevent performance degradation due to these drugs.
Collapse
|
4
|
Affiliation(s)
- Maude Marillier
- Department of Continuing Education of the Faculty of Medicine Lille University Lille France
| | - Alain G. Verstraete
- Department of Diagnostic Sciences Ghent University Ghent Belgium
- Department of Laboratory Medicine Ghent University Hospital Ghent Belgium
| |
Collapse
|
5
|
Strand MC, Mørland J, Slørdal L, Riedel B, Innerdal C, Aamo T, Mathisrud G, Vindenes V. Conversion factors for assessment of driving impairment after exposure to multiple benzodiazepines/z-hypnotics or opioids. Forensic Sci Int 2017; 281:29-36. [PMID: 29101905 DOI: 10.1016/j.forsciint.2017.10.022] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2017] [Revised: 09/06/2017] [Accepted: 10/11/2017] [Indexed: 11/18/2022]
Abstract
AIMS Norway has introduced legal concentration limits in blood for 28 non-alcohol drugs in driving under the influence cases. As of 2016 this legislation also regulates the assessment of combined effects of multiple benzodiazepines and opioids. We herein describe the employed methodology for the equivalence tables for concentrations of benzodiazepines/z-hypnotics and opioids implemented in the Norwegian Road Traffic Act. METHODS Legislative limits corresponding to impairment at blood alcohol concentrations (BAC) of 0.02%, 0.05% and 0.12% were established for 15 different benzodiazepines and opioids. This was based on a concept of a linear relationship between blood drug concentration and impairment in drug naïve users. Concentration ratios between these drugs were used to establish conversion factors and calculate net impairment using diazepam and morphine equivalents. RESULTS Conversion factors were established for 14 benzodiazepines/z-hypnotics (alprazolam, bromazepam, clobazam, clonazepam, etizolam, flunitrazepam, lorazepam, nitrazepam, nordiazepam, oxazepam, phenazepam, temazepam, zolpidem and zopiclone) and two opioids (methadone and oxycodone). CONCLUSIONS Conversion factors to calculate diazepam and morphine equivalents for benzodiazepines/z-hypnotics and selected opioids, respectively, have been operative in the Norwegian Road Traffic Act as of February 2016. Calculated equivalents can be applied by the courts to meter out sanctions.
Collapse
Affiliation(s)
| | - Jørg Mørland
- Norwegian Institute of Public Health, Division of Health Data and Digitalization, Oslo, Norway.
| | - Lars Slørdal
- Department of Laboratory Medicine, Children's and Women's Health, Norwegian University of Science and Technology, Trondheim, Norway; Department of Clinical Pharmacology, St. Olav University Hospital, Trondheim, Norway.
| | - Bettina Riedel
- University of Bergen, Faculty of Medicine and Dentistry, Department of Clinical Science, Bergen, Norway; Haukeland University Hospital, Laboratory of Clinical Biochemistry, Bergen, Norway.
| | | | - Trond Aamo
- Department of Clinical Pharmacology, St. Olav University Hospital, Trondheim, Norway.
| | - Grete Mathisrud
- Norwegian Ministry of Transport and Communications, Department of Public Roads and Traffic Safety, Oslo, Norway.
| | - Vigdis Vindenes
- Oslo University Hospital, Department of Forensic Medicine, Oslo, Norway; Center of Drug and Addiction Research, Faculty of Medicine, University of Oslo, Norway.
| |
Collapse
|
6
|
Telles JL, Agarwal S, Monagle J, Stough C, King R, Downey L. Driving Impairment Due to Propofol at Effect-Site Concentrations Relevant after Short Propofol-Only Sedation. Anaesth Intensive Care 2016; 44:696-703. [DOI: 10.1177/0310057x1604400602] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Australian guidelines state “Following brief surgery or procedures with short acting anaesthetic drugs, the patient may be fit to drive after a normal night's sleep. After long surgery or procedures requiring longer lasting anaesthesia, it may not be safe to drive for 24 hours or more”. The increasing use of the short-acting anaesthetic drug propofol as a solitary sedative medication for simple endoscopy procedures suggests a need to review this blanket policy. Thirty patients presenting for elective day surgery were recruited as volunteers for a pre-procedure driving simulation study and randomised to propofol or placebo arms. Driving ability was assessed at baseline and then, in the propofol group, at three effect-site concentrations. Driving impairment at these concentrations of propofol was compared to that of a third group of volunteers with a blood alcohol concentration of 0.05% (g/100 ml). Driving impairment at 0.2 μg/ml propofol effect-site concentration was not statistically different to placebo. Impairment increased with propofol effect-site concentration ( P=0.002) and at 0.4 μg/ml it was similar to that found with a blood alcohol concentration of 50 mg/100 ml (0.05%). Plasma propofol concentrations of 0.2 μg/ml, as might be found approximately an hour after short (<1 hour duration) propofol-only sedation for endoscopy, were not associated with driving impairment in our young cohort of volunteers.
Collapse
Affiliation(s)
- J. L. Telles
- Department of Anaesthesia and Perioperative Medicine, Monash Health, Melbourne, Victoria
| | - S. Agarwal
- Department of Anaesthesia and Perioperative Medicine, Monash Health, Melbourne, Victoria
| | - J. Monagle
- Department of Anaesthesia and Perioperative Medicine, Monash Medical Centre, Monash Health, Melbourne, Victoria
| | - C. Stough
- Centre for Human Psychopharmacology, Swinburne University, Melbourne, Victoria
| | - R. King
- Centre for Human Psychopharmacology, Swinburne University, Melbourne, Victoria
| | - L. Downey
- Centre for Human Psychopharmacology, Swinburne University, Melbourne, Victoria, Division on Addiction, Cambridge Health Alliance, Medford, Massachusetts, USA
| |
Collapse
|
7
|
Amphetamine-type stimulant use and the risk of injury or death as a result of a road-traffic accident: A systematic review of observational studies. Eur Neuropsychopharmacol 2016; 26:901-22. [PMID: 27006144 DOI: 10.1016/j.euroneuro.2016.02.012] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/12/2015] [Revised: 02/12/2016] [Accepted: 02/20/2016] [Indexed: 11/23/2022]
Abstract
Amphetamine-type substances are frequently detected among drivers injured or killed due to road-trauma. However, the role of this substance in crash causation remains equivocal. We performed a systematic review to evaluate existing evidence regarding the association between amphetamine use and the risk of injury or death due to road traffic accidents. A bibliographical search of PubMed, SafetyLit, Scopus, and Science Direct literature databases from 01 January 1980 until May 2015 was performed. The quality of included studies was assessed using the Newcastle-Ottowa Scale (NOS) (cut-off of ≥7 indicated high quality). Inter-rater reliability between three independent reviewers for the NOS was calculated using Cohens kappa (κ) statistic, and best-evidence synthesis was performed. A total of 182 articles were found. Nine studies met eligibility criteria for inclusion for review, and seven studies were included for best-evidence synthesis. Best-evidence synthesis demonstrated a conflicting level of evidence for associations between the use of-amphetamine-type substances and the risk of sustaining an injury, and a moderate level of evidence between amphetamine use and the risk of death due to road trauma. This is the first review to synthesise evidence regarding the association between amphetamine-type substance use and the risk of injury or death due to a road traffic accident. More conclusive evidence of death due to road trauma among amphetamine users may reflect significant and global deficits in functioning associated with effective vehicular control under the influence of this substance. Additional high quality, sufficiently powered studies are required to elucidate the magnitude of these associations.
Collapse
|
8
|
Liu C, Huang Y, Pressley JC. Restraint use and risky driving behaviors across drug types and drug and alcohol combinations for drivers involved in a fatal motor vehicle collision on U.S. roadways. Inj Epidemiol 2016; 3:9. [PMID: 27747546 PMCID: PMC4819806 DOI: 10.1186/s40621-016-0074-7] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2015] [Accepted: 02/27/2016] [Indexed: 11/24/2022] Open
Abstract
Background While driving impaired is a well-recognized risk factor for motor vehicle (MV) crash, recent trends in recreational drug use and abuse may pose increased threats to occupant safety. This study examines mechanisms through which drug and/or alcohol combinations contribute to fatal MV crash. Methods The Fatality Analysis Reporting System (FARS) for 2008–2013 was used to examine drugs, alcohol, driver restraint use, driver violations/errors and other behaviors of drivers of passenger vehicles who were tested for both alcohol and drugs (n = 79,932). Statistical analysis was based on Chi-square tests and multivariable logistic regression. Associations of restraint use and other outcomes with alcohol and drug use were measured by estimated odds ratios (ORs) and 95 % confidence intervals (95 % CIs). Results More than half (54.8 %) of the study population were positive for drugs or alcohol at the time of crash. Approximately half of drivers were belted, but this varied from 67.1 % (unimpaired) to 33.0 % (drugs plus alcohol). Compared to the unimpaired, the odds of a driver being unbelted varied: alcohol and cannabis (OR 3.70, 95 % CI 3.44–3.97), alcohol only (3.50,3.36–3.65), stimulants (2.13,1.91–2.38), depressants (2.09,1.89–2.31), narcotics (1.84,1.67–2.02) and cannabis only (1.55,1.43–1.67). Compared to belted drivers, unbelted drivers were over 4 times more likely to die. Driving violations varied across drug/drug alcohol combinations. Speed-related violations were higher for drivers positive for stimulants, alcohol, cannabis, and cannabis plus alcohol, with a more than two fold increase for alcohol and cannabis (2.36, 2.05, 2.71). Conclusions Mechanisms through which drugs, alcohol and substance combinations produce increased risks to occupant safety include lowered restraint use and increases in risky driving behaviors, including speeding, lane, passing, turning and signal/sign violations.
Collapse
Affiliation(s)
- Chang Liu
- Columbia University Mailman School of Public Health Department of Epidemiology, 722 West 168th St., Suite 812G, New York, NY, 10032, USA
| | - Yanlan Huang
- Columbia University Department of Biostatistics, 722 West 168th St., New York, NY, 10032, USA
| | - Joyce C Pressley
- Columbia University Mailman School of Public Health Department of Epidemiology, 722 West 168th St., Suite 812G, New York, NY, 10032, USA. .,Columbia University Mailman School of Public Health Departments of Epidemiology and Health Policy and Management, 722 West 168th St., Suite 812G, New York, NY, 10032, USA. .,Center for Injury Epidemiology and Prevention at Columbia University Mailman School of Public Health, 722 West 168th St., Suite 812G, New York, NY, 10032, USA.
| |
Collapse
|
9
|
Jones AW, Holmgren A, Ahlner J. High prevalence of previous arrests for illicit drug use and/or impaired driving among drivers killed in motor vehicle crashes in Sweden with amphetamine in blood at autopsy. THE INTERNATIONAL JOURNAL OF DRUG POLICY 2015; 26:790-3. [DOI: 10.1016/j.drugpo.2015.04.011] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2014] [Revised: 01/23/2015] [Accepted: 04/16/2015] [Indexed: 11/29/2022]
|
10
|
Høiseth G, Andås H, Bachs L, Mørland J. Impairment due to amphetamines and benzodiazepines, alone and in combination. Drug Alcohol Depend 2014; 145:174-9. [PMID: 25456327 DOI: 10.1016/j.drugalcdep.2014.10.013] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/23/2014] [Revised: 10/08/2014] [Accepted: 10/15/2014] [Indexed: 11/28/2022]
Abstract
INTRODUCTION The impairing effects of combined use of amphetamines and benzodiazepines among recreational drug users are not well described, but knowledge about this is important in the risk assessment of such combined drug use. The aim of this study was to compare the impairment, among apprehended drivers, as judged by a clinical test of impairment (CTI), in cases where a combination of amphetamines and benzodiazepines was detected, in blood, with cases where only one of the two drug groups was detected. METHODS The results of CTI judgments were compared to toxicological drug tests of blood samples that were obtained at the time of CTI screening in cases containing amphetamines only, cases containing different benzodiazepines only, and cases containing a combination of amphetamines and benzodiazepines. RESULTS There were significantly more drivers being judged as impaired in the combined group (n = 777), compared both with amphetamines alone (n = 267, χ(2) = 47.8, p < 0.001) and benzodiazepines alone (n = 153, χ(2) = 7.0, p = 0.008). This was also seen when only including the lowest concentrations of benzodiazepines (χ(2) = 4.3, p = 0.038). The concentrations of the drugs were higher in the single drug groups, compared with the combined group. CONCLUSION This study indicates that during real-life driving, those influenced by both amphetamines and benzodiazepines are more impaired, as judged by the CTI, compared with those influenced by either drug alone, although the combined group showed lower drug concentrations.
Collapse
Affiliation(s)
- Gudrun Høiseth
- Norwegian Institute of Public Health, Division of Forensic Sciences, Oslo, Norway; Center for Psychopharmacology, Diakonhjemmet Hospital, Oslo, Norway.
| | - Hilde Andås
- Norwegian Institute of Public Health, Division of Forensic Sciences, Oslo, Norway
| | - Liliana Bachs
- Norwegian Institute of Public Health, Division of Forensic Sciences, Oslo, Norway
| | - Jørg Mørland
- Norwegian Institute of Public Health, Division of Forensic Sciences, Oslo, Norway
| |
Collapse
|
11
|
Sinagawa DM, De Carvalho HB, Andreuccetti G, Do Prado NV, De Oliveira KCBG, Yonamine M, Muñoz DR, Gjerde H, Leyton V. Association between travel length and drug use among Brazilian truck drivers. TRAFFIC INJURY PREVENTION 2014; 16:5-9. [PMID: 24697351 DOI: 10.1080/15389588.2014.906589] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/03/2023]
Abstract
OBJECTIVE To investigate whether the use of the stimulants amphetamines and cocaine by truck drivers in Brazil was related to travel length. METHODS Truck drivers were randomly stopped by the Federal Highway Police on interstate roads in Sao Paulo State during morning hours from 2008 to 2011 and invited to participate in the project "Comandos de Saúde nas Rodovias" (Health Commands on the Roads). Participants were asked about the use of drugs, travel distance, and age, and gender was recorded. Samples of urine were collected and analyzed for amphetamine, benzoylecgonine (a metabolite of cocaine), and carboxytetrahydrocannabinol (THC-COOH; a metabolite of cannabis) by immunological screening and quantification by gas chromatography-mass spectroscopy. RESULTS Current use of amphetamine, cocaine, and cannabis was reported by 5.7%, 0.7%, and 0.3% of the truck drivers, respectively. Amphetamine, benzoylecgonine, and THC-COOH were found in urine samples from 5.4%, 2.6,% and in 1.0% of the drivers, respectively. There was a significant association between the positive cases for amphetamine and reported travel length; 9.9% of urine samples from drivers who reported travel length of more than 270 km were positive for amphetamine, and 10.9% of those drivers reported current use of amphetamines. In most cases, appetite suppressants containing amphetamines had been used, but the purpose was most often to stay awake and alert while driving. Truck drivers with travel length of more than 270 km had significantly higher odds ratio (OR) for having a urine sample that was positive for amphetamine when adjusted for age as confounding factor (OR = 9.41, 95% confidence interval [CI], 3.97-22.26). No significant association was found between the use of cocaine or cannabis and travel length. CONCLUSION Truck drivers who reported driving more than 270 km had significantly higher frequencies of urine samples positive for amphetamine and reported significantly more frequent current use of amphetamines than those who reported shorter driving distances.
Collapse
|
12
|
The influence of stimulants on truck driver crash responsibility in fatal crashes. Forensic Sci Int 2013; 228:15-20. [PMID: 23597733 DOI: 10.1016/j.forsciint.2013.02.001] [Citation(s) in RCA: 27] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2012] [Revised: 01/30/2013] [Accepted: 02/01/2013] [Indexed: 01/15/2023]
Abstract
INTRODUCTION Given the monotony and extended driving periods inherent in transport truck driving, drivers might rely on stimulants to sustain attention and combat fatigue. Research indicates that stimulant use improves some cognitive functions but impairs driving ability and is linked to crashes. The research on crash responsibility among stimulant-positive truck drivers is inconclusive due to small sample sizes and a lack of control over confounding variables. The present study investigated the influence of stimulants on unsafe driving actions (UDAs) in fatal crashes contained in the Fatality Analysis Reporting System (FARS) database. METHODS Logistic regression was used to calculate the odds ratio of an UDA (cases committed an UDA; controls did not) by stimulant status (present; absent) while accounting for the influence of confounding variables (age, previous driving record, and other drug use). RESULTS For all truck drivers, we found that 372 truck drivers tested stimulant-positive representing 0.57% of the entire truck driver sample and 3.7% of truck drivers who were actually tested for drug use. Stimulant-positive truck drivers had a greater proportion of driving record infractions and narcotic drug use compared to stimulant-negative truck drivers. The adjusted odds of committing an UDA were 78% greater for truck drivers who were stimulant-positive (OR: 1.78, 95% CI: 1.41-2.26) compared to truck drivers stimulant-negative. CONCLUSION The results suggest stimulants are associated with crash responsibility and warrant further study into their impact on truck drivers.
Collapse
|
13
|
Downey LA, King R, Papafotiou K, Swann P, Ogden E, Boorman M, Stough C. The effects of cannabis and alcohol on simulated driving: Influences of dose and experience. ACCIDENT; ANALYSIS AND PREVENTION 2013; 50:879-886. [PMID: 22871272 DOI: 10.1016/j.aap.2012.07.016] [Citation(s) in RCA: 135] [Impact Index Per Article: 12.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/17/2011] [Revised: 07/13/2012] [Accepted: 07/16/2012] [Indexed: 06/01/2023]
Abstract
BACKGROUND Cannabis and alcohol are the most popular drugs amongst recreational users, and most prevalent in injured and deceased drivers. Clarification of the interactive effects of these drugs upon driving behaviour is critical for reducing drug-related road deaths. OBJECTIVES The current study had two objectives, to examine the effects of cannabis and alcohol on driving performance, and identify if any differences between the effects of cannabis and alcohol on driving performance exist between regular cannabis users and non-regular cannabis users. METHODS The project involved 80 participants (49 male, 31 female) who were abstinent recreational users of alcohol and marijuana. They participated in six experimental sessions that involved the consumption of cannabis cigarettes containing no THC, 1.8% THC or 3% THC together with the consumption of alcohol to obtain either 0% BAC, 0.03% BAC or 0.05% BAC. The six sessions were double-blind, counter-balanced, placebo-controlled and medically supervised. Forty participants were allocated to the cannabis with low alcohol (0.03% BAC) group, and 40 participants were allocated to the cannabis with high alcohol (0.05% BAC) group. Driving simulator performance was assessed at 20min post-drug administration and blood samples were taken before and after driving. RESULTS Driving simulator performance was more impaired in the THC and alcohol combined conditions. Consistent with past research, the level of THC detected in blood is higher when THC is consumed with alcohol, than when cannabis is consumed alone, and regular cannabis users returned higher levels of THC in plasma than non-regular users. Generally, regular cannabis users displayed more driving errors than non-regular cannabis users.
Collapse
Affiliation(s)
- Luke A Downey
- Centre for Human Psychopharmacology, Swinburne University of Technology, Australia.
| | | | | | | | | | | | | |
Collapse
|
14
|
Hjälmdahl M, Vadeby A, Forsman A, Fors C, Ceder G, Woxler P, Kronstrand R. Effects of d-amphetamine on simulated driving performance before and after sleep deprivation. Psychopharmacology (Berl) 2012; 222:401-11. [PMID: 22638811 DOI: 10.1007/s00213-012-2744-7] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/31/2011] [Accepted: 05/08/2012] [Indexed: 02/04/2023]
Abstract
RATIONALE Stimulant drugs are commonly abused and also used to promote wakefulness, yet their effects on driving performance during sleep deprivation have not been thoroughly researched in experimental studies. OBJECTIVES The aims were to assess the effects on fundamental driving parameters during simulated driving of two doses of d-amphetamine and further to assess the interaction between d-amphetamine and sleep deprivation. METHODS A double-blind, placebo-controlled experiment including 18 healthy male volunteers was conducted. RESULTS The participants felt more alert when taking a dose of d-amphetamine than when taking placebo, and the effect was stronger for the higher dose. However, the data did not show any evidence that taking d-amphetamine prevented the subjects from becoming successively sleepier during the night. A significant main effect of the dose was found for three out of the five primary indicators where the lower dose led to improved driving. These indicators were crossing-car reaction time, and coherence and delay from a car-following event. Regarding sleep deprivation, a main effect was found for four of the primary indicators and three of the secondary indicators. The results showed overall impaired driving with respect to standard deviation of lateral position and delay in reaction time when the sleep-deprived conditions were compared to the alert condition. We found no interactions between dose and sleep deprivation for any of the performance indicators. CONCLUSIONS Our results suggest that administration of d-amphetamine does not compensate for impairment of driving due to fatigue. The positive effects of 10 mg were not further improved or even sustained when increasing the dose to 40 mg.
Collapse
Affiliation(s)
- Magnus Hjälmdahl
- Swedish Road and Transport Research Institute, SE-581 95 Linköping, Sweden.
| | | | | | | | | | | | | |
Collapse
|
15
|
Silber B, Croft R, Camfield DA, Downey LA, Papafotiou K, Stough C. The acute effects of d-amphetamine and d-methamphetamine on ERP components in humans. Eur Neuropsychopharmacol 2012; 22:492-500. [PMID: 22209365 DOI: 10.1016/j.euroneuro.2011.11.009] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/29/2011] [Revised: 11/11/2011] [Accepted: 11/25/2011] [Indexed: 10/14/2022]
Abstract
While a number of behavioural studies have been conducted to investigate the acute effects of amphetamines on tasks of attention and information processing, there is currently a scarcity of research concerning their electrophysiological effects in healthy adults. It is also unclear as to whether amphetamines exert effects on stimulus evaluation or response selection. In two studies, independent groups of twenty healthy illicit stimulant users aged between 21 and 32 years were administered 0.42 mg/kg d-amphetamine versus placebo, and 0.42 mg/kg d-methamphetamine versus placebo respectively, and completed an auditory oddball task on two separate testing days. A 62-channel EEG was recorded during the completion of the task, and the effects of amphetamines on N200 and P300 ERP components were analysed. d-amphetamine significantly decreased reaction time, improved accuracy, and reduced the latency of the P300 component relative to placebo, while having no effect on the N200 component. d-methamphetamine had no effect on reaction time, accuracy or the P300 component, but reduced the amplitude of the N200 component, relative to placebo. It was concluded that there is tentative support to suggest that d-amphetamine at a dose of 0.42 mg/kg may enhance speed of information processing while d-methamphetamine at a dose of 0.42 mg/kg may reflect changes to stimulus evaluation.
Collapse
Affiliation(s)
- B Silber
- Centre for Human Psychopharmacology, Swinburne University, Victoria, Australia
| | | | | | | | | | | |
Collapse
|
16
|
Impairment based legislative limits for driving under the influence of non-alcohol drugs in Norway. Forensic Sci Int 2012; 219:1-11. [DOI: 10.1016/j.forsciint.2011.11.004] [Citation(s) in RCA: 89] [Impact Index Per Article: 7.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2011] [Revised: 10/28/2011] [Accepted: 11/01/2011] [Indexed: 11/18/2022]
|
17
|
Stough C, King R, Papafotiou K, Swann P, Ogden E, Wesnes K, Downey LA. The acute effects of 3,4-methylenedioxymethamphetamine and d-methamphetamine on human cognitive functioning. Psychopharmacology (Berl) 2012; 220:799-807. [PMID: 22020992 DOI: 10.1007/s00213-011-2532-9] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/09/2011] [Accepted: 10/03/2011] [Indexed: 12/24/2022]
Abstract
RATIONALE This study investigated the acute (3-h) and 24-h post-dose cognitive effects of oral 3,4-methylenedioxymethamphetamine (MDMA), d-methamphetamine, and placebo in a within-subject double-blind laboratory-based study in order to compare the effect of these two commonly used illicit drugs on a large number of recreational drug users. METHODS Sixty-one abstinent recreational users of illicit drugs comprised the participant sample, with 33 females and 28 males, mean age 25.45 years. The three testing sessions involved oral consumption of 100 mg MDMA, 0.42 mg/kg d-methamphetamine, or a matching placebo. The drug administration was counter-balanced, double-blind, and medically supervised. Cognitive performance was assessed during drug peak (3 h) and at 24 h post-dosing time-points. Blood samples were also taken to quantify the levels of drug present at the cognitive testing time-points. RESULTS Blood concentrations of both methamphetamine and MDMA at drug peak samples were consistent with levels observed in previous studies. The major findings concern poorer performance in the MDMA condition at peak concentration for the trail-making measures and an index of working memory (trend level), and more accurate performance on a choice reaction task within the methamphetamine condition. Most of the differences in performance between the MDMA, methamphetamine, and placebo treatments diminished by the 24-h testing time-point, although some performance improvements subsisted for choice reaction time for the methamphetamine condition. CONCLUSIONS Further research into the acute effects of amphetamine preparations is necessary to further quantify the acute disruption of aspects of human functioning crucial to complex activities such as attention, selective memory, and psychomotor performance.
Collapse
Affiliation(s)
- Con Stough
- Centre for Human Psychopharmacology, Swinburne University of Technology, Hawthorn, VIC, 3122, Australia.
| | | | | | | | | | | | | |
Collapse
|
18
|
Stough C, Downey LA, King R, Papafotiou K, Swann P, Ogden E. The acute effects of 3,4-methylenedioxymethamphetamine and methamphetamine on driving: a simulator study. ACCIDENT; ANALYSIS AND PREVENTION 2012; 45:493-497. [PMID: 22269534 DOI: 10.1016/j.aap.2011.08.017] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/26/2011] [Revised: 08/15/2011] [Accepted: 08/31/2011] [Indexed: 05/31/2023]
Abstract
OBJECTIVES Illicit drugs such as MDMA and methamphetamine are commonly abused drugs that have also been observed to be prevalent in drivers injured in road accidents. Their exact effect on driving and driving behavior has yet to be thoroughly investigated. METHODS Sixty-one abstinent recreational users of illicit drugs comprised the participant sample, with 33 females and 28 males, mean age 25.45 years. The three testing sessions involved oral consumption of 100 mg MDMA, 0.42 mg/kg methamphetamine, or a matching placebo. The drug administration was counter-balanced, double-blind, and medically supervised. At each session driving performance was assessed 3 h and 24 h post drug administration on a computerized driving simulator. RESULTS At peak concentration overall impairment scores for driving (F(2,118)=9.042, p<0.001) and signaling (F(2,118)=4.060, p=0.020) were significantly different for the daytime simulations. Performance in the MDMA condition was worse than both the methamphetamine (p=0.023) and placebo (p<0.001) conditions and the methamphetamine condition was also observed to be worse in comparison to the placebo (p=0.055). For signaling adherence, poorer signaling adherence occurred in both the methamphetamine (p=0.006) and MDMA (p=0.017) conditions in comparison to placebo in the daytime simulations. CONCLUSIONS The findings of this study have for the first time illustrated how both MDMA and methamphetamine effect driving performance, and provide support for legislation regarding testing for the presence of illicit drugs in impaired or injured drivers as deterrents for driving under the influence of illicit drugs.
Collapse
Affiliation(s)
- Con Stough
- Centre for Human Psychopharmacology, Swinburne University of Technology, Australia.
| | | | | | | | | | | |
Collapse
|
19
|
Abstract
Scientific opinions differ whether the use of stimulants causes deterioration in driving skills. In 1857 of 8709 cases of driving under the influence of drugs, amphetamine-like drugs (amphetamine, methamphetamine, and methylendioxyamphetamine) were present either alone or together with other licit or illicit drugs. In 338 cases, amphetamines were the only psychoactive substance group in plasma at mean, median, and highest concentrations of 0.18, 0.12, and 1.05 mg/L, respectively. A widespread opinion is that after the consumption of amphetamines, centrally stimulating effects with corresponding consequences on safe driving are expected. In contrast, many cases were observed that rather suggested an influence of centrally sedating substances when considering the psycho-physical conditions. Relations between concentration and effect could not be established. The apparent sedation is probably the consequence of sleep deprivation during an amphetamine binge and the after-effects of the drug.
Collapse
|
20
|
The effect of d,l-methamphetamine on simulated driving performance. Psychopharmacology (Berl) 2012; 219:1081-7. [PMID: 21842157 DOI: 10.1007/s00213-011-2437-7] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/16/2011] [Accepted: 08/01/2011] [Indexed: 10/17/2022]
Abstract
RATIONALE Illicit drugs such as methamphetamine are commonly abused drugs that have also been observed to be prevalent in drivers injured in road accidents. The exact effect of methamphetamine or its specific isomers on driving and driving behaviour have yet to be thoroughly investigated. METHODS Twenty healthy recreational illicit stimulant users (ten males, ten females), aged between 21 and 34 years (mean = 24.3 years, SD = 3.4 years), attended two testing sessions involving oral consumption of 0.42 mg/kg d,l-methamphetamine or a matching placebo. The drug administration was counterbalanced, double-blind, and medically supervised. At each session, driving performance was assessed 2.5 h post-drug administration. RESULTS Mean blood and saliva d,l-methamphetamine concentrations of approximately 90 and 400 ng/ml, respectively, at 2 h and 95 and 475 ng/ml at 3 h were observed. These levels of d,l-methamphetamine were found not to significantly impair, or improve, driving performance at the 2.5-h post-drug administration time point. CONCLUSIONS The findings of this study illustrate that d,l-methamphetamine has no significant effect on simulated driving performance.
Collapse
|
21
|
Simons R, Martens M, Ramaekers J, Krul A, Klöpping-Ketelaars I, Skopp G. Effects of dexamphetamine with and without alcohol on simulated driving. Psychopharmacology (Berl) 2012; 222:391-9. [PMID: 22076246 PMCID: PMC3395339 DOI: 10.1007/s00213-011-2549-0] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/31/2011] [Accepted: 10/12/2011] [Indexed: 11/16/2022]
Abstract
RATIONALE In party circuits dexamphetamine is frequently used in combination with alcohol. It is hypothesized that co-administration of dexamphetamine to alcohol might reduce the sedative effects of alcohol, but may potentiate risk-taking behaviour. OBJECTIVES The study was aimed at assessing the effects of alcohol, dexamphetamine and the combination of both on simulated driving and cognitive performance. METHOD Eighteen subjects participated in a randomized, crossover, placebo-controlled study employing four conditions: 10 mg dexamphetamine, 0.8 g/kg alcohol, 10 mg dexamphetamine + 0.8 g/kg alcohol, and placebo. Fundamental driving skills and risk-taking behaviour were assessed in a driving simulator. Subjects also completed vigilance and divided attention tasks, and subjective ratings. RESULTS Mean BAC levels during simulated driving were between 0.91‰ and 0.64‰. Subjects using alcohol showed a significantly larger mean standard deviation of lateral position and shorter accepted gap time and distance. Use of alcohol or dexamphetamine + alcohol was associated with a higher frequency of red light running and collisions than the dexamphetamine or placebo conditions. Performance of vigilance and divided attention tasks was significantly impaired in the alcohol condition and, to a lesser degree, in the dexamphetamine + alcohol condition. CONCLUSION Single doses of 0.8 g/kg alcohol increased risk-taking behaviours and impaired tracking, attention and reaction time during a 3-h period after drinking when BACs declined from 0.9 to 0.2 mg/ml. The stimulatory effects of co-administration of dexamphetamine 10 mg were not sufficient to overcome the impairing effects of alcohol on skills related to driving.
Collapse
Affiliation(s)
- Ries Simons
- Department of Behavioral and Social Sciences, TNO Netherlands Organization for Applied Scientific Research, P.O. Box 23, 3769 ZG, Soesterberg, Netherlands.
| | - Marieke Martens
- Department of Behavioral and Social Sciences, TNO Netherlands Organization for Applied Scientific Research, P.O. Box 23, 3769 ZG Soesterberg, Netherlands
| | - Jan Ramaekers
- Department of Neuropsychology & Psychopharmacology, Faculty of Psychology and Neuroscience, Maastricht University, Maastricht, The Netherlands
| | - Arno Krul
- Department of Behavioral and Social Sciences, TNO Netherlands Organization for Applied Scientific Research, P.O. Box 23, 3769 ZG Soesterberg, Netherlands
| | - Ineke Klöpping-Ketelaars
- Department of Behavioral and Social Sciences, TNO Netherlands Organization for Applied Scientific Research, P.O. Box 23, 3769 ZG Soesterberg, Netherlands
| | - Gisela Skopp
- Institute of Legal Medicine, University Hospital, Heidelberg, Germany
| |
Collapse
|
22
|
Ramaekers JG, Kuypers KPC, Bosker WM, Brookhuis KA, Veldstra JA, Simons R, Martens M, Hjälmdahl M, Forsman Å, Knoche A. Effects of stimulant drugs on actual and simulated driving: perspectives from four experimental studies conducted as part of the DRUID research consortium. Psychopharmacology (Berl) 2012; 222:413-8. [PMID: 22700041 PMCID: PMC3395336 DOI: 10.1007/s00213-012-2766-1] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/09/2012] [Accepted: 05/28/2012] [Indexed: 12/04/2022]
Affiliation(s)
- J. G. Ramaekers
- Department Neuropsychology and Psychopharmacology, Faculty of Psychology and Neuroscience, Maastricht University, Maastricht, The Netherlands
| | - K. P. C. Kuypers
- Department Neuropsychology and Psychopharmacology, Faculty of Psychology and Neuroscience, Maastricht University, Maastricht, The Netherlands
| | - W. M. Bosker
- Department Neuropsychology and Psychopharmacology, Faculty of Psychology and Neuroscience, Maastricht University, Maastricht, The Netherlands
| | - K. A. Brookhuis
- University of Groningen, Groningen, The Netherlands ,Delft University of Technology, Delft, The Netherlands
| | | | - R. Simons
- TNO Human Factors, Soesterberg, The Netherlands
| | - M. Martens
- TNO Human Factors, Soesterberg, The Netherlands
| | | | | | | |
Collapse
|
23
|
Siliquini R, Bert F, Alonso F, Berchialla P, Colombo A, Druart A, Kedzia M, Siliquini V, Vankov D, Villerusa A, Manzoli L. Correlation between driving-related skill and alcohol use in young-adults from six European countries: the TEN-D by Night Project. BMC Public Health 2011; 11:526. [PMID: 21722358 PMCID: PMC3145590 DOI: 10.1186/1471-2458-11-526] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2010] [Accepted: 07/01/2011] [Indexed: 01/09/2023] Open
Abstract
BACKGROUND Only few studies with small experimental samples investigated the impact of psychoactive substances on driving performance. We conducted a multicenter international cross-sectional study to evaluate the correlation between alcohol use and driving-related skill as measured by brake reaction time (RT). METHODS Before and after the entrance into randomly selected recreational sites from six European countries, all subjects aged 16-35 years, owning a driver license, were asked to compile a structured socio-demographic questionnaire and measure RT (SimuNomad3 driving simulator), breath alcohol concentration (BAC; Drager Alcoltest), and drug use (Oratect III saliva test, only at the exit). Mixed regression modeling was used to evaluate the independent association between RT and alcohol concentration or drug use. RESULTS Before the entrance into the recreational site, 4534 subjects completed all assessments and composed the final sample. Their mean age was 23.1±4.2 y; 68.3% were males; 54.7% had BAC>0 g/L (assumed alcoholics); 7.5% declared illegal drug assumption (mostly cannabis). After the exit, 3019 also completed the second assessment: 71.7% showed BAC>0 g/L. Controlling for age, gender, educational level, occupation, driver license years, and drug use, BAC was positively associated with RT, achieving significance, however, only when BAC was higher than 0.49 g/L. Significant interaction terms were found between BAC and female gender or drug use, with highest RTs (>1 sec.) recorded among drug users with BAC>or=1 g/L. CONCLUSIONS This field study confirms previous experimental data on the negative impact of alcohol use on driving-related skill, supporting regulations and educational campaigns aimed at discouraging driving after consumption of psychoactive substances.
Collapse
|
24
|
Stough C, Camfield D, Kure C, Tarasuik J, Downey L, Lloyd J, Zangara A, Scholey A, Reynolds J. Improving general intelligence with a nutrient-based pharmacological intervention. INTELLIGENCE 2011. [DOI: 10.1016/j.intell.2011.01.003] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
|
25
|
Siliquini R, Piat SC, Alonso F, Druart A, Kedzia M, Mollica A, Siliquini V, Vankov D, Villerusa A, Manzoli L. A European study on alcohol and drug use among young drivers: the TEND by Night study design and methodology. BMC Public Health 2010; 10:205. [PMID: 20420663 PMCID: PMC2873581 DOI: 10.1186/1471-2458-10-205] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2010] [Accepted: 04/26/2010] [Indexed: 11/30/2022] Open
Abstract
Background Young individuals are the age group with the highest risk of car accidents. One of main explanations relies on the use of psychoactive substances (alcohol, illegal and medicinal drugs), which are known to be major risk factors of road accidents, and whose consumption is almost universally more common among younger drivers. Although the correlation between psychoactive substances use and decrease in driving performance has been established in controlled experimental or laboratory settings, few studies were conducted in naturalistic circumstances. The TEND by Night project has been designed to evaluate the relationship between driving performance and psychoactive substances assumption in young drivers enrolled at typical places of consumption. Methods/Design The TEND by Night project, endorsed by the European Commission, is a multidisciplinary, multi-centric, cross-sectional study conducted in six European countries (Italy, Belgium/Netherlands, Bulgaria, Spain, Poland and Latvia). The study population consists of 5000 young drivers aged 16-34 years, attending recreational sites during weekend nights. The intervention is based on the portal survey technique and includes several steps at the entrance and exit of selected sites, including the administration of semi-structured questionnaires, breath alcohol test, several drug assumption test, and measurement of the reaction time using a driving simulator. The main outcome is the difference in reaction time between the entrance and exit of the recreation site, and its correlation with psychoactive substances use. As a secondary outcome it will be explored the relationship between reaction time difference and the amount of consumption of each substance. All analyses will be multivariate. Discussion The project methodology should provide some relevant advantages over traditional survey systems. The main strengths of the study include the large and multicentric sample, the objective measurement of substance assumption (which is typically self-reported), the application of a portal survey technique and the simultaneous evaluation of several psychoactive substances.
Collapse
|
26
|
DYER KYLER, WILKINSON CATHERINE. The detection of illicit drugs in oral fluid: another potential strategy to reduce illicit drug-related harm. Drug Alcohol Rev 2009; 27:99-107. [DOI: 10.1080/09595230701727583] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
|
27
|
Abstract
AIMS According to Norwegian guidelines, patients who are in opioid-assisted rehabilitation programmes are permitted to drive a motor vehicle provided that certain requirements are met. The purpose of this study was to investigate apprehended drivers who had methadone in their blood at the time of apprehension and, further, the relationship between blood methadone concentration and impairment as measured by the clinical test of impairment (CTI). METHODS The division of Forensic Toxicology and Drug Abuse (DFTDA) at the Norwegian Institute of Public Heath analyses blood samples from all drivers suspected of driving under the influence of drugs nation-wide. Cases with positive results for methadone in blood were collected over the period 2001-2006. RESULTS A total of 635 drivers with methadone found in their blood samples were identified. The majority of drivers were men (>80%), aged between 30 and 40 years. Methadone was the only psychoactive drug detected in blood in only 10 cases. Benzodiazepines were a frequent finding (in approximately 90% of cases). A significant difference in blood methadone concentration was found between cases where only methadone was detected [median 0.46 mg/l (range 0.19-0.65)] and cases where methadone was detected in combination with other psychoactive drugs [median 0.28 mg/l (range 0.06-1.24)]. A CTI had been carried out, in conjunction with blood sampling, in 577 of the cases. A concentration-impairment relationship was not seen for methadone in these cases. CONCLUSIONS Cases of driving impairment involving methadone alone were very rare, with combination use most frequent. No correlation between methadone concentration and impairment as judged by the CTI was seen either for these cases or for the material as a whole.
Collapse
Affiliation(s)
- Jean-Paul Bernard
- Division of Forensic Toxicology and Drug Abuse, Norwegian Institute of Public Health, Oslo, Norway.
| | | | | | | |
Collapse
|
28
|
Boorman M, Owens K. The Victorian legislative framework for the random testing drivers at the roadside for the presence of illicit drugs: an evaluation of the characteristics of drivers detected from 2004 to 2006. TRAFFIC INJURY PREVENTION 2009; 10:16-22. [PMID: 19214873 DOI: 10.1080/15389580802542365] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/27/2023]
Abstract
In December 2004, a new legislative framework for the random drug screening of drivers modeled on the successful random alcohol screening methodology came into force in Victoria, Australia. The new framework prohibits driving while methamphetamine (MA), 3,4-methylenedioxymethamphetamine (MDMA), and cannabis, delta-9-tetrahydrocannabinol (THC), are present at any level in a driver's specimen. This is enforced by police who have the legislative authority to randomly drug test drivers for the presence of MA, MDMA, and THC by oral fluid (saliva) sample screening at the roadside. This article outlines the new random drug testing legislative framework and the drug testing procedures currently in place in Victoria. This article also examines the data collected through the operation of the framework for the first two years since implementation in Victoria (December 2004-December 2006).
Collapse
Affiliation(s)
- Martin Boorman
- Traffic Drug and Alcohol Section, Technical Unit, Victoria Police, Brunswick, Victoria, Australia
| | | |
Collapse
|
29
|
Lia K, Spigset O, Slørdal L. Kjøring under påvirkning av amfetamin og metamfetamin. TIDSSKRIFT FOR DEN NORSKE LEGEFORENING 2009; 129:105-8. [DOI: 10.4045/tidsskr.09.34091] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/02/2022] Open
|
30
|
Mills KC, Drazkowski JF, Hammer AE, Caldwell PT, Kustra RP, Blum DE. Relative influences of adjunctive topiramate and adjunctive lamotrigine on scanning and the effective field of view. Epilepsy Res 2007; 78:140-6. [PMID: 18155445 DOI: 10.1016/j.eplepsyres.2007.10.013] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2007] [Revised: 10/08/2007] [Accepted: 10/28/2007] [Indexed: 11/26/2022]
Abstract
A subsample of 67 adult patients with partial seizures participating in a randomized, double-blind study comparing the cognitive effects of adjunctive lamotrigine (LTG) and adjunctive topiramate (TPM) was administered Performance On-Line (POL) in addition to a battery of neuropsychological tests at baseline, week 8 and week 16 of treatment. The POL is a self-administered computer task that measures scanning, divided-attention, and the effective field of view. Although the POL does not measure driving performance, POL scores are correlated with driving performance. The results show that adjunctive TPM, but not adjunctive LTG, negatively impacted cognition. Both simple target identification and divided-attention performance on POL were compromised in the TPM group but not in the LTG group. The relative POL impairment associated with chronic TPM treatment was similar to that observed with the acute effects of alcohol with a breath level of .045% or a low dose of alprazolam (0.5mg). Thus, driving-related visual and cognitive skills were compromised by adjunctive TPM treatment. Therapeutic doses of adjunctive TPM pose a potential risk of impaired scanning and divided-attention skills.
Collapse
|
31
|
Boorman M, Papafotiou K. The Victorian legislative framework for testing drivers for impairment caused by drugs other than alcohol: an evaluation of the characteristics of drivers detected from 2000 to 2005. TRAFFIC INJURY PREVENTION 2007; 8:217-23. [PMID: 17710710 DOI: 10.1080/15389580701362022] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/16/2023]
Abstract
On December 1, 2000, new legislation came into force in Victoria, Australia, that involved a framework for the procedure to be followed by the police for the detection of drivers impaired by drugs other than alcohol. An integral part of the procedure is the use of performance tests known as the standardized field sobriety tests (SFSTs) and the analysis of blood samples for the presence of drugs other than alcohol. This paper outlines the new legislative framework and the drug impairment detection procedures currently in place in Victoria. This paper also evaluates the data collected using the framework for the first five years since implementation in Victoria.
Collapse
Affiliation(s)
- Martin Boorman
- Traffic Drug and Alcohol Section, Brunswick, Victoria, Australia.
| | | |
Collapse
|
32
|
Silber BY, Croft RJ, Papafotiou K, Stough C. The acute effects of d-amphetamine and methamphetamine on attention and psychomotor performance. Psychopharmacology (Berl) 2006; 187:154-69. [PMID: 16761129 DOI: 10.1007/s00213-006-0410-7] [Citation(s) in RCA: 89] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/04/2005] [Accepted: 04/10/2006] [Indexed: 11/26/2022]
Abstract
RATIONALE It is not clear how the deleterious effects of amphetamines on driving performance are mediated in terms of select cognitive processes. OBJECTIVES The current three separate experiments assessed the acute effects of an oral dose of either 0.42-mg/kg d-amphetamine, d,l-methamphetamine and d-methamphetamine on driving-related cognitive functions in a total of 60 healthy non-fatigued adults. MATERIALS AND METHODS Three separate repeated measures counterbalanced, double-blind, placebo-controlled designs were employed in which 20 volunteers completed two treatment conditions, either d-amphetamine, d,l-methamphetamine or d-methamphetamine and placebo. Performance was assessed on a range of attentional, psychomotor and perceptual speed tasks. RESULTS Mean blood concentrations at 120-, 170- and 240-min postdrug administration were 83, 98 and 96 ng/ml, respectively, for d-amphetamine, 90, 95 and 105 ng/ml, respectively, for d,l-methamphetamine and 72, 67 and 59 ng/ml, respectively, for d-methamphetamine. The amphetamines, in general, improved various aspects of attention (Digit Vigilance, Digit Symbol Substitution Test and Movement Estimation Performance) with some evidence to suggest possible enhancement in psychomotor functioning (Tracking ability) and perceptual speed (Inspection Time). CONCLUSIONS The current series of studies primarily provides evidence of low-level amphetamine-related enhancement of function; however, it also provides evidence of less conservative movement estimation that might contribute to amphetamine-related road fatalities.
Collapse
Affiliation(s)
- Beata Y Silber
- Drugs and Driving Research Unit, Brain Sciences Institute, Swinburne University of Technology, 400 Burwood Rd, Hawthorn, Victoria 3122, Australia.
| | | | | | | |
Collapse
|
33
|
Gustavsen I, Mørland J, Bramness JG. Impairment related to blood amphetamine and/or methamphetamine concentrations in suspected drugged drivers. ACCIDENT; ANALYSIS AND PREVENTION 2006; 38:490-5. [PMID: 16343411 DOI: 10.1016/j.aap.2005.11.005] [Citation(s) in RCA: 62] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/19/2005] [Revised: 10/14/2005] [Accepted: 11/11/2005] [Indexed: 05/05/2023]
Abstract
Experimental studies have investigated effects of low oral doses of amphetamine and methamphetamine on psychomotor functions, while less work has been done on effects of high doses taken by abusers in real-life settings. There are indications that intake of high doses may impair traffic related skills, and that abuse of amphetamines may cause hypersomnolence at the end-of-binge. The present study aimed at investigating the concentration-effect relationship between blood amphetamines concentrations and impairment in a population of real-life users. Eight hundred and seventy-eight cases with amphetamine or methamphetamine as the only drugs present in the blood samples were selected from the impaired driver registry at The Norwegian Institute of Public Health. In each case the police physician had concluded on whether the driver was impaired or not. 27% of the drivers were judged as not impaired, while 73% were judged as impaired. There was a positive relationship between blood amphetamines concentrations and impairment. The relationship reached a ceiling at blood amphetamines concentrations of 0.27-0.53 mg/l. Younger drivers were more often judged impaired than older drivers at similar concentrations. Despite the performance enhancing qualities of amphetamines demonstrated in some low dose laboratory experiments; this study revealed a positive relationship between blood amphetamines concentration and traffic related impairment.
Collapse
Affiliation(s)
- Ingebjørg Gustavsen
- Norwegian Institute of Public Health, Division of Forensic Toxicology and Drug Abuse, Norway
| | | | | |
Collapse
|
34
|
Silber BY, Papafotiou K, Croft RJ, Stough CKK. An evaluation of the sensitivity of the standardised field sobriety tests to detect the presence of amphetamine. Psychopharmacology (Berl) 2005; 182:153-9. [PMID: 15986192 DOI: 10.1007/s00213-005-0042-3] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/25/2005] [Accepted: 04/18/2005] [Indexed: 11/28/2022]
Abstract
RATIONALE The Standardised Field Sobriety Tests (SFSTs), designed and validated to assess impairment associated with alcohol intoxication, are currently being employed by the Victoria Police (Australia) for the identification of driving impairment associated with drugs other than alcohol. OBJECTIVES The aim of this study was to evaluate whether the SFSTs are a sensitive measure for identifying the presence of dexamphetamine and methamphetamine. METHODS Three studies each employed a repeated-measures, counterbalanced, double-blind placebo-controlled design. In each study, 20 healthy volunteers completed two treatment conditions: either 0.42 mg/kg d,l-dexamphetamine and placebo, 0.42 mg/kg d,l-methamphetamine and placebo, or 0.42 mg/kg d-methamphetamine and placebo. Performance was assessed using the SFSTs, consisting of the Horizontal Gaze Nystagmus test, the Walk and Turn test, and the One Leg Stand test. Blood and saliva samples were obtained before and immediately after the administration of the SFSTs (120 and 170 min post drug administration). RESULTS At 120 and 170 min post drug administration, d,l-dexamphetamine blood levels were 83.16 and 98.42 ng/ml, respectively; d,l-methamphetamine levels were 90 and 95 ng/ml, respectively; and d-methamphetamine blood levels were 72 and 67 ng/ml, respectively. None of the three amphetamine doses impaired performance on the SFSTs. Using the SFSTs, the presence of dexamphetamine was identified in 5% of cases, d-methamphetamine in 5%, and d,l-methamphetamine in 0% of cases. CONCLUSIONS Under these conditions, the SFSTs are not a sensitive measure for detecting the presence of low levels of amphetamine.
Collapse
Affiliation(s)
- Beata Y Silber
- Drugs and Driving Research Unit, Centre for Neuropsychology, Swinburne University of Technology, P.O. Box 218 , Hawthorn, Victoria, 3122, Australia.
| | | | | | | |
Collapse
|