Development of a standardized boating sobriety test

Enhancing the Standardized Field Sobriety Test to detect cannabis impairment: An observational study

OBJECTIVE

The purpose of this study was to explore various tests of impairment that could potentially be added to the Standardized Field Sobriety Test (SFST) to enhance its sensitivity to identify drivers whose abilities are adversely affected by cannabis.

METHODS

An observational study was conducted in which participants were invited to use their own cannabis at the research facility. Once prior to cannabis use and at four times during the 150 min after cannabis use, participants performed the three tests of the Standardized Field Sobriety Test (SFST) (i.e., Horizontal Gaze Nystagmus, Walk and Turn, and One Leg Stand) as well as the Modified Romberg Balance and Finger to Nose tests. In addition, assessments were made of physiological indicators (i.e., eyelid, leg and body tremors, rebound dilation, lack of convergence) and vital signs (pulse, blood pressure and body temperature). Participants also completed a digit-symbol substitution task at each testing interval. With the exception of vital signs and the digit symbol task, all tests and assessments were administered and scored by certified Drug Recognition Experts using the standard procedures of the Drug Evaluation and Classification Program.

RESULTS

Twenty minutes after vaping cannabis (mean THC concentration = 6.34 ng/mL), participants displayed performance deficits on a variety of tasks; 67% met the criterion for suspected impairment on the SFST. Addition of the Finger-to-Nose (FTN) test along with observations of head movements and jerks (HMJ) increased the percentage of participants who met the criterion for suspected impairment by 33% and improved the sensitivity of the test from 0.67 to 0.88.

CONCLUSIONS

The results of this study support supplementing the SFST with the Finger-to-Nose test and observations of HMJ to assist in the detection of drivers who are adversely affected by the use of cannabis. The observational study design and the use of assessors who were not blinded as to the use of cannabis by participants limits the strength of the evidence. Further research, including randomized trials and field studies of drivers, is required to confirm and validate this enhanced version of the SFST.

Intervening to decrease the probability of alcohol-impaired driving: Impact of novel field sobriety tests

The efficacy of novel field sobriety tests to predict breath alcohol content (BAC) and perceptions of driving risk was evaluated. Participants (N = 210) were passersby at two downtown locations near local bars and one on-campus location near a late-night dining facility between the hours of 10:00 p.m. and 2:00 a.m. Participants gave ratings of their perceived risk to drive at their current level of intoxication, then completed three sobriety tests (a hand-pat, tracing test, and Romberg test), and finally provided new ratings of their perceived risk to drive. After completing the final set of questions, participants were administered a Lifeloc FC20 breath alcohol test (±.005 g/dL). Each of the sobriety tests performed better than chance at predicting participant intoxication, but the performance feedback did not enhance awareness of one's risk to drive at a given BAC. Actually, after the sobriety tests, Greek-life females perceived themselves to be less at-risk to drive.

Comparison of different methods assessing alcohol contribution to emergency room visits

INTRODUCTION

The main objective of research was to compare different methods of assessing alcohol's contribution to injuries and medical conditions treated in ER in Poland. Four methods are discussed, including breathalyzer reading, clinical appraisal following Y91 codes of ICD 10, interviewer's observation and self-report.

METHODS

In two Polish sites Warsaw and Sosnowiec probability samples of patients admitted to ER were selected and interviewed face-to-face by trained interviewers. Almost 1.5 thousand patients were interviewed with response rate of 67%. To identify injuries and medical conditions associated with drinking (preceded by alcohol consumption) four methods were used: clinical observations made by nurses trained in applying Y91 codes of ICD-10 (in the Sosnowiec ER only), observations by interviewers who did not receive such a training, breathalyzer readings and patient self-reports of drinking within six hours prior to the event.

RESULTS

A breathalyzer reading identified 4.5% under the influence of alcohol among all patients, and 5.7% among those who were breathalyzed. Clinical assessment in Sosnowiec and interviewers' observations in both cites identified almost the same proportion: 5.1% and 4.7%, respectively and self-reports almost 10%. All four measures for identifying potentially alcohol related ER visits found a total of 11.5% cases among sampled patients.

Judging intoxication

Judgments of whether a person is intoxicated by alcohol are important in a number of civil and law enforcement settings. This paper reviews how well people are able to make such judgments, the evidence for individual signs of intoxication, several structured rating techniques, and the use of sobriety tests. It is concluded that observers relying on common-sense clues of intoxication have limited ability to assess the blood alcohol concentration (BAC) levels of strangers, particularly below .10%. This generalization holds across professions that might be expected to show greater accuracy. Structured assessment instruments based on observable signs have shown promise but are confounded by the wide variations between casual social drinkers and those that have obtained a high level of tolerance. Among sobriety tests, only NHTSA's Standardized Field Sobriety Tests (SFSTs) have substantial, but seriously flawed, research support. Assessing the sobriety of strangers in the low to moderate BAC ranges without resort to chemical tests remains a daunting task.

Horizontal gaze nystagmus: a review of vision science and application issues

The Horizontal Gaze Nystagmus (HGN) test is one component of the Standardized Field Sobriety Test battery. This article reviews the literature on smooth pursuit eye movement and gaze nystagmus with a focus on normative responses, the influence of alcohol on these behaviors, and stimulus conditions similar to those used in the HGN sobriety test. Factors such as age, stimulus and background conditions, medical conditions, prescription medications, and psychiatric disorder were found to affect the smooth pursuit phase of HGN. Much less literature is available for gaze nystagmus, but onset of nystagmus may occur in some sober subjects at 45 degrees or less. We conclude that HGN is limited by large variability in the underlying normative behavior, from methods and testing environments that are often poorly controlled, and from a lack of rigorous validation in laboratory settings.

The Standardized Field Sobriety Tests: a review of scientific and legal issues

This article details the history and development of the National Highway and Safety Administration's Standardized Field Sobriety Tests. They are reviewed in terms of relevant scientific, psychometric, and legal issues. It is concluded that the research that supports their use is limited, important confounding variables have not been thoroughly studied, reliability is mediocre, and that their developers and prosecution-oriented publications have oversold the tests. Further, case law since their development has severed the tests from their validation data, so that they are not admissible on the criterion for which they were validated (blood alcohol concentration), and admissible for a criterion for which they were not (mental, physical, or driving impairment). Directions for further research are presented.

Review of the role of alcohol in drowning associated with recreational aquatic activity

OBJECTIVE AND DESIGN

To assess the role of alcohol in drowning associated with recreational aquatic activity by reviewing the English language literature published up to October 2003.

RESULTS

Alcohol is widely used in association with recreational aquatic activity in the United States, but there is minimal information regarding the extent of use elsewhere. A priori and anecdotal evidence suggests that alcohol is an important risk factor for drowning associated with recreational aquatic activity. Specific studies provide good evidence supporting this, but the extent of increased risk associated with alcohol use, and the attributable risk due to alcohol use, is not well characterised. Drowning appears to be the overwhelming cause of death associated with recreational aquatic activity with alcohol detected in the blood in 30%-70% of persons who drown while involved in this activity. The few relevant studies on degree of increased risk suggest persons with a blood alcohol level of 0.10 g/100 ml have about 10 times the risk of death associated with recreational boating compared with persons who have not been drinking, but that even small amounts of alcohol can increase this risk. The population attributable risk seems to be in the range of about 10%-30%.

CONCLUSIONS

Alcohol consumption significantly increases the likelihood of immersions resulting in drowning during aquatic activities. However, more information is required if appropriate prevention activities are to be planned, initiated, and evaluated. This includes better information on alcohol use, and attitudes to alcohol use, in association with recreational aquatic activity, and the nature and extent of increased risk associated with alcohol use. Evaluation of interventions is also needed.