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November 2014

Three perspectives on the legalization of marijuana.

 

iStock 000005913775Medium 1Drive High: Get a DUI

The Washington Traffic Safety Commission (WTSC) has had efforts underway to combat drug-impaired driving for a long time, as impaired driving is the single largest cause of fatal collisions in our state. The legalization of medical marijuana (1998) and recreational marijuana (2012) have increased the visibility of these efforts, as well as the urgency.

When it comes to drug involvement in fatal crashes, marijuana is the drug that shows up most often in toxicology blood samples. Our data comes from these blood samples and they show both active THC—reflective of impairment—and carboxy-THC, an inactive metabolite of marijuana use. There are many factors that influence the detection of THC in blood, and as such, interpretation is challenging and lacking in certainty. Between 2008 and 2012, about half of the marijuana fatality cases were just carboxy-THC (the metabolite). A blood sample with only carboxy-THC tells us that the person is a marijuana user, but it doesn’t tell us if marijuana impairment was a factor in the crash. Marijuana (active THC and carboxy-THC) showed up in 12 percent of fatal crashes during this time period.

Will recreational marijuana result in increased use? Yes. Will these users drive impaired? Colorado’s market research found that marijuana users do not believe that their driving is impaired and we, too, heard this in our conversations with users at Seattle’s Hempfest: “I am a better driver when I am high. When I am high, I drive more cautiously, and I drive the speed limit.” Research published in June 2014 by the National Institutes of Health determined that marijuana does negatively affect a person’s driving ability, although not as much as alcohol. Users say they often combine the two, and the two drugs together have a synergistic effect on impairment.

Our organization, in collaboration with city, county and state law enforcement, conducts multiple highly publicized statewide mobilizations throughout the year to intercept impaired drivers and increase awareness about the likelihood of getting a DUI. Funds from the sale of recreational marijuana will be used to educate the public about the potential for becoming addicted to marijuana, and there will be increased funding for addiction treatment.

Will marijuana legalization cause impaired driving deaths and serious injuries to increase? Intuitively speaking, yes, but it is too early to make any definitive conclusions. Driving is a privilege, not a right, and therefore requires the driver to make responsible decisions; smoking marijuana and driving don’t mix. Like Colorado, in Washington we’re telling motorists: Drive high, get a DUI.

iStock 000005913775Medium 2Growing Concerns Over Marijuana-Impaired Driving

With a number of states looking at easing their marijuana laws, there is a rising concern among law enforcement and highway safety officials regarding an increase in the number of drivers impaired by marijuana and its effect on highway safety.

Marijuana continues to be one of the most common drugs detected in drug-impaired drivers. A recent review of the literature on drug-impaired driving found that marijuana nearly doubles the risk of a driver being involved in a motor vehicle crash resulting in serious injury or death at certain concentrations (Ashbridge et al. 2012).

Many experts agree that marijuana slows decision-making, decreases peripheral vision and impedes multitasking—all important for safe driving. At recreational doses, effects include relaxation, euphoria, relaxed inhibitions, sense of well-being, disorientation, altered time and space perception, lack of concentration, impaired memory, drowsiness, sedation and mood changes. Stronger doses can intensify those reactions and may cause fluctuating emotions and possible psychosis. (NHTSA Drug Driving Fact Sheets, April 2014).

To help address the concerns of drugged impaired driving, the International Association of Chiefs of Police (IACP) working in partnership with National Highway Traffic Safety Administration (NHTSA) is working to expand training to help educate and equip police officers, prosecutors and toxicologists with the tools to deter drugged driving. This education and training includes a stronger emphasis on marijuana impairment through two proven and effective drugged driving detection programs: Advanced Roadside Impaired Driving Enforcement (ARIDE) and the Drug Evaluation and Classification Program (DECP).

ARIDE bridges the gap between the basic Standardized Field Sobriety Testing (SFST) program and DECP. Not all police officers are able to go through DECP training (nine days of classroom training followed by a week of field training) to become drug recognition experts (DREs). In a 16-hour course, ARIDE provides police officers with general knowledge and impairment indicators to help identify drug impairment at roadside. The goal is to get as many officers working patrol who have the possibility of encountering a drugged driver trained in ARIDE as possible.

The DECP, also referred to as the DRE Program, continues to be the premier impaired driving program focusing on the expanded and in-depth detection of drug-impaired drivers. All 50 states plus the District of Columbia and Canada are participating in the DECP. There are currently over 7,500 police officers credentialed by the IACP as DREs in the U.S. and Canada, and there are over 1,500 DRE instructors.

iStock 000005913775Medium 3aIn an Era of Legalized Marijuana

Washington State voters ushered in the new era of legal recreational sale and use of marijuana in December 2012. This groundbreaking change coincided with Colorado’s passing of Amendment 64, making Washington and Colorado the de facto, if reluctant, leaders in marijuana legalization in the United States. Navigating the creation, regulation and taxing of a new industry is a daunting task for any government. It is particularly difficult when that industry remains illegal under federal law.

Washington and Colorado have spent the last two years engaged in a delicate balancing act between respecting the will of the voters, the need to ensure safe and responsible distribution and use of marijuana, and the restrictions imposed by the federal government. As other states such as Alaska, Oregon, Hawaii, California and Maine move forward with legalizing recreational marijuana sales and use, all eyes are on the West as we begin to tackle the mounting concerns.

One serious consequence of increased marijuana availability and use is its effect on the safety of our roadways. While the arrest and prosecution of marijuana-impaired driving is not new to law enforcement or prosecutors, legal recreational marijuana sales and use have altered the landscape. Increased availability and relaxed public perceptions of the potential dangers of marijuana use have contributed to difficulty proving guilt beyond a reasonable doubt in many marijuana-impaired driving cases.

Myths and science of marijuana-impaired driving

There is relatively little research dedicated to how marijuana impairs users and/or influences their ability to safely operate a motor vehicle. Most studies have been restricted to dosing subjects with marijuana containing roughly 1–3 percent THC. By comparison, Analytical 360, the only Washington State Liquor Control Board-certified laboratory to provide potency and safety testing of marijuana from state-licensed producers and processors, is regularly testing samples in the state between 10–25 percent THC. Clearly that disparity would have a significant impact on the real-life application of the marijuana driving studies. Despite the low-THC level of marijuana administered in the scientific studies, a recent review of the literature published in Clinical Chemistry found a twofold increase in the risk of being involved in a crash after the individual smoked marijuana. It is easy to see that smoking the higher THC concentration marijuana being sold by medical marijuana dispensaries, recreational marijuana shops, and illicit drug dealers across the US would likely have an even greater impact on a user’s driving skills.

A common claim from pro-marijuana groups and casual users alike is that those who consume marijuana before driving are safer than their sober counterparts. Movies and Internet memes portray the marijuana-impaired driver as an overly-cautious, hyper alert, slow driver. Scientific studies portray a much more dangerous set of driving behaviors: impact to an individual’s ability to perform divided attention tasks (ie. driving), reduces short term memory, and correlates to a driver’s inability to stay within his or her lane, and a failure to stop appropriately.

How much marijuana is too much?

There is a persistent call to adopt “per se” level for the amount of marijuana that a person can have in his or her system at the time of driving. Washington’s Initiative 502 adopted a 5 nanogram per se level, a level also currently adopted by Montana (which has only medical marijuana to date), as well as Colorado. Although it may sound appealing to have a set level of marijuana in the blood, at or above would be impaired driving, and below would be permissible, the reality is far less clear.

Prosecutors around Washington are struggling with the 5 nanogram per se level in the courtroom. Much of this struggle can be traced to the public’s lack of knowledge about the effects of marijuana on the user, the huge increase in potency of marijuana available and consumed today versus just 5–10 years ago, and the danger associated with small amounts of marijuana being combined with alcohol and other drugs.

Dissipation, the per se level and estimated duration of impairment

One major hurdle for prosecutors taking marijuana DUI cases to court is how quickly marijuana dissipates from the blood. The dissipation rate also varies tremendously according to the method of ingestion, THC concentration of the product, frequency of use, gender and combination with other drugs (including alcohol). Experts differ on this timeline, but smoked marijuana is typically believed to be less than the 5 nanogram level in the blood within 60 minutes to an outside of three hours from last use. Unfortunately, many mistakenly believe that because THC is not present in the blood, it means that it is no longer impairing the user. If fact, smoked marijuana has been shown to have residual effects up to 24 hours after last use. THC binds with receptors in the brain (CB1 and CB2) and other parts of the body affecting the function of the hippocampus (short-term memory), cerebellum (coordination) and basal ganglia (unconscious muscle movements). Even though it passes the “blood-brain barrier” quickly, the marijuana is still very much affecting the ability of the user to safely operate a motor vehicle.

It’s not just the number

Because securing a blood sample to test also generally requires application and service of a search warrant on the suspect, it is typical for a suspect’s blood to be drawn well after we would expect to see higher than 5 nanograms remaining in the blood. Although the 5 nanogram per se level only added an additional way to prove DUI in Washington State, rather than changing the burden of proof for the State, jurors often interpret the number as a necessity for finding a defendant guilty of a marijuana DUI. Washington’s DUI statute permits proof of marijuana-DUI under either the 5 nanogram per se prong, or the more inclusive “affected by” prong, which relies on proving the defendant was under the influence of alcohol and/or any drug. The reality is that an officer is able to detect and articulate clues and observations of impairment due to marijuana when the suspect’s blood sample will test below the 5 nanogram per se level. This mirrors the fact that many drivers are “impaired” and “affected by alcohol,” therefore guilty of DUI, with alcohol levels below the .08 BrAC per se level. Prosecutors, law enforcement and subject-matter experts on marijuana and impairment need to educate the public, and jurors, that there is far more to marijuana impairment (and the dangers on our roadways) than a number.

Next steps, sensible regulation and public safety

One perhaps enviable claim for both Washington and Colorado is that with the “should marijuana be legal or illegal” issue resolved, we are free to dedicate resources and implement strategies aimed at sensible and safe regulations shaping marijuana use and distribution in our communities. Those opposing legalization in both Washington and Colorado were largely drowned out by the persistent and well-funded claims of pro-legalization groups. With that battle behind us, the next critical steps in Washington include bringing the medical marijuana industry under the same safety standards and regulations as are being applied to recreational marijuana, and ensuring that our laws adequately address the need to keep marijuana out of the hands of underage users, and discourage legal users from driving while impaired by marijuana. 

Prosecutors, law enforcement and those concerned with traffic safety must convey the message that although marijuana may be legal to use recreationally and even drive after consuming, just like alcohol, it is not legal to drive while impaired by the substance. Thirty years ago we began the battle to change the culture of permissible drinking and driving, and we have now entered the next era. The battle cry must be consistent: driving high isn’t a joke; it is literally a matter of life and death.