The typical teenage girl spends her lunch break exchanging memes and dating advice with her besties, cramming for math quizzes and history exams, and filming viral TikTok dance challenge videos. On March 22, 2022, however, lunchtime looked tragically different for a group of six girlfriends in Tishomingo, Oklahoma.

The girls were returning to school from an off-campus restaurant when the 16-year-old driver failed to stop at a stop sign. Instead, she accelerated and turned left in front of a tractor-trailer loaded with gravel. All six girls died in the subsequent collision.

In a July 2024 post-incident report, the National Transportation Safety Board (NTSB) attributed the crash to “distraction from having five teen passengers in the car, limited driving experience and likely impairment from cannabis.”

“The lesson from this tragedy is painfully clear: Marijuana is an impairing substance, period,” NTSB Chair Jennifer Homendy said in a statement. “States have to do a better job of protecting road users from impaired drivers, regardless of the substance or its legality.”

What Is Drugged Driving?

Stopping drug-impaired driving first requires understanding what it is.

“Any substance that affects judgment, coordination, balance, depth perception, reaction times or fatigue—or that otherwise hinders the ability of a driver to operate a vehicle safely—is an impairing substance,” says Darrin Grondel, senior vice president of traffic safety for the Foundation for Advancing Alcohol Responsibility and director of the National Alliance to Stop Impaired Driving.

While driving under the influence of alcohol is typically cut and dry, when it comes to other substances, things aren’t always so simple. “We have a lot of history and understanding about alcohol, including how it affects a person and how it is eliminated from the body,” explains Lt. Jeff Leonard of the Washington State Patrol (WSP), where he is commander of WSP’s Impaired Driving Section. “With a lot of other drugs that people commonly use, we don’t know as much. The effects can vary depending on how much a person consumes and certain genetic and tolerance factors, so there’s no way to assign an objective number to impairment like we do with alcohol and blood alcohol concentration.”

While the effects substances have on any one individual aren’t always clear, their collective impact on roadways is plain to see. In Ohio, for example, the number of fatal drug-related traffic crashes increased from 369 in 2019 to 507 in 2023. Total deaths in those crashes increased from 421 to 551.

“Our fatal crashes overall have gone down in recent years, but impaired driving has gone up,” says Capt. Christopher Kinn of the Ohio State Highway Patrol (OSHP), where he is the executive officer in OSHP’s Office of Field Operations.

The numbers are due in part to recreational cannabis, which is now legal in 24 states, not to mention Washington, D.C., Guam and all of Canada. But marijuana isn’t the only culprit. Other likely factors include the opioid epidemic, increases in depression and other mental health conditions for which people might self-medicate, and reduced traffic enforcement by police experiencing anti-law enforcement sentiment following the COVID-19 pandemic and the 2020 death of George Floyd.

“This is not an indictment on one drug,” Grondel says. “This is happening because of a confluence of things and drivers consuming multiple impairing substances.”

Step One: Education

If a confluence of things is fueling drug-impaired driving, a confluence of things will be required to stop it, according to Brian Ursino, vice president of law enforcement programs & services at AAMVA. In the fight against drugged driving, he says, there are three primary pillars: education, enforcement and treatment.

Education is essential, according to Leonard. “An ideal world is a world where these things don’t occur at all because people simply know not to drive,” he says. “So, the fight begins with making sure people are educated enough to know that if you use a substance—any impairing substance—you should not get behind the wheel in the first place.”

From sponsoring booths and guest speakers at community events to creating social media campaigns, utilizing electronic traffic message boards and passing out pamphlets during routine traffic stops, law enforcement agencies have many educational tools at their disposal. Getting the point across requires them to use every available channel repeatedly.

Empowering Better Enforcement

Because it’s a powerful deterrent, enforcement is just as vital as education, according to Grondel, who cites high-visibility enforcement as one particularly effective tactic.

“There are some states and jurisdictions that have roving patrols as well as sobriety checkpoints,” explains Grondel, who notes that several states have laws that prohibit sobriety checkpoints. In states that permit them: “You’ll have a sobriety checkpoint at a certain location, and people will see or hear about them and try to go around them. That’s when they’ll run into your roving patrol behind them.”

Of course, enforcement of that variety can only be effective if patrol officers can recognize drug-impaired drivers alongside alcohol-impaired drivers during traffic stops. To ensure they can, the International Association of Chiefs of Police (IACP) and National Highway Traffic Safety Administration (NHTSA), in addition to the basic Standard Field Sobriety Test Training, offer a 16-hour Advanced Roadside Impaired Driving Enforcement training that gives officers the skills they need to recognize and arrest drug-impaired drivers. That’s critical because impaired driving often involves both drugs and alcohol, Grondel notes.

An officer who wants to become more adept at recognizing drug-impaired drivers also can become a drug recognition expert (DRE), which requires DRE Pre-School (16-hours), DRE School (56 hours) and DRE Field Certification (40-60 hours).

DREs can’t shoulder enforcement alone, however. The problem is too big, and there are too few of them. What’s needed is a systemic approach to evidence collection, Grondel says. DREs are one piece of that puzzle. Other pieces are electronic search warrants, law enforcement phlebotomists and better-funded toxicology labs, all of which can help expedite the collection of biological evidence before drugs in a driver’s system metabolize.

“Toxicology labs are a huge challenge,” Grondel says. “They often don’t have enough personnel, equipment or the right validations for which drugs to test. Instead of testing three or four drugs, we need to test for 80 to 100. Not for enhancing penalties, but so a judge can look at that information and ensure the right kind of accountability, whether that’s a treatment facility, a drug court or something else.”

“Any substance that affects judgment, coordination, balance, depth perception, reaction times or fatigue is an impairing substance.”

Darrin Grondel
Senior Vice President of Traffic Safety for the Foundation for Advancing Alcohol Responsibility and Director of the National Alliance to Stop Impaired Driving

In Ohio, OSHP is piloting a fresh solution to drugged driving’s evidentiary challenges: oral fluid collection and testing, which it believes is an easier and faster alternative to blood or urine sampling.

“Oral fluid is more than just saliva. There’s a lot of other stuff in the mouth, so oral fluid shows what’s active in a person’s body at the moment of collection,” Kinn says. “When you couple that with the indicators of impairment that gave an officer probable cause to make an arrest in the first place, and probable cause to ask a driver to submit to a chemical test, that oral fluid testing can confirm the presence of drugs.”

Ultimately, however, the key to better enforcement and evidence isn’t better testing. It’s better leadership, Ursino argues. “Law enforcement leaders need to make impaired driving a priority,” he says. “Officers on the street won’t think it’s important unless the chief, colonel or commissioner says it’s important.”

What About Treatment?

Because of high recidivism rates, the third and final pillar in the fight against drugged driving is treatment. Although it lies outside their scope of practice, there are important things law enforcement agencies can do to help facilitate.

For example, one program that has been effective for WSP is IACP’s and NHTSA’s Drug Impairment Training for Educational Professionals program. This program trains school administrators and nurses to recognize young people who are impaired by drugs and provide early recognition and intervention.

In Ohio, meanwhile, OSHP began partnering with mental health, substance abuse and behavioral health providers in counties across the state in 2023. When officers make an arrest for impaired driving, they offer drivers information on providers and treatment options in their local area.

“We’re trying to make sure they’re aware of that help and know how to access it if they’re ready to make a change in their life,” explains Kinn.

All Hands on Deck

Ursino says AAMVA is an important partner to law enforcement agencies that are trying to move the needle on drug-impaired driving. He says that educational sessions on various impaired driving topics are mainstays at AAMVA conferences and events, and motor vehicle administrators often play key roles in driver license privilege hearings.

Leonard adds that AAMVA helps by facilitating the sharing of information about drivers with a history of impaired driving through its State-to-State Verification Service and Driver License Compact. “People are more transitory today than they used to be,” he says. “If there’s a problem offender who’s moving between states, they need to be recognized and placed into the appropriate system.”

It’s all hands on deck, according to Grondel. “We need to look at the whole system, from how people are educated to what happens when they’re stopped, to how they’re tested and what happens when they go to court,” he says. “That’s going to take everyone working together.”