THE `SLEEPING GIANT' OF DRUGDRIVING

The dangers of driving under the influence of drugs, prescribed or illegal,
can no longer be ignored.

The wrecked remains of cars on the verges of many a suburban
dualcarriageway or city motorway are stark proof of the inherent dangers
of modern driving as deaths on the Republic's roads rise to more than 400
so far this year. The message is clear and repeatedly instilled into every
motoring citizen: speed kills, and alcohol and speed kill even faster.

However, there is one crucial factor that is often left out of the equation
when it comes to teasing out the underlying cause of an accident,
apportioning blame and cautioning motorists. This is the presence of drugs
prescribed or illegal in the bodily fluids of the drivers involved in
the accident. "This is something we should be seriously addressing," says
Dr Ide Delargy, GP coordinator in substance abuse for Dublin's northside.
"We give warnings verbally and in writing to everyone we treat about
the potential risks of driving or using heavy machinery when on methadone.

And we encourage people to take this information on board. "On the illegal
end of drugs, the problem is unquantifiable. People are taking totally
random amounts and types of medicine. I'm horrified by the thought that
such people are behind the wheel of vehicles, yet we know it happens."

Evidence of this was heard in an inquest last month following the horrific
accident on the Drogheda to Dundalk road in which six people were killed.
The driver of the car, Anthony O'Brien, who was estimated to have been
doing 100 miles per hour on the wrong side of the road when he collided
headon with the lorry, tested positive for cannabinoids as well as having
a bloodalcohol reading of 202 milligrammes per 100 millilitres.

Dr Delargy continues: "Then there are huge numbers of people taking
prescribed medications such as antidepressants and benzodiazepines such as
valium, sleeping tablets and relaxants and continuing to drive despite the
sideeffects which can cause drowsiness and impaired awareness. Drugtaking
and driving is something we are just not taking seriously enough in this
country. And while some drugs may be perfectly safe to take at a
therapeutic level, when mixed with alcohol, the consequences can be
serious."

Supt Alistair McLuckie, head of the Traffic Department of Strathclyde
Police where the first British survey of drugdriving is being carried
out concurs: "The whole issue of drugtaking and driving is a sleeping
giant. It doesn't make a difference whether you are talking about illegal
drugs, prescribed medicines or overthecounter medicines, the crux of the
matter is whether the ability to drive is impaired," he says.

Recent figures in Britain claim that more than 100,000 motorists could be
driving under the influence of drugs. Early findings of a threeyear study
confirmed that a quarter of those involved in 465 road traffic deaths in a
period of 11 months had taken drugs.

In Ireland, no such figures are available and the 1996 Garda Commissioner's
Crime Report did not identify drugdriving offences as a specific category
of crime. Are we perhaps ignoring that sleeping giant at our peril? And
should drugtaking and driving be getting more serious attention from the
lawenforcing agencies of our State?

Supt Vincent Maguire of the National Road Traffic Policy Bureau at Garda
headquarters says that the number of drugdriving cases identified here is
small at present but it is an area which is currently being looked at. The
fact that only 16 blood or urine samples were sent for drug testing last
year (following drivers being stopped by the Garda for appearing to be
incapable of driving and then brought to a Garda station for tests) perhaps
indicates more a disinclination to test for drugs rather than the absence
of them in dangerous drivers.

The results of these 16 tests did, however, find a wide range of drugs,
including amphetamines, methadone and morphine. At present, drugdriving
offences are dealt with under the Road Traffic Act 1994 which states that
it is an offence to drive or attempt to drive or be in charge of a vehicle
under the influence of an intoxicant. While intoxicants include alcohol,
drugs or both, alcohol remains the first (and often only) intoxicant to be
tested for by the Garda. Penalties include up to £1,000 fine and two years
mandatory disqualification from driving with a discretionary sixmonth term
of imprisonment.

However, random testing for either drugs or alcohol is not permitted in
this country. A garda can request a driver to comply with a breathalyser
test if he or she is "of the opinion" that the driver is unfit to drive.
Currently, there is no roadside drugs test. This situation, by its very
nature, is biased towards alcohol as being the main substance of abuse in
dangerousdriving cases. Fair enough, given the statistics, you may say.
But, isn't this the typical, youonlygetwhatyou'relookingfor scenario?

If drivers were tested for drugs as well as alcohol, might we not see a
rise in the number of cases where drugs were a major factor in driver
incompetence? And furthermore, if pathologists reports included more
detailed information about the levels of drugs detected during postmortem
examinations of drivers killed in road accidents, would this not increase
our awareness of the problem? "There is no standardised equipment as yet to
use in a roadside test for drugs and there is nothing in the pipeline that
will be here quickly," says Supt Maguire. "It doesn't strike me as being
particularly urgent."

Dr Denis Cusack of the Medical Bureau of Road Safety, Department of
Forensic Medicine, University College Dublin points to a current model for
roadside drug testing. Called drugwipe, it can detect and confirm the
presence of heroin, morphine, amphetamines, ecstasy, cocaine and cannabis.
The growing campaign for the legalisation of cannabis in Britain (which has
some supporters in this country) must also consider how such a socalled
soft drug would impair driver competence if it were legalised. The
Strathclyde Police Department has been tackling the drugdriving problem
for three years now. "In the fullness of time, there will be a generic
drugscreening device.

In the interim, how many people will die or be seriously injured?," asks
Supt McLuckie. "The difficulty is that a lot of people may have a mixture
of drugs and alcohol in their system," comments Dr Cusack. It is
significant perhaps that postmortem examinations of Henri Paul, the
Mercedes driver in the fatal Paris crash which killed Diana, Princess of
Wales, Dodi alFayed and the driver himself, was found to have traces of
antidepressants and the alcoholism treatment drug, antibuse, as well as
175 mls of alcohol in his blood.

Experts agree that those taking legally prescribed medicines should be very
aware of any side effects that may cause drowsiness or dizziness when
driving. There is also an onus on doctors to check whether patients need to
drive to help them choose the most appropriate medication. Ofcourse the
arrival of roadside tests is only one factor in approaching the
drugdriving problem. Educating the Garda to identify the aforementioned
hidden symptoms of drug taking which affect driving is another.

Supt Vincent Maguire admits that identifying drivers under the influence of
drugs is more difficult than recognising the presence of alcohol. Does this
mean that those taking drugs feel that if they drive, they will not be
checked or tested?

Supt Alastair McLuckie concludes: "My personal viewpoint is what is needed
is mass public education to convince the public that there is a problem
with drugtaking and driving. Alongside this, we need to reeducate the
police force on how to identify and deal with the symptoms of drugtaking
and driving."