Drug driving

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Key facts:

• Impairment by illegal or medical drugs was officially recorded as a contributory factor in 62 fatal road crashes and 259 crashes resulting in serious injuries in 2015 in Britain [1], but experts estimate the true figure could be much higher;
• One in six bodies of dead drivers (18%) and 16% of the bodies of dead motorcyclists were found to have illegal drugs in their bodies, in research commissioned by the Department for Transport published in 2001. About 6% of dead drivers and dead motorcyclists had taken medicines that could have affected their driving [2];
• One in six (17%) of 1,396 randomly-tested Glasgow drivers in 2005 had taken at least one illegal drug, with the most common being MDMA and cannabis [3];
• After extensive campaigning by Brake and others, in 2015, legislation came into force in England and Wales, banning driving on certain listed illegal and prescription drugs (previously it was only a crime if there was evidence of impaired driving) [4]. Similar laws have not yet been adopted in Scotland or Northern Ireland;
• The new law’s enforcement requires use of type-approved testing devices. However, at present, type approval has only been given to devices able to identify just two of the drugs listed as illegal to drive on (cannabis and cocaine) [5]. There is no type-approved testing device for MDMA as yet;
• Despite this limitation, between March 2015 and April 2016, almost 8,000 people were arrested for drug-driving in England and Wales [6];
• There is evidence that police are able to target effectively who they drug screen. During the one-month Christmas 2015 drink and drug drive campaign, 1,888 targeted drug screening tests were carried out in England and Wales, and nearly 50% were positive [7].
Many illegal and medicinal drugs seriously impair driving ability. In Britain, impairment by illegal or medical drugs was recorded as a contributory factor in at least 62 fatal road crashes and 259 serious injuries in 2015 [8]. Experts have estimated the true figure could be much higher.

Illegal drugs: prevalence among drivers

In research carried out in 2005 in Glasgow, 1,396 drivers were stopped at random and asked to participate voluntarily in a saliva test. One in six (17%) tested positive for at least one drug. In 85% of cases, one drug had been taken, with the most common drugs being MDMA (ecstasy) (more than 4% of those tested) and cannabis (more than 3% of those tested). The research was part of the EU-funded IMMORTAL project (Impaired Motorists, Methods of Roadside Testing and Assessment for Licensing) [9].

Self-admission rates in surveys are predictably lower, but still at very significant levels. A Brake and Direct Line 2016 survey found 7% of drivers surveyed admitted driving on illegal drugs in the past year (with nearly half of these saying they do it weekly or more), and one in five think they may have been a passenger with a driver on drugs. One in seven (16%) say they wouldn't always speak out to stop a friend driving on drugs [10].

Illegal drugs and rising prevalence in bodies of dead drivers

UK government-commissioned research by TRL (the Transport Research Laboratory), published in 2001, found illegal drugs (with the most common being cannabis) in the bodies of 18% of drivers and 16% of motorcyclists (out of more than 1,000 drivers who died in road crashes) [11].
This study was a repeat of a study carried out by TRL looking at dead drivers in the 1980s; that earlier study had found evidence of illegal drug use in the bodies of only 3% of drivers.
This useful research has unfortunately not been repeated more recently by the government.

Effects of illegal drugs

The effects of illegal drugs can be highly unpredictable. However there are a number of adverse effects on driving ability [12].

Effects of drugs most commonly found in the systems of British drug drivers

Cannabis: This slows reactions; affects concentration; often gives a sedative-like effect, resulting in fatigue; affects co-ordination [13]. Research using driver simulators has found cannabis makes drivers less able to steer accurately and slower to react to another vehicle pulling out [14].

MDMA (ecstasy): This makes the heart beat faster, which can cause a surge of adrenaline and result in a driver feeling over-confident and taking risks. Short-term risks can also include anxiety, panic attacks, confused episodes, paranoia or even psychosis, all of which can have a negative impact on drivers [15].

Cocaine: This causes over-confidence and can cause erratic behaviour. After a night out using cocaine, people may feel like they have flu, feel sleepy and lack concentration [16].

Other drugs and their effects:

Dissociative drugs: Common ones are ketamine and PCP. These can cause muscle paralysis; hallucinations; confusion, agitation, panic attacks; and memory impairment [17].

Hallucinogens: Most common ones are LSD (Acid) and magic mushrooms (psilocybin). Can speed up or slow down time and movement, making the speed of other vehicles difficult to judge. Causes colours, sounds and objects to appear distorted. They can cause disorientation, confusion, panic, fatigue and nausea [18] [19].

Amphetamines and methamphetamines: This includes speed (and more powerful versions including ice (crystal meth)). These drugs make people feel wide awake and excited, causing erratic behaviour and risk-taking; and can make people panicky. Users have difficulty sleeping, so will also be tired for days [20].

Opiates: This includes heroin and opium. They have a sedative affect, slowing reaction times, causing inappropriate responses, reduced coordination and reduced ability to think clearly. They cause blurred vision and drowsiness, nausea and vomiting. [21]

Illegal drugs and estimates of how much they increase crash risk

Some studies have sought to identify the risk rate of drug drivers being involved in fatal or serious crashes. 

A study of fatal crashes in France between 2001 and 2003 concluded cannabis almost doubles the risk of being involved in a fatal crash [22]. Analysis of road crash hospital admissions in Canada between 2009 and 2011 found cannabis use increases the risk of being involved in a serious crash by four times [23].

The EU-commissioned “DRUID” research programme into the risks found fatal or serious injury crash risk increased by:
• 2 times for drivers on cannabis;
• 16 times for drivers on cannabis combined with alcohol;
• 2-10 times for drivers on cocaine or opiates;
• 5-30 times for drivers on amphetamines [24].
Separate studies have found MDMA to be impairing when driving [25].

Combining illegal drugs with alcohol increases risk: analysis of fatal crashes in the USA found drivers who have consumed both are 23 times more likely to be involved in a fatal crash than sober drivers [26].

Medicinal drugs

Many prescription and over-the-counter medications impair ability to drive safely, for instance causing drowsiness, affecting reaction times, coordination, concentration or vision.

Warnings on medication can be vague or in small print only. They may indicate there is a risk of impairment but not relate it to driving. They may leave it to the user to judge their own level of impairment (which can be hard).

In some countries, warning labels are required to be more obvious and give clearer advice on driving. For example, in Australia medications are legally required to display a visible warning label if a driver can be affected [27].

Effects of medicinal drugs

Medical drugs that can impair driving include some cough and cold medicines, anti-inflammatories, anti-histamines, antibiotics, antidepressants, epilepsy drugs and sleeping pills.

Many drivers are unaware: a Brake and Direct Line survey found three in 10 drivers (30%) are unaware some hay fever and allergy medications can impair driving, more than half (53%) are unaware of the risks of decongestants and four in 10 (40%) don’t know cough medicines can impair driving [28].

Among hay fever medications, earlier varieties of anti-histamines are known to cause drowsiness, and some impair coordination and reaction times in a similar manner to alcohol [29]. Second- and third-generation antihistamines have also been found to cause drowsiness in some people [30].

Prevalence among drivers

A survey by Brake and Direct Line found one in six (17%) UK drivers admit either ignoring warnings that medication can cause side effects that could impair their driving ability, or not checking labels for such warnings. Almost half (44%) of drivers who use hay fever medication admit sometimes or never checking the instructions to see if it will affect their driving ability [31].
Medicinal drugs and crash risk

UK government-commissioned research by TRL (the Transport Research Laboratory), published in 2001, found 5% of drivers and 4% of motorcyclists who died in road crashes had taken medicines that could have affected their driving [32].

A Norwegian study found the risk of being involved in a road crash doubled or tripled, depending on the type of drug, for up to seven days after being prescribed medicinal drugs (including opiates, tranquillizers, hypnotics, anti-inflammatory drugs and penicillin), with a marked increase in users prescribed opiate painkillers and some tranquilizers [33].

Research from New Zealand found drivers who have taken any psychoactive illegal or medical drugs (such as some medicines used to treat bipolar disorder) are more than three times more likely to be at fault in collisions than sober drivers [34].

Learn more: Read the Brake and Direct Line Fit to drive report.

The law

In the UK, it is an offence to drive impaired by drugs.

In England and Wales, it is also an offence (since 2015 under the Crime and Courts Act) to drive with certain controlled drugs listed under the Misuse of Drugs Act 1971 in your system. These basically comprise the most commonly taken illicit drugs plus some prescription-only drugs. This law does not apply in Scotland nor Northern Ireland.

Police can stop and test any driver they suspect of being on drugs, and may also test if a driver is stopped for another offence, or if they are involved in a crash.

The illegal drugs banned are: cannabis, cocaine, MDMA, LSD (acid), methamphetamines (ice (crystal meth)), ketamine, and heroin. The limits for these drugs are extremely low; effectively zero tolerance.

Medicinal drugs are banned at certain levels. Drugs banned include benzodiazepine tranquillizers at the following levels: diazepam 550ug/L, clonazepam 50ug/L, temazepam 1,000ug/L, flunitrazepam (commonly known as rohypnol) 300ug/L, lorazepam 100ug/L and oxazepam 300ug/L.

Methadone (commonly prescribed to opiate addicts) is banned at 500ug/L. The painkiller morphine is also banned at 80ug/L.

Amphetamine is also listed as a banned substance, either as a medicinal or illicit drug depending on use.

The limits for medical drugs are set at level where they are thought to begin to affect driving, as advised by a panel of medical experts [35].

The need for type-approved testing devices that detect more drugs

The law is reliant on police having access to drug testing devices that are “type approved” to test for a particular drug. Police do not have access to such devices to test for most of the drugs covered in the law.

In March 2015 devices that can test only two of the 17 drugs featured in the Act (cannabis and cocaine) were given type approval for use in roadside drug screening [36].

Experts have argued that the most important priority is for a drug testing device to be approved that identifies drivers using ecstasy (MDMA). Dr Rob Tunbridge, co-author of the 2001 TRL report showing prevalence of illegal drugs in dead drivers, says: “As a first step, roadside screening devices need approval for testing of MDMA. Along with cannabis and cocaine, all social survey and epidemiological evidence suggests that these three drugs represent the major problem for drug driving in GB.” [37]

Rise in drug detection and convictions since March 2015 in England and Wales

However, even with screening limited to cannabis and cocaine testing, there has been a huge rise in detection of drug drivers by police in England and Wales since the new law’s introduction in March 2015.

Arrests have soared in different police force areas by up to 800% since the law has been introduced [38].
Between March 2015 and April 2016, almost 8,000 people were arrested for drug-driving in England and Wales according to a Freedom of Information answer provided to the BBC by the government [39].

During the Christmas 2015 drink and drug drive campaign alone, 1,888 targeted drug screening tests were carried out in one month across England and Wales, and nearly 50% were positive [40].

Conviction data is beginning to emerge. Information held by the Driver and Vehicle Licensing Agency in February 2016 showed at least 619 drivers were convicted of the new offences of driving, or being in charge of a vehicle, with a drug in their system above the specified limit in 2015. Together with convictions for driving, or being in charge of a vehicle, while unfit through drugs (more than 800 convictions) and convictions for death by careless driving while unfit through drugs (3) this meant convictions for drug driving offences (known to the DVLA at the time of the provided information) rose from 1,039 in 2014 to 1,490 in 2015 [41].

Time line of how the law changed in England and Wales

2003: The government implemented the Railways and Transport Safety Act (RATS) [42] which allowed for roadside testing for drugs using “type approved” devices that test saliva or sweat. However, at that time no such type approved devices were available to police, who were reliant on “field impairment testing” (FIT) (which sets tests for a suspected driver (such as walk in a straight line) and only indicates impairment rather than provides proof).

2010: Sir Peter North published a Review of Drink and Drug Driving Policy. [43] North and a House of Commons Transport Select Committee concluded that drug screening of drivers should be introduced as soon as practically possible.

2012: An ‘expert’ panel was set up to consider the technical aspects of introducing an offence of driving after taking illegal drugs and the possibility of identifying impairing levels for these drugs.

2013: Expert panel recommended limits. [44] The panel's evidence was based partly on the Pan European study DRUID (DRiving Under the Influence of Drugs, alcohol and medicines) [45]

2013: The Crime and Courts Act made it illegal in England and Wales (not Scotland nor Northern Ireland) for “driving or being in charge of a motor vehicle with a concentration of a specified drug above a specified limit.”[46]

2014: Limits for drugs were specified under The Drug Driving (Specified Limits) (England and Wales) Regulations 2014 [47]

2015 (March): Limits specified and the law is applied. Devices that can test only two of the 17 drugs featured in the Act (cannabis and cocaine) were given type approval for use in roadside drug screening.

Penalties

Following the introduction of the new legislation in England and Wales in 2015, drivers caught and convicted of drug-driving can receive a minimum 12-month driving ban; a criminal record; and a fine of up to £5,000, or up to 6 months in prison, or both. The penalty for causing death by dangerous driving under the influence of drugs is a maximum prison sentence of 14 years.
A drug-drive conviction can also make it harder to gain employment, increases car insurance costs and causes difficulty when gaining a visa to travel abroad to certain countries, for example the USA. [48]


End notes

[1] Department for Transport, 2016, Reported road casualties in Great Britain 2015, table RAS50001
[2] Transport Research Laboratory, 2001, The Incidence of Drugs and Alcohol in Road Accident Fatalities, report no. 495
[3] Assum T, Mathijssen MP, Houwing S, Buttress SC, Sexton B, Tunbridge RJ and Oliver J., 2005, The prevalence of drug driving and relative risk estimations. A study conducted in The Netherlands, Norway and United Kingdom. IMMORTAL EU research project, Deliverable D-R4.2. 2005. Final programme report
[4] gov.uk The Drug Driving (Specified Limits) (England and Wales) Regulations 2014
[5] Tunbridge, R, 2016, The preliminary effects of new drug driving legislation in Great Britain, Presentation to the October 2016 Brazil World Rescue Challenge Conference
[6] Freedom of Information request, BBC, 2016
[7] Department for Transport press release, 28 Feb 2016, Drug drive arrests on the rise
[8] Department for Transport, 2015, Reported road casualties Great Britain: Annual report 2014, Table RAS50001
[9] Assum T, Mathijssen MP, Houwing S, Buttress SC, Sexton B, Tunbridge RJ and Oliver J., 2005, The prevalence of drug driving and relative risk estimations. A study conducted in The Netherlands, Norway and United Kingdom. IMMORTAL EU research project, Deliverable D-R4.2. 2005. Final programme report
[10] Brake and Direct Line, 2016, Fit to drive: drug driving
[11] Transport Research Laboratory, 2001, The Incidence of Drugs and Alcohol in Road Accident Fatalities, report no. 495
[12] PACTS, 2016, Fit to Drive?
[13] A-Z of drugs: Cannabis, Talk to Frank, undated
[14] Transport Research Laboratory, 2000, The Influence of Cannabis on Driving
[15] A-Z of drugs: Ecstasy, Talk to Frank, undated
[16] A-Z of drugs: Cocaine, Talk to Frank, undated 
[17] A-Z of drugs: Ketamine, Talk to Frank, undated
[18] A-Z of drugs: LSD, Talk to Frank, undated
[19] A-Z of drugs: Magic mushrooms, Talk to Frank, undated
[20] A-Z of drugs: Speed, Talk to Frank, undated
[21] Alcohol and Drug Foundation, Australia, How does heroin and other opiates affect driving?
[22] British Medical Journal, 2005, Cannabis intoxication and fatal road crashes in France: population based case-control study
[23] University of Toronto, 2013, Cannabis and traffic collision risk
[24] EU DRUID Programme, 2012, DRUID Final Report: work performance, main results and recommendations
[25] Logan BKCouper FJ, 2001. Washington State Toxicology Laboratory, Bureau of Forensic Laboratory Services, Washington State Patrol, Seattle, 2001. 3,4-Methylenedioxymethamphetamine (MDMA, ecstasy) and driving impairment.
[26] Columbia University, 2013, Drug use and fatal motor vehicle crashes
[27] Australian pharmaceutical formulary and handbook (21st ed.), Pharmaceutical Society of Australia (PSA), 2009.
[28] Brake and Direct Line, 2014, Fit to drive: medication and driving
[29] University of Utrecht, 2004, Antihistamines and driving ability: evidence from on-the-road driving studies during normal traffic
[30] NHS Choices, 2015, Antihistamines – side effects
[31] Brake and Direct Line, 2014, Fit to drive: medication and driving
[32] Transport Research Laboratory, 2001, The Incidence of Drugs and Alcohol in Road Accident Fatalities, report no. 495
[33] Norwegian Institute of Public Health, 2007, Risk of Road Traffic Accidents Associated With the Prescription of Drugs: A Registry-Based Cohort Study
[34] Queensland University of Technology, 2012, Medications and driving: community knowledge, perceptions and experience
[35] Department for Transport, 2015, Table of drugs and limits
[36] Tunbridge, R, 2016, The preliminary effects of new drug driving legislation in Great Britain, Presentation to the October 2016 Brazil World Rescue Challenge Conference
[37] ibid
[38] Department for Transport press release, 28 Feb 2016, Drug drive arrests on the rise
[39] Freedom of Information Request, BBC, 1 June 2016, Drug driving: almost 8,000 arrests
[40] Department for Transport press release, 28 Feb 2016, Drug drive arrests on the rise
[41] Freedom of Information Request, DVLA, 16 Nov 2016, Number of Drug Driving Convictions
[42] Railways and Transport Safety Act, gov.uk, 2016
[43] Sir Peter North, June 2010, Report of the Review of Drink and Drug Driving Law
[44] Wolff et al., 2013, Driving under the influence of drugs
[45] EU DRUID Programme, 2012, DRUID Final Report: work performance, main results and recommendations
[46] Crime and Courts Act, 2013
[47] The Drug Driving (Specified Limits) (England and Wales) Regulations 2014, gov.uk
[48] Drugs and Driving: the law, Department for Transport, 2016


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Page last updated: December 2016