Drug driving

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Key facts:

  • The number of fatal crashes involving drivers impaired by drugs or medicines increased by 8% in 2017-2018 [1];
  • Impairment by illegal or medical drugs was officially recorded as contributing to 80 fatal road crashes and 404 crashes resulting in serious injuries in 2018 in Britain [2], but experts estimate the true figure could be much higher;
  • Six in 10 people feel the number of drug-drivers on the roads has increased in the last five years [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]. Scotland has since adopted similar laws [5];
  • Drug-driving prosecutions almost doubled in 2018, from 5,368 to 10,215 [6];
  • More than 40% of drivers screened for drugs in December 2017 were found to be impaired [7].

Introduction

Driving requires your full concentration and anything that impairs your ability to focus on the road makes it more likely that you will be involved in a crash. Being under the influence of illegal or medicinal drugs may affect your awareness, judgment and reaction times, putting yourself and other road users in danger.

It is an offence to drive impaired by drugs, or with certain controlled substances in your system. Police can stop and test any driver they suspect of being on drugs, and may test drivers if they are stopped for another offence, or are involved in a crash.

Research suggests that use of drugs by drivers is growing. The most recent statistics for drug driving show that the number of fatal and serious crashes involving drivers impaired by drugs or medicines increased by 8% between 2017 and 2018, from 447 to 484 incidents [8]. The total number of collisions involving drivers impaired by drugs or medicines also grew from 594 to 1,321 between 2014 and 2018. Department for Transport research shows 60% of people feel the number of people driving while impaired by legal or illegal drugs has increased in the past five years [9].

Self-reported drug-driving figures show approximately more than four times fewer drivers admit driving while impaired than nine years ago. In 2009/10, 2.3% of drivers admitted being behind the wheel after taking illegal substances, but by 2018/19 this proportion had fallen to 0.5% [10]. Only 0.1% said they drove under the influence of drugs a few times a week.

Slightly more men admit driving while impaired by drugs than women do, at 0.7% and 0.2% respectively [11]. Drug-driving is most common among drivers aged 16-19, with 2% admitting being impaired at the wheel in 2018/19. Usage tends to decline as people get older, with 1.8% of 20-24 year olds driving after taking drugs, compared with 0.1% of people aged 50 or over.

However, Brake’s own research shows that drug-driving rates may be even higher. 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 [12].

There is evidence that police are able to effectively target who they screen for drugs. During the one-month Christmas 2017 drink and drug drive campaign, 1,888 targeted drug screening tests were carried out by police in England and Wales, and nearly 50% were positive [13].

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) [14]. This study was a repeat of a study carried out by TRL looking at dead drivers in the 1980s, which 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.

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 [15]. These basically comprise the most commonly taken illicit drugs. It is also illegal in England, Wales and Scotland to drive with certain prescription medicines in your system.

However, almost two thirds of people feel that drug driving laws are not being properly enforced. Research carried out by the Department for Transport found 63% of people agree the laws on driving while impaired by legal or illegal drugs are not being implemented effectively [16].

The illegal drugs covered by the Crime and Courts Act: 2015 include: 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 also 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 [17].

Effects of illegal drugs

There is no one way that drugs affect the body. The exact effect they will have will depend on the type of substance [18].

Cannabis slows reactions, affects concentration. It often gives a sedative-like effect, resulting in fatigue, and affects co-ordination [19]. Research using driver simulators has found cannabis makes drivers less able to steer accurately and slower to react to another vehicle pulling out [20].

MDMA (ecstasy) 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 [21].

Cocaine 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 [22].

Other drugs and their effects:

Dissociative drugs: Common dissociative drugs are ketamine and PCP. These can cause muscle paralysis; hallucinations; confusion, agitation, panic attacks; and memory impairment [23].

Hallucinogens: Common hallucinogens include 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 [24] [25].

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 [26].

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. [27].

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.

Studies have shown that drivers impaired by cannabis are 1.65 times more likely to cause a fatal collision, and that the 4.2% of fatal crashes could be prevented if no drivers ever drove under the influence of cannabis [28]. 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 [29].

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 [30].

Separate studies have found MDMA to be impairing when driving [31].

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 [32].

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 [33].

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 of how medicines can affect their ability to drive safely: 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 [34].

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 [35]. Second- and third-generation antihistamines have also been found to cause drowsiness in some people [36].

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 [37].

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 [38].

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 [39].

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 [40].

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

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 [41].

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.” [42]

Timeline of how the law changed in England and Wales

2003: The government implemented the Railways and Transport Safety Act (RATS) [43] 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. [44] 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. [45] The panel's evidence was based partly on the Pan European study DRUID (DRiving Under the Influence of Drugs, alcohol and medicines) [46].

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”[47].

2014: Limits for drugs were specified under The Drug Driving (Specified Limits) (England and Wales) Regulations 2014 [48].

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 [49].


End notes

[1] Department for Transport (2019), Reported road casualties in Great Britain, annual report: 2018, table RAS50001
[2] Ibid
[3] Department for Transport (2020), National travel attitudes survey: Wave 2
[4] gov.uk, The Drug Driving (Specified Limits) (England and Wales) Regulations 2014
[5] gov.uk, Drugs and driving: the law
[6] Fleet News (2019), Freedom of Information Request
[7] National Police Chiefs’ Council (2018), Police stop nearly 100,000 vehicles as part of Christmas drink and drug driving crackdown
[8] Department for Transport (2019), Reported road casualties in Great Britain, annual report: 2018, table RAS50001
[9] Department for Transport (2020), National travel attitudes survey: Wave 2
[10] Department for Transport (2019), Reported road casualties in Great Britain, annual report: 2018, table RAS51103
[11] Department for Transport (2019), Reported road casualties in Great Britain, annual report: 2018, table RAS51104
[12] Brake and Direct Line (2016), Fit to drive: drug driving
[13] National Police Chiefs’ Council (2018), Police stop nearly 100,000 vehicles as part of Christmas drink and drug driving crackdown
[14] Transport Research Laboratory (2001), The Incidence of Drugs and Alcohol in Road Accident Fatalities, report no. 495
[15] gov.uk, Drugs and driving: the law
[16] Department for Transport (2020), National travel attitudes survey: Wave 2
[17] Department for Transport, Changes to drug driving law
[18] PACTS (2016), Fit to Drive?
[19] Talk to Frank, A-Z of drugs: Cannabis
[20] Sexton, B. et al (2000), The Influence of Cannabis on Driving
[21] Talk to Frank, A-Z of drugs: Ecstasy
[22] Talk to Frank, A-Z of drugs: Cocaine
[23] Talk to Frank, A-Z of drugs: Ketamine
[24] Talk to Frank, A-Z of drugs: LSD
[25] Talk to Frank, A-Z of drugs: Magic mushrooms
[26] Talk to Frank, A-Z of drugs: Speed
[27] Tan, K., Opioids and driving – a review
[28] Martin, J. et al (2017), Cannabis, alcohol and fatal road accidents, PLoS One 12(11)
[29] Asbridge, M. et al (2013), Cannabis and traffic collision risk
[30] EU DRUID Programme (2012), DRUID Final Report: work performance, main results and recommendations
[31] Logan, B., and Couper, F. (2001), 3,4-Methylenedioxymethamphetamine (MDMA, ecstasy) and driving impairment, Journal of Forensic Science 46(6), 1426-1433
[32] Li, G., Brady, E. and Chen, Q. (2013), Drug use and fatal motor vehicle crashes, Accident Analysis & Prevention 60, 205-210
[33] Pharmaceutical Society of Australia (PSA) (2009), Australian pharmaceutical formulary and handbook (21st ed.)
[34] Brake and Direct Line (2014), Fit to drive: medication and driving
[35] Verster, J. and Volkerts, E. (2004), Antihistamines and driving ability: evidence from on-the-road driving studies during normal traffic, Annals of Allergy, Asthma and Immunology 92(3), 294-303
[36] NHS Choices (2015), Antihistamines – side effects
[37] Brake and Direct Line (2014), Fit to drive: medication and driving
[38] Tunbridge, R. et al (2001), The Incidence of Drugs and Alcohol in Road Accident Fatalities, report no. 495
[39] Engeland, A, et al (2007), Risk of Road Traffic Accidents Associated With the Prescription of Drugs: A Registry-Based Cohort Study, Annals of Epidemiology 17(8), 597-602
[40] Williamson, A. et al (2012), Medications and driving: community knowledge, perceptions and experience
[41] Tunbridge, R., (2016), The preliminary effects of new drug driving legislation in Great Britain, Presentation to the October 2016 Brazil World Rescue Challenge Conference
[42] ibid
[43] gov.uk, Railways and Transport Safety Act
[44] North, P. (2010), Report of the Review of Drink and Drug Driving Law
[45] Wolff, K. et al. (2013), Driving under the influence of drugs
[46] EU DRUID Programme (2012), DRUID Final Report: work performance, main results and recommendations
[47] gov.uk, Crime and Courts Act
[48] gov.uk, The Drug Driving (Specified Limits) (England and Wales) Regulations 2014
[49] Department for Transport (2016), Drugs and Driving: the law


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Page last updated: March 2020

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