Turkiye Klinikleri Journal of Forensic Medicine and Forensic Sciences

.: ORIGINAL RESEARCH
Driving Under the Influence of Drugs
Uyuşturucu Madde Etkisi Altında Araç Kullanımı
Faruk AŞICIOĞLUa, Emre MUTLUb, Mustafa OKUDANb
aİstanbul University-Cerrahpasa Institute of Forensic Sciences,
bThe Ministry of Justice, Council of Forensic Medicine,
İstanbul, TURKEY
Turkiye Klinikleri J Foren Sci Leg Med. 2019;16(3):164-73
doi: 10.5336/forensic.2019-65818
Article Language: EN
Full Text
ABSTRACT
 Objective: Driving performance can easily be deteriorated as a result of drug use. Many observational studies show an increase in the presence of drugs detected in biological samples among drivers. This is an alarming situation, and the likelihood of drug users being exposed to a fatal accident,- especially after multiple drug use- is higher than that of non-users. Material and Methods: In our study, cases with requested reports regarding 'the effect of drug on safe driving' between 2012 and June 2018, from the 5th Specialized Board of The Council of Forensic Medicine were examined in means of distribution by year, sender judicial authorities, regional distribution, biological samples used during evaluation, the types of drugs and their frequency of detection, the rates of verification analysis performed and the report results of the board. Results: It has been determined that cases regarding driving under the influence of narcotic drugs have increased over years. The identified drugs in order of frequency are cannabis, amphetamine, methylenedioxymethamphetamine (MDMA), synthetic cannabinoids, benzodiazepines and opioids. Multiple drug use was detected in 38 out of 88 cases. In 56% of the cases, it was evaluated that the person could not handle and manage the vehicle safely. In 29% of the cases positive for screening test, there was no opinion presented since confirmation analysis in blood was not performed. Conclusion: The number of drug users has been increasing over years, and risk assessment and prevention of drug-related vehicle use are becoming increasingly important.

Keywords: Driving under the influence of drug (DUI); biological sample; confirmation analysis; forensic toxicology
ÖZET
 Amaç: Uyuşturucu madde kullanımının bir sonucu olarak sürüş performansı kolayca bozulmaktadır. Birçok gözlemsel çalışma, sürücüler arasında biyolojik örneklerde tespit edilen uyuşturucu varlığının artmakta olduğunu göstermektedir. Bu endişe verici bir durum olup uyuşturucu kullanan sürücülerin ölümcül bir kazaya maruz kalma olasılığı, özellikle çoklu uyuşturucu kullanımından sonra, kullanıcı olmayanlardan daha yüksektir. Gereç ve Yöntemler: Çalışmamızda 2012- 2018 yılı Haziran ayı arasında Adli Tıp Kurumu 5. İhtisas Kurulu'ndan uyuşturucunun güvenli sürüşe etkisi konusunda rapor istenilen dosyalar, yıllara göre dağılım, gönderen adli makam, bölgesel dağılım, değerlendirme sırasında kullanılan biyolojik örnekler, uyuşturucu maddelerin çeşitleri ve saptanma sıklıkları, doğrulama analizinin yapılma oranları ve kurulun rapor sonuçları açısından incelenmiştir. Bulgular: Uyuşturucu madde etkisi altında sürüş olgularının yıllara göre artış gösterdiği tespit edilmiştir. Tespit edilen uyuşturucu maddeler sıklık sırasına göre esrar, amfetamin, etilendioksimetamfetamin, sentetik kanabinoidler, benzodiazepinler ve opioidlerdir. Seksen sekiz olgunun 38'inde çoklu uyuşturucu madde kullanımı saptanmıştır. Olguların %56'sında kişinin emniyetli şekilde araç sevk ve idare edemeyeceği değerlendirilmiştir. Tarama testinde pozitif çıkan vakaların %29'unda kanda doğrulama analizi yapılmadığından görüş bildirilememiştir. Sonuç: Uyuşturucu uyarıcı madde kullanıcılarının sayısı, geçen yıllar itibariyle artış göstermekte olup, risk değerlendirmesi ve uyuşturucuya bağlı araç kullanımının önlenmesi giderek önem kazanmaktadır.

Anahtar Kelimeler: Uyuşturucu etkisi altında sürüş; biyolojik örnek; doğrulama analizi; adli toksikoloji
REFERENCES:
  1. Movig KL, Mathijssen MP, Nagel PH, van Egmond T, de Gier JJ, Leufkens HG, et al. Psychoactive substance use and the risk of motor vehicle accidents. Accid Anal Prev. 2004;36(4):631-6. [Crossref] 
  2. Augsburger M, Rivier L. Drugs and alcohol among suspected impaired drivers in Canton de Vaud (Switzerland). Forensic Sci Int. 1997;85(2):95-104. [Crossref] 
  3. Penning R, Veldstra J, Daamen AP, Olivier B, Verster JC. Drugs of abuse and traffic safety. Vol. 9781461433, Drug Abuse and Addiction in Medical Illness: Causes, Consequences and Treatment; 2012. [Crossref] 
  4. Acar F, Asirdizer M, Aker RG, Kucukibrahimoglu EE, Ates I, Erol Y, et al. A review of suspected cases of driving under the influence of drugs (DUID) involved in traffic accidents in Istanbul (Turkey). J Forensic Leg Med. 2013;20(6):626-31. [Crossref]  [PubMed] 
  5. Asirdizer M, Yilmaz M, Aker RG, Esra Kucukibrahimoglu E, Ates I, Haluk Ince C. [The evaluation of blood ethyl alcohol levels of drivers involved in traffic accidents]. Nobel Med. 2016;12(1):5-13.
  6. Calafat A, Blay N, Juan M, Adrover D, Bellis MA, Hughes K, et al. Traffic risk behaviors at nightlife: drinking, taking drugs, driving, and use of public transport by young people. Traffic Inj Prev. 2009;10(2):162-9. [Crossref]  [PubMed] 
  7. Bergeron J, Paquette M. Relationships between frequency of driving under the influence of cannabis, self-reported reckless driving and risk-taking behavior observed in a driving simulator. J Safety Res. 2014;49:19-24. [Crossref]  [PubMed] 
  8. Sussman S, McCuller WJ, Dent CW. The associations of social self-control, personality disorders, and demographics with drug use among high-risk youth. Addict Behav. 2003;28(6):1159-66. [Crossref] 
  9. Hingson RW, Heeren T, Edwards EM. Age at drinking onset, alcohol dependence, and their relation to drug use and dependence, driving under the influence of drugs, and motor-vehicle crash involvement because of drugs. J Stud Alcohol Drugs. 2008;69(2):192-201. [Crossref]  [PubMed] 
  10. Baron SW, Forde DR, Kay FM. Self-control, risky lifestyles, and situation: the role of opportunity and context in the general theory. J Crim Justice. 2007;35(2):119-36. [Crossref] 
  11. Maas A, Wippich C, Madea B, Hess C. Driving under the influence of synthetic phenethylamines: a case series. Int J Legal Med. 2015;129(5):997-1003. [Crossref]  [PubMed] 
  12. Kelly E, Darke S, Ross J. A review of drug use and driving: epidemiology, impairment, risk factors and risk perceptions. Drug Alcohol Rev. 2004;23(3):319-44. [Crossref]  [PubMed] 
  13. Busardo FP, Pichini S, Pellegrini M, Montana A, Lo Faro AF, Zaami S, et al. Correlation between blood and oral fluid psychoactive drug concentrations and cognitive impairment in driving under the influence of drugs. Curr Neuropharmacol. 2018;16(1):84-96. [Crossref]  [PubMed]  [PMC] 
  14. Elvik R. Risk of road accident associated with the use of drugs: a systematic review and meta-analysis of evidence from epidemiological studies. Accid Anal Prev. 2013;60:254-67. [Crossref]  [PubMed] 
  15. Quaglio G, Talamini G, Lechi A, Venturini L, Lugoboni F, Mezzelani P. Study of 2708 heroin-related deaths in north-eastern Italy 1985-98 to establish the main causes of death. Addiction. 2001;96(8):1127-37. [Crossref]  [PubMed] 
  16. Declues K, Perez S, Figueroa A. A 2-year study of ? 9-tetrahydrocannabinol concentrations in drivers: examining driving and field sobriety test performance. J Forensic Sci. 2016;61(6):1664-70. [Crossref]  [PubMed] 
  17. European Monitoring Centre for Drugs and Drug Addiction. European Drug Report 2016. EMCDDA-Europol Jt Publ; 2016. p.80.
  18. European Monitoring Centre for Drugs and Drug Addiction. Drug use, impaired driving and traffic accidents. 2nd ed. Vol. 8. Insight Series. Lisbon: Portugal: EMCDDA; 2014. p.1-196.
  19. Toennes S, Kauret GF, Steinmeyer S, Moeller MR. Driving under the influence of drugs--evaluation of analytical data of drugs in oral fluid, serum and urine, and correlation with impairment symptoms. Forensic Sci Int. 2005;152(2-3):149-55. [Crossref]  [PubMed] 
  20. Wille SM, Raes E, Lillsunde P, Gunnar T, Laloup M, Samyn N, et al. Relationship between oral fluid and blood concentrations of drugs of abuse in drivers suspected of driving under the influence of drugs. Ther Drug Monit. 2009;31(4):511-9. [Crossref]  [PubMed] 
  21. Busardo FP, Pichini S, Pellegrini M, Montana A, Lo Faro AF, Zaami S, et al. Correlation between blood and oral fluid psychoactive drug concentrations and cognitive impairment in driving under the influence of drugs. Curr Neuropharmacol. 2018;16(1):84-96. [Crossref]  [PubMed]  [PMC] 
  22. Vindenes V, Lund HM, Andresen W, Gjerde H, Ikdahl SE, Christophersen AS, et al. Detection of drugs of abuse in simultaneously collected oral fluid, urine and blood from Norwegian drug drivers. Forensic Sci Int. 2012;219(1-3):165-71. [Crossref]  [PubMed] 
  23. Drummer OH. Drug testing in oral fluid. Clin Biochem Rev. 2006;27(3):147-59.
  24. Oiestad EL, Johansen U, Christophersen AS. Drug screening of preserved oral fluid by liquid chromatography-tandem mass spectrometry. Clin Chem. 2007;53(2):300-9. [Crossref]  [PubMed] 
  25. Kato K, Hillsgrove M, Weinhold L, Gorelick DA, Darwin WD, Cone EJ. Cocaine and Metabolite Excretion in Saliva under Stimulated and Nonstimulated Conditions. J Anal Toxicol. 1993;17(6):338-41. [Crossref]  [PubMed] 
  26. Van der Linden T, Wille SM, Ramirez-Fernandez M, Verstraete AG, Samyn N. Roadside drug testing: comparison of two legal approaches in Belgium. Forensic Sci Int. 2015;249:148-55. [Crossref]  [PubMed] 
  27. Maurer HH. Mass spectrometric approaches in impaired driving toxicology. Anal Bioanal Chem. 2009;393(1):97-107. [Crossref]  [PubMed] 
  28. Maurer HH. Multi-analyte procedures for screening for and quantification of drugs in blood, plasma, or serum by liquid chromatography-single stage or tandem mass spectrometry (LC-MS or LC-MS/MS) relevant to clinical and forensic toxicology. Clin Biochem. 2005;38(4):310-8. [Crossref]  [PubMed] 
  29. Felli M, Martello S, Chiarotti M. LC-MS-MS method for simultaneous determination of THCCOOH and THCCOOH-glucuronide in urine: application to workplace confirmation tests. Forensic Sci Int. 2011;204(1-3):67-73. [Crossref]  [PubMed] 
  30. Wolff K, Johnston A. Cannabis use: a perspective in relation to the proposed UK drug-driving legislation. Drug Test Anal. 2014;6(1-2):143-54. [Crossref]  [PubMed] 
  31. Bondallaz P, Favrat B, Chtioui H, Fornari E, Maeder P, Giroud C. Cannabis and its effects on driving skills. Forensic Sci Int. 2016;268:92-102. [Crossref]  [PubMed] 
  32. Wong K, Brady JE, Li G. Establishing legal limits for driving under the influence of marijuana. Inj Epidemiol. 2014;1(1):26. [Crossref]  [PubMed]  [PMC] 
  33. Verstraete A, Knoche A, Jantos R, Skopp G, Gjerde H, Vindenes V, et al. Driving under the inflence of drugs, alcohol and medicines (DRUID): per se limits-methods of defining cut-off values for zero tolerance. IEEE Transactions on Biomedical Engineering. 2011;58.

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