Presentation to the Saskatchewan Special Committee on ...docs.legassembly.sk.ca/legdocs/Legislative... · • Presentation to the Saskatchewan Special Committee on Traffic Safety

www.ccsa.ca • www.cclt.ca

Presentation to the Saskatchewan

Special Committee on Traffic Safety

Doug Beirness, Ph.D.

Saskatoon SK

June 3, 2013

Overview

• Two Topics:

1. Alcohol-impaired driving

2. Drug-impaired driving

• Context

• Major issues within each

• Opportunities for change

• Evidence/rationale supporting change

• Recommendations/Suggestions

www.ccsa.ca • www.cclat.ca 2


Overview

Alcohol-impaired Driving

Background/Context

What works?

High visibility enforcement

Administrative sanctions

Alcohol ignition interlocks

Assessment & rehabilitation


Overview

Drug-impaired Driving

Background/Context

Issues/Areas of Concern

Surveillance

Enforcement

Administrative sanctions

Assessment & rehabilitation

Prevention

Context: Impaired Driving Laws

• Criminal Code of Canada • Driving while ability impaired by alcohol or drug

or a combination of alcohol and drugs

• Driving with a blood alcohol concentration (BAC)

over 80 mg/dL

• Refusing to comply with a demand for a sample of

breath, blood, urine or oral fluid or a demand to

participate in field sobriety tests or a drug

influence evaluation

Context: SK Provincial Legislation

Over 80 mg/dL

• Immediate 24 hr suspension

• 90 day administrative suspension

Over 40 mg/dL


New Drivers over 0 mg/dL (zero tolerance)

• 30 day suspension

Fail or refuse SFST



Magnitude of the Problem

From 2000 to 2010, 9175 people died in crashes on Canadian

roads involving a drinking driver

32,000 drinking drivers involved in serious injury crashes

Estimated $11 Billion in social costs per year

Surveillance

Windows on the problem


•Police charges

•Roadside surveys

•Crash-involved drivers

•Self-report surveys

http://www.google.ca/url?sa=i&rct=j&q=survey+icon&source=images&cd=&cad=rja&docid=vRxBuzsuBqLAKM&tbnid=NXCPSmXGz8cROM:&ved=0CAUQjRw&url=http://search.psjr.com/agentpage.xhtml?agentID=56449&ei=p4WnUY_gKMbRqQGeqIAI&bvm=bv.47244034,d.aWM&psig=AFQjCNEpKaMdmYrzD-W-HiJOMHeILe78fA&ust=1370019579865056

Self-reported Driving after Drinking

9

8.77.7 7.8 7.7

0

2

4

6

8

10

2008 2009 2010 2011

Source: Health Canada - CADUMS

2008 - 2011

Roadside Surveys

• Wed through Sat

• 9:00 PM to 3 AM

• 4 sites per night – 90 minutes each

• Set up survey site in parking lot

• police officer to direct traffic

• Response rates are high!

Purpose: To collect objective information

on alcohol (and drug) use by

drivers

Roadside Surveys:

Blood Alcohol Concentration

9.9

6.4

1.4 2.2

0

2

4

6

8

10

12

Alcohol Positive <50 50 - 80 >80

Perc

en

t

BAC mg/dL

Number and Rate of Impaired Driving

Charges: Canada (2006 – 2011)

79225 82718 80045 77645 80339 78370

74331 79513

84759 88630

84397 90277

0

50

100

150

200

250

0

20000

40000

60000

80000

100000

Number

Source: Statistics Canada Catalogue 85-002-X

Rate

Alcohol Use Among Fatally Injured Drivers (Canada: 2000 – 2010)

35.637.6 37.4

0

10

20

30

40

Percent SK=41.7%

Drinking Driver Fatalities

According to Age

0

10

20

30

40

50

60

16 -19 20 -24 25-34 35- 44 45 -54 55-64 65-74 75 +

Age Group

Percent

Alcohol Among Fatally Injured

Drivers: Canada 2000-2010

Tested Cases N=15,572

Alcohol

Negative

61.5% Alcohol

Positive

38.5%

BAC mg/dL

<50 11.5%

50-80 5.3%

80-160

26.8%

160+

56.4%

Alcohol Among Fatally Injured Drivers:

Saskatchewan 2000-2010

Tested Cases N=932

Alcohol

Negative

56.2% Alcohol

Positive

43.8%

BAC mg/dL

<50 10.5% 3.9%

80-160

21.3%

160+

64.5%

Countermeasures that Work

1. Administrative sanctions

2. Alcohol ignition interlocks

3. High profile intensive

enforcement

4. Assessment and rehabilitation


Administrative Sanctions

Already exist in SK

• Immediate 24 hr suspension for over 40 mg/dL

• Immediate 24 hr suspension followed by 90

suspension for BAC over 80 mg/dL

Is the room for improvement?

Can it be made more effective?



Canadian Council of Motor Transport Administrators (CCMTA) 2005 model for low BACs • Immediate 7-14 day suspension for over BAC over

50 mg/dL

• Confiscate licence and require a reinstatement fee

• More severe sanctions for repeat violations

• Ongoing public awareness and enforcement

Based on key components of deterrence –Swift, Certain, Severe


BC’s Immediate Roadside Prohibition (IRP)

September 2010 BC Introducted New


Warn Range (50-80 mg/dL)

3 day license suspension

3 day impoundment

Administrative Penalty ($200)

Reinstatement fee ($250)

Towing and Storage ($150+)

Total = $600

2010 Legislation – Immediate Roadside

Prohibition (IRP)

Fail Range (>80 mg/dL)

90 day license suspension

30 day impoundment

Administrative Penalty ($500)

Reinstatement fee ($250)

Towing and Storage ($680+)

Responsible Driver Program ($880)

Interlock ($1730)

Total = $4040

Evaluation: Does it work?

Roadside Surveys

• June 2010 – prior to new IRP

• June 2012 – following new IRP

• Surveys dating back to 1995

Alcohol-involved Fatalities

• Before and after IRP


Roadside Surveys:

Blood Alcohol Concentration

9.9

6.4

1.4 2.2

6.5

4.5

1.1 0.9

0

2

4

6

8

10

12

Alcohol Positive <50 50 - 80 >80

Perc

en

t

2010

2012

BAC mg/dL

59%

35%

Roadside Surveys:

Percent of Drivers with BACs > 80 mg%*

2.0 2.0 1.9

2.9 2.7

2.4

0.6

0.0

0.5

1.0

1.5

2.0

2.5

3.0

1995 1998 2003 2006 2008 2010 2012

* Vancouver and Saanich only

75%

Number of Alcohol-involved Fatalities:

October 2005 – September 2012

116 127

112

95

118

66 58

0

25

50

75

100

125

05/06 06/07 07/08 08/09 09/10 10/11 11/12

29.5%

Alcohol Ignition Interlocks

1970:

Solution to the alcohol-crash

problem was a car that “Drunks

couldn’t drive”


Breath test device linked to the vehicle’s ignition to prevent it from being started by someone who has had too much to drink

What is it?

Do interlocks work?

1. Do interlock devices work? • Technical Standards for interlock devices

• Advanced technology prevents driver with BAC .01% over set point from driving 90% of the time

• Anti-circumvention features built into device

2. Are they effective? • Several studies all show reduced recidivism

among interlock participants relative to control groups

• Up to 90% fewer repeat offences among interlock participants

Repeat Offenders Survival Rate

80

82

84

86

88

90

92

94

96

98

100

3 months 6 months 12 months 24 months

% n

ot

recid

ivati

ng

Interlock Period

3 months 6 months 12 months 24 months

After Interlock Period

Interlock

Suspended Interlock

Suspended

Ineligible

Cochrane Review of Interlocks


Centers for Disease Control Review

• “Strong evidence” that interlocks are effective in

reducing re-arrest rates

• Limited evidence that interlocks reduce alcohol-

related crashes

• Potential for interlocks to have significant impact

on impaired driving limited by the small

proportion of offenders who participate in

programs

• Link with rehabilitation


Am J Preventive Medicine 2011;40(3); 362-76

Interlocks in SK

• Voluntary program

• Offenders can reduce the period of

suspension by participating in interlock

program

• Approximately 500 interlock installations

per year

• Only 7% of offenders!!

• There is room for improvement


Maximizing the Impact of Interlocks

Best Practices

• Perspective

• Purpose, rationale, guiding principles

• Form of incapacitation, not punishment

• Interlock is just a device. It cannot do more than

it was made to do.

• Interlocks are part of a comprehensive program

that includes education, rehabilitation, and

behaviour change


Maximizing the Impact of Interlocks

• Mandatory participation for all convicted

offenders – including “first” offenders!

• Minimum installation of 12 months

• Behaviour-based criterion for removal –

make participants prove that they no

longer require the device before it is

removed

• Integrate interlock program with

rehabilitation program


High Visibility Intensive Enforcement

• Police Checkpoints

• Purpose is deterrence

• Create real probability of detection

• Requires publicity

• Identify and charge violators


High Visibility Intensive Enforcement

• Effectiveness

• US studies show up to 20% reduction in

fatal crashes associated with intensive

enforcement

• For every $1 invested in intensive

enforcement, $3.4 - $6 saved

• Publicity is a key element


Screening, Assessment & Rehabilitation

• Alcohol abuse is a major contributing

factor

• Breaking the cycle is critical

• Evidence shows 8% benefit of

rehabilitation programs

• More comprehensive/inclusive programs

are better

• Need to review current system to

determine if it could be improved


Recommendations

1. Strengthen administrative sanctions

2. Make interlock program mandatory for all

offenders

3. Integrate interlock program with rehabilitation

4. Enhance high visibility enforcement

5. Review current system of

screening/assessment and rehabilitation

6. Ensure all high BAC offenders complete

rehabilitation www.ccsa.ca • www.cclat.ca 38




Background/Context

Issues/Areas of Concern

Surveillance

Policy and Legislation

Enforcement

• Training - DEC/SFST/ARIDE

Assessment & Rehabilitation

Prevention


Starting Points


Related but different than alcohol

60+ years of research on alcohol

In retrospect, alcohol was “easy”

Drugs present a much more complex series

of problems

Extent of information pales in comparison

with that on alcohol

What’s a Drug?

LSD

Illicit Drugs Pharmaceuticals

•LSD

•Crack

•Ecstasy

•Heroin

•Anti-

depressants

•Anti-

psychotics

Oxycodone Amphetamine

Ketamine

Dextromethorphan

Cannabis

Methamphetamine

Fentanyl

What’s a Drug?

A “Drug” is any substance

which, when taken into the

human body, can impair the

ability of the person to operate a

vehicle safely.

Surveillance

Windows on the problem


•Police charges

•Roadside surveys

•Crash-involved drivers

•Self-report surveys

http://www.google.ca/url?sa=i&rct=j&q=survey+icon&source=images&cd=&cad=rja&docid=vRxBuzsuBqLAKM&tbnid=NXCPSmXGz8cROM:&ved=0CAUQjRw&url=http://search.psjr.com/agentpage.xhtml?agentID=56449&ei=p4WnUY_gKMbRqQGeqIAI&bvm=bv.47244034,d.aWM&psig=AFQjCNEpKaMdmYrzD-W-HiJOMHeILe78fA&ust=1370019579865056

Self-report Data

45 Source: Health Canada - CADUMS

2008 - 2011

8.79.0

7.87.7

2.82.4

2.6

2.2

0

1

2

3

4

5

6

7

8

9

10

2008 2009 2010 2011

Drive After Drinking

Drive After Cannabis

Driving After Drinking and Driving After

Driving after Alcohol or Cannabis

According to Age

10.7

9.6

7.9

9.7

6.3

12.6

4.0

1.6 1.5 1.4

0

2

4

6

8

10

12

14

15-24 25-34 35-44 45-54 55-64

Drive after Drinking

Drive after Cannabis

Source:

Health Canada - CADUMS 2011

Age

Percent

www.ccsa.ca • www.cclat.ca

Roadside Surveys

• BC 2008, 2010, 2012

• Collected oral fluid samples as

well as breath

• > 70% of drivers provide a

sample

• Sent to a lab for analysis

• Tested for:

– Cannabis

– Cocaine

– Opiates

– Amphetamine

– Benzodiazepines 47

www.ccsa.ca • www.cclat.ca

Roadside Surveys

• Drug Positive = 8.1%

Cannabis

Cocaine

Opiates

48

Fatally Injured Drivers

• Substances classified into 7 categories used by the Drug Evaluation and Classification program CNS Depressants (e.g., benzodiazepines) Inhalants (e.g., toluene, nitrous oxide) Dissociative Anaesthetics (e.g., ketamine, PCP) Cannabis CNS Stimulants (e.g., cocaine, amphetamines) Hallucinogens (e.g., LSD, ecstasy) Narcotic Analgesics (e.g., codeine, oxycontin)


Drug and Alcohol Use Among Fatally Injured Drivers

36.6

40.9

29.7

35.3

0

5

10

15

20

25

30

35

40

45

2000 2001 2002 2003 2004 2005 2006 2007 2008 2009

Alcohol

Drugs

Percent

Drug and Alcohol Positive Driver Fatalities According to Age

16.3

28.426.7

25.224.0

17.1

10.8

18.8

15.9 16.4

19.2 18.917.9

19.5

0

5

10

15

20

25

30

≤18 19 -24 25-34 35- 44 45 -54 55-64 65+

Alcohol Only

Drugs Only

51

Percent

Driver Fatalities Positive for Drugs or Alcohol According to Day of Week

17.115.3

16.518.7

23.0

33.7

28.9

20.923.2

21.1

17.9 17.5

13.314.9

0

5

10

15

20

25

30

35

Mon Tue Wed Thu Fri Sat Sun

Alcohol

Drugs

52

Percent

Day of Week

Percent of Driver Fatalities Positive for Drugs or Alcohol Positive According to Time of Crash

13.1

6.58.9

13.7

27.0

33.9

40.043.8

23.426.4

23.4 21.7

15.812.4

9.6 10.4

0

10

20

30

40

50

6-9 9-12 12-15 15-18 18-21 21-00 00-3 3-6

Alcohol

Drugs

53

Percent

Crash Time

Drugs Among Fatally Injured Drivers:

Canada 2000-2010

Tested Cases N=9,547

Drug

Negative

66.3% Drug

Positive

33.7%

Drug Type

Stim 6.3%

Dep 17.7%

Cannabis

36.9%

Polydrug

34.3%

Opiates 3.5%

Drug Use According to Age Group

0

10

20

30

40

50

60

70

80

16-19 20-24 25-34 35-44 45-54 55-64 64-75 75+

Depressant

Cannabis

Stimulant

Narcotic


Key Action Areas

1. Legislation/Policy

What is it we’re trying to control?


2. Surveillance

Understand the magnitude and nature of the problem

3. Enforcement

Drug Evaluation and Classification Program

4. Prevention

Target groups

Focus

Policy and Legislation

• Keep focus on road safety, not drug control

• Criminal Code Amendments 2008 gave police the powers and tools necessary to enforce drug-impaired driving

• Provincial sanctions lag behind, creating disparity

• Administrative suspensions

• SK provides 24 hr suspension for failing SFST


Surveillance

• Need to know more about the nature and

magnitude of the problem

• Monitor drug use among drivers involved in

crashes

– Coroner data

– Hospital data

– Police data

• Roadside survey


Enforcement

• 2008 Legislation provided police with

authority to demand a driver submit to:

Standardized Field Sobriety Test

(SFST)

Drug Influence Evaluation by a Drug

Recognition Expert (DRE)

SK has 27 active DREs


SFST

• Horizontal Gaze Nystagmus

• One-leg Stand

• Walk-and-Turn


http://www.google.ca/imgres?imgurl=http://massduitriallawyer.com/blog/wp-content/uploads/2011/09/mass_dui_attorney_sobriety.jpg&imgrefurl=http://massduitriallawyer.com/blog/dui-defense-challenge-the-standard-field-sobriety-test/&docid=vVlVwjmifUWtfM&tbnid=yQMKEqq2p8PPZM:&w=298&h=203&ei=rxmqUZjWHpKTqwGe64DABw&ved=0CAIQxiAwAA&iact=rics

http://daxlegal.com/dwi-tips-info/sobriety-testing-information/

Drug Evaluation and Classification (DEC)

• Systematic and standardized assessment of drug influence

• 12-step process assessing both clinical and psychophysical indicators of drug influence

• Purpose is to determine impairment and the drug category responsible for the impairment

• Concludes with the demand for a sample of bodily fluid for analysis of drug content to confirm officer’s opinion

• 2-week training course plus certification as a Drug Recognition Expert (DRE)


DEC Program – Issues for Action

Training – lengthy, expensive, demanding

Training will become responsibility of provinces

Need to take steps to ensure strong, sustainable

program with a core of DREs and instructors

Enhance training for patrol officers in the

detection of signs and symptoms of drug use

that can form the basis of “suspicion” and

“reasonable and probable grounds” of drug

impairment


Assessment and Rehabilitation

• Screening and Assessment

– Specific to different patterns of drug use

• Driving Without Impairment course

– 16 hours, $150

– Focus on alcohol

• Treatment/Rehabilitation

– Brief interventions


http://www.google.ca/url?sa=i&rct=j&q=counselling+session&source=images&cd=&cad=rja&docid=5K3Va1zo2XS1WM&tbnid=Qk2A81mrJSO_NM:&ved=0CAUQjRw&url=http://www.swinburne.edu.au/stuserv/counselling/swin_ecounselling/resources/counselling.htm&ei=Hy6qUaWpOoHnqgG6_IDgAw&bvm=bv.47244034,d.aWM&psig=AFQjCNHMytmVqekbWcA9u_5W0yLTNVjJJA&ust=1370193738363844

Prevention

• Not simply a matter of changing

“Don’t Drink and Drive”

messages to include drugs

• Specific, targeted messages

Youth

Seniors

Health care providers

Those who mix drugs and

alcohol

• Opportunities abound


Suggestions

1. Administrative sanctions

2. Create structure for a strong DRE

program

3. Review Assessment/Treatment and

ensure programs for drug-impaired

drivers

4. Facilitate Prevention activities

5. Roadside Survey


Documents

Presentation to the Saskatchewan Special Committee on ...docs.legassembly.sk.ca/legdocs/Legislative... · • Presentation to the Saskatchewan Special Committee on Traffic Safety