10 Worst Drinking Trends of 2010

Glad to see Four Loko made the list!

Merry Christmas!

Wishing everyone a wonderful holiday filled with joy, magic and friends and family!

The Trouble with DUID: Part II

So in the last post we began our discussion on DUID and some of the many problems that go along with the legislation involved to enforce it. We spoke of how legislation is often reactionary and because of that only focuses on the minutia and not the overall concern.

So what is our concern with DUID?

I would hazard a guess and say that our concern is that we do not want potentially dangerous people driving on our roads, and by having a DUID law we have said that people using drugs fit into that category of dangerous people.

So what's the problem? Well, lots of people are on "drugs" in this country at any one time. Does that mean that anyone using a prescription drug should be banned from driving? The legislature clearly doesn't want that, and I agree that would go too far. Some prescription drugs are impairing and others are not. How do we know that the person is impaired? With drugs, impairment seems to occur at different levels in different people, making per se limits controversial even in the scientific community.

Some countries have operators accused of DUID examined by doctors at arrest and have the doctor determine whether they are impaired or not, which is then confirmed by blood test. In this country we have a DRE program, which in theory, should do the same thing. Specially trained officers certified by this program are trained to conduct a 12 point exam to determine whether a person is impaired by drugs or not. The blood is then tested to confirm their observations.

So that should solve it right? Well, no and for two reasons.

#1. In our state at least the statute states that when drugs are involved, the operator must be incapable of operating safely. So, if the subject crashed their car and they are under the influence of an illegal drug, then great! The reality is that's not what you see most often. What if the drug they're using is prescription and within therapeutic ranges? Are they impaired or not? It depends. What about on a snowy day where lots of car crashes have occurred? Can you prove it was the drug and not the snow?

#2. DRE's are often told to ensure they don't make errors to simply have the blood screened for everything. Ok. Now what? Although it's not the intention, screening for everything implies that they cannot determine the impairment or at least what caused it. Is it enough for them simply to see impairment without knowing what drug or class of drug caused it? That depends on how we want to use the information. Don't get me wrong, I think the DRE program is an excellent system with well trained officers. I just think it's not always used to it's fullest potential.

Now, if the statute was like the alcohol statute where impairment was to the slightest degree rather than incapable of operating safely, I think the DRE program would be able to work more effectively. We would have a subject suspected of impairment from drugs, the DRE would confirm they were impaired and the test result would support the observations. Then it wouldn't matter so much whether they were stopped for speeding or for crashing their car.

The trouble with impairment in driving however is that there are many things that will impair your driving and most aren't illegal. Experience, age, fatigue, distraction. People have tried to address issues like these by banning hand held cell phones only to find that it's the actual conversation that distracts people and not the holding of the phone.Others are in the same boat as prescription drugs, we don't want to ban grandma from driving just because this happens.

So what do we do?

I'm not going to pretend I know the answer to that. But I do believe it's time that we start looking at the big picture rather than chasing lists. The idea of banning any chemical which binds to a certain receptor is an interesting idea, and it is going towards the right direction of thinking about the problem rather than the specific instant.

It's something to think about anyway.

The Trouble with DUID: Part I

Five years ago, give or take, when Vermont was first getting a DRE ("Drug Recognition Evaluator" formerly "Drug Recognition Expert") program I did a presentation for my colleagues entitled "The Trouble with DUID." With the recent talk of banning Four Loko and dealing with the "Spice" issue, which I will save to discuss in detail later, it's gotten me thinking again about that presentation and the issue of legislation.

Legislation, as with any move from government agencies it seems, is very reactionary in it's nature. "Oh my God, here's one instance of something that happened, quick ban it!" Maybe a bit of a dramatization, but it certainly seems that way. Don't believe me? Look up www.stupidlaws.com. You'll note that in Vermont at one time it was illegal to tie a giraffe to a telephone pole. Think that was reactionary? Or another example. How about the TSA screening procedures?

What has the focus been on the Four Loko ban? Look at any of the articles or the bills being introduced and you will see the focus is on the caffeine and the brightly colored packaging. Were those college kids hospitalized for caffeine intoxication? No, it was alcohol poisoning. My prediction is that the bills will ban caffeine containing alcoholic beverages. My second prediction is that Four Loko will simply drop the caffeine, add a little more guarana and be back on the shelves in no time. Leaving the problem of a 12% alcohol 24 ounce pop top beverage that will still be intriguing due to it's low price and high alcohol content.

The same thing is occurring with Spice. There are 400 variations of the synthetic THC used, but the lawmakers are all busily making lists of chemicals to ban. Chemicals that they are seeing now. They'll ban those few that are common place now, leaving the rest legal. The manufacturers will simply switch variations and it will be legal again. A presenter at NEAFS presented an interesting idea. Simply ban anything that binds to the cannabinoid receptor. Then every variation is, by mechanism of action, illegal.

So what does that have to do with DUID? Driving Under the Influence of Drugs for those not familiar with the acronym. Well, several years ago, I was presented with pending legislation to change the DUID statute in Vermont. We were asked to review and comment on the wording. The bill wasn't original. It was adapted from another state and followed a similar pattern and a poor one at that. It simply listed drugs that were no-nos. This created a problem for some. #1 Drugs that were Schedule I were less of an issue, since they are already illegal, but the legislature wanted numbers like the per se limits in the DUI laws. #2 Those drugs that had therapeutic uses were concerning. The legislature did not want to make it illegal for someone to drive "legally impaired."

That phrase absolutely screeches in my head like nails on a chalkboard. I'm sure I'd feel much better if a friend or family member were killed by someone driving "legally impaired." What they meant was that they felt that people who were prescribed medication should not be banned from driving since they were given the drug legally by their doctor. Some how the fact that those medications all come with warnings that people should not operate motor vehicles was irrelevant. The biggest problem with this is our country's love affair with pharmaceuticals, but that's a separate issue.

Anyways, I digress. Alcohol is a nice clean, linear, neat drug. The effects are universal and occur at vice nice linear progressions until at the highest level death occurs. Per se limits can be put into effect because ethanol's affect on people is very consistent. Drugs don't follow this pattern. They don't all affect people linearly nor have the same effects on every person. This makes per se limits very difficult to impose. Factoring in as well that people don't want to ban therapeutic levels of drugs, it's a complicated issue.

I think when we focus on lists and per se limits we're starting to be unable to see the forest for the trees. In Vermont, the DUI laws indicate that a person can not operate a motor vehicle when they are under the influence of alcohol to the slightest degree. The drug law however, states that the person must be unable to operate a motor vehicle safely. That is a huge discrepancy and due in part to the difficulties stated above. Unless someone crashes their car with an illegal drug in their blood at a high level, it's difficult to prove that the drug caused it.

On the next post we'll continue from there and continue to outline the Trouble with DUID.

Friday Cartoon!

Splash Patterns- Detecting a Hoax

Every once in a while a story appears in the crime section that stuns everyone as to it's apparently random and horrible nature. How horrible that something like that could occur just for the sake of doing it! The random nature certainly puts a certain amount of fear into the public. If it's random then by it's very definition it could happen to anyone. Crimes of passion we understand. Those involved are already involved, they're not chosen at random.

Some times these random acts are real and truly horrible. One of these occurred in the town I was living in shortly after college where a man snapped for lack of a better word. After killing his cat he decided to kill the first person that passed his house, and he did. It was tragic and the work of a very sick mind.

More often then not however we find that these stories are hoaxes. The wounds, if there are any, have actually been self inflicted. Further works of sick minds, but at least not to the public. One of these occurred on Halloween of this year where a man reported that someone trick-or-treating in a gorilla costume stabbed him when he opened the door. Just thinking, innocently opening your door to hand out candy, and what do you get but stabbed for your efforts! How terrible! Well, turns out it was all a hoax. After further questioning, he confessed that he had stabbed himself.

Another story which made national news follows a similar pattern. Just a random girl out celebrating a new job and a woman throws acid in her face! How terrible! Why her? There's no connection! It could have been me. Well...maybe not so much. Although her story held up longer than our gorilla man, it did fall apart eventually. Part of what made it fall apart was good old fashion forensics.

So often these stories fall apart. Officers questioning them find holes in the story or inconsistencies. So too is this true in forensics. Although my testimony is focused on toxicology I am often asked, is this consistent? Is the story consistent with the test result? Is the behavior consistent with dose? In the case of the acid splash it was, are these burns consistent with acid being thrown into someone's face?

Well, actually it doesn't take a lot of training to see that no, they are not consistent. Let's forgive the fact that she was wearing sunglasses at night, a girl has to celebrate a new job somehow! Ok, so her eyes are protected. Well, let's look at the rest of her face. To me, it looks like an acid peel gone horribly wrong. Her hair and neck are untouched. Well, if the acid was thrown it should have splashed not only against her face but also her hair, neck and chest. What about her lips? Ok, sunglasses, we got the eyes, but her lips? Extra strength chapstick maybe? No. They make no mention of her clothes, but I would bet those too were untouched. Have worked for several years in a metals lab I can tell you what acid does to clothes. It would be noticeable. The burns look as if they were applied along her face rather than thrown at her and indeed, that is how it was. She put on a pair of gloves and swabbed her face.

One of the arguments I've scene made against this type of forensic work is that it's subjective. I know it when I see it. Well...Yeah. Why is that a "bad" thing though?  I would hope that if I were having surgery my surgeon would know it when he sees it. Just as the stories given in interviews to Officers must be consistent so too must the stories be consistent with the resulting data, injury, etc. It's actually a simple concept and one that must be relayed to attorneys, judges and juries. Science isn't always a mysterious, scary concept!