Impairment related to blood amphetamine and/or methamphetamine concentrations in suspected drugged drivers.

Experimental studies have investigated effects of low oral doses of amphetamine and methamphetamine on psychomotor functions, while less work has been done on effects of high doses taken by abusers in real-life settings. There are indications that intake of high doses may impair traffic related skills, and that abuse of amphetamines may cause hypersomnolence at the end-of-binge. The present study aimed at investigating the concentration-effect relationship between blood amphetamines concentrations and impairment in a population of real-life users. Eight hundred and seventy-eight cases with amphetamine or methamphetamine as the only drugs present in the blood samples were selected from the impaired driver registry at The Norwegian Institute of Public Health. In each case the police physician had concluded on whether the driver was impaired or not. 27% of the drivers were judged as not impaired, while 73% were judged as impaired. There was a positive relationship between blood amphetamines concentrations and impairment. The relationship reached a ceiling at blood amphetamines concentrations of 0.27-0.53 mg/l. Younger drivers were more often judged impaired than older drivers at similar concentrations. Despite the performance enhancing qualities of amphetamines demonstrated in some low dose laboratory experiments; this study revealed a positive relationship between blood amphetamines concentration and traffic related impairment.

[1]  J. Oates,et al.  Dextroamphetamine. Evaluation of psychomimetic properties in man. , 1972, Archives of general psychiatry.

[2]  J. Mørland,et al.  Impairment due to intake of carisoprodol. , 2004, Drug and alcohol dependence.

[3]  H. S. Koelega Stimulant drugs and vigilance performance: a review , 2005, Psychopharmacology.

[4]  H. de Wit,et al.  Acute tolerance to subjective but not cardiovascular effects of d-amphetamine in normal, healthy men. , 1996, Journal of clinical psychopharmacology.

[5]  J Mørland,et al.  Driving under the Influence of Non-Alcohol Drugs. , 2020, Forensic science review.

[6]  W. H. Barr,et al.  Comparison of Methods for the Assessment of Central Nervous System Stimulant Response after Dextroamphetamine Administration to Healthy Male Volunteers , 1996, Journal of clinical pharmacology.

[7]  N. Volkow,et al.  Drug addiction: the neurobiology of behaviour gone awry , 2004, Nature Reviews Neuroscience.

[8]  A. Christophersen,et al.  Rearrest rates among Norwegian drugged drivers compared with drunken drivers. , 2002, Drug and alcohol dependence.

[9]  H. Gjerde,et al.  Determination of amphetamine and methamphetamine in blood by derivatization with perfluorooctanoyl chloride and gas chromatography/mass spectrometry. , 1993, Journal of analytical toxicology.

[10]  Jørg Mørland,et al.  Clinical impairment of benzodiazepines--relation between benzodiazepine concentrations and impairment in apprehended drivers. , 2002, Drug and alcohol dependence.

[11]  H. Moskowitz,et al.  Effects of Alcohol and Other Drugs on Driver Performance , 2004, Traffic injury prevention.

[12]  D J Crouch,et al.  Laboratory validation study of drug evaluation and classification program: alprazolam, d-amphetamine, codeine, and marijuana. , 1998, Journal of analytical toxicology.

[13]  O H Drummer DRUGS AND ACCIDENT RISK IN FATALLY-INJURED DRIVERS , 1995 .

[14]  June Corwin,et al.  Early pharmacokinetics and clinical effects of oral d-amphetamine in normal subjects , 1987, Biological Psychiatry.

[15]  S. Strakowski,et al.  Progressive behavioral response to repeated d-amphetamine challenge: further evidence for sensitization in humans , 1998, Biological Psychiatry.

[16]  H. Gjerde,et al.  Screening for drugs in forensic blood samples using EMIT urine assays. , 1990, Forensic science international.

[17]  T. Prapamontol,et al.  Lifetime correlates associated with amphetamine use among northern Thai men attending STD and HIV anonymous test sites. , 2002, Drug and alcohol dependence.

[18]  B. Logan,et al.  Methamphetamine and driving impairment. , 1996, Journal of forensic sciences.

[19]  Merete Grung,et al.  Increased mortality among previously apprehended drunken and drugged drivers. , 2002, Drug and Alcohol Dependence.

[20]  D. Segal,et al.  An Escalating Dose/Multiple High-Dose Binge Pattern of Amphetamine Administration Results in Differential Changes in the Extracellular Dopamine Response Profiles in Caudate-Putamen and Nucleus Accumbens , 1997, The Journal of Neuroscience.

[21]  H C Sing,et al.  The effects of d-amphetamine on arousal, cognition, and mood after prolonged total sleep deprivation. , 1989, Neuropsychopharmacology : official publication of the American College of Neuropsychopharmacology.

[22]  E. Änggård,et al.  Pharmacokinetic and clinical studies on amphetamine dependent subjects , 1970, European Journal of Clinical Pharmacology.

[23]  J. Caldwell,et al.  Utility of dextroamphetamine for attenuating the impact of sleep deprivation in pilots. , 2003, Aviation, space, and environmental medicine.

[24]  R. P. Maguire,et al.  Effects of high amphetamine dose on mood and cerebral glucose metabolism in normal volunteers using positron emission tomography (PET) , 1998, Psychiatry Research: Neuroimaging.

[25]  B. Logan,et al.  Methamphetamine - Effects on Human Performance and Behavior. , 2002, Forensic science review.

[26]  P. Swann,et al.  The involvement of drugs in drivers of motor vehicles killed in Australian road traffic crashes. , 2004, Accident; analysis and prevention.

[27]  B. Logan Amphetamines: an update on forensic issues. , 2001, Journal of analytical toxicology.

[28]  R. Mattick,et al.  Attention and memory in illicit amphetamine users. , 1997, Drug and alcohol dependence.

[29]  J. Mørland,et al.  Codeine and clinical impairment in samples in which morphine is not detected , 2003, European Journal of Clinical Pharmacology.

[30]  B. Rodda,et al.  Effects of marihuana‐dextroamphetamine combination , 1976, Clinical pharmacology and therapeutics.

[31]  S. Strakowski,et al.  Enhanced response to repeated d-amphetamine challenge: Evidence for behavioral sensitization in humans , 1996, Biological Psychiatry.

[32]  R. Croft,et al.  The effects of dexamphetamine on simulated driving performance , 2005, Psychopharmacology.

[33]  Ying Zhang,et al.  The Influence of Stimulants, Sedatives, and Fatigue on Tunnel Vision: Risk Factors for Driving and Piloting , 2001, Hum. Factors.

[34]  E. Kelly,et al.  A review of drug use and driving: epidemiology, impairment, risk factors and risk perceptions. , 2004, Drug and alcohol review.

[35]  H. Moskowitz,et al.  A review of the literature on the effects of low doses of alcohol on driving-related skills , 2000 .

[36]  H. de Wit,et al.  Subjective and behavioral effects of repeated d-amphetamine in humans. , 1999, Behavioural pharmacology.

[37]  M D Robertson,et al.  Responsibility analysis: a methodology to study the effects of drugs in driving. , 1994, Accident; analysis and prevention.

[38]  W. Pickworth,et al.  Effects of abused drugs on psychomotor performance. , 1997, Experimental and clinical psychopharmacology.

[39]  J. Mørland,et al.  Testing for benzodiazepine inebriation—relationship between benzodiazepine concentration and simple clinical tests for impairment in a sample of drugged drivers , 2003, European Journal of Clinical Pharmacology.

[40]  R. Croft,et al.  An evaluation of the sensitivity of the standardised field sobriety tests to detect the presence of amphetamine , 2005, Psychopharmacology.

[41]  T. Robinson,et al.  Enduring changes in brain and behavior produced by chronic amphetamine administration: A review and evaluation of animal models of amphetamine psychosis , 1986, Brain Research Reviews.

[42]  D. Segal,et al.  Repeated binge exposures to amphetamine and methamphetamine: behavioral and neurochemical characterization. , 1997, The Journal of pharmacology and experimental therapeutics.

[43]  B. Logan,et al.  Cause and manner of death in fatalities involving methamphetamine. , 1998, Journal of forensic sciences.

[44]  H. Ujike,et al.  Clinical Features of Sensitization to Methamphetamine Observed in Patients with Methamphetamine Dependence and Psychosis , 2004, Annals of the New York Academy of Sciences.

[45]  R. E. Hicks,et al.  Interaction between ethanol and dextroamphetamine: effects on psychomotor performance. , 1992, Alcoholism, clinical and experimental research.

[46]  L. Goldberg,et al.  Quantitative Studies on Alcohol Tolerance in Man. The Influence of Ethyl Alcohol on Sensory, Motor and Psychological Functions Referred to Blood Alcohol in Normal and Habituated Individuals. , 1943 .

[47]  A. Greenshaw,et al.  Relationship of plasma amphetamine levels to physiological, subjective, cognitive and biochemical measures in healthy volunteers , 2003, Human psychopharmacology.

[48]  M D Anglin,et al.  History of the Methamphetamine Problem , 2000, Journal of psychoactive drugs.

[49]  W. Ling,et al.  Cognitive impairment in individuals currently using methamphetamine. , 2000, The American journal on addictions.

[50]  L. Quan,et al.  Methamphetamine-related fatalities in forensic autopsy during 5 years in the southern half of Osaka city and surrounding areas. , 2000, Forensic science international.

[51]  M C Longo,et al.  The prevalence of alcohol, cannabinoids, benzodiazepines and stimulants amongst injured drivers and their role in driver culpability: part ii: the relationship between drug prevalence and drug concentration, and driver culpability. , 2000, Accident; analysis and prevention.

[52]  B. Everitt,et al.  Profiles of Cognitive Dysfunction in Chronic Amphetamine and Heroin Abusers , 2000, Neuropsychopharmacology.