Toronto Star

What cops get wrong about pot-impaired driving

- HASAN SHEIKH Dr. Hasan Sheikh is an emergency and addiction physician in Toronto, and a graduate student at the Harvard Kennedy School of Government.

With the legalizati­on of marijuana, pot holes aren’t the biggest concern on the road — pot-impaired drivers are. Police officers are desperatel­y trying to answer the question: is this driver high on cannabis?

With1-in-3 Canadians saying they have ridden in a car with a high driver, police chiefs pleaded for a rapid test for THC akin to the breathalyz­er for alcohol. Politician­s scrambled to approve a saliva screening test. But police chiefs are worried the test is unreliable and some are even refusing to use it.

Good. It was never the right test in the first place.

Police officers don’t need to detect marijuana use in drivers, they need to detect impairment — regardless of the drug or its legality.

Impaired driving kills an average of four Canadians every day. Impaired drivers have poor judgment, reaction time, co-ordination and motor skills. These are physical characteri­stics that require a physical test, not a microscopi­c one.

We can test impairment in driving simulators, and we can also test possible roadside predictors to develop the right test. A well-developed roadside test that focuses on global impairment will be better than any breathalyz­er, saliva test, or blood test. Best of all, it will be future proof.

There were THC-impaired drivers on the road prior to legalizati­on, and there will be THC-impaired drivers post legalizati­on. And there are impaired drivers on the road right now who aren’t using alcohol or marijuana. Opiates impair driving — and it doesn’t matter if it’s morphine prescribed by a doctor or heroin bought on the street. The legality of a substance doesn’t change its risk.

Police have no objective roadside test for opiates. Or for MDMA, ketamine, GHB, crystal meth, LSD, magic mushrooms or any future drug someone could take before getting behind the wheel.

Breathalyz­ers and blood levels aren’t perfect tests for safety, even for alcohol. That’s why in the emergency department, where I work, we don’t rely on blood tests to determine whether someone is intoxicate­d. We are trained to determine impairment clinically at the bedside.

Can police officers be trained to do clinical assessment­s like a doctor? Actually, they already are. Police officers use the standardiz­ed field sobriety test (SFST), which was developed to correlate with blood alcohol concentrat­ion.

The SFST has three parts. Two are fairly simple to assess: walking in a straight line and standing on one leg while doing a mental task. The third part is more complex and involves as assessment of involuntar­y eye jerks — and police officers do this complicate­d assessment regularly. With concerns over the roadside saliva test, police officers have begun to use the SFST to test for cannabis impairment.

Admittedly, there are significan­t flaws with the current SFST.

For alcohol, 1-in-10 times it determines that someone is safe to drive when they are actually above the legal limit. It performs even worse for other drugs, only identifyin­g half of people with high THC use. But it is important to understand that the SFST was developed to correlate specifical­ly with blood alcohol concentrat­ion, and not to correlate with impairment generally. And since blood levels don’t perfectly predict impairment, the SFST answered the wrong question in the first place.

Think about the last time you were on a crowded airplane. It’s stuffy and the person sitting next to you has monopolize­d the shared armrest. You can’t wait to land and get out. The pilot comes on the speaker and an announces that you only have 6,000 metres to go before you land. You don’t care about altitude, even though it’s correlated to thing you really care about: the time before you can get up and stretch your aching legs. Altitude is the right answer to the wrong question.

The legalizati­on of marijuana has highlighte­d that impaired driving is not just about alcohol. We shouldn’t repeat the same mistake now and make impaired driving just about alcohol and marijuana.

Our police officers shouldn’t be demanding a better saliva test for marijuana, they should be demanding better training at recognizin­g impaired driving regardless of the substance or its legality.

Our policy-makers need to see the big picture, and put resources into developing the right test to answer the right question: is this driver impaired?

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