Driving under the influence of chlormethiazole

This article describes a case of driving under the influence of the sedative-hypnotic-anticonvulsant drug chlormethiazole. The suspect, who was a physician, was driving dangerously on a busy highway and caused a traffic collision. When apprehended by the police, the man had bloodshot and glazed eyes and pupil size was enlarged. He could not answer the questions properly and his gait was unsteady. A roadside breath-alcohol screening test was positive but an evidential breath-alcohol test conducted about one hour later was below the legal limit for driving of 0.10 mg/L (10 microg/100 mL or 0.021 g/210 L). Because of the special circumstances of the traffic crash and the man's appearance and behaviour, the police suspected that drugs other than alcohol were involved and obtained a venous blood sample for toxicological analysis. The blood contained 0.23 mg/g alcohol, which is above the legal limit for driving in Sweden 0.20 mg/g (20 mg/100 mL or 0.020 g/100 mL), and codeine was also present at a therapeutic concentration of 0.02 mg/L. The conflict between the clinical signs of impairment and the toxicology report prompted a reanalysis of the blood sample with major focus on sedative-hypnotic drugs. Analysis by capillary GC-NPD identified chlormethiazole at a concentration of 5mg/L, the highest so far encountered in traffic cases in Sweden. In 13 other impaired driving cases over 10 years the mean (median) and range of concentrations of chlormethiazole were 1.6 mg/L (1.6 mg/L) and 0.3-3.3 mg/L. This case report underscores the need to consider clinical observations and the person's behaviour in relation to the toxicology report when interpreting and testifying in drug-impaired driving cases.     

Driving under the influence of amphetamine-like drugs

Scientific opinions differ whether the use of stimulants causes deterioration in driving skills. In 1857 of 8709 cases of driving under the influence of drugs, amphetamine-like drugs (amphetamine, methamphetamine, and methylendioxyamphetamine) were present either alone or together with other licit or illicit drugs. In 338 cases, amphetamines were the only psychoactive substance group in plasma at mean, median, and highest concentrations of 0.18, 0.12, and 1.05 mg/L, respectively. A widespread opinion is that after the consumption of amphetamines, centrally stimulating effects with corresponding consequences on safe driving are expected. In contrast, many cases were observed that rather suggested an influence of centrally sedating substances when considering the psycho-physical conditions. Relations between concentration and effect could not be established. The apparent sedation is probably the consequence of sleep deprivation during an amphetamine binge and the after-effects of the drug.     

Driving under the influence of alcohol: a sequence analysis approach

Driving under the influence of alcohol is a contributing factor to a number of road traffic accidents. There is, however, a lack of research into the behaviours that lead to drink driving. The current research used a novel approach, behaviour sequence analysis, to investigate the chains of behaviours that lead to drink driving. Statements were taken from individuals (N?=?60) in an interview, reporting a time they had consumed alcohol and driven a vehicle. Statements were coded and the sequences of behavioural pairs were analysed. Results were presented in a state transition diagram, and indicated a variety of behavioural sequences leading to drink driving. A significant chain of events showed that individuals who had attempted to calculate their blood alcohol concentration and then drive a vehicle felt unsafe to drive, after driving. Also, many individuals did not intend to drink and drive; however, influences such as peer pressure and being surrounded by alcohol lead to them being more likely to consume multiple alcoholic drinks, and then drive a vehicle. The current research outlines future research, and implications for polices and laws on behaviours that surround drink driving, as well as providing a new method for research.     

Driving under the influence of khat--alkaloid concentrations and observations in forensic cases

The use of the herbal stimulant khat (Catha edulis FORSK) is maintained by immigrants from countries where it is part of their cultural life (Arabian Peninsula and eastern Africa). In western countries the drug and its effects are largely unknown and no experience in evaluating impairment symptoms due to the khat-alkaloids, e.g. cathinone, cathine and norephedrine exists. Blood and urine samples from khat users involved in 19 cases of suspected driving under the influence of drugs were analysed and correlated with the results of medical examination and police officer reports. In 3 cases impaired driving and in 10 cases marked impairment of psychophysical functions was observed such as effects on the nervous system (slow pupil reaction to light, dry mouth, increased heart-rate), trembling, restlessness/nervousness, daze/apathy/dullness, impairment of attention, walking and standing on one leg. However, the alkaloid concentrations assayed in blood did not correlate with the impairment symptoms. Apart from an acute phase of indirect sympathomimetic action the development of habituation and withdrawal symptoms must also be considered in explaining the diversity of effects observed. From these results it can be concluded that chewing khat may severely impair driving ability, but may also be without noticeable effects.     

Driving under the influence in Greece: a 7-year survey (1998-2004)

Alcohol is one of the main causes of traffic accidents worldwide. Its use decreases significantly the driving ability of an individual increasing in this way the possibilities of their involvement in motor-vehicle accidents. The above possibilities are increased when a psychoactive substance has been taken in combination with alcohol due to their synergistic effect. The Laboratory of Forensic Medicine and Toxicology of the University of Athens is authorized to perform the toxicological investigation of traffic accidents that happen in the southern part of Greece. The objective of the present study was to identify the prevalence of alcohol and other psychoactive substances among drivers involved in road traffic accidents in Greece during the period 1998-2004. Alcohol was detected in the blood of about 37% of the drivers involved in traffic accident during the years 1998-2000. The detection of alcohol was lower (29%) in the years 2001-2004. Cannabis, benzodiazepines, opiates, and cocaine were found in 4%, 4%, 4% and 1% of the total number of cases, respectively. The above values were compared with those of a previous study concerning the period 1995-1997 and the reasons for the reduction of the number of alcohol-related traffic accidents during the last years are discussed.     

严格责任下的醉驾型危险驾驶罪

醉驾行为与危害结果之间的关联性并不贴合犯罪故意中"必然会"或"可能会"的紧密程度,醉驾人对危害结果也并不持有"追求或放任"的意志因素,因此醉驾型危险驾驶罪不属于我国《刑法》规定的故意犯罪。同时,现行规定不要求醉驾型危险驾驶罪的构成需要危害结果已经发生,因此也不属于传统理论上的过失犯罪。实际上,我国《刑法》对醉驾型危险驾驶罪作如此规定,是为了凸显刑法对醉驾行为最为严厉的惩罚性,是一种突破我国传统刑法罪过理论的立法模式,与英美刑法的严格责任有相通之处。     

Driving under the influence of alcohol and/or drugs in the Netherlands 1995-1998 in view of the German and Belgian legislation

This study presents the test results of blood and urine samples of impaired drivers in the Netherlands between January 1995 and December 1998. In this period, the blood alcohol concentrations of 11,458 samples have been determined and 1665 blood or urine samples have been analysed for drugs. The median alcohol concentration was between 1.7 and 1.8 mg/ml blood. In 80% of the 1665 analysed samples drugs were detected. At least 42% (702/1665) of the impaired drivers were poly-drug users, with cocaine present in the most frequent combinations. In the Netherlands, the procedure to prove driving under the influence is complex. This procedure can be made more efficient and more effective by embedding the analytical test results, needed to prosecute an impaired driver, in the law. In Belgium and Germany, such laws already are in force. If we would apply the qualifications of the new Belgian law on our analytical data, 67% of the impaired drivers included in this comparison could have been prosecuted without discussion in court.     

Driving under the influence of alcohol and/or drugs in the Netherlands 1995–1998 in view of the German and Belgian legislation

This study presents the test results of blood and urine samples of impaired drivers in the Netherlands between January 1995 and December 1998. In this period, the blood alcohol concentrations of 11,458 samples have been determined and 1665 blood or urine samples have been analysed for drugs. The median alcohol concentration was between 1.7 and 1.8 mg/ml blood. In 80% of the 1665 analysed samples drugs were detected. At least 42% (702/1665) of the impaired drivers were poly-drug users, with cocaine present in the most frequent combinations. In the Netherlands, the procedure to prove driving under the influence is complex. This procedure can be made more efficient and more effective by embedding the analytical test results, needed to prosecute an impaired driver, in the law. In Belgium and Germany, such laws already are in force. If we would apply the qualifications of the new Belgian law on our analytical data, 67% of the impaired drivers included in this comparison could have been prosecuted without discussion in court.     

Driving under the influence of drugs -- evaluation of analytical data of drugs in oral fluid, serum and urine, and correlation with impairment symptoms

A study was performed to acquire urine, serum and oral fluid samples in cases of suspected driving under the influence of drugs of abuse. Oral fluid was collected using a novel sampling/testing device (Dr?ger DrugTest System). The aim of the study was to evaluate oral fluid and urine as a predictor of blood samples positive for drugs and impairment symptoms. Analysis for cannabinoids, amphetamine and its derivatives, opiates and cocaine was performed in urine using the Mahsan Kombi/DOA4-test, in serum using immunoassay and gas chromatography-mass spectrometry (GC-MS) confirmation and in oral fluid by GC-MS. Police and medical officer observations of impairment symptoms were rated and evaluated using a threshold value for the classification of driving inability. Accuracy in correlating drug detection in oral fluid and serum were >90% for all substances and also >90% in urine and serum except for THC (71.0%). Of the cases with oral fluid positive for any drug 97.1% of corresponding serum samples were also positive for at least one drug; of drug-positive urine samples this were only 82.4%. In 119 of 146 cases, impairment symptoms above threshold were observed (81.5%). Of the cases with drugs detected in serum, 19.1% appeared not impaired which were the same with drug-positive oral fluid while more persons with drug-positive urine samples appeared uninfluenced (32.7%). The data demonstrate that oral fluid is superior to urine in correlating with serum analytical data and impairment symptoms of drivers under the influence of drugs of abuse.     

An unusual case of driving under the influence of enflurane

An unusual case of driving under the influence of the volatile anaesthetic enflurane is reported. A markedly affected anaesthetist was sniffing at an enflurane-moistened handkerchief before he crashed into a lorry at a red traffic light. In the blood sample enflurane (2.92 mg/l) as well as diclofenac (0.28 mg/l) and 4-aminophenazone (24.4 mg/l) were found. The way of driving and the accident and the deficiency symptoms could be explained by the central suppressing effects of enflurane. The physician was considered as impaired and not suitable to drive at the time of the incidence.     

Driving with the Handbrake On: Competition Class Actions under the Consumer Rights Act 2015

This paper examines the new class action procedure for competition cases established by the Consumer Rights Act 2015. It examines whether the legislation and the procedural rules for the Competition Appeal Tribunal address the failures of previous procedures, focusing on three issues in particular i) the treatment of conflicting interests amongst class members ii) the rules on certifying collective proceedings; and iii) rules on funding. It argues that while the Act is a considerable improvement on what preceded it, the safeguards adopted will act as a drag on meritorious and unmeritorious claims alike, and as such there is likely to be continued under‐enforcement of competition law.     

醉驾案件中醉酒标准认定之思考

目前,司法机关对危险驾驶犯罪的醉酒认定标准较为宽松,导致实践中部分无社会危害性的行为被纳入犯罪圈。为贯彻新时代良法善治的刑事司法理念,对危险驾驶犯罪中醉酒标准的认定应持审慎态度,建议借助证据法遏止醉酒驾驶行为过度犯罪化倾向,对于危险驾驶犯罪中的醉酒认定不宜过度依赖血液酒精鉴定,侦查机关应充分收集各类证据,统一交由审判者依其理性最终确定该行为是否构成犯罪。     

Expert examination and assessment of state under the influence of psychoactive substances

An expert examination is a medical examination performed by a doctor on the order of a police officer or investigating judge. It includes a clinical examination of the subject, collection of samples for toxicological analysis, and the doctor's assessment of whether the subject is under the influence of psychoactive substances. The doctor requires expert knowledge, skill, experience and sufficient time to successfully perform the examination. Since the accurate assessment of the effects of psychoactive substances present depends on a comprehensive evaluation of toxicological test results, the calculation of results at the time of the event and the results of the medical examination, an unprofessionally performed examination can have far-reaching consequences, primarily legal in nature.     

Delinquency under drug influence (author's transl)]

In delinquency, connected with alcohol, the immediate and acute effect of the substance is prominent, whereas in delinquency connected with drugs, one has to deal with chronic effects. The criteria for judging drunken offenders also stand as a model for judging the responsibility of the addicted offender for his crime. We consider: 1. the personality of the offender 2. the way, the amount and the point of time of the last intake of the drug 3. the potential dependence 4. the psychopathological state at the time of offense and at the time of examination 5. the kind of the offense itself. Most cases, which have to be examined, deal with indictable offenses, which were undertaken, in order to get new supply, i.e. "supply-offenes". These cases surmise, that the offender is physically addicted, that he knows about withdrawal symptoms from own experience, and that he committed the crime purely for securing his personal supply. We differentiate between direct "supply-offenses" (i.e. direct stealing by the addict himself) and indirect "supply-offenses" (i.e. mainly trading and commission business). For the latter offenses the state of consciousness and insight at the time of offense does not serve as a suitable criterion for judging the responsibility for the crime, since these offenders usually are not deprived of their drugs and therefore in a stable state of mind. Therefore the inner situation and the motivation for carrying out the crime has to be analysed carefully. For these indirect "supply-offenses" reduced responsibility for the offense has to be considered, whereas for direct "supply-offenses" a total lack of responsibility can be assumed.     

Acute toluene poisoning during painting

Autopsy findings on a man who fell from a height due to acute toluene poisoning while painting are described. Gas chromatographic examination revealed that the toluene concentrations of his blood, lung, liver and brain were 48, 35, 65 and 80 micrograms/g, respectively. These toluene levels were not enough to be definitely lethal, but were high enough to anesthetize the central nervous system.     

Detection of toluene in an adipoceratous body

A 24-year-old male was found dead in a car left in a river for about 3 months. The cadaver was almost adipoceratous and autopsy findings revealed that there were neither remarkable injuries nor lethal diseases. Toluene, ethanol, 1-propanol, 2-propanol, 1-butanol, dimethyl sulfide, dimethyl disulfide, isovaleraldehyde and n-butyl n-butyrate were detected in the specimens collected at the autopsy by head space gas chromatography/mass spectrometry (GC/MS). The toluene concentrations (μg/g) were 31.0 in brain, 10.6 in liver, 5.4 in kidney, 15.0 in skeletal muscle and 187.1 in adipose tissue. The presence of diatom in lung, liver and kidney suggested that death was caused by drowning. So far as we know, this is the first report of detection of toluene in an adipoceratous body.