New Drug Driving Offence

The News is rife with changes to the drink driving limit in Scotland today. There is much speculation as to whether England and Wales will follow suit. We think this is inevitable at some point but it is likely to take some time before any change to the drink drive limit is introduced here. However, on 2 March 2015 a new drug driving offence came into force in England. Wait for it… it is wordy – “driving with certain specified controlled drugs in excess of specified levels in the body”.

In short, this offence will run alongside the normal drug driving offence and existing rules on drug impaired driving and fitness to drive remain the same.

This new offence however will be pertinent for health care professionals. It will be important to understand the offence and to explain this to patients when prescribing medication.

Here is a brief overview of the key points that health care professionals will need to know before advising patients:

The new offence refers to driving, attempting to drive or being in charge of a vehicle with a specified controlled drug in the body, in excess of a specified limit (Section 5A of the Road Traffic Act 1988 as amended in April 2013). The drugs to be covered by this offence are defined in regulations supporting the offence and are listed in section 4.

Roadside drug screening devices will be developed using oral fluid (saliva) to identify if the person driving or in control of the vehicle had taken a drug as listed below (or one that may be metabolised into one of these drugs). Following a positive screening result using oral fluid, the person can then be requested to provide a blood sample for evidential purposes, to enable prosecution for the new offence if above the specified limit.

Those individuals who have taken their medicine(s) in accordance with the advice of the prescriber or supplier of the medicine(s) (and/or the product information included in the medicine pack) who are found to have a blood level higher than that specified in the regulations are entitled to raise the statutory “medical defence” at any stag.

A patient who was investigated for drug driving would generally be entitled to raise the statutory “medical defence” if:

a) The drug was lawfully prescribed, supplied, or purchased over-the-counter, for medical or dental purposes; and

b) The drug was taken in accordance with advice given by the person who prescribed or supplied the drug, and in accordance with any accompanying written instructions (so far as the latter are consistent with any advice of the prescriber).

The types of drugs that can produce, on testing, specified controlled drugs above specified levels, fall broadly into two groups.

The first group consists of commonly abused drugs for which low limits have been set.

This group includes certain medicines that will be taken by only a small proportion of drivers. Given the low limits set, a patient prescribed one of these medicines who chooses to drive could test above the specified limit but would still be entitled to raise the statutory “medical defence”. This ‘zero tolerance’ group currently includes:

• Cannabis (THC)

• Cocaine (and a cocaine metabolite, BZE)

• MDMA (Ecstasy)

• Lysergic Acid Diethylamide (LSD)

• Ketamine

• Heroin/diamorphine metabolite (6-MAM)

• Methylamphetamine

The second group consists of mainly licensed medicines that have a significant liability to be abused, and for which the specified limits have been set at a higher level than the first group. The higher limits are generally above the normal therapeutic range so most patients are unlikely to be driving with a concentration of a specified drug in their body above the specified limit. However, those on particularly high doses, for example, could test above the specified limit and would still be entitled to raise the statutory “medical defence”. This second group includes the following:

• Clonazepam

• Flunitrazepam

• Oxazepam

• Diazepam

• Lorazepam

• Temazepam

• Methadone

• Morphine

The statutory “medical defence” can be raised by patients taking medicines in accordance with instructions, from either of these two groups.

Information on whether any particular medicine is affected by the new legislation can be found in the Summary of Product Characteristics for that medicine.

If the police have evidence that the patient’s driving was impaired due to drugs, whether prescribed or not, they can prosecute under the existing offence of driving whilst impaired through drugs offence described in section 4 of the Road Traffic Act 1988, for which there is no statutory “medical defence”:

It is the responsibility of prescribers and suppliers of medicines to give suitable clinical advice to patients regarding the likely risks of their medicines as part of their normal professional practice (including advice on serious and common side-effects), which might include for example, for some drugs the advice that the drug, may cause sleepiness and so might impair driving.

For full guidance on the above – please visit the Department of Transport.