"THE NORTHWEST EVALUATOR"

The Pacific Northwest Drug Recognition Expert Newsletter

September 1998                                                                 Volume 3, Issue 9

Sergeant Jim Unsworth,

Phoenix, Arizona P.D.

History was made at the Fourth IACP DRE, Drugs, Alcohol and Impaired Driving Training Conference held in Portland, Oregon from June 28-30, 1998. For the first time the conference was the result of a partnership between professionals from three states; Oregon, Washington and Idaho. These states have made remarkable progress in the area of DRE/Impaired driving enforcement in the past three years. This was evidenced by the organization and content of this year's conference in Portland.

Appropriately, the lead off presenter was Dr. Marcelline Burns, Ph.D., one of the original founders of the DRE program. Dr. Burns gave an update on the SFST process. She was joined by Sgt. Teri Dioquino of the Pinellas County, Florida, Sheriff's Office. Together they presented the results of the recent Florida SFST Study. Dr. Burns explained that when SFSTs are administered by trained and skilled officers, their accuracy rate can range from 91 - 95 percent. She emphasized that law enforcement focus should be on getting not just the drunk driver, but in getting the impaired driver off the road.

Another familiar face belonged to Phyllis Good of the Michigan State Crime Laboratory. Since the first conference in 1995, Phyllis has shown that she can be relied upon to provide timely information on a variety of aspects of the current drug scene. This year was no exception. She updated delegates on Cannabis and the marijuana "Project Grow 420", DXM (Dextromethorphan), GHB (Gamma-Hydroxybutrate), Soma (Carisoporodol), Ephedrine, Ketamine, Phencyclidine, Ecstasy (MDMA), and various inhalants. Phyllis also included an extensive Internet bibliography of drug information resources in her handout material.

Many of the presenters were recognized experts in the medical and health professions. Dr. Robert M Julien, M.D., gave a presentation on the "Principles of Drug Action". Dr. Julien is the author of A Primer of Drug Action. This book has been a corner stone of basic DRE knowledge since the program began. It was a pleasant surprise to actually meet the author.

Dr. Richard Smith, of Oregon, gave a very timely, informative, and sometimes sobering presentation on "The DRE and Infectious Diseases". This presentation was a real "eye opener" to many of the delegates who attended it. In addition to having served as an emergency room physician, Dr. Smith is the Medical Director for the California Highway Patrol and a soon-to-be I.A.C.P. certified DRE.

Dr. Alex Stalcup, M.D., spoke on drug addiction and "The World of Hallucinogens". He is an active practitioner in this area. He maintains a private practice in addiction medicine and is the medical director of a treatment center in California. He is the former director of the Haight Ashbury Free Clinic in San Francisco where he became very familiar with many hallucinogens, including LSD and MDMA.

Doctors Robert Yolton, O.D.., and Karl Citek, O.D., faculty members at the Pacific University College of Optometry, presented "Nystagmus - Medical, Natural, or Induced?" Both have given expert court testimony on HGN and DRE issues and they shared this knowledge with attendees.

In the legal area, former prosecutor Patricia Gould, Director of the National Traffic Law Center, moderated a panel discussion of "What's New In DRE/HGN Court Cases". This panel even included a real, live, defense attorney, John Henry Hingson III, who shared his views with the delegates.

This conference provided excellent networking opportunities. A total of 441 delegates from 32 states, the District of Columbia, Canada and the Netherlands attended. Old contacts and friendships were renewed and new ones established. The facilities and staff of the Double Tree at Jantzen Beach were outstanding. One "off duty" highlight of the event was a late afternoon trip to the scenic Columbia River Gorge and the Multnomah Falls State Park.

An awards banquet was the final conference event. The banquet featured a tremendous keynote address by Pete Collins, a retired Captain from the Mississippi Highway Patrol. In addition, Dick and Karen Tarney of C.A.N.D.I.D. made their annual DRE awards. On an Arizona note, Eugene Adler, a criminalist with the Arizona Department of Public Safety, received the IACP/C.A.N.D.I.D. award for "Outstanding Research in the area of Impaired Driving". Oregon State Police Senior Trooper Ken Snook also was honored for his DRE Community Service from C.A.N.D.I.D.

The conference was truly outstanding in its organization, content, and in the caliber of the presenters selected. This could not have been possible without the hard work and dedication of Lt. Chuck Hayes of the Oregon State Police.

With the 1998 conference now behind us, we all look forward with great anticipation to the 1999 conference to be held June 27-29^th in Minnesota.

Dr. Robert Yolton, O.D.

Pacific University College of Optometry

I recently had two questions from officers about subjects with high phorias. Perhaps the defense has discovered this word and is using it to confuse things. First we have to do a little Optometry 101. If you look at an object and both eyes look exactly at the object, this would be referred to as an "ortho" (straight) posture. If you try to look at the object and one eye looks at the object and the other one looks inward or outward, this is called strabismus, also called tropia. About 3-5% of the population has this. Exotropia means that one eye looks outward, and esotropia means one eye looks inward.

These conditions can complicate HGN testing somewhat. I recommend having the strabismic suspect cover one eye at a time with their hand and then testing the other eye alone. This is a non-standard procedure and data obtained using this non-standard technique might be of interest to the officer, but should not be used in court.

A related concept is "Lazy Eye", often called amblyopia. During development, the brain expects the inputs from the two eyes to about equal and for these inputs to fight each other for connections on the brain cells. If one eye is disadvantaged during development and cannot fight for connections as hard as the other eye, the brain pays less attention to the signals from the eye and the result is a reduction in visual acuity (the 20/20 thing). This can occur only up to about 12 years of age when the brain's wiring is pretty much complete. A person with amblyopia will have reduced acuity in one eye only.

But it would be unusual for the acuity reduction to be severe enough to affect the HGN test results significantly.

Another term that gets used in regard to eye positions is phoria. Phorias can be thought of as resting positions of the eyes. If you ask a person to look at a stimulus with both eyes and then cover one eye, the covered eye will go to its position of rest. If it stays pointed right at the target, the person has ortho phoria (straight-ahead vision). If the eye that is covered swings outward behind the cover so its resting position is pointed outward, this is called exophoria, and if it is turned inward, it is esophoria. Phorias are only detectable with one eye covered or with the images seen by the two eyes separated in some way. Since HGN testing is done with both eyes open, it should not confuse the test results. Phorias can affect near point convergence testing by causing difficulty in converging. It is also possible that phorias can be accompanied by poor eye movement skills that might show up as jerky eye movements. However, I know of no strong association between phorias or strabismus and the specific type of nystagmus that would be seen in HGN testing.

Lately this has been a frequently asked question by many DRE's who wonder if the body temperature is all that important in the evaluation process. The best answer came from Sgt. Tom Page of L.A.P.D. who says temperature IS an important part of the validated DRE procedure. He reminds everyone that the curriculum does not give a DRE the option of not taking temperature. It is only a matter of time before the defense discredits the DRE who routinely strays from the proper procedure. LAPD and all DECP states mandate that temperature be taken.

Tom also reminds us that such things as hyperthermia (extremely elevated temperature) is an important indicator, for one thing, of life threatening stimulant overdose. As far as which thermometer works best, according to Tom, ear thermometers have been shown to not be as accurate as the oral digital type which remains the recommended type to use.

Euphoric feelings induced by cocaine are thought to be the result of increased dopamine levels in certain parts of the brain. Cocaine disrupts the normal sequence by which the action of most neurotransmitters (not just dopamine, but also serotonin and norepinephine) is terminated. An interesting, and often overlooked fact, is that dopamine transmission plays an important role in the visual system. Dopamine is found in very high concentrations in the retina, which means that there is a potential for visual changes in cocaine users. The results of a recent study indicate that is, in fact, the case (Desai, P., et al., Impaired Color Vision in Cocaine-Withdrawal Patients, Arch Gen Psychiat, 54: 696-699, 1997).

The ability to perceive color was compared in a group of 30 men and one woman who had been admitted to a locked detoxification/rehabilitation unit. All met DSM-III-R criteria for cocaine dependence, and none of the 31 studied used other drugs or had a history of any significant medical or ophthalmologic disorder. Random urine screening tests (type not specified) were administered throughout the study to ensure the participants were drug free. Results in the cocaine-withdrawal patients were compared with results in 31 normal controls (volunteers from the hospital).

Two separate color vision tests were administered to both groups (the Farnsworth-Munsell 100-hue test and the Lanthony desaturated D-15 color vision test). Both of the tests produced quantitative results that were then compared statistically. The cocaine withdrawal group had significant blue-yellow color vision losses. There was no correlation between color vision test results and the number of days since cocaine had been discontinued. The authors suggest that the impaired color vision found in the test group is the result of decreased retinal neurotransmission, probably a result of dopamine depletion. They also raise the possibility that this deficit may persist for a very long time after cocaine use is discontinued.

Source: Forensic Drug Abuse Advisor, Volume 9 (9).

Oregon just recently completed the certification phase of its last DRE School held in April 1998. A total of 22 officers are now in the process of completing their final Certification Knowledge Exams. With the latest group of DREs trained, Oregon will have 120 statewide.

The 1997 Oregon DECP Final Report is complete and has been mailed statewide and to each State DECP Coordinator. Oregon DREs conducted 803 evaluations last year and had an overall accuracy rate of 89% based upon toxicology results.

Oregon is planning the state's sixth DRE School scheduled for March 2 - 12, 1999. The class will train an additional 20 DREs from various locations throughout Oregon.

The Salem Police Department has an effective duo fighting the drug problem on the city streets - A DRE and Drug Dog working together. Officer Kris Knox and her drug dog, Mick, have been together for about a year and have turned out to be an effective team. Kris is using her DRE skills to "sniff out" impaired drivers, while Mick is using his skills to locate the drugs.

Together the two have accounted for some major arrests and seizures already. In 1997, Kris conducted 11 drug evaluations of suspected drug-impaired drivers, many from her own traffic stops. In the first five months working together, Mick accounted for the seizure of 225 grams of Methamphetamine, 354 grams of Marijuana, 10 pounds of cocaine, 10 grams of heroin which brings his total of cash and drugs to over $650,000.

The number of highway fatalities linked to alcohol or drugs jumped past 100 for the first time even as the overall percentage of drinking and drug-related accidents continued to drop. According to the office of Highway Safety, the annual safety report showed that although total fatalities declined for the third straight year, hovering just below the 1991 record of 263, the number of highway deaths associated with drugs or alcohol jumped more that 25% to 104.

But at the same time, the share of injuries related to alcohol has steadily been declining. Authorities credit the decline to better enforcement and tougher DWI laws in Idaho.

In the past several years, use of "ecstasy" (methlenedioxymethamphetamine) or MDMA, has grown in popularity among American teenagers. Its widespread use was first reported in Britain during the early 1990's at 'raves" or dance halls where attendees dance all night to loud, synthesized rock music. Now the "rave" scene has hit the U.S. and is becoming increasing popular.

One problem with "ecstasy" is the potential for serious toxicity. Though some people claim it is a safe drug, 53 deaths have occurred in Britain and at least five have occurred in the United States, primarily from a syndrome that is similar to heat stroke. Other effects of the drug include fatigue, sweating, muscle spasm and damage to the central nervous system, heart, liver and kidneys. The drug appeals to young people because it appears to enhance empathy and closeness with other people.

Results of drug use surveys show the prevalence of its use. In Texas, 9% of high school seniors reported using the drug in 1996. In 1990, a survey of students at Tulane University in New Orleans demonstrated that 24% of undergraduates were using the drug.

Source: Pediatrics, Vol. 100, No. 4, 1997

Forest Labs and Parke-Davis are marketing a new antidepressant called Celexa (Citalopram). It's similar to Prozac, Zoloft and Paxil, and has been widely used in Europe for years. The company is promoting Celexa as safer with fewer side effects and drug interactions. However, its side effects include, nausea, somnolence and sexual dysfunction. It comes in 20 and 40 mg tabs. The usual dose is 20 mg once a day and it can be increased to 40 mg a day if needed.

1. A person under the combined influence of heroin and PCP usually will have constricted pupils. This is an example of an ____________________________ effect?
2. Synthetic narcotics are produced by chemically treating __________________?
3. The term "analgesic" means ______________ __________________?
4. What year was the DRE program officially recognized by LAPD?
5. The only artery that carries de-oxygenated blood is the _________________________?
6. In the Univ. of Tennessee Study, what percentage of injured drivers had drugs other than alcohol in their urine?
7. In the LAPD "field study", how many subjects participated in the study?
8. In the DRE terminology "MURDERS INC.", what does the "I" stand for?
9. Pulse rate is measured in the number of ______________ per minute?
10. An usually slow heart rate is called __________________________?

1. Dopamine, Serotonin and GABA are types of neurotransmitters.
2. Homeostasis is the dynamic balance or steady state involving levels of salt, water, sugar, or other materials in the body fluids.
3. The Korotkoff Sounds are heard with the use of a stethoscope.
4. Skin popping a drug is also referred to as a subcutaneous injection.
5. The axon carries messages away from the cell body.
6. The artery carries blood from the heart.
7. The Pyloric Value controls alcohol (ETOH) moving into the intestines.
8. LSD was discovered in 1938 by Dr.Albert Hoffman.
9. LSD is manufactured from Lysergic Acid, found in ergot.
10. Phencyclidine (PCP) was developed in 1959 as an anesthetic and later used in veterinary medicine.

Until next time - Stay safe. Remember, the professional DRE is the informed DRE.

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This page was updated 10-01-98
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1997 Pacific Northwest DECP