"THE NORTHWEST EVALUATOR"
The Pacific Northwest Drug Recognition Expert Newsletter
November 1997 Volume 2, Issue 7
In this issue:
Hypoglycemia and Law
Enforcement Officers ...
What do they have in Common?"
A routine DWI, the kind that happens everyday. Get them off the road before another innocent victim suffers. It's a common scene, but it isn't always as it seems. In Albany, Oregon, a man was involved in an incident that has unfortunately happened once too often to law enforcement officers throughout the country. After some very poor driving his vehicle was stopped and he was arrested on suspicion of DWI. The driver, however, was actually diabetic and suffering from low blood sugar, known as hypoglycemia. The driver later sued the law enforcement agency and was awarded $13,000 in damages.
Recent lawsuits by people with diabetes and their family members emphasize the importance of taking precautions before a DWI arrest. Juries are sympathetic toward people who are falsely arrested based on a medical condition, even if that condition is not obvious to the arresting officers. Unfortunately, this type of situation has affected police departments and law enforcement officers too many times. Everyday, law enforcement officers stop drivers under the influence of alcohol and other drugs who are DWI. Many of these drivers exhibit some of the same actions as a diabetic suffering from hypoglycemia.
Hypoglycemia is defined as an abnormal decrease of sugar in the blood. Individuals suffering from hypoglycemia can feel cold and clammy. They can appear nervous, shaky, and very weak. Often, their face is a pale color. They may experience headaches and have blurred vision.
They become dizzy, demonstrate irritable behavior, and may exhibit personality changes. They may seem confused, uncooperative, and may have slurred speech. In severe stages, they may even have seizures or become unconscious, which can result in death. Most diabetics properly monitor and regulate their sugar intake to ensure they do not have adverse reactions. This condition can, and will, at times, happen suddenly and dramatically while the individual is driving a vehicle. The result can often mirror the responses of a suspected DWI driver.
Soon after the Oregon incident, a support group from Albany General Hospital developed a means to assist law enforcement officers in identifying vehicles operated by diabetics. The result was the "DM Med-Aware" sticker. This light-reflective, all-weather sticker, is placed on the automobile to the left of the rear license plate. This sticker is very visible and can communicate to a police officer, emergency response personnel, and others, the driver may be diabetic.
Law enforcement officers cannot totally depend on diabetics to wear medical tags or jewelry. In addition, officers often cannot search a wallet or purse in a critical situation. The "DM Med-Aware" sticker can be a positive addition in assisting in the identification of diabetics in emergency situations.
The use of the sticker is voluntary. It is currently in use and recognized by many law enforcement officers in the state of Oregon. The Albany General Hospital Foundation received a $20,000 grant from the Oregon affiliate of the American Diabetes Association to produce an educational video of the "DM Med-Aware" sticker program. The 8-minute video, primarily aimed at law enforcement, educates police officers on how to observe and detect the signs and symptoms of hypoglycemia and provide proper treatment in emergencies. The Oregon State Police is a sponsor of the program and has added the video to Medical First Responder and DWI training.
The DM Med-Aware sticker is not a "free ticket" to drink and drive. It is designed to alert police officers that the driver may be a diabetic and may be suffering from hypoglycemia. With this information, officers can be better prepared to seek additional signs of medical impairment and ask questions that may or may not support alcohol or drug impairment. Learning to recognize clues that identify a DWI suspect as hypoglycemic can help officers avert further injury to the patient and possibly avoid an unnecessary costly lawsuit.
For more information about the "DM Med-Aware" sticker or the training video, contact the Albany General Hospital, 1046 Sixth Avenue S.W., Albany, Oregon 97321.
NEW DRUG
INFORMATION
"BACLOFEN"
Baclofen is a muscle relaxant and antispasmodic medication manufactured by Cibagenva Pharmaceuticals under the name of Lioresal. It is a white or off-white colored crystalline powder available in 10 mg and 20 mg tablets with Lioresal imprinted on one side and the numbers 10 or 20 scored on the other. It is normally sold in bottles or blister packs of 100 tablets.
Baclofen is commonly prescribed for people suffering from MS and relieves muscle tightness or achiness in the limbs. Baclofen functions as a muscle relaxant and actually works directly on nerve pathways. It can produce the characteristics of central nervous system depressants, thereby causing ataxia, respiratory and cardiovascular depression, sedation, and somnolence. Abrupt withdrawal is discouraged by physicians due to possible hallucinations and seizures. Adverse reactions include confusion, dizziness, drowsiness, dry mouth, fatigue, miosis, mydriasis, nausea, nystagmus, perspiration, poor coordination, slurred speech, strabismus, and weakness. Due to the complex reactions of this drug, medical professionals recommend medical follow-up when it is prescribed. Usually, the dosages are small to begin with then slowly increased until optimum effects achieved. Some patients using this drug may experience a "rubbery" sensation while using the drug, usually resulting in a decreased dosage.
DREs who encounter people prescribed Baclofen or Lioresal should be aware that the user may be prescribed the drug for MS or other similar medical conditions.
"ELDERLY DRIVERS CRASH RISK"
Prescribed for relief of insomnia and anxiety, benzodiazepines that remain in the body for longer periods increase crash risk among elderly drivers who take them, particularly in the first week of their use. This is the major finding of a new study by Quebec researchers.
Commonly prescribed long half-life benzodiazepines, defined as those that take more than a day for half the dose to be eliminated from the body, include Dalmane, Limbritrol, Klonopin, Tranxene, and Valium. Short half-life benzodiazepines in which half the dose is eliminated from the body in fewer than 24 hours include Halcion, Restoril, Ativan, Xanax, and Serax.
Researchers studied 5,579 licensed Quebec drivers ages 67-84 involved in a vehicle crash resulting in bodily injury during 1990-1993. The crash involved drivers were compared with 18,490 licensed drivers in the same age group.
In that first week of using half life benzodiazepines elderly patients crash risk increased 45%, the study indicates. After one year of use, patients still had a 25% increased crash risk. In contrast, the study found that elderly people taking short half-life benzodiazepines did not have an elevated crash risk in the first week of using the medication or after prolonged periods of use.
For a copy of "Benzodiazepines Use and the Risk of Motor Vehicle Crashes in the Elderly" by B. Hemmelgarn et al., write: Sammy Suissa, Division of Clinical Epidemiology, Royal Victoria Hospital, 687 Pine Ave. W, Ross 4.29, Montreal, Quebec, Canada H3A 1A1.
Source: Insurance Institute for Highway Safety, October 1997.
"LOLLIPOPS" FOR DRUG DETECTION?
In London, England, scientists have developed a way of testing suspected drug-impaired drivers to determine what type of drug they may have ingested. It is done with a specially designed "lollipop" swab stick. The scientists report that by licking the absorbent end of the stick just once will provide police with a sample of the driver's saliva for analysis inside a test box the size of a mobile telephone. Then within five minutes, provide a digital reading of drugs present in the persons saliva.
Early trials, held by Cozart Bioscience, who have developed the device, indicates a success rate of between 95 - 100 percent. Drugs which can be detected by the "lollipop" tester include cannabis, MDMA, cocaine, methadone, amphetamines, heroin, morphine and barbiturates. The device is relatively new and has not been tested by England law enforcement officials yet.
"INTERACTIONS BETWEEN TRICYCLICS AND MARIJUANA"
Marijuana may interact with tricyclic antidepressants causing symptoms such as confusion, rapid heartbeat, light-headedness, irritability and hallucinations, according to a report in the Journal of the American Academy of Child and Adolescent Psychiatry. The report describes the cases of four teenage boys who were being treated with tricyclics for attention-deficit/hyperactivity disorder. In one case, reported by Harvard Medical School researches, a 16-year old taking nortriptyline experienced light-headedness, a racing heart and confusion half an hour after smoking a marijuana cigarette. He was taken to the hospital emergency room where he was found to have a heart rate of 130 beats per minute and symptoms of delirium. The symptoms resolved 24 hours later. Although the study did not measure the amount of marijuana consumed and the researchers didn't know whether the teens were taking the antidepressant properly, they suggest that the two drug combinations may create a potential risk. DREs may also encounter such combination when conducting evaluations.
Source: Alcoholism and Drug Abuse Weekly, Vol. 9, No.6, Feb 10, 1997
"ASK THE DRE DOCTOR"
"Ask the DRE Doctor" is a regular feature of the "Northwest Evaluator" and utilizes the DRE medical knowledge and experience of Dr. Richard Smith Jr. Richard is employed by the California Highway Patrol working at their Academy as the academy physician and medical director. He has been a practicing emergency physician for over 25 years after graduating from Stanford University Medical School in 1969. He has also instructed at DRE schools in Oregon, Idaho, and California.
"INSULIN IMPAIRMENT?"
In this issue, Dr. Smith answers a question from Chuck Swift, an instructor from the California Highway Patrol in Sacramento, California. Chuck's question is, "If a diabetic gave themselves too much insulin, could they become impaired to the point where they were unable to operate a motor vehicle safely?
Dr. Smith: First, a couple of points of interest. 1) Insulin is a prescribed medication; 2) Its action in the body is not on brain cells; 3) When brain cells and the heart are effected it is because of a secondary, not primary effect of the drug. Therefore, yes, someone can take, or be given, an overdose of insulin and, thereby, have the blood sugar lowered to the point their brain and heart will not function properly. If they did so, it usually is accidental, i.e., an older person with poor eye sight or with confusion. Many times this type of person should not be driving anyway. If they knowingly take an excess of insulin as a suicide attempt and subsequently drive then one would probably have a case for knowingly creating the condition of driving while impaired. However, depending upon state statute, DUI may not apply.
Some people are known as "brittle diabetics" and should not drive as their blood sugar goes dangerously low often. Their doctors should have advised them not to drive anymore and in many cases have filed the proper Motor Vehicle forms to keep them from driving.
If you have a specific question about medical disorders or other medical issues which may effect your drug evaluation opinion, please contact Dr. Richard Smith by e-mail or contact Lt. Chuck Hayes by e-mail or at (541) 967-2026.
THE OREGON DECP UPDATE
"1998 DRE Training"
As 1998 nears, Oregon is preparing for its 4th DRE School. A $10,000 grant from the Oregon Department of Transportation - Transportation Safety Section will provide funding for 22 new DRE officers. The 1998 school is scheduled for April 6-16, 1998, at the Oregon Police Academy in Monmouth, Oregon.
Officers trained in the April 1997 DRE class are completing their final certification testing. Most of the 25 officers trained have successfully completed the final knowledge exam and will soon be certified.. Once the final officers are certified, Oregon will have 103 DREs.
"Evaluation Highlights"
During the past several months some of the Oregon DREs have encountered some very interesting cases. Some of the more unusual include:
Roseburg Trooper Tim Plummer was requested to conduct an evaluation on a female driver arrested for DUII by one of his fellow Roseburg troopers. The trooper had arrested the driver, who was accompanied by her sister, after the suspect and her sister ran into a local truck stop restaurant and began screaming at the employees to lock the doors because "the truckers were harassing them and gang raping them." Before officers respond to the truck stop, both the suspect and her sister left. A short time later their vehicle was located traveling northbound on I-5. Officers had difficulty getting their vehicle stopped and when the suspect did, she stopped in the traffic lanes blocking traffic. The driver was arrested for DUII and her sister taken into protective custody. The suspect later gave a .00% breath test and admitted that she and her sister had smoked some "crystal meth" in California earlier that day. A urine test confirmed that she had ingested methamphetamine.
In July, Sgt. Kevin Sawyer of the Bend Police Department was requested to conduct a drug evaluation on a 28 year old male driver arrested for DUII. The arresting officer had been out of his car on an investigation when the suspect drove his car at the officer and tried to run the officer over. The arresting officer had to take cover behind a tree to avoid being struck by the suspect. The suspect gave a .07% breath test, however, the noted impairment and actions were not consistent with the BAC. Sgt. Sawyer concluded that the suspect was under the influence of ETOH, cannabis and a stimulant. A urine test confirmed ETOH, methamphetamine and marijuana.
In August, Officer Jeff Durbin of Gresham PD conducted an evaluation on a subject he arrested for DUII that led to an interesting drug seizure. After observing the suspect drifting from lane to lane, Officer Durbin arrested the driver for DUII. A pat-down search revealed a vile of methamphetamine in his pocket. The suspect admitted to drug use and agreed to allow Officer Durbin to search his residence for additional drugs. With the assistance of a cover officer, Officer Durbin conducted a search of the residence locating additional drugs and drug paraphernalia. In one room a mirror, with two piles of tan powder ready for snorting was located. Next to the mirror, 20 grams of marijuana was located. Further searching of the house revealed more methamphetamine, chemicals to produce methamphetamine, a rifle, and additional marijuana.
In September, Officer Rusty Morris of the Salem Police Department assisted fellow DRE Trooper John Burright with an interesting case. Trooper Burright had been working speed enforcement in a highway paving project on I-5 north of Albany when a vehicle entered the paving project at 92 mph on radar! Trooper Burright gave pursuit and stopped the driver before he endangered any of the construction workers. The driver was determined to be under the influence and arrested for DUII. After a .00% BAC, Officer Morris was requested to conduct a drug evaluation. The evaluation by Officer Morris concluded that the suspect was under the influence of a CNS Stimulant. A urine test confirmed the presence of methamphetamine.
"Oregon Leads Nation In Morphine Use"
Oregon has jumped to the top of the U.S. in the medical use of morphine, according to the most recent federal data. Wholesale, per-capita distribution of the painkilling drug was more than 50% higher in the state that the U.S. average in the first six months of 1996, internal DEA records show. Arizona came in a close second, followed by New Hampshire, Nevada and Washington.
Oregon's increasing use of morphine is consistent with its leading role in end-of-life issues, researchers say. In 1994, when voters approved a doctor-assisted suicide measure, it ranked 11th in morphine distribution. Because the assisted-suicide law has been blocked in the courts, researchers attribute the greater demand for morphine not to an outbreak of assisted suicides but to doctors' growing willingness to give gravely ill patients "comfort care". For the first six months of 1996, the DEA figures show 832 grams of morphine were distributed per 100,000 residents of Oregon, compared to a national average of 500 grams per 1,000,000 people.
Source: Los Angeles Times
IDAHO DECP REPORT
"Idaho Huffing Leads To Death"
Drug Recognition trained officers are probably over represented among police officers when it comes to doing public safety talks. DREs give presentations to schools, teachers, administrators, parents, prosecutors, DARE officers and the general public. Having given many such talks I have found that these groups generally want to talk about "drugs". You know, real drugs like methamphetamine, heroin, and cocaine. When these groups scan the outline I frequently hear "why would we want to spend time talking about paint?"
During the last four years, southwest Idaho has witnessed three deaths as a result of breathing inhalants. In 1993, a 20 year old Caldwell male died after inhaling nitrous oxide at a college fraternity house. In January 1996, a Nampa subject died after huffing dozens of hits of Airwick air freshener. The air freshener coated his lungs and he asphyxiated. Then in September of this year, a 16-year old juvenile died after inhaling nitrous oxide at a medical clinic where he was working as a custodian.
One in five students in the U.S. has used an inhalant to get high by the time he or she reaches the 8th grade. This is based upon a study in Texas in which 176,000 students were surveyed. If 20% of our school students are experimenting with inhalants, then we should be putting more emphasis on the drug curriculum officers are currently doing.
A good resource for your future safety talk is from the NIPC (National Inhalant Prevention Coalition). It is a free resource with excellent information. If you have an interest in reducing inhalant usage in your area, contact the NIPC at 1-800-269-4237 or by e-mail
"Idaho DRE Study"
The second Idaho DRE class completed their classroom training in July and are scheduled to complete their field certification phase this fall. Once the officers become certified, Idaho will have 40 DREs trained statewide. A study was conducted to determine how accurate the new Idaho DREs have been. The six month pilot project evaluated statistics from November 1, 1996 through April 30, 1997. The information was taken directly from the officers evaluation reports narrative reports and the toxicology reports submitted by the forensic laboratory.
A total of 176 evaluations were included in the study. Of those, 93% of the suspects completed the entire evaluation with only 12 suspects failing to complete an entire evaluation. Toxicology samples were obtained 75% of the time. Males constituted 76% of the suspects evaluated. The drug categories most encountered were cannabis (46%), Stimulants (39%), narcotic analgesics (7%), and non-alcoholic depressants (8%). Alcohol (ETOH) was used in combination with other drugs 22% of the time and poly-drug use was present in 35% of the evaluations. The most significant result of the study showed that the Idaho DREs predictions of impairment by a category of drug(s) was confirmed by toxicology in 95% of the evaluations.
WASHINGTON DECP REPORT
"Washington Gets New DRE Coordinator"
The big news from Washington is the change in the DECP State Coordinator position. In September, I was promoted to Captain in charge of the Human Resources Division for the Washington State Patrol. In other words, I am in charge of all the personnel, both sworn and non-sworn for the agency. However, the DRE program will not be one of my duties any longer. I have truly enjoyed my time spent in DRE and SFST training. It was very rewarding to see the program get started in Washington and to witness the enthusiasm and dedication of the many officers involved in the program.
One of the projects I was involved in as the State Coordinator, and very proud of, is the finalizing of the Northwest DECP Compact. The compact between Oregon, Washington, and Idaho is the first written compact of its kind in the nation. The compact serves as an agreement between the northwest states to develop, share, and improve DECP programs and resources. It has already been instrumental in assisting Oregon in obtaining state and federal funding for its next DRE school. Hopefully, Washington and Idaho will also benefit from the document and demonstrate the cooperative DRE efforts occurring in the Pacific Northwest. Although I have officially moved on, I will be assisting our new State Coordinator, Lieutenant Kim Zangar. Kim is a graduate of Washington State University and a former deputy sheriff with the Thurston County Sheriff's Office. She was hired by WSP in 1978 and assigned to Bellevue. She has a background in patrol, the Organized Crime Unit, the Human Resource Division and the Computer Services Division. She is also an instructor at the WSP Academy. She was promoted to Sergeant in 1988, assigned to Vancouver, then promoted to Lieutenant in 1992 and was the Commander of the Identification and Criminal History Section for two and half years. She was the assistant to the Intergovernmental Services Bureau Commander prior to appointment as the State DRE Coordinator for Washington State on October 16, 1997.
DRE NEWS ELSEWHERE
"L.A. DRE Shot and Killed"
Sergeant Tom Page, Los Angles Police Department, reported the tragic death of a
fellow DRE from the Los Angeles County Sheriff's Office. In the early morning hours of
October 30, 1997, Deputy Michael Hoening was shot and killed by a suspect who may
of been under the influence of methamphetamine. According to a report from the Los
Angles Times, the 32 year old deputy was on patrol and tried to stop a male subject
riding a bicycle who was flailing his arms and acting erratically. Upon stopping the
bicyclist, the suspect fired a shot from a .45 caliber semi-automatic through the rear
window of the deputies patrol car, striking him in the neck. The suspect fired a total of
six rounds at the deputy, hitting him four times.
The suspect, a 25 year male, was apprehended near the crime scene. He was found hiding in a crawl space and was bitten by a police dog. He has been charged with Murder. According to Sergeant Page, Deputy Hoening graduated from the LAPD/Monrovia Police Department DRE School in August of 1995. He was later certified as a DRE on February 9, 1996, and was assigned IACP #4677.
Our thoughts and prayers go to the family, friends, and fellow workers of Deputy Michael Hoening.
"DRE Technical Advisory
Panel
and
DRE Section Meet in Orlando"
On October 24th - 25th, the DRE Technical Advisory Panel (TAP) and the DRE Section met prior to the annual IACP Conference in Orlando, Florida. Those attending included Chair Earl Sweeney, Chuck Peltier and Ernie Floegel - IACP; Russ Arend and Bob Jacob - IPTM; Paul Helzer - Colorado; Chuck Hayes - Oregon; Tom Page - LAPD; Doug Thooft, Karen Sprattler and Karen Herland - Minnesota; Sandy Richardson - NHTSA; Mark Lewis and Doug Paquette - New York; Bill Tower - Maryland: Cliff Miller - Georgia and Mel Poff - Texas.
The meeting began with an update on the DRE program and by the states represented. According to Ernie, there are 4,278 certified DREs in 32 states. Of those, 764 are DRE instructors. Tom Page of LAPD reported that they are gearing up for their "Monster School" with 55 students from 13 agencies. LAPD and the California Highway Patrol are also working together on seven full DRE schools next year.
New York has had two DRE schools in the last six weeks and the program is growing in interest. They have an "Advanced Instructor" School planned that is five days long. In Florida, there is lots of interest at the street level, however, they are having difficulty getting agency administrators on board. They intend to invite some of the big DUI enforcement officers to their next school which may be in April 1998. In Texas, Texas A&M University took over the DRE program coordination and with the assistance of the University, they are collecting DRE data. Texas has four DRE schools scheduled next year and have also revised their SFST training program to include 5 days on SFST and two days on basic drug impairment.
Agenda items covered at the Technical Advisory Panel meeting included:
On Saturday, October 25th, the DRE Section held their yearly meeting. Out-going Section Chair, Paul Helzer of Colorado coordinated the meeting. New officers for the following year were announced. Chair - Doug Paquette, 1st Vice-Chair - Chuck Hayes, 2nd Vice Chair - Tom Page, 3rd Vice Chair - Dick Yost, and 4th Vice Chair - Cliff Miller.
The DRE Section now consists of 42 members from throughout the U.S. A great deal of discussion centered on how to involve more DREs into the Section. According to Ernie Floegel, some states, such as New Jersey are starting their own DRE Associations. It was suggested that states should look into forming DRE groups or associations and each state should elect a member to the DRE Section. This will be discussed further at the next Section meeting and reviewed with many of the State Coordinators.
"DRE INFORMATION ON THE WEB"
As many computer "hackers" already know, the Internet provides endless information on medical conditions, drugs, drug use, drug trends, and other valuable and not so valuable information. A couple of web sites which contain some good information for the DRE include:
INTERNET HUMOR
Speaking of the Internet and the World Wide Web, the following are actual statements found on insurance forms where drivers attempted to summarize the details of an accident in the fewest words. Any of these sound familiar?
Test Your DRE
Knowledge:
This Newsletter Study Questions:
Questions and answers from the last Northwest Evaluator Newsletter:
MARK YOUR CALENDARS FOR THE:
"4TH IACP DRE,
DRUGS, ALCOHOL AND IMPAIRED DRIVING
TRAINING CONFERENCE"
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Albany, OR 97321
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This page was updated 12-15-97
Copyright © 1997 LAPD,
Pacific Northwest DECP
