1. Basic Drug Recognition for Parents Brian Kozak Avon Police Department

2. Purpose To improve your ability to recognize individuals who may be medically impaired or impaired by drugs and to take appropriate action when you encounter such a person. 1 Graphic Picture Warning

3. Objectives Define the term “drug” in the context of DWI enforcement or recreational use. Define the term “drug” in the context of DWI enforcement or recreational use. Describe the incidence of drug involvement in motor vehicle crashes and DWI enforcement. Describe the incidence of drug involvement in motor vehicle crashes and DWI enforcement. Name the major categories of drugs. Name the major categories of drugs. 2A

4. Objectives (Continued) Describe the observable signs associated with the major drug categories. Describe the observable signs associated with the major drug categories. Describe medical conditions and other situations that can produce similar signs. Describe medical conditions and other situations that can produce similar signs. Describe appropriate procedures for dealing with drug-impaired or medically-impaired individuals. Describe appropriate procedures for dealing with drug-impaired or medically-impaired individuals. 2B

5. One important thing that this training will not accomplish: It will not qualify you to perform the functions of a Drug Recognition Expert. 3

6. What is a “drug”? 4

7. Working Definition of “Drug” Any substance which, when taken into the human body, can impair the ability of the person to operate a vehicle safely. 5

8. Central Nervous System Depressants Alcohol Alcohol Rohypnol Rohypnol Valium/Xanax Valium/Xanax GHB - Gamma-hydroxybutyrate GHB - Gamma-hydroxybutyrate 6

9. GHB

12. Central Nervous System Stimulants Cocaine Cocaine Amphetamines Amphetamines Methamphetamine Methamphetamine 7

14. Crack is to Cocaine as Crank is to Methamphetamine

20. Hallucinogens LSD LSD Peyote Peyote MDMA (Ecstasy) MDMA (Ecstasy) 8

25. Dissociative Anesthetics 9 Phencycline (PCP) Phencycline (PCP) Ketamine Ketamine Analogs Analogs Dextromethorphan Dextromethorphan

27. Narcotic Analgesics Heroin Heroin Morphine Morphine Codeine Codeine Synthetic Opiates (e.g., Demerol, Methadone, Fentanyl) Synthetic Opiates (e.g., Demerol, Methadone, Fentanyl) 10

29. Inhalants Toluene Toluene Glue Glue Paint Paint 11

32. Cannabis Marijuana Marijuana Hashish Hashish 12 Can Weed Kill?

34. Results from the 2004 National Survey on Drug Use and Health: National Findings In 2004, 19.1 million Americans (7.9%of the population) aged 12 years or older were current illicit drug users. In 2004, 19.1 million Americans (7.9%of the population) aged 12 years or older were current illicit drug users. Marijuana was the most commonly used illicit drug in 2004, with 14.6 million. Marijuana was the most commonly used illicit drug in 2004, with 14.6 million. In 2004, 6.0 million people were users of psychotherapeutic drugs taken non-medically. In 2004, 6.0 million people were users of psychotherapeutic drugs taken non-medically. In 2004, an estimated 2 million persons were current Cocaine users. In 2004, an estimated 2 million persons were current Cocaine users. 13

35. Fact University of Tennessee found 40% of crash- injured drivers had drugs other than alcohol in them. University of Tennessee found 40% of crash- injured drivers had drugs other than alcohol in them. The Maryland Shock Trauma Center found nearly one-third of crash-injured drivers had recently used Marijuana. The Maryland Shock Trauma Center found nearly one-third of crash-injured drivers had recently used Marijuana. 14

36. Studies show that nearly 20% of fatally-injured drivers have ingested drugs or a combination of drugs and alcohol. 15

37. The Eye Examinations 16 HGN Test Pupilmeter

38. Drugs That Induce Nystagmus CNS Depressants CNS Depressants PCP PCP Inhalants Inhalants 17

39. Drugs Causing Pupil Dilation CNS Stimulants CNS Stimulants Hallucinogens Hallucinogens Cannabis Cannabis 18

40. Narcotic Analgesics Usually Cause Pupil Constriction 19A

41. Drugs That Usually Don’t Affect Pupil Size CNS Depressants CNS Depressants PCP PCP Inhalants Inhalants 19B

42. PCP May Cause Immediate Onset of Nystagmus 19C

43. Vertical Nystagmus 20

44. Pulse Increase Pulse: CNS Stimulants CNS Stimulants Hallucinogens Hallucinogens PCP PCP Inhalants Inhalants Cannabis Cannabis Lower Pulse: CNS Depressants CNS Depressants Alcohol increase Alcohol increase Narcotic Analgesics Narcotic Analgesics Normal range is 60-90 beats per minute

45. Central Nervous System Depressants Alcohol Alcohol Rohypnol Rohypnol Valium/Xanax Valium/Xanax GHB - Gamma-hydroxybutyrate GHB - Gamma-hydroxybutyrate 21

46. Indicators of CNS Depressant Impairment Drunken behavior and appearance Drunken behavior and appearance Uncoordinated Uncoordinated Drowsy Drowsy Sluggish Sluggish Disoriented Disoriented Thick, slurred speech Thick, slurred speech General Indicators Horizontal Gaze Nystagmus Horizontal Gaze Nystagmus Possible Vertical Nystagmus * Possible Vertical Nystagmus * Pupil size generally normal (but dilated by Methaqualone and Soma) Pupil size generally normal (but dilated by Methaqualone and Soma) Pulse is down Pulse is down Eye Indicators 22A * With high doses for that individual

47. Central Nervous System Stimulants Cocaine Cocaine Amphetamines Amphetamines Methamphetamine Methamphetamine 22B

48. Indicators of CNS Stimulant Impairment Restlessness, Excitation Restlessness, Excitation Talkative Talkative Euphoria Euphoria Exaggerated Reflexes Exaggerated Reflexes Anxiety Anxiety Grinding Teeth Grinding Teeth Redness to Nasal Area Redness to Nasal Area Runny Nose Runny Nose Body Tremors Body Tremors General Indicators No Nystagmus No Nystagmus Pupils will be noticeably dilated Pupils will be noticeably dilated Pulse is up Pulse is up Eye Indicators 23A

49. Hallucinogens LSD LSD Peyote Peyote MDMA (Ecstasy) MDMA (Ecstasy) 23B

50. Synesthesia Transposing of the Senses “Seeing Sounds” “Hearing Colors” 24A

51. Indicators of Hallucinogen Impairment Hallucinations Hallucinations Dazed Appearance Dazed Appearance Disoriented, Uncoordinated Disoriented, Uncoordinated Body Tremors Body Tremors Perspiring Perspiring Paranoia Paranoia Difficulty in Speech Difficulty in Speech Nausea Nausea Piloerection (goose bumps) Piloerection (goose bumps) General Indicators No Nystagmus No Nystagmus Pupils will be noticeably dilated Pupils will be noticeably dilated Pulse is up Pulse is up Eye Indicators 24B

52. 24C Dissociative Anesthetics Phencyclidine (PCP) Phencyclidine (PCP) Ketamine Ketamine Analogs Analogs Dextromethorphan Dextromethorphan

53. Indicators of Dissociative Anesthetic Impairment Warm to the Touch Warm to the Touch Perspiring Perspiring Blank Stare Blank Stare Repetitive Speech Repetitive Speech Incomplete Verbal Responses Incomplete Verbal Responses Confused Confused Muscle Rigidity Muscle Rigidity Possibly Violent and Combative Possibly Violent and Combative General Indicators Horizontal Gaze Nystagmus often with Very Early Onset Horizontal Gaze Nystagmus often with Very Early Onset Pupils Size Generally Normal Pupils Size Generally Normal Pulse is up Pulse is up Eye Indicators 25A

54. Narcotic Analgesics Heroin Heroin Morphine Morphine Codeine Codeine Synthetic Opiates (e.g., Demerol, Methadone, Fentanyl) Synthetic Opiates (e.g., Demerol, Methadone, Fentanyl) 25B

55. The Concept of Tolerance for a Drug The same dose of the drug will produce diminishing effects. The same dose of the drug will produce diminishing effects. A steadily larger dose is needed to produce the same effect. A steadily larger dose is needed to produce the same effect. 26A

56. Indicators of Narcotic Analgesic Impairment “On the Nod” “On the Nod” Droopy Eyelids Droopy Eyelids Depressed Reflexes Depressed Reflexes Dry Mouth Dry Mouth Facial Itching Facial Itching Low, Raspy Speech Low, Raspy Speech Possible Puncture Marks, “Tracks” Possible Puncture Marks, “Tracks” General Indicators No Nystagmus No Nystagmus Pupils will be constricted Pupils will be constricted Pulse is down Pulse is down Eye Indicators 26B

57. 26C Inhalants Toluene Toluene Glue Glue Paint Paint

58. Indicators of Inhalant Impairment Disorientation Disorientation Slurred Speech Slurred Speech Residue of Substance on Face, Hands, Clothing Residue of Substance on Face, Hands, Clothing Confusion Confusion Possible Nausea Possible Nausea General Indicators Horizontal Gaze Nystagmus will be present Horizontal Gaze Nystagmus will be present Vertical Nystagmus may be present * Vertical Nystagmus may be present * Pupil size generally normal Pupil size generally normal Pulse is up Pulse is up Eye Indicators 27A * High doses for that individual

59. Cannabis Marijuana Marijuana Hashish Hashish 27B

60. Indicators of Cannabis Impairment Very bloodshot eyes, with pronounced veins in the eyeballs Very bloodshot eyes, with pronounced veins in the eyeballs Body Tremors Body Tremors Odor of Marijuana Odor of Marijuana Disoriented Disoriented Relaxed Inhibitions Relaxed Inhibitions Difficulty in Dividing Attention Difficulty in Dividing Attention General Indicators No Nystagmus No Nystagmus Pupil size usually will be dilated - but may be normal Pupil size usually will be dilated - but may be normal Pulse is up Pulse is up Eye Indicators 28A

61. Polydrug Use Use of two or more drugs at the same time. EXAMPLES: Alcohol and Almost Anything Else Alcohol and Almost Anything Else PCP and Cannabis PCP and Cannabis Heroin and Cocaine Heroin and Cocaine Many Others Many Others 28B

62. General Types of Polydrug Effects ADDITIVE (The two drugs independently produce similar effects on the indicator) EXAMPLE Stimulant and Hallucinogen will both dilate the pupils 29A

63. General Types of Polydrug Effects ANTAGONISTIC (The two drugs produce opposite effects on the indicator) EXAMPLE Stimulants usually cause pupil dilation, Narcotic Analgesics usually cause constriction. 29B

64. General Types of Polydrug Effects OVERLAPPING (Each drug affects the indicator in a different way) EXAMPLE PCP causes nystagmus but doesn’t affect pupil size; Narcotic Analgesics constrict pupils, but do not cause nystagmus. Nystagmus will be seen. 29C

65. General Types of Polydrug Effects NULL (Neither drug has an effect on the indicator.) EXAMPLE Stimulants do not cause nystagmus. Narcotic Analgesics do not cause nystagmus. Therefore, nystagmus will not be present. 29D

66. Investigation SFST’s SFST’s Rhomberg Rhomberg Finger to Nose Finger to Nose Pulse Pulse Pupils Pupils Signs of Ingestion Signs of Ingestion Impairment Impairment Chemical Test Chemical Test Pharmacy Pharmacy Doctor Doctor Intervention Intervention Last Call Last Call