What is the problem?
The use of mood- or mind-altering substances
has increased dramatically in the U.S. population, and
there is evidence that substance use—including over-the-counter (OTC), prescription, and illicit drugs—is
increasing in commercial rail and highway operations,
as well. The legalization of recreational marijuana
use in some states adds new complexity and risk to
transportation safety—the impact of which has yet to
be fully understood. The opioid crisis that is plaguing
the country has led to the expansion of the Department
of Transportation (DOT) drug testing panel for DOT-regulated
industries. Drug manufacturers are rapidly
altering the chemical makeup of illicit designer drugs
at such a high rate that they are evading regulation and
detection.
Many drugs have performance-impairing effects, but
determining the relationship between the presence of a
drug in one’s body and its effect on that person’s ability
to safely operate a vehicle can be challenging. Unlike
alcohol, the diversity of other drugs makes understanding their effects
on human performance an ongoing and challenging task.
In several of our recent investigations, we have also seen the tragic
consequences of alcohol mixed with other drugs.
But drug impairment isn’t just an illicit drug issue—prescription and
OTC medications can also impair drivers. Between 2001 and 2003, the
Federal Motor Carrier Safety Administration (FMCSA) and the National
Highway Traffic Safety Administration conducted a Large Truck Crash
Causation Study and found that 26 percent of truck crashes were
associated with prescription drug use, 17 percent with OTC drug use,
and 2 percent with illegal drug use.
In 1990, we published a safety study, Fatigue, Alcohol, Other Drugs, and
Medical Factors in Fatal-to-the-Driver Heavy Truck Crashes, in which we
analyzed 182 crashes and made several recommendations, including
that postaccident toxicological specimen collection, testing, and
reporting be standardized.
Analysis of Federal Railroad Administration data revealed that
4.2 percent of railroad employees involved in accidents
in 2016 tested positive for drugs such as marijuana,
cocaine, ecstasy, benzodiazepine, oxycodone, and
morphine—up from 2.9 percent in 2015.
In our 2007 investigation of a Massachusetts Bay Transportation
Authority passenger train strike against a track maintenance vehicle
in Woburn, Massachusetts, we found evidence of impairment of
maintenance-of-way employees. Postaccident test data for fatally
injured railroad employees indicated greater alcohol and other drug
use among maintenance-of-way employees than among railroad
employees subject to random and postaccident testing requirements.
What can be done?
Accidents and crashes caused by drug-impaired operators are
100 percent preventable. In addition to conducting preemployment
drug screening, consistent postaccident toxicology testing to
determine the prevalence of impairing substance use among
operators will help clarify the problem in all modes. For many
years, we have investigated operator impairment in accidents
and issued many recommendations to address the problem in all
transportation modes.
To address the problem of impairment in
commercial operations, the following actions
should be taken:
Railroad
Regulators
- Establish comprehensive toxicological testing requirements to
identify the role played by common prescription and OTC medications.
- Revise the definition of “covered employee” for purposes of
mandatory alcohol and controlled substances testing programs to
encompass all employees in safety-sensitive positions.
- Develop medical certification regulations for employees in
safety-sensitive positions that include sleep disorder screening,
standardized testing protocols, and centralized certification
oversight for those who fail testing.
Industry
- Develop and publish an easy-to-understand source of information
for train-operating crewmembers on the hazards of using specific
medications when performing their duties.
Industry
- Accelerate widespread implementation of Driver Alcohol Detection
System for Safety technology (a technology that can detect driver
alcohol use) by defining usability testing that will guide driver
interface design, and by implementing a communication program
that will direct driver education and promote public acceptance.
Operators
- As an employee performing safety-sensitive functions in the
transportation industry, you should provide a safe work environment
for your coworkers and the traveling public. Creating a safe work
environment not only means following established work rules but
also following the DOT’s rules on drug use and alcohol misuse.
- Consider the effects of your prescription medicine. It could
be making you drowsy or otherwise reducing your decision-making
abilities. Ask your doctor about any medications they’re
prescribing you.
Commercial Highway
Regulators
- Develop and disseminate to appropriate state officials a common
standard of practice for drug toxicology testing, including the
circumstances under which tests should be conducted, a minimum
set of drugs for which to test, and cutoff values for reporting the
results.
- Determine the prevalence of commercial motor vehicle driver use
of impairing substances.
- Work with motor carrier industry stakeholders to develop a plan to
help motor carriers address driver use of impairing substances.
- Determine the prevalence of commercial motor vehicle driver use
of impairing substances, particularly synthetic cannabinoids, and
develop a plan to reduce the use of such substances.
- Disseminate information to motor carriers about using hair
testing as a method of detecting the use of controlled substances,
under the appropriate circumstances.
Industry
- Inform members about the dangers of driver use of synthetic
drugs and encourage them to take steps to prevent drivers from
using substances that could affect their driving performance or
safety.
Drivers
- Don’t drive after drinking alcohol or after using any substance
that can impair your performance. Be aware that not just illegal
substances can be impairing, but some prescription and OTC
medicines can also affect how you drive.
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