The Problem

This module contains research that describes the magnitude and characteristics of the drug-impaired driving problem. It briefly highlights the types of drugs that can impair driving ability and the types of studies that are employed to investigate this problem. It also summarizes research about the magnitude of the drug-impaired driving problem based on different types of data from several countries around the world to illustrate the effect on road safety. In addition, this module highlights sex differences between male and female drivers that are drug-impaired, as well as the differences in the frequency of drug-impaired driving according to time of day and day of week.

This module also includes research about populations of drivers that are more likely to use drugs and drive, as well as those drivers who have a higher crash risk. Research about public awareness and perceptions of the problem is also reviewed in terms of knowledge of the impairing effects of drugs on driving, and how the problem is perceived in comparison to alcohol-impaired driving.

  1. What is drug-impaired driving?
  2. What are the different types of drugs that can impair driving?
  3. How is the drug-impaired driving problem studied?
  4. How widespread is the drug-impaired driving problem in Canada, the United States, Europe, & Australia?
  5. Are there differences between male and female drivers in terms of drug type and frequency of drug-impaired driving?
  6. Does the drug type and frequency of drug-impaired driving differ according to age group?
  7. Does the drug type and frequency of drug-impaired driving differ according to the time of day and day of week?
  8. Are certain types of drivers at higher risk for drug-impaired driving?
  9. Is there social concern and awareness about drug-impaired driving?
  10. Are drivers aware of the impairing effects of drugs on driving abilities?
  11. Do drivers think that drug-impaired driving is a more or less serious problem than alcohol-impaired driving?

1. What is drug-impaired driving?

Drug-impaired driving is defined as the operation of a motor vehicle while under the influence of any type of psychoactive substance (illegal substances, prescription medication, over-the-counter medication) or a combination of drugs and alcohol that is established or likely to impair abilities required for safe driving.1

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2. What are the different types of drugs that can impair driving?

Drugs that can impair driving are categorized according to the seven drug categories established by the International Drug Evaluation and Classification Program (DECP). These include: cannabis2, central nervous system (CNS) depressants, central nervous system (CNS) stimulants, hallucinogens, dissociative anesthetics, narcotic analgesics, and inhalants.

2 The term “cannabis” refers to the cannabis plant that contains more than 100 cannabinoids. The primary psychoactive component of cannabis is delta-9-tetrahydrocannabinol, commonly known as THC. THC and its psychoactive metabolite, 11-hydroxy-THC or 11-OH-THC, and primary inactive metabolite, 11-nor-9-carboxy-THC or THC-COOH are frequently measured in biological fluids to document cannabis intake.

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3. How is the drug-impaired driving problem studied?

The two central methods to investigate drug-impaired driving are experimental and epidemiological studies.3 Experimental studies examine the effects of specific drugs on driving ability. Within a clinical and controlled setting, individuals are administered an active or placebo drug, followed by tests that assess skills and abilities relevant to driving. Typically, the results of the experimental group are compared to those of a control group. The control group receives a placebo and performs the same tests as the experimental group. This enables researchers to determine if there is significant impairment of driving-related skills experienced as a result of the drug. These test results help researchers to infer the level of risk posed by driving under the influence of a drug.4

Epidemiological studies seek to determine the prevalence or magnitude of the drug-impaired driving problem. There are two types of epidemiological studies: culpability studies and case-control studies. Culpability studies compare the at-fault rates of crash-involved, drug-positive drivers to that of crash-involved, drug-negative drivers. Case-control studies compare drug use by crash-involved drivers to drug use by non-crash involved drivers and the crash/driver characteristics are matched as closely as possible.5

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4. How widespread is the drug-impaired driving problem in Canada, the United States, Europe, & Australia?

Canada. The number of fatally injured drivers in Canada that test positive for drugs each year is collected and reported in the Traffic Injury Research Foundation’s (TIRF) National Fatality Database. This database includes crash reports, medical examiner and coroners’ data on persons fatally injured in motor vehicle collisions in all jurisdictions across Canada since 1987. On average, high percentages (80%) of fatally injured drivers in TIRFs’ National Fatality Database are consistently tested for drugs. Furthermore, there are only slight variations in the types of drugs that are tested for in each jurisdiction and the data are collected directly from the medical examiner and coroner’s office, thus increasing the accuracy of the results. It should be noted that the data from the National Fatality Database demonstrates the prevalence of drugs in fatality injured drivers and does not imply causality, as the presence of drugs in the bodies of drivers contributes to the resulting crash to an unestablished degree.

In 2013, for example, 82.9% of fatally injured drivers were tested for drugs; among those tested, 44.5% were positive for drugs.6 Among these fatally injured drivers who were positive for drugs:

  • 49.1% tested positive for cannabis;
  • 35.8% for CNS depressants;
  • 26.9% for CNS stimulants;
  • 1.0% for hallucinogens;
  • 2.1% for dissociative anesthetics; and,
  • 20.4% for narcotic analgesics.

In comparison, 87.2% of fatally injured drivers were tested for alcohol in 2013; among those tested, 31.6% tested positive for alcohol. Therefore, more fatally injured drivers tested positive for drugs than for alcohol in 2013.

In the general population, the prevalence of drugs and driving can also be measured via roadside surveys. A recent roadside survey in British Columbia7 of 2,840 drivers showed that drugs were detected in 7.2% of drivers tested.8 This included:

  • 4.5% of drivers tested positive for THC;
  • 2.3% tested positive for cocaine;
  • <1% tested positive for amphetamines;
  • <1% tested positive for benzodiazepines; and,
  • 1.2% tested positive for opiates.

United States. The number of fatally injured drivers in the United States that tested positive for drugs can be found in the Fatality Analysis Reporting System (FARS) database, maintained by the National Highway Traffic Safety Administration (NHTSA). This database draws on police reports, coroner reports and medical records, containing information on fatal vehicle crashes that occur on American public roads.9 However, it is important to note that the FARS data have limitations that should be considered when examining the prevalence of drugs in drivers. The fatal driver testing rates in FARS are inconsistent and often low in many states. Furthermore, the types of drugs that are tested for are not consistent across states therefore making comparisons difficult and making it unclear if absence implies that the type of drug was not present or that the test did not include this drug type. It is also important to note that not only the types of drugs but the concentration cut-offs for each drug are different across laboratories, and some laboratories test for and report drug-levels at such low concentrations that are not likely to cause impairment.10

More than half (63.3%) of all fatally injured drivers were tested for drugs in 2014; among those tested, 43.1% were positive for drugs. Among these fatally injured drivers who were positive for drugs11:

  • 34.3% tested positive for cannabinoids12;
  • 19.6% for CNS depressants;
  • 21.1% for CNS stimulants;
  • 0.7% for hallucinogens;
  • 0.4% for dissociative anesthetics; and,
  • 17.9% for narcotic analgesics.

Similarly, in the general population, the prevalence of drugs in drivers can be measured via roadside surveys. The NHTSA National Roadside Survey (NRS) 2013-2014 examined the use of drugs, including illegal drugs, prescription, and over-the-counter drugs by day and time of use. Blood and/or oral fluid results from weekday daytime drivers showed that illegal drugs were present in 12.1% of drivers, and medicinal drugs (prescription and over-the-counter) were present in 8.4% of drivers. Blood and/or oral fluid results from weekend nighttime drivers showed that illegal drugs were present in 15.2% of drivers and medicinal drugs were present in 7.3%. When comparing the results from the latest 2013-2014 NRS to the previous 2007 NRS, it was observed that cannabis use in the general United States driving population increased by 48% over a six year period. The authors speculated that this increase may be due to changes in state policies for medical and legal recreational cannabis, although it is not certain that this is the case without individual state data.

It is important to note that not all drivers provided both oral fluid and blood samples, some drivers only provided one.13 Although oral fluid drug screening is non-invasive, it can have high reliability and validity due to the shorter window of drug detection, and quantitative oral fluid drug concentrations can be performed in the laboratory. The analysis of drugs in blood allows for precise quantification of drug concentrations and correlate better than oral fluid with impairment, but blood collection is more invasive and requires greater training in sample collection.14

Europe. The number of fatally injured drivers in Europe that tested positive for drugs was reported in the Driving under the Influence of Drugs, Alcohol and Medicines (DRUID) project.15 It included crash data from 1,118 fatally injured drivers in four countries16 from January 2006 to December 2009. Results showed that a combination of alcohol and drugs and/or medication was detected in 4.3% to 7.9% of fatally injured drivers. Conversely, relatively low concentrations of illegal drugs and medications were detected in fatally injured drivers when alcohol was not present. The prevalence of drug detection in fatally injured drivers from the four countries included:

  • 0.0 to 1.8% of fatally injured drivers tested positive for cannabis;
  • 0.0 to 2.1% tested positive for illicit amphetamines;
  • 0.0 to 5.2% tested positive for benzodiazepines; and,
  • 0.6 to 1.5% tested positive for medicinal opioids.

The DRUID roadside survey17 measured drug-impaired driving in the general population. The survey was completed in 13 countries18 and included samples from over 50,000 drivers. Results showed that illicit drugs were detected in 0.2 to 8.2% of drivers tested. Medicinal drugs were detected in 0.17 to 3.0% of drivers tested. The prevalence of detection for each drug from the thirteen countries was:

  • 0.0 to 5.9% of drivers tested positive for cannabis;
  • 0.0 to 1.45% of drivers tested positive for cocaine;
  • 0.14 to 2.73% of drivers tested positive for benzodiazepines; and,
  • 0.00 to 0.79% of drivers tested positive for medicinal opioids.

Australia. The number of fatally injured Australian drivers that tested positive for drugs in 2004 was captured in a culpability study with toxicology results from sub-groups of drivers in three Australian states.19 Results showed that:

  • 13.5% of fatally injured drivers tested positive for cannabis;
  • 4.1% tested positive for stimulants;
  • 4.9% tested positive for opioids; and,
  • 4.1% tested positive for benzodiazepines.

Among the general population, a roadside survey of 781 drivers was conducted in Queensland and 3.5% of drivers tested positive for at least one drug, as compared to 0.8% who tested positive for alcohol. The most commonly detected drugs included cannabis, which was found in 1.7% of all drivers, and amphetamines in 1.4% of all drivers.20

8 A random sample of drivers was collected from five cities in British Columbia, carried out between the hours of 9pm and 3am, Wednesday to Saturday nights.
12 Cannabinoid is used to represent the FARS coding system encompassing sub-categories: Delta-9, hashish oil, hashish, marijuana, marinol, tetrahydrocannabinoid, THC & cannabinoid type unknown
16 Portugal, Finland, Sweden and Norway
18 Belgium, Hungary, Poland, Czech Republic, Italy, Portugal, Denmark, Lithuania, Sweden, Spain, the Netherlands, Finland, Norway
19 the sample consisted of 3,398 fatally injured drivers from three Australian states (Victoria, New South Wales, and Western Australia)
20 the roadside survey sample included the oral fluid samples of 781 drivers

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5. Are there differences between male and female drivers in terms of drug type and frequency of drug-impaired driving?

Canada. Results from the Alcohol and Drug-Crash Problem in Canada: 2013 prepared by TIRF21 for the Canadian Council of Motor Transport Administrators (CCMTA) revealed a sex difference with respect to specific drug type, such that males were more likely to test positive for illegal substances such as cannabis and CNS stimulants. Overall, males and females were equally as likely to test positive for drugs.22

United States. Results from fatal crash data and the national roadside survey revealed a sex difference with respect to specific drug type. Male drivers were more likely to test positive for illegal substances such as cannabis and cocaine, whereas female drivers were more likely to test positive for narcotics and depressants. However, male and female drivers were equally likely to test positive for drugs.23

Europe. Results from the DRUID study (fatal crash data & roadside survey)24 and the IMMORTAL project (roadside survey)25 showed male drivers were more likely to test positive for illegal drugs, including cannabis, cocaine, amphetamines and opioids. Comparatively, medicinal opioids, and benzodiazepines were commonly found among older female drivers. Overall, male drivers were more likely to test positive for drugs than female drivers.

Australia. Results from fatality data26 and roadside surveys27 showed that male drivers were more likely to test positive for cannabis, ecstasy, and amphetamines. Female drivers were more likely to test positive for benzodiazepines. Overall, males were more likely to test positive for drugs.

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6. Does the drug type and frequency of drug-impaired driving differ according to age group?

Canada. According to the results from the Alcohol and Drug-Crash Problem in Canada: 2013 prepared by TIRF for CCMTA, the fatality data showed a positive test for drugs was more prevalent in younger drivers (under the age of 35) in comparison to those older than age 35. With respect to drug type, cannabis was more prevalent among young drivers, while older drivers were more likely to test positive for CNS depressants.28

United States. According to FARS data, the highest prevalence of overall drug positive results was among fatally injured drivers aged 35 to 64. In regards to the drug type by age group, a larger percentage of fatally injured young drivers tested positive for cannabis, CNS stimulants and multiple drugs, whereas a higher percentage of fatally injured older drivers tested positive for CNS depressants and narcotic analgesics.29 Results of roadside surveys revealed that among daytime drivers, positive drug tests were most prevalent among those aged 45 to 64, and among nighttime drivers it was most prevalent among those aged 16 to 44. Consistent with the above crash data, the National Roadside Surveys (NRS) showed that younger drivers were more likely to test positive for THC and its’ inactive metabolite (THC-COOH), whereas older drivers were more likely to test positive for narcotic analgesics.30

Europe. The fatality data from the DRUID study revealed that positive tests for drugs were most prevalent among young and middle-aged drivers. Cannabis and cocaine were most prevalent among fatally injured drivers aged 18 to 35, and benzodiazepines were prevalent among fatally injured male drivers aged 25 to 49 and fatally injured female drivers aged 35 and older. Results of the DRUID roadside surveys reinforced this relationship, and showed a higher prevalence of illegal drugs in younger drivers, and a higher prevalence of benzodiazepines and medicinal opioids in middle-aged and older drivers31. Results of the roadside survey in the IMMORTAL project also confirmed that illegal drugs were more commonly detected in young male drivers, and prescription drugs in older female drivers.32

Australia. In fatal crashes, the highest prevalence of illicit drugs was detected in drivers aged 25 to 39 (34.5%) and 17 to 24 (28.6%) and the lowest prevalence of illicit drugs was detected in those aged 60 and older (0.6%) and 50 to 59 (10.3%). Furthermore, cannabis was more prevalent in fatally injured younger drivers, and the prevalence of prescription drugs detected in fatal crashes increased with age.33

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7. Does the drug type and frequency of drug-impaired driving differ according to the time of day and day of week?

Canada. According to TIRF’s 2013 fatality data34, on weekdays 43.3% of fatally injured drivers tested positive for drugs compared to 47.2% of those drivers who died in weekend crashes.

United States. An analysis of FARS data from 1998-2010 did show that CNS depressants and narcotics were more prevalent during daytime hours, whereas cannabinoids and CNS stimulants were more prevalent during nighttime hours. However, the number of drug positive drivers was equally present and did not differ according to the time of day or day of the week.35 The 2013/2014 NRS also indicated that illegal drugs were more prevalent during nighttime hours, and medicinal drugs were more prevalent during daytime hours. However, the overall prevalence of all types of drugs was not different between and did not differ according to the time of the day or day of the week.36

Europe. Results of the DRUID study that assessed the prevalence of drugs in fatally injured drivers37found a larger percentage of drug positive drivers involved in nighttime crashes as compared to those involved in daytime crashes.38 However, there was not a significant difference in the number of drug positive fatally injured drivers involved in weekend versus weekday crashes. The DRUID roadside surveys from 13 countries39 revealed that illicit drugs were detected in a larger percentage of weekend drivers and medicinal drugs were detected in a larger percentage of weekday drivers.40

Australia. Research on fatally injured drivers in Australia indicated that nighttime drivers were more likely to test positive for drugs as compared to daytime drivers. Furthermore, the prevalence of drugs detected in drivers was similar between weekdays and weekends.41

37For Belgium, Denmark, Finland, Italy, Lithuania, and the Netherlands.
39Belgium, the Czech Republic, Denmark, Spain, Italy, Lithuania, Hungary, the Netherlands, Poland, Portugal, Finland, Sweden, and Norway.

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8. Are certain types of drivers at higher risk for drug-impaired driving?

Young drivers are identified as a high-risk population for drug-impaired driving. In general, the crash risk of younger drivers is 2-3 times that of adult drivers.42 This, in combination with their higher rates of drug use makes young drivers a greater concern for drug-impaired driving. Studies from Canada, the United States, Europe and Australia showed that a much larger proportion of young drivers self-report drug-impaired driving, as compared to national percentages.43

Drug users are also considered a high-risk population as a considerably large percentage of drug users and nightclub/rave attendees in Canada, the United Kingdom and Australia reported drug-impaired driving frequently in the previous year. Of concern, they also reported intention to engage in the behaviour again. In general, permissive attitudes were held by drug users and nightclub/rave attendees towards drug-impaired driving.44

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9. Is there social concern and awareness about drug-impaired driving?

Results of the Road Safety Monitor: 2015, conducted by TIRF, revealed that the majority of Canadian drivers (63.3%) agreed that drug-impaired driving was a very or extremely serious road safety issue. However, 36.7% felt that it was not an issue or only posed a lesser problem for traffic safety. A significantly larger percentage of female drivers (67.2%) agreed drugged-driving was a very or extremely serious issue as compared to male drivers (58.9%). A larger percentage of drivers aged 65 and older (77%) and drivers between 45 and 64 (63.1%) agreed it was a very or extremely serious issue as compared to younger drivers.45 Public opinion surveys in the United States, and Europe reported similar results, such that the majority of respondents agreed that drug-impaired driving was a serious road safety issue. 46

Awareness of laws and penalties related to drug-impaired driving was measured by a public opinion survey conducted by CCMTA. It showed that 85% of Canadians were aware that drug-impaired driving was a criminal offence. However, knowledge of drug-impaired driving laws was greatest among those aged 16 to 19 (92%) and lowest among those aged 65 and older (77%). A larger percentage of men (90%) were aware that drug-impaired driving was an offence in the Criminal Code as compared to women (79%).

In addition, the same survey revealed that a majority of drivers (64%) believed it was very likely that a driver would be stopped and charged for alcohol-impaired driving, but only 39% agreed it was likely that drivers impaired by street drugs would be stopped. Furthermore, 26% indicated that it was likely for drivers to be stopped for cannabis-impaired driving, and only 8% reported it was likely for drivers impaired by prescription drugs. 47

Specific concern in relation to marijuana impaired driving was measured most recently in a public opinion poll by State Farm Canada. Results indicated that 80% of respondents were concerned about drivers under the influence of cannabis. In addition, 3 out of 4 respondents did not believe that police had the tools and resources to identify cannabis-impaired drivers.48

The State Farm Canada public opinion poll also revealed that three-quarters of Canadians were worried about drivers impaired by prescription drugs, and those aged 16-25 and 55+ years were most likely to associate driving under the influence of prescription drugs with their respective age group.

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10. Are drivers aware of the impairing effects of drugs on driving abilities?

The public opinion survey by CCMTA also inquired about knowledge of the impairing effects of alcohol and drugs on driving ability. A majority (90%) of the respondents reported that alcohol would impair driving ability in comparison to 68% of respondents that indicated cannabis would impair driving ability. Just over half (55%) indicated that prescription drugs would have an impact on driving ability. Young drivers (aged 16 to 19) were less likely to report that cannabis impaired driving ability, and those aged 35 and older were less likely to agree that prescription medications could impair driving. Furthermore, female drivers generally reported higher levels of agreement regarding the impairing effects of drugs as compared to males.49

More specifically, awareness of the impairing effects of cannabis is lacking, according to a public opinion poll by State Farm Canada. Over eighty percent (83%) of respondents felt that there is not enough information available about the risks associated with driving under the influence of cannabis.50

In the United States, a survey by the Governers Highway Safety Association (GHSA) reported that only half of the responding states had information on drugged driving included in the driver education courses. Additionally, only one third of the responding states had employee education programs on drugged driving.51

Public opinion surveys in Europe showed that the majority of the general population believe that the risk associated with driving after drug use was high, and only a small percentage of those who had previously driven under the influence of drugs thought that drug-impaired driving was risky.52

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11. Do drivers think that drug-impaired driving is a more or less serious problem than alcohol-impaired driving?

Canadian youth (aged 14 to 19) reported that, in general, cannabis-impaired driving was safer than alcohol-impaired driving.53 Furthermore, a survey of 5,173 Manitoba high school students indicated that while only 3.8% of students thought it was acceptable to drink and drive, 19.4% of male students and 15.9% of female students felt it was acceptable to use cannabis and drive.54 In a recent study, the perceptions on cannabis of Canadian youth (aged 14-19) were examined. Participants indicated that they felt that cannabis impaired driving was “safer” or less dangerous than alcohol-impaired driving, and that they were against getting in a car with a drunk driver, but may take a ride from a driver who had smoke cannabis depending on who it was and how much they had smoked.55

In the United States, public opinion polls indicated that alcohol-impaired driving was a more concerning issue than drug-impaired driving. A survey of US residents aged 21 and older showed that 67% of respondents agreed that driving after using illegal drugs was a major concern to traffic safety, whereas 78% of respondents believed that driving after drinking was a major concern to traffic safety.56

Similar results were reported in the Social Attitudes to Road Traffic Risk in Europe (SARTRE 3) survey. Respondents rated alcohol-impaired driving as the primary factor in car crashes, and drug-impaired driving as the second most likely causal factor.57

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A variety of data about drug-impaired driving suggest that the prevalence of this problem and its effect on road crashes is cause for concern. A particular focus on cannabis is a priority since there is evidence that it is one of the most frequently detected drugs in fatally injured in drivers worldwide.

Research indicates that there are important differences in drug-impaired driving according to the age and sex of drivers. Young and middle-aged drivers are more likely to test positive for drugs. Additionally, male drivers are more likely to drive under the influence of illegal drugs, whereas females are more likely to drive under the influence of prescription drugs. These results suggest that it is important for road safety stakeholders to tailor strategies and educational campaigns towards populations of driver at greater risk.

Generally speaking, research underscores that education campaigns are much-needed to overcome misperceptions about the problem. Of concern, results from several surveys showed that drivers believed that alcohol-impaired driving was more risky, and posed more cause for concern than drug-impaired driving. Overall, these findings demonstrate the importance of a comprehensive and cross-disciplinary approach to prevent and reduce drug-impaired driving.

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  • Verstraete, A. G., Legrand, S. A., Vandam, L., Hughes, B., & Griffiths, P. (2014). Drug use, impaired driving and traffic accidents. Publications Office of the European Union.
  • 24/7 program: A post-conviction program that grants offenders an unrestricted driving privilege in exchange for daily alcohol and drug testing to measure sobriety. Participants are required to report for alcohol and/or drug testing twice a day at a pre-determined facility, and may also be required to wear a drug patch and/or use a continuous alcohol monitor. Offenders who test positive for alcohol and/or drugs are subject to escalating sanctions.
  • Administrative hearing: A driver may request a hearing to contest an action or sanction against their driving privilege that was imposed by a driver licensing agency on a variety of grounds. The purpose of the hearing is to permit drivers an opportunity to review the evidence and contest the action. Drivers are informed about the legal grounds for the action, and are able to present evidence, witnesses and testimony to support a request to the licensing agency to modify or rescind the action. Hearings are typically recorded and rules applying to hearings are specified by the licensing agency.
  • Aerosols: A substance contained under pressure and able to be released as a fine spray, typically by means of a propellant gas. When used as a recreational drug, aerosols are classified as an inhalant.
  • Alcohol ignition interlock: An alcohol ignition interlock is a breath testing device that connects to the starter or ignition, or other on-board computer system of a vehicle. The device prevents the vehicle from starting if breath test results shows a breath alcohol concentration (BrAC) is found to exceed a certain pre-set limit (usually corresponding to blood alcohol concentration of .02). This device also requires drivers to continue to pass repeated breath tests while the vehicle is in use to ensure that they remain sober. In addition, these programmable devices possess a range of anti-circumvention features.
  • Alcohol-impaired driving: A criminal offence whereby one’s driving ability is impaired due to the consumption of alcohol in excess of a legal threshold. Jurisdictions often utilize a per se limit of .05 to .08mg/%. In addition to a per se limit, many jurisdictions also have an alcohol-impaired driving offence that is based on behavioural indicators of impairment which permits drivers under the per se limit to also be charged with an offence.
  • Amphetamine: Amphetamines are a synthetic, addictive, mood altering drug and are classified as a CNS stimulant drug.
  • Anti-anxiety tranquillizers: A tranquilizer is a drug that acts on the central nervous system and is used to calm, decrease anxiety, or help a person to sleep. Often called depressants because they suppress the central nervous system and slow the body down, they are used to treat mental illness as well as common anxiety and sleeplessness. Anti-anxiety tranquilizers are classified as a CNS depressant.
  • Antidepressants: Drugs used for the treatment of major depressive disorders and other conditions, including dysthymia, anxiety disorders, obsessive compulsive disorder, eating disorders, chronic pain, neuropathic pain and, in some cases, dysmenorrhoea, snoring, migraine, attention-deficit hyperactivity disorder (ADHD), addiction, dependence, and sleep disorders. Antidepressants are classified as a CNS depressant.
  • Attention deficit hyperactivity disorder (ADHD): A mental disorder of the neurodevelopmental type. It is characterized by problems paying attention, excessive activity, or difficulty controlling behavior which is not appropriate for a person’s age.
  • Barbiturates: Drugs that act as central nervous system depressants, and can therefore produce a wide spectrum of effects ranging from mild sedation to total anesthesia.
  • Behavioural impairment laws: This type of laws is based upon behavioural measures of impairment and police officers are required to document observed impaired behaviour that is directly linked to consumption of a specific drug. Evidence that is gathered may include observations by officers while the vehicle in motion, during contact with the driver and throughout the interaction with the driver. Drivers may be required to perform Standardized Field Sobriety Tests (SFSTs) and/or a battery of tests by a trained Drug Recognition Expert (DRE). Suspected impairment is confirmed using toxicological analysis.
  • Benzodiazepines: Benzodiazepines enhance the effect of the neurotransmitter gamma-aminobutyric acid (GABA) at the GABAA receptor, resulting in sedative, hypnotic (sleep-inducing), anxiolytic (anti-anxiety), anticonvulsant, and muscle relaxant properties. High doses of many shorter-acting benzodiazepines may also cause anterograde amnesia and dissociation. These properties make benzodiazepines useful in treating anxiety, insomnia, agitation, seizures, muscle spasms, alcohol withdrawal and as a premedication for medical or dental procedures. Benzodiazepines are categorized as either short-, intermediate-, or long-acting. Short- and intermediate-acting benzodiazepines are preferred for the treatment of insomnia; longer-acting benzodiazepines are recommended for the treatment of anxiety. Benzodiazepines are classified as a CNS depressant.
  • Blood alcohol concentration (BAC): A specific measurement of the level or concentration of alcohol in a person’s blood that is usually measured as mass per volume using the number of grams of alcohol in 100grams of blood. For example, 0.08grams of alcohol in 100 grams of blood is measured as .08.
  • Cannabinoids: Cannabinoids are a group of active compounds found in the cannabis plant. Cannabinoids act on the cannabinoid receptors in cells and alter neurotransmitter release in the brain.
  • Cannabis: The term “cannabis” refers to the cannabis plant that contains more than 100 cannabinoids. The primary psychoactive component of cannabis is delta-9-tetrahydrocannabinol, commonly known as THC. THC and its psychoactive metabolite, 11-hydroxy-THC or 11-OH-THC, and primary inactive metabolite, 11-nor-9-carboxy-THC or THC-COOH are frequently measured in biological fluids to document cannabis intake.
  • Case-control studies: A type of study that compares people with a disease or condition (‘cases’) to another group of people from the same population who do not have that disease or condition (‘controls’). A case-control study is designed to identify risks and trends, and suggest some possible causes for disease, or for particular outcomes.
  • Central nervous system depressant: This type of drug results in the physiological depression of the central nervous system that can result in decreased rate of breathing, decreased heart rate, and loss of consciousness possibly leading to coma or death. CNS depression is specifically the result of inhibited brain activity.
  • Central nervous system stimulant: These types of drugs and medicines speed up physical and mental processes.
  • Cocaethylene: Cocaethylene is the ethyl ester of benzoylecgonine. It is structurally similar to cocaine, which is the methyl ester of benzoylecgonine. Cocaethylene is formed by the liver when cocaine and ethanol coexist in the blood.
  • Cocaine: A crystalline alkaloid obtained from the coca plant that is an illicit drug in many jurisdictions. As an illicit substance, cocaine (also referred to as “coke”), is identified as a clear white powdery substance. It is commonly snorted, inhaled, or injected as a stimulant. Cocaine can also be used by medical practitioners as a form of anesthetic, however it is considered highly addictive and its use is heavily regulated.
  • Cognitive test: This type of test is an assessment of the cognitive capabilities of humans and other animals. Tests administered to humans include various forms of IQ tests; those administered to animals include the mirror test (a test of visual self-awareness) and the T maze test (which tests learning ability).
  • Community supervision: A post-conviction program that substitutes incarceration with supervised community integration. Community supervision programs can be in lieu of incarceration, in the form of probation, or as a condition of early release from incarceration as a continued part of an individual’s sentence, in the form of parole. Offenders who are granted community supervision typically pose a lower risk to public safety.
  • Controlled setting: This type of setting is controlled for the purpose of comparisons to an experimental setting in a research study. A control is a standard against which experimental observations may be evaluated. In a controlled group study, one group of participants is given an intervention, while another group (i.e., the control group) is given the standard treatment or a placebo.
  • Criminal law: The body of law that defines and prohibits conduct that is harmful to public safety and threatening to the welfare of the general population. Violators of criminal law are prosecuted through the criminal justice system and sanctions that are applied vary based upon the specific crime committed. Criminal law is generally applied when an action is harmful to individuals or public safety, as opposed to civil law which regulates the disputes between private and/or public individuals/entities.
  • Critical tracking task: This type of test is an assessment of the participants’ motor response to a visual stimulus. Participants are asked to control the position of a light bar on a display screen using a steering wheel or joystick. The instability of the bar gradually increases until the subject reaches a threshold of ability to control its position.
  • Culpability studies: This type of study allows for the comparison between a group of drivers who are at-fault versus not at-fault for a particular incident.
  • Dimethyltryptamine: A hallucinogenic drug that can be either naturally occurring or synthesized. Commonly referred to as DMT, it can be inhaled, injected, or ingested to produce hallucinogenic effects. The effects of DMT vary depending upon the specific dosage. DMT is not generally considered addicting or toxic, however it is prohibited in several jurisdictions.
  • Dissociative anesthetic: Dissociative anesthesia is a form of anesthesia characterized by catalepsy, catatonia, analgesia, and amnesia. It does not necessarily involve loss of consciousness and thus does not always imply a state of general anesthesia. Dissociative anesthetics probably produce this state by interfering with the transmission of incoming sensory signals to the cerebral cortex and by interfering with communication between different parts of the central nervous system.
  • Dose-response relationship: This measures the changes or effects in an organism when exposed to different doses of stressors of either the same substance or varying substances in combination with one another. The dose-response relationship in terms of impaired driving measures the impact of alcohol and/or drugs (the stressor) upon the individual’s (organism) driving ability. While the dose-response relation between alcohol and individuals is uniform, the dose-response between individuals and drugs is variable according to the characteristics of individuals.
  • Driving under the influence (DUI): A subset of a driving while impaired (DWI) offence in some U.S. jurisdictions. A DUI is considered a serious criminal offence whereby offenders were in clear excess of the per se limit for a specific substance or their observed behaviour conclusively demonstrates that they were impaired in their driving ability. Generally a DUI is most easily prosecuted for BAC levels that are greater than the pre-determined legal limit, usually in excess of 0.08 but in some jurisdictions the limit is 0.05.
  • Driving while ability impaired (DWAI): A subset of a driving while impaired (DWI) offence in some U.S. jurisdictions. A DWAI offence is considered a lesser offence than a DUI or DWI; however it is generally still a matter of criminal law. DWAIs are usually, although not always, charged when the BAC level is below the legal limit but drivers demonstrated driving behaviour which suggests impairment. In such cases, the onus is on police officers who observed this behaviour to provide sufficient evidence of impaired behaviour as a basis for the charge.
  • Driving while impaired (DWI): An offence whereby one’s ability to safely operate a vehicle was impaired by either alcohol or drugs in many U.S. jurisdictions. DWI offences have varying level of severity but are generally considered a matter of criminal law.
  • Drug recognition expert (DRE): A DRE is a qualified law enforcement official who is trained to recognize impairment in drivers due to drugs other than, or in addition to, alcohol. Interchangeably called a drug recognition evaluator in some jurisdictions, DRE certification requires extensive knowledge of the effects of different types of drugs on the body and officers are required to undergo extensive training prior to receiving this designation, as well as biannual certification.
  • Drug-impaired driving: The operation of a motor vehicle while under the influence of any type of psychoactive substance (illegal substances, prescription medication, over the-counter medication) or a combination of drugs and alcohol that is established or likely to impair abilities required for safe driving. It is a criminal offence and laws used to enforce this type of offence vary as behaviourial laws, per se laws, and zero tolerance laws. All are actively used throughout North American, European, and Australian jurisdictions.
  • DWI court: A specialty court that deals specifically with alcohol-impaired offences. DWI courts deal with alcohol impaired drivers exclusively whereas hybrid courts may deal with alcohol impaired driving as well as various drug offences. Courts are typically post-conviction, and the emphasis of the court is on offender accountability in tandem with rehabilitative measures. The operation and administration of these courts varies from jurisdiction to jurisdiction, and they are more resource-intensive than traditional courts. Court participants are designated high-risk and are either high-BAC or repeat impaired driving offenders.
  • Epidemiological studies: These studies examine the distribution and determinants of health events among specific populations of persons to try to determine the cause of the events.
  • Experimental studies: These types of studies keep certain variables constant while other variables are manipulated in order to determine if the observed results are directly related to the outcome of the experimental manipulations.
  • Felony offence: A serious criminal offence which is subject to long-term imprisonment in excess of one year and can also be punishable by execution in some jurisdictions. Felony offences typically cannot be expunged after any period of time and will remain on a person’s criminal record unless granted an executive pardon. Felony offence sanctions are usually applied to DWI offenders who have committed in excess of a prescribed number of lesser offences, or when they have caused serious injury and/or death.
  • Fine: A monetary fine is usually applied as the least severe sanction that can be given in response to a criminal offence. Fines can range from a few hundred dollars to several thousand dollars depending on the offence, and can be imposed in addition to other sanctions such as probation or short-term incarceration. For DWI offenders, fines are usually applied in addition to other penalties such as licence suspension or enrollment in an interlock program.
  • First offender: Persons convicted of their first criminal offence are designated first offenders. However, research shows that impaired drivers may drink and drive many times before being detected and convicted. Hence the term first offender means the first time a person has been convicted, and not necessarily the first time they committed the offence. Additionally, some jurisdictions allow first impaired driving offenders to plead to lesser traffic offences or to complete a diversion program so their conviction is expunged from their criminal record.
  • GHB: Gamma hydroxybutyrate (GHB) is a central nervous system depressant that can slow brain activity and reduce reaction time. It is colourless and odourless, often being dissolved in alcoholic beverages. GHB has been identified in some jurisdictions as a common narcotic used in instances of sexual assault where an individual is unaware there are consuming it to lessen their resistance to unwanted sexual advances. For this reason many jurisdictions have enacted strict penalties for those who distribute the drug.
  • Hallucinogen: A hallucinogen is a psychoactive agent which can cause hallucinations, perceptual anomalies, and other substantial subjective changes in thoughts, emotion, and consciousness.
  • Heroin: This opiate drug, also known as diamorphine, is often used for recreational purposes. Heroin can be injected, smoked, snorted, or inhaled. It is usually either a white or brown powdery substance. Heroin is considered highly addictive and it is heavily regulated by many states. Although it does have medical applications as a sedative, due to the addicting nature of the drug it is rare that it will be used for this purpose.
  • Hybrid Drug/DWI court: A specialty court that deals with DWI cases as a subset of drug-related offences. Hybrid courts are a combination of a drug/substance abuse court and standalone DWI courts, dealing with all manner of substance abuse-related crimes.
  • Hybrid offences: Most criminal offences in Canada are categorized as hybrid offences which mean the Crown prosecutor can decide whether the offence will be prosecuted as a summary conviction offence or an indictable offence. This decision is often based on the seriousness of the offence as well as any aggravating or mitigating factors.
  • Illicit drug use: Consumption of illegal/prohibited drugs. Common illicit drugs are cannabis, cocaine, heroin, LSD, and methamphetamine.
  • Incarceration: A state of confinement and imprisonment. Incarceration is a common criminal penalty that can be applied for summary conviction (i.e., misdemeanor) and indictable (i.e., felony) offences. For DWI offenders, incarceration can be used as a sanction for both first and repeat offenders of varying lengths depending upon the severity of the crime.
  • Indictable offences: In Canada, more serious offences are deemed indictable offences. Examples include drug trafficking, robbery, aggravated sexual assault and murder. Indictable offences typically have minimum and maximum penalties, which may include life in prison, specified as sentencing guidelines. Defendants have a right to select the mode of trial, including whether a preliminary inquiry is conducted. Convictions are appealed to the Provincial Court of Appeals.
  • Inhalant: These substances are volatile and produce chemical vapors that can be inhaled to induce a psychoactive, or mind-altering effect.
  • Jail: Short-term incarceration facilities for arrested suspects who have not been arraigned, persons awaiting a court appearance, or persons convicted of lesser charges awaiting trial or sentencing. Jails sentences can vary in length from a few days to up to over a year.
  • Ketamine: This substance produces a detachment from reality, distorting perceptions of sight and sound. Ketamine is classified as a dissociative anaesthetic.
  • Licence suspension: A type of sanction whereby an individual’s driving privilege is suspended for a period of time by the licencing authority. The reason for a licence suspension can vary as can the length of the suspension. Licence suspension is a common administrative sanction for an impaired driving offence. Licencing authorities may permit alcohol-impaired drivers to retain their driving privileges with an interlock device installed in lieu of a suspension.
  • LSD: Also known as acid, this substance is a psychedelic drug known for its psychological effects. This may include altered awareness of the surroundings, perceptions, and feelings as well as sensations and images that seem real though they are not. LSD is classified as a hallucinogen.
  • MDMA: Commonly known as ecstasy (E), this substance is a psychoactive drug used primarily as a recreational drug. Desired effects include increased empathy, euphoria, and heightened sensations. MDMA is classified as a hallucinogen.
  • Methamphetamine: A central nervous system stimulant also known as meth, ice, crystal, and chalk. Commonly used as a recreational drug for its euphoric effects, methamphetamine has limited use to treat medical conditions such as attention deficit hyperactivity disorder and obesity in the form of methamphetamine hydrochloride tablets. However this use must be prescribed. More generally, methamphetamine is recognized as a highly addictive drug and is prohibited in many jurisdictions.
  • Millilitre (ml): A unit of measurement being one thousandth of a litre.
  • Misdemeanor offence: A category of criminal offence that is less severe than a felony and may be expunged after a certain amount of time. Summary convictions are often misdemeanor offences for most jurisdictions.
  • Morphine: An opioid pain medication used to treat severe/long-term pain. Morphine is commonly used by medical professionals to help manage pain in patients who suffer from chronic conditions. It can be injected or ingested. Although it can be addictive, it is considered to be extremely safe and effective when administered n proper dosages by a health care professional.
  • Nanogram (ng): A unit of measurement being one billionth of a gram.
  • Narcolepsy: This condition is characterized by extreme drowsiness and sudden onset of sleep.
  • Narcotic analgesic: This substance mimics the activity of endorphins which are substances produced by the body to control pain.
  • New psychoactive substance: Synthetic substances that are designed to mimic the pharmacological effects of existing controlled substances.
  • Nitrates: Although nitrates are used medically, they can also be used illegally as recreational drugs and are often referred to as “poppers”. Poppers cause your veins and arteries to dilate, producing a temporary state of euphoria, relaxation, increased heart beat and a drop in blood pressure. Nitrates are classified as an inhalant.
  • Non-benzodiazepine hypnotics: A class of psychoactive drugs very similar in nature to benzodiazepines. The pharmacodynamics of non-benzodiazepine is almost entirely the same as benzodiazepine drugs and therefore employ similar benefits, side-effects, and risks. However, non-benzodiazepines have dissimilar or entirely different chemical structures and are therefore unrelated to benzodiazepines on a molecular level. Non-benzodiazepine hypnotics are classified as a CNS depressant.
  • Non-compliance: Failure to comply with or complete a criminal justice sanction imposed by a court or supervision agency. For impaired driving offenders non-compliance is usually interpreted as any action that is not in accordance an imposed sanction or condition of supervision.
  • Object movement estimation under divided attention (OMEDA): This is a computerised dual task with two parts. Part 1 allows researchers to obtain an individual’s error in time-to-collision (TTC) estimation. Different target speeds can be simulated, as can various degrees of occlusion. A secondary task is also incorporated in the form of a visual divided attention task. This requires the identification of peripheral duplication of stimuli presented centrally.
  • Opiates: Opiate drugs are derived from the poppy plant, and are therefore non-synthetic. These include opium, morphine and codeine.
  • Opioid: Opioid drugs are synthetic or semi-synthetic derived through chemical synthesis. Opioids function like opiates, and have the same pain-killing effects. Opioids are classified under the narcotic analgesic category.
  • Parole: A post-conviction form of community supervision. Parole is granted to offenders as an early release provision, usually upon the merits of good behaviour and compliance with their previous sanctions. Parole is strictly a post-release supervision program which is granted after serving a longer period of incarceration and is monitored by parole officers. The conditions of parole are generally similar to probation.
  • Passive exposure: Individuals are unintentionally exposed to traceable amounts of drugs or drug residue even though they did not directly consume, ingest, or inhale a drug. For example, persons who inhale cannabis smoke from cigarettes smoked by other individuals in their presence may have detectable levels of THC in their blood despite the fact they have not directly smoked it. The traceable amount of drug is very low.
  • Per se laws: A type of law that makes an act inherently illegal. Alcohol-impaired driving offences often utilize a per se threshold of .08 or .05 grams of alcohol in 100 grams of blood. The presence of alcohol in excess of this limit constitutes an offence which may be proven by demonstrating the driver had a BAC of .08 or greater.
  • Phencyclidine: This substance is used recreationally to produce a feeling of detachment from reality, and can induce hallucinations, anxiety and paranoia. This drug is often referred to as PCP or “angel dust” and is classified as a dissociative anaesthetic.
  • Placebo: A substance or treatment with no active therapeutic effect.
  • Plate impoundment: A form of sanction whereby the licence plate of a vehicle is seized by law enforcement, on behalf of the driver licencing agency in order to prevent an individual from driving. Plate impoundment is viewed as a cost-effective alternative to vehicle impoundment.
  • Post-conviction program: A penalty or program that is imposed upon conviction for an offence.
  • Prevalence: In criminology prevalence can be understood here to mean how often or how frequently a behaviour is committed (i.e. how many people are deterred from offending).
  • Prison: Long-term incarceration facilities which house offenders convicted of serious offences and who received a term of incarceration in excess of two years. A prison sentence may be served in provincial/state or federal facilities managed by a government department or a private prison under contract with the government agency.
  • Probation: A post-conviction program of community supervision involves the supervision of the behaviour of a convicted offender, deemed to be a low risk or moderate risk to public safety. Probation is usually in lieu of incarceration and is used for less serious offences. Probation officers function similar to parole officers.
  • Psilocybin: A hallucinogenic crystalline solid drug that is naturally occurring in 200 species of mushrooms. It has been used for religious/spiritual purposes by many different cultures due to its perception-altering effects on the individual. In general, the effects include euphoria, visual and mental hallucinations, changes in perception, a distorted sense of time, and spiritual experiences, and can include possible adverse reactions such as nausea and panic attacks. Its use is highly regulated and often prohibited in many jurisdictions. Psilocybin is classified as a hallucinogen.
  • Psychomotor: This term refers to the origination of movement in conscious mental activity. Psychomotor learning is demonstrated by physical skills such as movement, coordination, manipulation, dexterity, grace, strength, speed; actions which demonstrate fine motor skills such as use of precision instruments or tools.
  • Quaalude: Also known as methaqualone, is a non-barbiturate sedative-hypnotic substance which can be used to induce sleep but is also widely used as an illicit drug for recreational purposes. Due to health problems associated with overdoses, such as cardiac arrest, the use of Quaalude is highly regulated in many jurisdictions.
  • Recidivism: The commission of additional criminal offences following a first conviction. Recidivism rates are a standard outcome measure in the criminal justice system and in criminal justice research. High recidivism rates are usually an indicator that sanctions are not deterring offending behaviour or that the underlying problems which contribute to offending behaviour are not being addressed.
  • Repeat offenders: Persons convicted of any criminal offence more than once. Repeat offenders can be convicted of one or more offences as part of separate incidents. These offences may be similar in nature or different. For example, a repeat impaired driving offender is someone who has more than one conviction for this offence.
  • Roadside drug testing (RDT): A form of driver screening conducted at the roadside by police to determine whether or not drivers are impaired by drugs. RDT is usually only one step in a process to determine impairment. Subsequent confirmatory tests of biological fluids are usually conducted by a toxicologist to verify screening results.
  • Simple reaction time test: This test involves just one stimulus, and when it appears, subjects performing the test must react with the one response required in this type of experiment.
  • Solvent: A substance that dissolves a solute (a chemically distinct liquid, solid or gas), resulting in a solution. A solvent is classified as an inhalant.
  • Standardized field sobriety test (SFST): A form of driver screening conducted at the roadside by police to determine whether drivers are impaired by alcohol and/ drugs. SFSTs are a battery of validated tests that identify impairment in drivers. Test results can be used as evidence of impairment in court proceedings.
  • Substance abuse education: Education programs that describe the impacts and health risks associated with substance abuse. Substance abuse education may be a post-conviction sanction used in addition to other sanctions to educate offenders about the risks and consequences of substance use and share strategies to prevent or reduce harmful use.
  • Substance abuse treatment: A treatment regime that is designed to help individuals abstain or reduce the harmful use of substances, and understand their behaviour. In the criminal justice system, substance abuse treatment can often be used as a sanction, in conjunction with other sanctions, to help correct offending behaviour and improve the overall health of offenders.
  • Substance abuse: The excessive or harmful use of addictive substances that can result in misuse, abuse or dependence. Substance abuse can have accompanying health and public safety issues that have lead jurisdictions to regulate the sale and consumption of specific substances and/or prohibit their use.
  • Summary conviction offences: In Canada, less serious criminal offences are deemed summary conviction offences. The maximum penalty for a summary offence is usually a $5,000 fine and/or six months in jail. Some summary offences have higher maximum sentences and in some instances a breach of a probation order may be considered a summary offence. Persons are not fingerprinted by police for summary conviction offences, and cases may be appealed to the Superior Court of the Jurisdiction.
  • Synthetic cathinones: Synthetic cathinones are a man-made chemical related to the khat plant, a shrub grown in East Africa and Arabia. Synthetic cathinones are often referred to as “bath salts”, and are consumed for their stimulant properties.
  • THC: Tetrahydrocannabinol, or more precisely its main isomer-trans-Δ⁹-tetrahydrocannabinol, is the principal psychoactive constituent of cannabis.
  • Time Wall test: Participants estimate when an occluded, moving object reaches a target point.
  • Toluene: This substance is a colorless, water-insoluble liquid with a smell that is often associated with paint thinners. Toluene is classified as an inhalant.
  • Tower of London task: This test is used in applied clinical neuropsychology to specifically assess executive functioning to detect deficits in planning, which may occur due to a variety of medical and neuropsychiatric conditions. The test consists of two boards with pegs and several beads with different colors. The examiner uses the beads and the boards to present the subject with problem-solving tasks.
  • Vehicle impoundment: A post-conviction sanction for vehicle related offences whereby the physical vehicle is confiscated by the state and held at a predetermined location. Vehicle impoundment is often seen as a last resort for DWI offenders given that it is fairly costly to collect and store offender vehicles.
  • Vigilance: This is the action or state of keeping careful watch for possible danger or difficulties.
  • Wisconsin Card Sorting task (WCST): This is a neuropsychological test of “set-shifting” (i.e., the ability to display flexibility in the face of changing schedules of reinforcement). A number of stimulus cards are presented to subjects who are told to match the cards, but are not told how to match them; however, he or she is told whether a particular match is right or wrong.
  • Young/juvenile offenders: Offenders who, at the time of their offence, were below the age of majority that legally determines adulthood. In most jurisdictions this age is 18 however in some jurisdictions it can be as high as 21.
  • Zero tolerance laws: Laws that prohibit any amount of an impairing substance in the body of a driver who is operating a vehicle.  The value may be zero or less than a preset threshold close to zero. Zero tolerance laws are a form of per se laws. For drug-impaired driving, zero tolerance laws often have limits set slightly above zero to account for prescription medication and instances of passive exposure, neither of which would likely impair individuals.