Drugged driving investigation workflow and oral fluid testing used around the world: Survey results of SOFT/AAFS Drugs and Driving and Oral Fluid Committees

Survey the international forensic toxicology community to assess approaches to drugged driving investigations and testing, increase awareness of drugs frequently detected among drivers, and promote future partnerships between TIAFT, the Society of Forensic Toxicologists (SOFT), and the American Academy of Forensic Sciences (AAFS) members. In the United States, alcohol, cannabinoids, and opioids were found in 25%, 33%, and 15% of seriously injured or killed drivers, respectively, during the second quarter of 2020. Oral fluid drug testing has gained traction in the US, but is not currently used to the same extent as in parts of the world such as Europe and in countries such as Australia. The SOFT/AAFS Drugs and Driving (DD) and Oral Fluid (OF) Committees are focused on provided professional support and development in the area of drugs and driving impairment and oral fluid drug testing for forensic toxicologists and collaborating organizations. We introduced the mission of our Committees at the virtual 58th Annual meeting of TIAFT. We hope the survey results included herein will further future joint projects with TIAFT. A survey was developed by the SOFT/AAFS DD and OF Committees to collect information on drugged driving investigation and analytical workflows, laws and policies, commonly tested specimen types, and the most prevalent drugs detected in DUID testing. The survey consisted of 20 questions distributed using SurveyMonkey to over 100 TIAFT representatives from different countries and jurisdictions. Participant responses were reviewed and summarized. Specific comprehensive programs with selected for detailed follow-up and featured in spotlight workflows to provide guidance and models to less developed programs. Cannabinoids and ethanol were the most commonly detected drugs in driving cases with methamphetamine/amphetamine, MDMA, fentanyl, 6-MAM/morphine, and cocaine frequently encompassing the top five most prevalent drugs. Blood was the specimen of choice for DUID testing and traffic fatalities followed by oral fluid and urine. Oral fluid confirmation devices included Quantisal® and Oral-Eze®. Roadside oral fluid devices included Draeger DT5000®, Alere SoToxa®, and Drugwipe®. The most common per se limit for ethanol was 0.05%. The practice of stop testing limits, where drugs are not analyzed if a blood alcohol concentration reaches a specific concentration (e.g., 0.10%), is less common outside the US. SOFT/AAFS DD and OF Committees are actively engaged in various projects to support its mission including offering special sessions at the SOFT and AAFS annual meetings, sponsoring drugs and driving and oral fluid drug testing related workshops, providing literature lists on the SOFT website, and conducting surveys of laboratories to gather information and facilitate advancement of the drugged driving investigations and testing. Our goal is to collaborate with TIAFT membership in sharing drug trends and laboratory practice while supporting prevention efforts to reduce drug-impaired driving. The survey results highlight differences and similarities among countries in their drugged driving investigation processes. This project will encourage future partnerships and continuing education opportunities.