Jones Alan Wayne
Department of Forensic Toxicology, University Hospital, Linköping, Sweden.
Traffic Inj Prev. 2005 Dec;6(4):317-22. doi: 10.1080/15389580500253760.
This article describes the background and implementation in Sweden of zero-concentration limits for controlled drugs in the blood of drivers. Eliminating the need to prove that a person's ability to drive safely was impaired by drugs has greatly simplified the prosecution case, which now rests primarily on the forensic toxicology report. Driving under the influence of a prescription drug listed as a controlled substance is exempt from the zero-limit law provided the medication was being used in accordance with a physician's direction and the person was not considered unfit to drive.
The prevalence of driving under the influence of drugs (DUID) in Sweden was evaluated from police reports with the main focus on the toxicological findings. A large case series of DUID suspects was compared before and after introducing zero concentration limits in blood for controlled substances on July 1, 1999. The spectrum of drugs used by typical offenders and the concentrations of various licit and illicit substances in blood were evaluated and compared.
Immediately after the zero-limit law came into force, the number of cases of DUID submitted by the police for toxicological analysis increased sharply and is currently ten-fold higher than before the new legislation. Statistics show that about 85% of all blood samples sent for toxicological analysis have one or more banned substances present. Amphetamine is by far the leading drug of abuse in Sweden and was identified in about 50-60% of all DUID suspects either alone or together with other controlled substances. The next most frequently encountered illicit drug was tetrahydrocannabinol (THC), with positive findings in about 20-25% of cases. Various prescription drugs, mainly sedative-hypnotics like diazepam and flunitrazepam, were also highly prevalent and these occurred mostly together with illicit substances. Opiates, such as 6-acetyl morphine and morphine, the metabolites of heroin, were high on the list of substances identified. Most DUID suspects in Sweden were men (85%) who were poly-drug users combining illicit substances, like amphetamine and/or cannabis, with a prescription medication such as various benzodiazepines.
Sweden's zero-concentration limit has done nothing to reduce DUID or deter the typical offender because recidivism is high in this population of individuals (40-50%). Indeed, many traffic delinquents in Sweden are criminal elements in society with previous convictions for drunk and/or drugged driving as well as other offenses. The spectrum of drugs identified in blood samples from DUID suspects has not changed much since the zero-limit law was introduced.
本文介绍了瑞典对驾驶员血液中管制药物实行零浓度限制的背景及实施情况。无需证明一个人的安全驾驶能力因药物而受损，这极大地简化了检控案件，目前该案件主要依据法医毒理学报告。若按照医生指示使用处方药且该人不被认为不适宜驾驶，则使用列为管制物质的处方药驾驶可免于零限制法律。
通过警方报告评估瑞典药物影响下驾驶（DUID）的流行情况，主要关注毒理学结果。对1999年7月1日对管制物质实行血液零浓度限制前后的大量DUID嫌疑人案例系列进行比较。评估并比较典型违法者使用的药物种类以及血液中各种合法和非法物质的浓度。
零限制法律生效后，警方提交进行毒理学分析的DUID案件数量急剧增加，目前比新立法前高出十倍。统计数据显示，送去进行毒理学分析的所有血液样本中约85%含有一种或多种违禁物质。在瑞典，苯丙胺是迄今为止最主要的滥用药物，在所有DUID嫌疑人中，约50 - 60%的人单独或与其他管制物质一起被检测出含有该物质。接下来最常遇到的非法药物是四氢大麻酚（THC），约20 - 25%的案例检测呈阳性。各种处方药，主要是像地西泮和氟硝西泮这样的镇静催眠药，也非常普遍，且大多与非法物质一起出现。阿片类药物，如6 - 乙酰吗啡和吗啡（海洛因的代谢物），在检测出的物质清单中排名靠前。瑞典大多数DUID嫌疑人是男性（85%），他们是多药使用者，将苯丙胺和/或大麻等非法物质与各种苯二氮䓬类等处方药混合使用。
瑞典的零浓度限制对减少DUID或威慑典型违法者毫无作用，因为这群人的累犯率很高（40 - 50%）。事实上，瑞典许多交通违法者是社会中的犯罪分子，之前有过酒后和/或吸毒驾驶以及其他犯罪的定罪记录。自实行零限制法律以来，从DUID嫌疑人血液样本中检测出的药物种类变化不大。
