Holmgren Anita, Holmgren Per, Kugelberg Fredrik C, Jones A Wayne, Ahlner Johan
Department of Forensic Genetics and Forensic Toxicology, National Board of Forensic Medicine, Artillerigatan 12, Linköping, Sweden.
Traffic Inj Prev. 2007 Dec;8(4):361-7. doi: 10.1080/15389580701329344.
After Sweden's zero-tolerance law came into force (1 July 1999), the number of cases of driving under the influence of drugs (DUID) submitted by the police for toxicological analysis increased more than 10-fold. This prompted an in-depth investigation into the kinds of drugs used by DUID offenders, whether licit or illicit, and the frequency of their occurrence.
All blood samples from DUID suspects sent by the police for toxicological analysis over a 4-year period (2001-2004) were investigated (N = 22,777 cases). Specimens of blood or urine were subjected to a broad screening analysis by immunoassay methods aimed at detecting amphetamines, cannabis, opiates, cocaine metabolite, and the major benzodiazepines. All positive results from the screening stage were verified by use of more specific analytical methods (e.g., GC-MS, LC-MS, GC-FID, and GC-NPD).
Between 80 and 85% of all the blood samples contained at least one banned substance and many contained two or more therapeutic and/or illicit drugs. About 15% of cases were negative for drugs, although these frequently (30-50%) contained ethanol above the legal limit for driving in Sweden, which is 0.20 mg/g (0.02 g%). Amphetamine was the most prominent illicit drug seen in 55-60% of cases either alone or together with other drugs of abuse. Stimulants like cocaine and/or its metabolite were infrequently encountered ( approximately 1.2% of cases). The next most prevalent illicit drug was cannabis, with positive results for tetrahydrocannabinol (THC) in blood either alone ( approximately 4%) or together with other psychoactive substances ( approximately 20%). Morphine, codeine, and/or 6-acetyl morphine were identified in approximately 2% of all DUID suspects, being indicative of heroin abuse. The major prescription drugs identified in blood were benzodiazepines (10%) as exemplified by diazepam, alprazolam, nitrazepam, and flunitrazepam. Drugs for treating insomnia, zolpidem and zopiclone, were also identified in blood samples from DUID suspects over the study period. Other therapeutic agents were encountered in only 1-2% of all cases.
The dramatic increase in DUID after the zero-tolerance law came into force probably reflects enhanced police activity and more enthusiasm to apprehend and charge individuals for this offence. Illicit drugs, particularly amphetamine and cannabis, and poly-drug use were predominant compared with use of scheduled prescription drugs. The typical DUID offender in Sweden abuses central stimulants, particularly amphetamine, and has probably done so over many years. Options for treating offenders for their underlying substance abuse problem should be considered instead of the more conventional penalties for drug-impaired driving.
瑞典的零容忍法生效后（1999年7月1日），警方提交进行毒理学分析的药物影响下驾驶（DUID）案件数量增加了10倍多。这促使对DUID犯罪者使用的药物种类（无论合法或非法）及其出现频率进行深入调查。
对警方在4年期间（2001 - 2004年）送交进行毒理学分析的所有DUID嫌疑人的血样进行调查（N = 22,777例）。血液或尿液样本通过免疫分析方法进行广泛筛查分析，旨在检测苯丙胺、大麻、阿片类药物、可卡因代谢物和主要苯二氮䓬类药物。筛查阶段的所有阳性结果均通过使用更特异的分析方法（如气相色谱 - 质谱联用、液相色谱 - 质谱联用、气相色谱 - 火焰离子化检测器和气相色谱 - 氮磷检测器）进行验证。
所有血样中80%至85%至少含有一种违禁物质，许多样本含有两种或更多治疗性和/或非法药物。约15%的案件药物检测呈阴性，尽管这些案件中经常（30 - 50%）含有高于瑞典法定驾驶限量0.20 mg/g（0.02 g%）的乙醇。苯丙胺是最常见的非法药物，在55% - 60%的案件中单独出现或与其他滥用药物一起出现。可卡因和/或其代谢物等兴奋剂很少见（约1.2%的案件）。其次最常见的非法药物是大麻，血液中四氢大麻酚（THC）单独呈阳性结果（约4%）或与其他精神活性物质一起呈阳性结果（约20%）。在所有DUID嫌疑人中约2%检测出吗啡、可待因和/或6 - 乙酰吗啡，这表明存在海洛因滥用情况。血液中鉴定出的主要处方药是苯二氮䓬类药物（10%），以地西泮、阿普唑仑、硝西泮和氟硝西泮为例。在研究期间，DUID嫌疑人的血样中还鉴定出治疗失眠的药物唑吡坦和佐匹克隆。在所有案件中仅1 - 2%遇到其他治疗药物。
零容忍法生效后DUID案件的急剧增加可能反映了警方活动的加强以及对逮捕和指控此类犯罪者的更大热情。与使用预定处方药相比，非法药物，特别是苯丙胺和大麻以及多药使用更为普遍。瑞典典型的DUID犯罪者滥用中枢兴奋剂，特别是苯丙胺，并且可能已经这样做了很多年。应考虑为犯罪者治疗其潜在的药物滥用问题，而不是对药物影响下驾驶采取更传统的处罚措施。
