Ferrari D, Locatelli M, Sabetta E
SCVSA (Chemistry, Life Sciences, and Environmental Sustainability) Department, University of Parma, Parma, Emilia-Romagna, Italy.
IRCCS (Scientific Institute for Research, Hospitalization, and Healthcare) Ospedale San Raffaele. Milan, Lombardy, Italy.
Forensic Sci Rev. 2025 Jul;37(2):105-115.
Driving under the influence (DUI) of alcohol and/or illicit drugs has been shown to increase the risk of involvement in road traffic collisions. Thanks to the scientifically proven link between blood alcohol concentration and impaired driving ability, a broadly accepted legislative framework has been established and is now widely adopted across the globe. In contrast, less is known about the effects of illicit drugs, and a clear correlation between blood drug concentrations and driving performance has been defined by some authors as a "mirage". In this review, we examine the advantages and limitations of current legislative initiatives regulating DUI of psychoactive drugs. The predominant approaches employed are "zero tolerance", "legal limits", and "impairment assessment". We discuss the distinctions among these methods, focusing on their implications for balancing citizens' rights and public safety. Additionally, we address the pre-analytical, analytical, and post-analytical challenges associated with the implementation of each legislative framework. The application of these three approaches is also discussed in light of recent changes in drug policies observed in many countries, including the decriminalization of certain substances, such as cannabis, and the growing prevalence of drugs prescribed for medical purposes. In conclusion, due to the absence of a robust scientific foundation, determining the most appropriate approach among the three remains challenging. The choice of method is primarily influenced by the government's policy priorities, which may emphasize either the protection of citizens' rights or the promotion of road safety.
酒精和/或非法药物影响下驾驶（DUI）已被证明会增加卷入道路交通事故的风险。由于血液酒精浓度与驾驶能力受损之间的科学关联已得到证实，一个广泛接受的立法框架已经建立，并且目前在全球范围内广泛采用。相比之下，人们对非法药物的影响了解较少，一些作者将血液药物浓度与驾驶表现之间的明确关联定义为一种“幻影”。在本综述中，我们研究了当前管制精神活性药物影响下驾驶的立法举措的优点和局限性。所采用的主要方法是“零容忍”、“法定限度”和“损害评估”。我们讨论了这些方法之间的区别，重点关注它们在平衡公民权利和公共安全方面的影响。此外，我们还探讨了与每个立法框架实施相关的分析前、分析中和分析后挑战。鉴于许多国家观察到的毒品政策的近期变化，包括某些物质（如大麻）的非刑事化以及用于医疗目的药物的日益普及，我们还讨论了这三种方法的应用。总之，由于缺乏坚实的科学基础，在这三种方法中确定最合适的方法仍然具有挑战性。方法的选择主要受政府政策重点的影响，政府政策重点可能强调保护公民权利或促进道路安全。
