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TIME:XX
LESSON PLAN
Course:
DUI/SFST
Class Title:
Determination of Driving Under the
Influence of Drugs
Effective Date:
January 14, 2013
1
COVER PAGE
TIME:
COURSE :
CLASS TITLE:
240 Minutes
DUI/SFST
Determination of Driving
Under the Influence of Drugs
CLASS LEVEL:
OBJECTIVES:
AIT
See page 3
METHOD OF INSTRUCTION:
METHOD OF TESTING:
TRAINING AIDS:
Lecture
Written
PowerPoint, Proxima, Screen,
Computer, Drug Cart
REFERENCES:
See page 4
COMPLETED BY:
DATE:
REVISIONS BY:
DATE OF REVISIONS:
Bill Eckler
February 2008
Michael Roe
December 18, 2012
APPROVED BY (signature):
DATE APPROVED:
Scottie Saltsman
December 18, 2012
2
OBJECTIVES
Without reference, the recruit will be able to:
8.7.1
describe in approximate, quantitative terms the
incidence of drug involvement in motor vehicle
crashes and in DUI enforcement in accordance
with NHTSA standards.
8.7.2
define the term “drug” in the context of DUI
enforcement in accordance with NHTSA
standards.
8.7.3
name the major categories of drugs in
accordance with NHTSA standards.
8.7.4
describe the observable signs of impairment
generally associated with the major drug
categories in accordance with NHTSA standards.
8.7.5
identify and describe appropriate procedures for
dealing with drug impaired and/or medically
impaired subjects in accordance with NHTSA
standards.
8.7.6
describe medical conditions and other situations
that can produce similar signs as impairment as
explained n class.
3
REFERENCES:
NHTSA. DWI Detection and Standardized Field Sobriety
Testing, 2006, U. S. Department of Transportation,
Washington D.C.
The Detection of DWI Motorcyclists, July 2006, NHTSA:
Pamphlet: DOT HS 807856, Washington D.C.
The Visual Detection of DWI Motorists, NHTSA: Pamphlet:
DOT HS 808 677, Washington, D.C.
4
LEC:
INTRO
The purpose of this session is to improve your ability to
recognize suspects who may be medically impaired or
under the influence of drugs other than alcohol and to
take appropriate action when you encounter such a
suspect. Alcohol remains the most frequently abused
drug, and most impaired drivers are under the influence of
alcohol. But many drivers also routinely abuse many
other drugs.
It is highly likely that every experienced DUI enforcement
officer has encountered at least some suspects who were
impaired by drugs other than alcohol. Depending on what
specific type or types of drugs they have taken, some
drug-impaired suspects may look and act quite a bit like a
person under the influence of alcohol. But others will look
and act very differently from alcohol-impaired suspects.
It is important that you be able to recognize suspects
who may be under the influence of other drugs, so
you will be able to summon assistance from
TIME: NA—opening slide
5
physicians or other appropriate people.
5
LEC:
So, the purpose for this block of training is: to improve
your ability to recognize suspects who may be medically
impaired or impaired by drugs other than alcohol and to
take appropriate action when you encounter such a
suspect.
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6
LEC:
By the end of this class you should be able to…
•
Describe the term Drug in the context of DUI
enforcement.
•
Describe the incidence of drug involvement in motor
vehicle crashes and DUI enforcement.
•
Name the Major categories of drugs.
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7
LEC:
Describe the observable signs associated with the major
drug categories.
Describe medical conditions and other situation that can
produce similar signs.
Describe appropriate procedures for dealing with drugimpaired or medically-impaired suspects.
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8
QTC:
What is a drug?
AR:
Medicines, cocaine, marijuana, etc
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9
LEC:
QTC:
AR:
QTC:
AR:
LEC:
Any substance which, when taken into the human body, can
impair the ability of the person to operate a vehicle safely.
What are some things physicians would consider being
drugs that are not covered under this definition?
Nicotine, caffeine………
What are some common chemical substances that doctors
do not usually consider as drugs, but definitely impair driving
ability?
Model airplane glue, gasoline, spray paint etc.
I am going to show you the seven categories of drugs that
we will be discussing during this block of training. I will
discuss in more detail, step by step on each category later in
our training.
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10
Category # 1 Central Nervous System Depressants
LEC:
CNS Depressants slow the mind and body down.
Some depressants include:
Alcohol
Barbiturates
Rohypnol ro-hip-nol (old date rape drug)
Muscle relaxants
Valium/Xanax/Prozac/ Librium
GHB - gamma hydroxy butyrate (new date rape drug)
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11
Category # 2 Central Nervous System Stimulants
LEC:
Stimulants: are psychoactive drugs which induce temporary
improvements in either mental or physical function or both.
Examples of these kinds of effects may include enhanced
alertness, wakefulness, and locomotion, among others. Due
to their effects typically having an "up" quality to them,
stimulants are also occasionally referred to as "uppers".
Cocaine
Amphetamines
Meth-amphetamines
Ritalin
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Category # 3 Hallucinogens
LEC:
These classes of psychoactive drugs have in common
that they can cause subjective changes in perception,
thought, emotion and consciousness. Unlike other
psychoactive drugs, such as stimulants and opiods,
these drugs do not merely amplify familiar states of mind,
but rather induce experiences that are qualitatively
different from those of ordinary consciousness. These
experiences are often compared to non-ordinary forms of
consciousness such as trance, meditation, and dreams.
LSD (Lysergic Acid Diethylamide) di-eth-la-mide
Peyote (cactus button)
MDMA (Methylene-Deoxy Meth-Amphetamines) Better
known as ECTASY
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13
Psilocybin (sil-o-sybin) Magic Mushrooms
13
Category # 4 Dissociative Anesthetics
LEC:
The most significant subjective differences between
dissociatives and the classical hallucinogens (such as
LSD and mescaline) are the dissociative effects,
including: depersonalization, the feeling of being unreal,
disconnected from one's self, or unable to control one's
actions; and derealization, the feeling that the outside
world is unreal or that one is dreaming
PCP - Phencyclidine
Ketamine
Dextro-meth-orphan or DXM which is the substance
found in cough syrups like Robitussin.
Analogs refer to the various formations of PCP,”K” DXM
(Powder, liquid, pills, capsules, etc…)
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14
Category # 5 Narcotic Analgesics (pain killer)
LEC:
Opioids are among the world's oldest known drugs; the use
of the opium poppy for its therapeutic benefits predates
recorded history. The analgesic (painkiller) effects of
opioids are due to decreased perception of pain, decreased
reaction to pain as well as increased pain tolerance.
Heroin
Morphine
Codeine
Oxycontin
Synthetic Opiates (Demerol, Methadone Fentanyl)
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15
Category # 6 Inhalants
LEC:
Inhalants are a broad range of drugs whose volatile
vapors are taken in via the nose and trachea. They are
taken by volatilization, and do not include drugs that are
inhaled after burning or heating. For example, amyl nitrate
and toluene are considered inhalants, but tobacco,
marijuana, and crack are not.
Examples:
Toluene
Spray paint
Gasoline
Glue
Nitrous Oxide
Hundreds of common household items
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16
LEC:
AFQ:
LEC:
Category # 7 Cannabis
Cannabis, also known as marijuana and by other names
that refers to preparations of the Cannabis plant intended
for use as a psychoactive drug and as medicine.
Chemically, the major psychoactive compound in marijuana
is delta-9-tetrahydocannabanol (Δ9-THC); it is one of 400
compounds in the plant, including other cannabanoids, such
as cannabidiol (CBD), cannabinol (CBN), and
tetrahydrocannabivarin (THCV), which can produce sensory
effects unlike the psychoactive effects of THC. Marijuana is
the herbal form of cannabis, and comprises the flowers, the
subtending leaves, and the stalks of mature pistillate female
plants; hashish is the resinous, concentrated form of
cannabis.
Marijuana
Hashish
Marinol (medical marijuana)
Hash oil
These seven categories are organized on the basis of the
clinical effects that they produce.
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Category # 7 Cannabis (Continued)
LEC:
A) The drugs that belong to a particular category all produce
basically the same effects.
Example- Alcohol and Valium both are CNS Depressants. A
person under the influence of Valium will look, act and feel
basically the same as a person under the influence of
alcohol.
B) Two different categories produce different effects.
Example- A person under the influence of a CNS Stimulant
will not look, act or feel exactly like someone under the
influence of PCP.
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LEC:
Results from the 2010 National Survey on drug use and
Health: National Findings.
http://www.samhsa.gov/data/NSDUH/2k10Results/Web/PD
FW/2k10Results.pdf
If time permits go to the above url and review some other
interesting drug and alcohol statistics from the 2010 survey.
In 2010, an estimated 11.4 percent of persons aged 12 or
older drove under the influence of alcohol at least once in
the past year. This percentage had dropped since 2002,
when it was 14.2 percent. The rate of driving under the
influence of alcohol was highest among persons aged 21 to
25 (23.4 percent).
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LEC:
Nearly less than half (49%) of the inmates surveyed in
state prisons reported being under the influence of drugs
or alcohol while committing the offense they were
incarcerated for.
17 % reported committing the offense for money to buy
drugs.
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LEC:
University of Tennessee found 40 % of crash injured drivers
had drugs other than alcohol in them.
The Maryland Shock Trauma Center found nearly one-third
of crash–injured drivers had recently used marijuana.
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LEC:
Studies of fatally injured drivers consistently show that
nearly 20 percent had drugs or the combination of drugs
and alcohol in their systems at the time of the crash.
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22
QTC:
What is one of the most reliable signs of alcohol
influence that can be observed in the eyes?
AR:
Red eyes, blood-shot eyes, relaxed eyelids……..
LEC:
Horizontal Gaze Nystagmus
1. The eyes disclose some of the clearest signs of
drug impairment or medical conditions.
a. Horizontal gaze nystagmus is a very clear
indication, in a suspect's eyes, of possible alcohol
impairment.
b. There are a number of drugs, other than alcohol,
that will enhance H.G.N.
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LEC:
c. There are a number of other drugs that will not
cause horizontal gaze nystagmus. (Cannabis,
stimulants, hallucinogens, narcotics)
d. There are many other clues that the eyes will
disclose, all of which will suggest the presence or
absence of drugs or medical impairment. ( a need to
call E.M.S.)
If the eyes track equally, but "jerk" while they are
moving, then the possible presence of three
categories of drugs should be noted: they are:
Depressants, Inhalants, Dissociative Anesthetics.
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LEC:
Drugs that will enhance nystagmus:
Depressants
Inhalants
Dissociative Anesthetics
“These are what we call our DID drugs”.
This involuntary jerking is what we call Horizontal
Gaze Nystagmus (HGN).
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Drugs causing pupil dilation.
LEC:
Cannabis, Stimulants, Hallucinogens.
If the pupils are noticeably dilated, then
the possibility exists that the subject could
be impaired by certain categories of drugs:
CNS stimulants
Examples: cocaine, methamphetamine, amphetamine, etc.
Hallucinogens
Examples: LSD, peyote, psilocybin, MDA, Ecstasy, etc.
Cannabis
Examples: Marijuana, Hashish, Hash Oil.
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LEC:
Notice how large the pupils are, even with light shining in to
them. the normal pupil would constrict in this case. There
are times the suspect’s pupils are so large or dilated, it is
hard to tell the color of the eyes.
If the two pupils are distinctly different in size it is possible
that the subject has a glass eye, or is suffering from a head
injury or a neurological disorder. It is sufficient to look at a
suspect's pupils and estimate whether they look noticeably
small ,(constricted) about normal, or noticeably large,
(dilated).
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Narcotic analgesics usually cause pupil constriction.
LEC:
NTF:
If the pupils are noticeably constricted, then the possibility
exists that the subject could be impaired by a narcotic
analgesic.
Examples: Heroin, codeine, demerol, oxycodone, fentanyl,
etc.
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Constricted Pupils
LEC:
Notice how small the pupils are.
(Do you think his nose has been broken a time or two!)
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C.N.S. Depressants, Inhalants, Dissociative Anesthetics
(D.I.D. drugs)
LEC:
The types of drugs that usually enhance nystagmus usually
do not affect pupil size.
Major exception- Methaqualone (a CNS depressant) will
cause pupils to dilate.
Methaqualone is a sedative-hypnotic drug that is similar in
effect to barbiturates, a general CNS depressant.
Quaaludes became increasingly popular as a recreational
drug in the late 1960s and early 1970s. The drug was used
during sexual activity because of heightened sensitivity and
lowered inhibition coupled with relaxation and euphoria. It
was withdrawn from many developed markets in the early
1980s (in 1982 in the United States), being made a
Schedule 1 drug in the U.S. in 1984.
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LEC:
PCP is a dissociative anesthetic
PCP may exhibit immediate onset of nystagmus prior to
45 degrees, also vertical nystagmus usually will be
present in subjects under the influence of PCP or CNS
depressants or inhalants.
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LEC:
You are expected to remember this! Log it in your brain!
Depressants
Inhalants
Drugs that cause nystagmus
but does not effect the pupil size
Dissociative Anesthetics
_______________________________________
Cannabis
Drugs that effect the pupil size
Stimulants
but does not cause nystagmus
Hallucinogens
(causes the pupils to dilate
_______________________________________
Narcotics
Drugs that effect the pupil size
But does not cause nystagmus
(causes the pupils to constrict)
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LEC:
Let’s talk about the seven drug categories and their
observable effects.
Category # 1 CNS Depressants
*Alcohol- The most familiar CNS depressant.
*Rohypnol--street name- roopies, roofies, rib.
Single or double scored white tablets with manufacturer
name as either ROCHE or <RH> and with the number 1 or
number 2 on it, meaning 1 mg or 2 mg tablets.
Method of use- usually mixed in a drink.
Duration of effects 6-10 hours with onset 10-15 min.
Flunitrazepam is marketed as a potent hypnotic, sedative,
anticonvulsant, anxiolytic, amnestic, and skeletal muscle
relaxant drug most commonly known as Rohypnol. An
intermediate acting benzodiazapine, flunitrazepam is
prescribed for the treatment of severe insomnia.
In the United States, the drug has not been approved by the
FDA and is considered to be an illegal drug.[
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LEC:
Benzodiazepines are prescribed for short-term relief of
severe and disabling anxiety. Benzodiazepines may also be
indicated to cover the latent periods associated with the
medications prescribed to treat an underlying anxiety
disorder. They are used to treat a wide variety of conditions
and symptoms and are usually a first choice when shortterm CNS sedation is needed. Longer-term uses include
treatment for severe anxiety.
Benzodiazepines include:
Xanax, Librium, Klonopin, Valium, Ativan
GHB- Gamma Hydroxy Butyrate- (bew-ta-rate)
Street Names: Liquid Ecstasy, Scoop, Easy Lay, Georgia
Home Boy, Grievous Bodily Harm, Liquid X, and Goop.
The only common medical applications for GHB today are in
the treatment of narcolepsy and more rarely alcoholism.
GHB has a salty taste but, as it is colorless and odorless, it
has been described as "very easy to add to drinks" that
mask the flavor. GHB has been used in cases of drugrelated sexual assault, usually when the victim is vulnerable
due to intoxication with a sedative, generally alcohol.[16]
However it is difficult to establish how often GHB is used to
facilitate rape as it is difficult to detect in a urine sample
after a day, and many victims may not recall the rape until
some time after this. GHB can be detected in hair.[22] This
can be a useful tool in court cases and/or for the victim's
own information. Over-the-counter urine test kits only test
for date rape drugs that are benzodiazepines, which GHB is
not. To detect GHB in urine, the sample must be taken
within 8-12 hours of GHB ingestion, and cannot be tested at
home. GHB can be detected in hair for months after GHB
ingestion.
Duration of effects 3-5 hours with onset 10-15 minutes.
In the United States, it was placed on Schedule I of the
Controlled Substances Act in March 2000. However, when
sold as Xyrem, it is considered a Schedule III substance but
with Schedule I trafficking penalties, one of several drugs
that are listed in multiple schedules.
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Indicators of CNS depressants influence
LEC:
General indicators;
*Drunken behavior and appearance
*Uncoordinated
*Drowsy
*Sluggish
*Disoriented
*Thick, slurred speech
Eye indicators;
*Horizontal Gaze Nystagmus
*Possible Vertical Nystagmus
*Pupil size generally normal
(but dilated if using Methaqualone or Soma)
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GHB Traffic #1
VID
TIME:XX
DATE:(MAR.2012/updated)
36
Category # 2 CNS Stimulants
LEC:
Central Nervous System Stimulants accelerate the
heart rate, respirations and many other processes of
the body.
The two most widely abused kinds of CNS stimulants
are: Cocaine and Amphetamines.
Cocaine is made from the leaves of the coca plant.
Amphetamines are synthetically produced, or
(manufactured) drugs ie, man made.
Meth-amphetamines- such as ICE-a crystalline rock
that is smoked similar to the way crack is.
Crank or Speed – Beige powder, white crystalline rock,
white powder.
Duration of effects 4–8 hours with an onset of 8 – 30
seconds.
Method of use – smoked, snorted, injected.
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Living and dying harder and faster in the night of the
living dead.
LEC:
A look at stimulant use / abuse / addiction.
People under the influence of CNS stimulants tend to
be hyperactive indicated by nervousness extreme
talkativeness and an inability to sit still. They also are
usually unable to concentrate, or think clearly for any
length of time.
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LEC:
General Indicators:
Restlessness, excitation
Talkative
Euphoria
Exaggerated reflexes
Anxiety
Grinding teeth (bruxism)
Redness to the nasal area (if snorting)
Runny nose (if snorting)
Body tremors
Eye indicators:
No nystagmus
Pupils will be noticeably dilated
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LEC:
Dilated Pupil caused by stimulants
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LEC:
Methamphetamine increases alertness,
concentration, energy, and in high doses, can induce
euphoria, enhance self-esteem and increase libido.
Methamphetamine has high potential for abuse and
addiction, activating the psychological reward system
by triggering a cascading release of dopamine in the
brain. Methamphetamine is FDA approved for the
treatment of ADHD and exogenous obesity. It is
dispensed in the USA under the trademark name
Desoxyn.
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LEC:
Physical effects can include anorexia, hyperactivity,
dilated pupils, flushing, restlessness, dry mouth,
headache, tachycardia, hypertension, hypotension,
hyperthermia, diaphoresis, diarrhea, constipation,
blurred vision, dizziness, twitching, insomnia,
numbness, palpitations, arrythmias, tremors, dry
and/or itchy skin, acne, pallor, and with chronic
and/or high doses, convulsions, heart attack, stroke,
and death.
Psychological effects can include euphoria, anxiety,
increased libido, alertness, concentration, increased
energy, increased self-esteem, self-confidence,
sociability, irritability, aggressiveness,
psychosomatic disorders, psychomotor agitation,
delusions of grandiosity, hallucinations, excessive
feelings of power and invincibility, repetitive and
obsessive behaviors, paranoia, and with chronic
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use and/or high doses, amphetamine psychosis can occur.
42
Stimulants signs and symptoms/white tongue if smoked.
LEC:
Crack cocaine is a substance that affects the brain
chemistry of the user: causing euphoria, supreme
confidence, loss of appetite, insomnia, alertness, increased
energy, a craving for more cocaine, and potential paranoia
(ending after use). Its initial effect is to release a large
amount of dopamine, a brain chemical inducing feelings of
euphoria. The high usually lasts from 5–10 minutes,[2][7]
after which time dopamine levels in the brain plummet,
leaving the user feeling depressed and low.
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Evidence of smoking cocaine, - burnt blistered
thumb/fingers, lips
LEC:
The short-term physiological effects of cocaine include
constricted blood vessels, dilated pupils, and increased
temperature, heart rate, and blood pressure. Large
amounts (several hundred milligrams or more) intensify the
user's high, but may also lead to bizarre, erratic, and violent
behavior. Large amounts can induce tremors, vertigo,
muscle twitches, paranoia, or, with repeated doses, a toxic
reaction closely resembling amphetamine poisoning. Some
users of cocaine report feelings of restlessness, irritability,
and anxiety. In rare instances, sudden death can occur on
the first use of cocaine or unexpectedly thereafter.
Cocaine-related deaths are often a result of cardiac arrest
or seizures followed by respiratory arrest.
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Evidence of smoking cocaine – blackened gums
LEC:
Crack cocaine is popularly thought to be the most
addictive form of cocaine, and one of the most addictive
forms of any drug.
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Yasmine Bleeth Mug Shot
LEC:
Former Baywatch star Yasmine Bleeth was arrested in
September 2001 by Michigan police and charged with
cocaine possession. The actress pleaded guilty to one
criminal count and was sentenced in January 2002 to two
years probation and 100 hours of community service.
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Meth User 1979
LEC:
The L.A.P.D. Hollywood division arrested this lady.
She is a meth user. The L.A.P.D. tracked her many
arrests over the course of 9 years.
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Meth User 1982
LEC:
Remember it’s the same lady!!
TIME:XX
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Meth User 1988
LEC:
9 years later. The average life expectancy of a meth
addict is about 10 years!
TIME:XX
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LEC:
Hallucinogens are drugs that cause hallucinations;
they cause the user to perceive things differently
from the way that they really are.
LSD – Lysergic Acid Diethylamide (Blotter Acid)
Small squares of heavy stock paper, perforated for
tearing, with a drop of LSD on each. Ingested
orally. Sometimes there are pictures stamped on
each one.
Method of use – ingested
Duration of effects – variable
Peyote – Peyote Cactus Button
Visual description – Capsules, hard brown discs,
tablets.
Methods of use – Capsules & Tablets – ingested
Discs – Chewed, smoked, swallowed
Ingested in soup or tea form
Duration of effects - variable
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LEC:
MDMA – Methylene Dioxy Meth-Amphetamine
Ecstasy (XTC) “The Hug Drug” sometimes
Referred to as “The Love Drug”
Visual description – brown crystalline powder, or
tablets in many different colors.
Method of use – ingested, injected, snorted.
Duration of effects – variable
Most commonly used at Raves
Notice the girls have pacifiers in their mouths; this is
to keep them from grinding their teeth. MDMA causes
bruxism. The males usually chew on small glowsticks. (Play RAVE Video if time allows or at end of
block)
Most of the people at the Rave parties will use a
mask that has Vicks salve rubbed on the inside of it.
This opens up the bronchial tree; therefore, if they
see a red light pass in front of them they may smell a
rose; this is called (synethesia) we will talk about that
in a few minutes, also the menthol in the mask helps
keep them cool since ecstasy heats up the body.
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LEC:
Various forms of MDMA tablets.
Notice the colors and the markings set in each tablet.
This is how some of the pushers mark their pills. For
example the Mitsubishi man has got good clean stuff.
It’s just another way of marketing.
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LEC:
(Sin-us-thee-sha)
A transposition of senses
Remember earlier how I was talking about if a person
using MDMA saw a red light they may smell a rose?
Well this is “Synesthesia”. It is a transposing of the
senses. Sounds for example may be transposed into
sights. Sights may be transposed into odors or sounds.
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LEC:
Hallucinations
Dazed appearance
Body tremors
Uncoordinated
Perspiring
Disorientation
Paranoia
Difficulty in speech
Nausea
Piloerection (goose bumps)
Eye indicators of Hallucinogen influence:
Neither horizontal nor vertical nystagmus will be
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present. The pupils will usually be noticeably dilated.
54
LEC:
Flower pods containing seeds.
Flower pods containing seeds, which are consumed.
The plant grows wild in most of the United States.
Jimson is a green bush with white trumpet shaped
flowers. The pods when dried are light green in color and
prickly.
Methods of use – ingested, (made into a tea)
Duration of effects – Variable
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LEC:
Peyote – Peyote Cactus Button
Dried, about the size of a nickel.
Visual description – Capsules, hard brown discs,
tablets.
Methods of Use:
Capsules & Tablets – ingested
Discs – Chewed, smoked, swallowed, ingested in
soup or tea
Duration of effects - variable
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LEC:
Mushrooms
Psilocybin (sil-o-sybin) / Magic Mushrooms
Visual description – Fresh or dried mushrooms
Methods of use – Chewed and swallowed
Duration of effects – Variable
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57
LEC:
A closer look at ecstasy and size comparison.
Visual description – brown crystalline powder.
Method of use – ingested, injected, snorted.
Most common – ingested.
Duration of effects – variable
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LEC:
LSD
Blotter Acid, the Grateful Dead “Dead Heads”
(groupies) carried this stuff all over the country. They
basically toured with the band. They would usually
arrive at the location of the concert well before the
actual concert took place.
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LEC:
More blotter Acid with various designs
LSD – Lysergic Acid Diethylamide
Blotter Acid:
Small squares of heavy stock paper, perforated for
tearing, with a drop of LSD on each. Ingested orally.
Sometimes there are pictures stamped on each one.
Method of use – ingested
Duration of effects – variable
TIME:XX
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LEC:
LSD
Notice how they started putting cartoon characters and
teddy bears on the stock paper. Appears to be a lick and
stick tattoo.
TIME:XX
61
Category # 4 Phencyclidine (PCP) & its analogs
PCP- Phencyclidine
LEC:
Analogs refer to the various formations of PCP
(Powder, liquid, pills, capsules, etc…)
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62
LEC:
PCP LIQUID – Clear yellow liquid.
Method of use – smoked, injected.
Duration - onset-10-15 minutes
Peak-15-30 minutes
Loaded- 4-6 hours
TIME:XX
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LEC:
“PCP”
PCP laced in a cigarette is called a “Sherman”
If laced with PCP a marijuana joint it is called
“Wack” or “Super Grass” or “Super Joint”. Other
street names for PCP:
Wack
Wet Daddies
Rocket Fuel
Lovely
Jet Fuel
Hog
Dust
Elephant
Angel Dust
TIME:XX
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LEC:
PCP Powder (Angel Dust)
3.3 grams 96% pure
TIME:XX
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LEC:
Ketamine has a lot of the same characteristics as PCP.
Street Names: K, Special K, Cat Valium, Jet, Super Acid,
Green.
Marketed as a dissociative general anesthetic for human
and veterinary use, the only known source of ketamine is
via diversion of pharmaceutical products. Recent press
reports indicate that a significant number of veterinary
clinics are being robbed specifically for their ketamine
stock. DEA reporting indicates that a major source of
ketamine in the United States is product diverted from
pharmacies in Mexico. Ketamine liquid can be injected,
applied to smokable material, or consumed in drinks.
Continued next page…….
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LEC:
Ketamine has a lot of the same characteristics as PCP.
Street Names: K, Special K, Cat Valium, Jet, Super Acid,
Green.
Marketed as a dissociative general anesthetic for human
and veterinary use, the only known source of ketamine is
via diversion of pharmaceutical products. Recent press
reports indicate that a significant number of veterinary
clinics are being robbed specifically for their ketamine
stock. DEA reporting indicates that a major source of
ketamine in the United States is product diverted from
pharmacies in Mexico. Ketamine liquid can be injected,
applied to smokable material, or consumed in drinks.
Continued next page…….
Ketamine produces physical effects similar to PCP, with
the visual effects of LSD. Users report that it is better than
PCP or LSD because the trip lasts an hour or less. Low
doses of the drug produce an experience called “K-Land,”
a mellow, colorful “wonder world.” Higher doses produce
an effect referred to as “K-Hole,” an “out of body,” or
“near-death” experience. Use of the drug can cause
delirium, amnesia, depression, and long-term memory
and cognitive difficulties. Due to its dissociative effect, it is
reportedly used as a date-rape drug.
Ketamine was placed on Schedule III of the CSA on
August 12, 1999.
TIME:XX
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LEC:
This man was under the influence of “Angel Dust”
the street name for PCP.
He used a broken mirror to peel off his face and lips to
feed to his dogs.
TIME:XX
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LEC:
Warm to the touch
Perspiring
Blank stare
Repetitive speech
Incomplete verbal responses
Confused
Muscle rigidity
Possibly violent & combative
Eye indicators of PCP influence:
Horizontal gaze nystagmus usually will be present often
with very early onset and very distinct jerking.
Vertical nystagmus usually will be present.
TIME:XX
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Pupil size usually will be normal.
69
LEC:
Heroin-Asian china-white, Black tar, Colombian, and
Mexican Brown are all various forms of Heroin
Morphine- Tablets, Pink Liquid
continue…
Codeine-Capsules, Tablets, Dark Liquid
Oxycontin- White, Pink, Yellow, Green, Blue tablets
which is prescribed in tablet sizes of:
10mg
20mg
40mg
80mg
160mg (Canada only)
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LEC:
Synthetic Opiates (e.g. Demerol, Methadone, Fentanyl )
“man made narcotics”.
Narcotic Analgesics include a large number of drugs that
share three important characteristics.
a. They will relieve pain. Point out that "analgesic"
means "pain killer".
b. They will produce withdrawal signs and symptoms,
when the drug is stopped after chronic administration.
Point out that this characteristic implies that narcotic
analgesics are physically addicting.
c. They will suppress the withdrawal signs and symptoms
of chronic morphine administration.
d. Some narcotic analgesics are natural derivatives of
opium:
Morphine
Heroin
Codeine
Many Others.
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LEC:
e. Some are synthetic drugs:
Demerol
Methadone (used to treat heroin addicts)
Fentanyl
Many Others.
f. Some narcotic analgesics (such as heroin) usually are
injected.
g. Others (such as codeine) usually are taken orally.
h. An important characteristic of narcotic analgesics is that
users develop tolerance to them.
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LEC:
"Tolerance" means that the same dose of the drug will
produce diminishing effects, or that a steadily larger dose
is needed to produce the same effects.
A tolerant user who has taken his or her "normal“ dose of
heroin (for example), may exhibit little or no evidence of
physical impairment.
TIME:XX
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LEC:
"On the nod"
Droopy eyelids
Depressed reflexes
Dry mouth
Facial itching
Low, raspy speech
Fresh puncture marks may be evident
Clarification: "On the nod" is a sedated condition. The
subject is in a semi-conscious type of sleep, but will
awaken quickly to answer questions.
Eye indicators of Narcotic Analgesic influence:
Neither horizontal nor vertical nystagmus will be
present.
Pupils usually will be severely constricted.
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LEC:
Pupil Comparison: Constricted Pupils
(notice you can easily see the eye color) pupils pin point
What a nose!!!!!
TIME:XX
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LEC:
A look at some heroin.
Mexican Brown Heroin
TIME:XX
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LEC:
China White Heroin
TIME:XX
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LEC:
Some paraphernalia used for injecting heroin.
TIME:XX
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LEC:
Abscessed Injection Marks (Tracks)
TIME:XX
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LEC:
More of the same.
TIME:XX
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LEC:
Now lets move on to category #6 “Inhalants”
Inhalants (toluene) pronounced tal-you-een
Not tol-u-leen, don’t say it Man!!
Say it right!!
There is no such thing as Toluleen
Toluene-(tal-u-een or tol-u-win) is the substance
found in paints, glues, etc.
TIME:XX
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LEC:
Inhalants are breathable chemicals that produce
mind-altering results.
Volatile Solvents:
a. A wide variety of familiar household items are
sometimes abused as inhalants.
Examples:
plastic cement (model airplane glue, Toluene), gasoline,
paint , vegetable frying pan lubricants, hair sprays,
insecticides and many others
b. Certain anesthetics also may be abused as inhalants.
Examples: nitrous oxide, ether, chloroform
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LEC:
Inhalants – Aerosols
Hair sprays
Photo/computer duster
Deodorants
Frying pan lubricants
Glass Chillers – used in restaurants
Whipped cream refills – used in restaurants
TIME:XX
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LEC:
Inhalants – Anesthetic Gases
Ether/isobutyl – A volatile, highly flammable liquid,
derived from the distillation of ethyl alcohol with sulfuric
acid and used chiefly in industry and as an anesthetic.
Chloroform - A clear, colorless, heavy liquid, used in
refrigerants, propellants, and resins and also used as an
anesthetic.
Nitrates/amyl, butyl- packaged in small bottles, sold under
brand names – Locker room, Rush, Come, they are sold
as room deodorizers.
Nitrous Oxide/NOS – Laughing gas – small metal cylinder
with a balloon or pipe, also vapors are taken from whip
cream cans – they hold it upright instead of upside down.
TIME:XX
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LEC:
Huffing or inhaling
This power point shows subject inhaling substance
through nose; however, sometimes they use mouth and
nose to breathe the chemical into their body.
TIME:XX
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LEC:
General indicators of inhalant influence:
Disorientation
Slurred speech
Residue of substance on face, hands, clothing
Confusion
Possible nausea
Eye indicators of Inhalant influence:
Horizontal gaze nystag-mus usually will be
present.
Vertical nystagmus may be present (especially with
high doses).
Pupil size usually will be normal.
TIME:XX
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LEC:
Our last Category, # 7, is Cannabis
Marijuana – a dried leafy substance mixed with stems
and possibly seeds.
Hashish – Solid dark green or gold substance ingested
or smoked. It is usually in a brick-like formation that is
somewhat pliable and very high in THC level.
Hash oil – Concentrated marijuana, thick liquid dark
green in color, very high THC level. Method of use –
smoked, mixed with tobacco or marijuana.
Marinol – Medical marijuana in a pill or capsule form,
used for cancer patients to help them with queasy/upset
stomach after chemo/radiation treatments, also to help
with appetite.
Cannabis is the category that includes the various
products of the Cannabis Sativa plant.
Cannabis products usually are smoked, although they
also can be ingested orally. Like in brownies
TIME:XX
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LEC:
Stalked green plant with saw like or serrated edged
leaves. Usually an odd number of leaves.
Notice this picture shows 9 dominant leaves.
TIME:XX
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LEC:
Here are some flowering tops or “BUDS”.
TIME:XX
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LEC:
Unless you know what you are looking for, marijuana can
be easily overlooked in sub-divisions, especially in the
woods.
AFQ:
TIME:XX
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LEC:
Lets take a look at the indicators of marijuana/cannabis
influence:
General indicators of Cannabis influence:
Very bloodshot eyes, with pronounced veins
in the eyeballs.
Body tremors
Odor of marijuana
Disoriented
Relaxed inhibitions
Difficulty in dividing attention.
Eye indicators of Cannabis influence:
No Nystagmus
Neither horizontal nor vertical nystagmus will be
present.
Pupil size usually will be dilated, but may be
normal, depending on amount, “dose”, strength, “THC”
marijuana type.
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LEC:
The veins in the eyes will be very pronounced and red.
TIME:XX
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LEC:
The lower eye sockets will be very red where the blood
seems to pool in that area. You can see this below the
eyeball, but, if you have subject to pull their lower eyelids
down, it will be very vivid for you to see.
TIME:XX
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LEC:
Polydrug Use – Using two or more drugs at the same
time.
Examples:
Alcohol and almost anything else
PCP and Cannabis
Heroin and Cocaine
Many others
Combinations of Drugs
1. Many drug users appear to be "chemical gluttons": they
routinely use more than one drug at a time.
TIME:XX
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LEC:
This term for this condition is "polydrug use".
Point out that the prefix "poly" derives from the Greek
word for "many". We say more than one drug on board.
In the Los Angeles Field Study (1985), 72% of the
suspects, had two or more drugs in them. In that study,
alcohol was often found in combination with one or more
other drugs.
But even if we discount alcohol, nearly half (45%) of
the Field Study suspects had two or more other drugs in
them.
Point out that 81 of the 173 suspects (47%) in the Los
Angeles Field Study had alcohol in combination with one or
more other drugs.
During D.R.E. Certification Training in New York City in
early 1989, two-thirds (67%) of the suspects evaluated had
two or more drugs other than alcohol in their urine.
2. Certain combinations of drugs appear to be fairly
common.
NTF:
Some common combinations:
Alcohol and some other drug is the most frequent
combination.
PCP and Cannabis is another common combination.
TIME:XX
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NTF:
Remind students that many PCP users prefer to ingest that
drug by smoking, and a favorite method is to sprinkle
powdered PCP on marijuana.
Cocaine and Heroin is another common combination.
LEC:
3. Because polydrug use is so common, you should not be
surprised to encounter suspects who are under the
influence of more than one category of drugs.
At some times and places, polydrug users may be more
common than single drug users. Such as: clubs, bars etc.
Be especially alert to the possibility that suspects who
have been drinking may also have ingested some other
drug or drugs.
4. The effects of polydrug use may vary widely, depending
on exactly what combination of drugs is involved, how
ingested and when they were ingested.
5. Any particular combination of drugs may produce three
general kinds of effects.
TIME:XX
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General types of Polydrug effects are:
LEC:
* Additive - The two drugs may independently produce
some similar effects. In combination, these effects may
be enhanced.
EXAMPLE OF ADDITIVE EFFECTS
Stimulants and Hallucinogens both cause pupil dilation.
Pupils would be dilated.
TIME:XX
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LEC:
Antagonistic - The two drugs may produce some
effects that are exactly opposite. In combination, these
effects may mask each other.
EXAMPLE OF ANTAGONISTIC EFFECTS:
A CNS Stimulant, usually causes pupil dilation, a
narcotic usually causes constriction. It is possible that
someone who is simultaneously under the influence of a
stimulant and a narcotic may have pupils that are nearly
normal in size. It is also possible that the suspect's
pupils may be dilated at one time, and then become
constricted, as the effects of one drug diminish while the
effects of the other increase.
TIME:XX
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LEC:
Overlapping - Each drug may affect the suspect in
some different way. In combination, both effects may
appear.
EXAMPLE OF OVERLAPPING EFFECTS:
PCP and Narcotic Analgesic. PCP will enhance
nystagmus, while a Narcotic Analgesic does not cause
nystagmus. There-fore, you will see nystagmus.
TIME:XX
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LEC:
Null - Neither drug has an effect on the indicator.
EXAMPLE OF NULL EFFECTS:
CNS Stimulant and Narcotic Analgesic. Neither drug
causes nystagmus, there-fore you will not see nystagmus
with this combination.
TIME:XX
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Medical conditions
QTC:
AR:
LEC:
What are some medical conditions that can be similar
to some of the effects that we have discussed in
class?
Sugar Diabetes, Complex partial seizures, muscular
sclerosis, Parkinson’s disease.
With sugar diabetes, it is either high sugar or low sugar.
With high sugar the person will emit a fruity wine like odor
that is sometimes mistaken for alcohol. This odor is
acetone. The body is producing too much insulin.
Sometimes the person will have thick slurred speech,
stupor or staggering. Excessive urination and disoriented
behavior.
TIME:XX
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LEC:
With low sugar, the body is not producing enough insulin;
therefore the person will have similar indicators, with the
exception of the acetone (the fruity wine like odor). This is
when the person will need orange juice or a candy bar or
glucose tablets to get their sugar level up. When they do
this they will start to feel better and become more oriented
to their surroundings.
What can we do as an officer to help determine if this
person is under the influence of a drug or a
combination of drugs, or if it is a medical emergency?
Ask the person if they have a medical condition you
should know about.
Look for medical arm bracelets or necklaces. Look for
open alcohol containers or drug paraphernalia.
Ask neighbors or people (witnesses) on the scene.
Ask other officers if they have had any contact with this
person before.
When in doubt, call EMS or have a person with a higher
level of training in that field to help you assess the
situation.
TIME:XX
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LEC:
QTC:
AR:
With low sugar, the body is not producing enough insulin;
therefore the person will have similar indicators, with the
exception of the acetone (the fruity wine like odor). This is
when the person will need orange juice or a candy bar or
glucose tablets to get their sugar level up. When they do
this they will start to feel better and become more
oriented to their surroundings.
What can we do as an officer to help determine if this
person is under the influence of a drug or a
combination of drugs, or if it is a medical
emergency?
Ask the person if they have a medical condition you
should know about.
Look for medical arm bracelets or necklaces. Look for
open alcohol containers or drug paraphernalia.
Ask neighbors or people (witnesses) on the scene.
Ask other officers if they have had any contact with this
person before.
LEC:
When in doubt, call EMS or have a person with a higher
level of training in that field to help you assess the
situation.
TIME:XX
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QTC:
What is a drug?
AR:
Any substance which, when taken into the human body,
can impair the ability of the person to operate a vehicle
safely.
QTC:
AR:
Name the seven major categories of drugs?
Depressants
Drugs that cause nystagmus
Inhalants
but does not effect the pupil size
Dissociative Anesthetics
_______________________________________
Cannabis
Drugs that effect the pupil size
Stimulants
but does not cause nystagmus
Hallucinogens
(causes the pupils to dilate)
_______________________________________
Narcotics
Drugs that effect the pupil size
But does not cause nystagmus
(causes the pupils to constrict)
TIME:XX
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QTC:
AR:
QTC:
AR:
QTC:
AR:
QTC:
AR:
QTC:
AR:
QTC:
AR:
QTC:
AR:
What effects do the DID drugs have on the eyes?
They cause nystagmus, but do not affect the pupil size.
What effects do the CSH drugs have on the eyes?
They affect the pupil size, but do not cause nystagmus.
They cause the pupils to dilate.
What effect does N “narcotics” have on the eyes?
They also affect the pupil size, but do not cause
nystagmus. They cause the pupils to constrict.
What is poly-drug use?
Using two or more drugs at the same time.
What is the additive effect?
Two drugs independently produce some similar effects,
such as: stimulants and hallucinogens will both dilate the
pupils.
What is the antagonistic effect?
Two drugs produce some opposite effects, such as:
stimulants usually cause pupil dilation; narcotic analgesics
usually cause pupil constriction.
What is the overlapping effect?
Each drug affects people in some different way, such as:
PCP causes nystagmus but doesn’t affect pupil size;
Narcotic Analgesics constrict pupils, but does not cause
nystagmus. Nystagmus will be seen. Constricted pupils
and nystagmus is an overlapping effect.
TIME:XX
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QTC:
On the HGN, what is done to rule out medical
problems?
AR:
Equal tracking and pupil size.
QTC:
How can we rule out medical problems on an
impaired person?
AR:
Ask the person if they have a medical condition you
should know about.
Look for medical arm bracelets or necklaces. Look for
open alcohol containers or drug paraphernalia.
Ask neighbors or people (witnesses) on the scene.
Ask other officers if they have had any contact with
this person before.
When in doubt, call EMS or have a person with a
higher level of training in that field to help you assess
the situation.
TIME:XX
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LEC:
AFQ:
NTF:
LEC:
Although this course is not designed to qualify you as a
DRE, (drug recognition expert) it is intended to make you
more knowledgeable when encountering suspects
impaired by substances other than alcohol.
Show the videotapes of the examinations of suspects
under the influence of various drugs. (Videos in box)
GHB, RAVES, Heroin alley, Bell air Marijuana raid, PCP
and any other video snip-its that will help demonstrate the
drug categories.
I am going to show you some videos that will help you
understand how subjects look and act while on some of
the drugs we have discussed today.
This will culminate the four hour drug block.
TIME: 240 MIN
107