Identifying a Drugged Person - Kansas Law Enforcement Training
Transcription
Identifying a Drugged Person - Kansas Law Enforcement Training
Multijurisdictional Counterdrug Task Force Training Identifying Drugged Persons Identifying a Drugged Person Tim McClure, Investigator Ford County Sheriff’s Office Define “Drug” As It Relates To Law Enforcement Recognized as drugs in United States Pharmacopoeia or National Formulary Intended for use in the diagnosis, cure, mitigation, treatment or prevention of disease in man or animals Other than food, intended to affect the structure or function of the body Multijurisdictional Counterdrug Task Force Training 2 Working Definition of a “DRUG” “A chemical substance, such as a narcotic or hallucinogen, that affects the central nervous system, causing changes in behavior and often addiction” Multijurisdictional Counterdrug Task Force Training 3 1 A partnership between The Florida National Guard and St. Petersburg College Multijurisdictional Counterdrug Task Force Training Identifying Drugged Persons Illicit Drug Use In 2005, an estimated 19.7 million Americans aged 12 or older were current (past month) illicit drug users Used an illicit drug during the month prior to the survey interview Represents 8.1 percent of the population aged 12 years old or older Illicit drugs include marijuana/hashish, cocaine (including crack), heroin, hallucinogens, inhalants, or prescription-type psychotherapeutics used nonmedically Source: SAMHSA, Results from the 2005 National Survey on Drug Use and Health Multijurisdictional Counterdrug Task Force Training 4 Marijuana Use Marijuana was the most commonly used illicit drug (14.6 million past month users) Source: SAMHSA, Results from the 2005 National Survey on Drug Use and Health. Multijurisdictional Counterdrug Task Force Training Source: SAMHSA, Results from the 2009 National Survey on Drug Use and Health. Multijurisdictional Counterdrug Task Force Training 5 6 2 A partnership between The Florida National Guard and St. Petersburg College Multijurisdictional Counterdrug Task Force Training Identifying Drugged Persons Source: SAMHSA, Results from the 2009 National Survey on Drug Use and Health. Multijurisdictional Counterdrug Task Force Training 7 Seven Drug Categories Cannabis Hallucinogens CNS Dissociative Stimulants Narcotic Analgesics CNS Depressants Multijurisdictional Counterdrug Task Force Training Anesthetics Inhalants 8 Cannabis Marijuana Hashish Hash Oil Marinol Multijurisdictional Counterdrug Task Force Training 9 3 A partnership between The Florida National Guard and St. Petersburg College Multijurisdictional Counterdrug Task Force Training Identifying Drugged Persons Central Nervous System Stimulants Cocaine Amphetamine Methamphetamine Multijurisdictional Counterdrug Task Force Training 10 Narcotic Analgesics Heroin Morphine Codeine Synthetic opiates Demerol Methadone Multijurisdictional Counterdrug Task Force Training 11 Central Nervous System Depressants Alcohol Barbiturates Valium Chloralhydrate Multijurisdictional Counterdrug Task Force Training 12 4 A partnership between The Florida National Guard and St. Petersburg College Multijurisdictional Counterdrug Task Force Training Identifying Drugged Persons Hallucinogens LSD Peyote Psilocybin Multijurisdictional Counterdrug Task Force Training 13 Dissociative Anesthetics PCP Ketamine DXM Multijurisdictional Counterdrug Task Force Training 14 Inhalants Toluene Glue Paint Multijurisdictional Counterdrug Task Force Training 15 5 A partnership between The Florida National Guard and St. Petersburg College Multijurisdictional Counterdrug Task Force Training Identifying Drugged Persons Definitions Associated with DRE Examinations Pupil size Nystagmus Convergence Blood pressure Pulse rate Body temperature Internal clock Multijurisdictional Counterdrug Task Force Training 16 Pupil Size Normal Range 2.5 to 5.0 mm (room light) 5.0 to 8.5 mm (near total darkness) 2.0 to 4.5 mm (direct light) Multijurisdictional Counterdrug Task Force Training 17 Pupil Size Multijurisdictional Counterdrug Task Force Training 18 6 A partnership between The Florida National Guard and St. Petersburg College Multijurisdictional Counterdrug Task Force Training Identifying Drugged Persons Mydriasis (Dilated Pupils) Multijurisdictional Counterdrug Task Force Training 19 Miosis (Constricted Pupils) Multijurisdictional Counterdrug Task Force Training 20 Ptosis (Droopy Eyelids) Multijurisdictional Counterdrug Task Force Training 21 7 A partnership between The Florida National Guard and St. Petersburg College Multijurisdictional Counterdrug Task Force Training Identifying Drugged Persons Nystagmus Involuntary jerking of the eyes Multijurisdictional Counterdrug Task Force Training 22 Strabismus A condition in which a person can not align both eyes simultaneously under normal conditions A condition in which the eyes deviate (turn) when looking at the object of regard Convergence Lack of convergence Multijurisdictional Counterdrug Task Force Training 23 Vital Signs Internal Clock: 30 sec +/- 5 sec Pulse: 60-90 bpm Blood Pressure: 120-140 / 70-90 Body Temp: 98.6 F +/- 1 degree Multijurisdictional Counterdrug Task Force Training 24 8 A partnership between The Florida National Guard and St. Petersburg College Multijurisdictional Counterdrug Task Force Training Identifying Drugged Persons Observations Suspect’s Breath Odor of alcohol Chemical odor Cannabis odor Suspect’s Face Normal Flushed Pale Other Multijurisdictional Counterdrug Task Force Training 25 Observations General Appearance Eyes Normal Clean Watery Orderly Bloodshot Disarranged Pink/red Bloody Vomit Urine Multijurisdictional Counterdrug Task Force Training 26 Observations Attitude Anxious Restless Agitated Excited Combative Disinterested Uninhibited Disoriented Drowsy Confused Hallucinating Multijurisdictional Counterdrug Task Force Training Loss of memory Cyclic mood swings Polite Antagonistic Stuporous Cooperative/indifferent Laughing Insulting Argumentative Fumbling 27 9 A partnership between The Florida National Guard and St. Petersburg College Multijurisdictional Counterdrug Task Force Training Identifying Drugged Persons Observations Speech Physical Talkative Facial Thick, Dry slurred Incoherent Rapid Slow Non-communicative Repetitive Actions itching mouth Nodding Droopy eyelids Low, raspy voice Body tremors Muscle tone Grinding of teeth Multijurisdictional Counterdrug Task Force Training 28 Observations Other Nasal redness nose Track marks Perspiring Warm to the touch Intense headaches Runny Multijurisdictional Counterdrug Task Force Training Residue of paint on person Debris Pills Vials Syringes Drug paraphernalia 29 Observations Multijurisdictional Counterdrug Task Force Training 30 10 A partnership between The Florida National Guard and St. Petersburg College Multijurisdictional Counterdrug Task Force Training Identifying Drugged Persons Psychophysical Exams Multijurisdictional Counterdrug Task Force Training 31 Walk and Turn Instructions Demonstration Subject’s Record Attempts Results Multijurisdictional Counterdrug Task Force Training 32 One-Leg Stand Instructions Demonstration Subject’s Each Record Attempts leg Results Multijurisdictional Counterdrug Task Force Training 33 11 A partnership between The Florida National Guard and St. Petersburg College Multijurisdictional Counterdrug Task Force Training Identifying Drugged Persons Rhomberg Test Instructions Demonstration Subject’s Attempts Record Results Multijurisdictional Counterdrug Task Force Training 34 Multijurisdictional Counterdrug Task Force Training 35 Cannabis Multijurisdictional Counterdrug Task Force Training 36 12 A partnership between The Florida National Guard and St. Petersburg College Multijurisdictional Counterdrug Task Force Training Identifying Drugged Persons Cannabis Schedule I widely abused illegal drug in the U.S. Derived from the Indian hemp plant Botanical name Cannabis Sativa Grows wild in climates all over the world Most Multijurisdictional Counterdrug Task Force Training 37 Cannabis: Methods of Ingestion Smoking Oral Multijurisdictional Counterdrug Task Force Training 38 Cannabis: Effects Horizontal gaze nystagmus - none Vertical nystagmus - none Lack of convergence/strabismus present Pupil size - possibly dilated Multijurisdictional Counterdrug Task Force Training Reaction to light - normal Blood pressure - up Body temperature - normal Pulse rate - up 39 13 A partnership between The Florida National Guard and St. Petersburg College Multijurisdictional Counterdrug Task Force Training Identifying Drugged Persons Cannabis: Effects Short-term memory loss Paranoia Loss of ambition “Munchies” Multijurisdictional Counterdrug Task Force Training 40 Cannabis: General Indicators Diminished inhibitions perception of time/distance Disorientation Body and/or eyelid tremors Reddening of the conjunctiva Possible debris in mouth Impaired Multijurisdictional Counterdrug Task Force Training 41 Central Nervous System Stimulants Multijurisdictional Counterdrug Task Force Training 42 14 A partnership between The Florida National Guard and St. Petersburg College Multijurisdictional Counterdrug Task Force Training Identifying Drugged Persons Stimulants Drugs that speed up the body's metabolism caffeine, nicotine, cocaine Synthetic: amphetamine, methamphetamine, methcathinone Natural: Multijurisdictional Counterdrug Task Force Training 43 Stimulants: Method(s) of Ingestion Injected Oral Inhaled Smoked Multijurisdictional Counterdrug Task Force Training 44 Stimulants: Effects HGN - none VGN - none Lack of convergence none Pupil size - dilated (mydriasis) Multijurisdictional Counterdrug Task Force Training Pupil reaction to light slow to none visible Pulse rate - up Blood pressure - up Body temperature - up Bruxism 45 15 A partnership between The Florida National Guard and St. Petersburg College Multijurisdictional Counterdrug Task Force Training Identifying Drugged Persons Stimulants: General Indicators Restlessness Euphoria Anxiety Talkativeness Irritability Runny nose Redness to nasal area Leg and eyelid tremors Rigid muscle tone Multijurisdictional Counterdrug Task Force Training 46 Methamphetamine Effects Multijurisdictional Counterdrug Task Force Training 47 16 A partnership between The Florida National Guard and St. Petersburg College Multijurisdictional Counterdrug Task Force Training Identifying Drugged Persons 17 A partnership between The Florida National Guard and St. Petersburg College Multijurisdictional Counterdrug Task Force Training Identifying Drugged Persons 18 A partnership between The Florida National Guard and St. Petersburg College Multijurisdictional Counterdrug Task Force Training Identifying Drugged Persons PET Scan of Long-Term Methamphetamine Brain Damage 19 A partnership between The Florida National Guard and St. Petersburg College Multijurisdictional Counterdrug Task Force Training Identifying Drugged Persons Partial Recovery of Brain Dopamine Transporters in Methamphetamine (METH) Abuser After Protracted Abstinence 3 0 ml/gm Normal Control METH Abuser (1 month detox) METH Abuser (24 months detox) Source: Volkow, ND et al., Journal of Neuroscience 21, 9414-9418, 2001. CHERIE Multijurisdictional Counterdrug Task Force Training 59 Narcotic Analgesics Multijurisdictional Counterdrug Task Force Training 60 20 A partnership between The Florida National Guard and St. Petersburg College Multijurisdictional Counterdrug Task Force Training Identifying Drugged Persons Narcotic Analgesics Strong sleep painkilling drugs that also produce Most drugs in this class are produced from the opium poppy Multijurisdictional Counterdrug Task Force Training 61 Narcotic Analgesics: Characteristics Pain relief (analgesic) withdrawal signs and symptoms (when stopped after chronic administration) Stop withdrawal signs and symptoms (note: other N.A. can be substituted for relief of withdrawal symptoms Produces Multijurisdictional Counterdrug Task Force Training 62 The Concept of Drug Tolerance The same dose of the drug will produce diminishing effects A steadily larger dose is needed to produce the same effect Multijurisdictional Counterdrug Task Force Training 63 21 A partnership between The Florida National Guard and St. Petersburg College Multijurisdictional Counterdrug Task Force Training Identifying Drugged Persons Narcotics: Effects HGN - none - none Lack of convergence - none Pupil size - constricted (miosis) Pulse rate - down Blood pressure - lowered Body temperature - down VGN Multijurisdictional Counterdrug Task Force Training 64 Narcotics: General Indicators Slow reflexes, sluggish movements Slow, low, raspy speech Slow breathing, cold skin “On the nod” Droopy eyelids (ptosis) Dry mouth Euphoria Track marks Multijurisdictional Counterdrug Task Force Training 65 Method(s) of Ingestion Injected Oral Inhaled Smoked: Heroin, Opium, Morphine Multijurisdictional Counterdrug Task Force Training 66 22 A partnership between The Florida National Guard and St. Petersburg College Multijurisdictional Counterdrug Task Force Training Identifying Drugged Persons CNS Depressants Multijurisdictional Counterdrug Task Force Training 67 Depressants Drugs that slow down the body's metabolism Barbiturates: sleeping pills anxiety-fighting depressants Methaqualone: non-barbiturate hypnotic Tranquilizers: Multijurisdictional Counterdrug Task Force Training 68 Depressants: General Indicators Drowsiness Droopy eyelids (ptosis) Thick, slurred speech Lack of coordination Slow, sluggish reactions Flaccid muscle tone Reduced social inhibitions In other words, drunk Multijurisdictional Counterdrug Task Force Training 69 23 A partnership between The Florida National Guard and St. Petersburg College Multijurisdictional Counterdrug Task Force Training Identifying Drugged Persons Depressants: Effects HGN - present VGN - present Lack of convergence present Pupil size - normal Pupil reaction to light slow Pulse rate - down (Qualudes & alcohol) Blood pressure lowered Temperature - normal Multijurisdictional Counterdrug Task Force Training 70 Depressants: Method(s) of Ingestion Oral Injected Multijurisdictional Counterdrug Task Force Training 71 Hallucinogens Multijurisdictional Counterdrug Task Force Training 72 24 A partnership between The Florida National Guard and St. Petersburg College Multijurisdictional Counterdrug Task Force Training Identifying Drugged Persons Notable Hallucinogens Lysergic Acid Diethylamide (LSD) Psilocybin Mushrooms Peyote (mescaline) Multijurisdictional Counterdrug Task Force Training 73 Hallucinogens Drugs that cause distortions of reality This class of drug can alter vision, sense of smell and touch Some can be absorbed through skin Multijurisdictional Counterdrug Task Force Training 74 Hallucinogens: Effects HGN - none VGN - none Lack of convergence none Pupil size - dilated Multijurisdictional Counterdrug Task Force Training Pupil reaction to light normal Pulse rate - up Blood pressure - up Body temperature - up 75 25 A partnership between The Florida National Guard and St. Petersburg College Multijurisdictional Counterdrug Task Force Training Identifying Drugged Persons Hallucinogens: General Indicators Dazed appearance tremors Perspiring Rigid muscle tone Difficulty with speech Body Statements suggesting hallucinations Distorted sensory perceptions Multijurisdictional Counterdrug Task Force Training 76 Dissociative Anesthetics PCP Ketamine DXM Multijurisdictional Counterdrug Task Force Training 77 Multijurisdictional Counterdrug Task Force Training 78 26 A partnership between The Florida National Guard and St. Petersburg College Multijurisdictional Counterdrug Task Force Training Identifying Drugged Persons Coricidan OD clip Multijurisdictional Counterdrug Task Force Training 79 PCP: General Indicators Slow, slurred speech Disorientation Loss of memory Agitation, excitement Blank stare (“1000yard stare”) Non-communicative Rigid muscle tone Multijurisdictional Counterdrug Task Force Training 80 PCP: General Indicators Loss of a sense of personal identity Sensory distortions Auditory hallucinations A feeling of extreme heat, profuse perspiration Increased pain threshold Multijurisdictional Counterdrug Task Force Training 81 27 A partnership between The Florida National Guard and St. Petersburg College Multijurisdictional Counterdrug Task Force Training Identifying Drugged Persons PCP: Effects HGN - present (early onset) VGN - present Lack of convergence present Pupil size - normal Pupil reaction to light normal Pulse rate - up Blood pressure - up Body temperature - up Multijurisdictional Counterdrug Task Force Training 82 Inhalants Volatiles paint thinners gasoline Aerosols Alkyl nitrites Nitrous oxide Schedule IV hair sprays spray paints Multijurisdictional Counterdrug Task Force Training 83 Inhalants: General Indicators Odor of inhaled substance of substance on face, nose, hands, clothing Bloodshot, watery eyes Confused, disoriented appearance Flushed face, possible sweating Slow, thick, slurred speech Traces Multijurisdictional Counterdrug Task Force Training 84 28 A partnership between The Florida National Guard and St. Petersburg College Multijurisdictional Counterdrug Task Force Training Identifying Drugged Persons Inhalants: Effects HGN - present VGN - present Lack of convergence present Pupil size - normal (may be dilated with certain anesthetic gases) Pupil reaction to light slow Pulse rate - up Blood pressure - up or down Body temperature up, down, normal Muscle tone - usually normal Multijurisdictional Counterdrug Task Force Training 85 Drugs Which Induce Nystagmus CNS Depressants Inhalants Dissociative Anesthetics (Most) Multijurisdictional Counterdrug Task Force Training 86 PCP Usually Causes Immediate Onset of Nystagmus Multijurisdictional Counterdrug Task Force Training 87 29 A partnership between The Florida National Guard and St. Petersburg College Multijurisdictional Counterdrug Task Force Training Identifying Drugged Persons Drugs That Cause Lack of Convergence CNS depressants Inhalants Dissociative anesthetics Cannabis Strabismus Multijurisdictional Counterdrug Task Force Training 88 Drugs Which Usually Don’t Affect Pupil Size CNS Depressants Inhalants PCP Multijurisdictional Counterdrug Task Force Training 89 Drugs Which Cause Pupil Dilation CNS stimulants Hallucinogens POSSIBLY Cannabis (slight dilation) Multijurisdictional Counterdrug Task Force Training 90 30 A partnership between The Florida National Guard and St. Petersburg College Multijurisdictional Counterdrug Task Force Training Identifying Drugged Persons Narcotic Analgesics Usually Cause Pupil Constriction Multijurisdictional Counterdrug Task Force Training 91 Polydrug Use Using two or more drugs at the same time Examples: PCP and marijuana; heroin and cocaine; many others Multijurisdictional Counterdrug Task Force Training 92 Field Studies Los Angeles Field Study 72% New of suspects had 2 or more drugs York Certification Training Study 67% of suspects had 2 or more drug categories other than alcohol Multijurisdictional Counterdrug Task Force Training 93 31 A partnership between The Florida National Guard and St. Petersburg College Multijurisdictional Counterdrug Task Force Training Identifying Drugged Persons Prevalence of Polydrug Use P.I.R.E.* DRE database indicates that 25% of all DRE-reported cases revealed two or more drug categories detected (2005) *Pacific Institute of Research and Evaluation Multijurisdictional Counterdrug Task Force Training 94 Two Drugs in Combination: How Do They Affect Pupil Size? Situation #1 Neither drug affects pupil size Example: PCP and Valium Neither one affects the size of the pupils The combination will also not affect pupil size Multijurisdictional Counterdrug Task Force Training 95 Null Effect No action plus no action equals no action If neither drug affects a particular indicator of impairment, their combination also will not affect that indicator Multijurisdictional Counterdrug Task Force Training 96 32 A partnership between The Florida National Guard and St. Petersburg College Multijurisdictional Counterdrug Task Force Training Identifying Drugged Persons Two Drugs in Combination: How Do They Affect Pupil Size? Situation #2 One drug affects the pupil size, but the other does not Example: PCP and cocaine Cocaine dilates pupils, PCP doesn’t affect pupils The combination will affect pupil size Multijurisdictional Counterdrug Task Force Training 97 Overlapping Effect Action plus no action equals action If one drug affects a particular indicator of impairment, and another drug has no effect on that indicator, the combination of those two drugs will affect the indicator, in the same way as the first drug alone Multijurisdictional Counterdrug Task Force Training 98 Two Drugs in Combination: How Do They Affect Pupil Size? Situation #3 The two drugs affect pupil size in the same way LSD and cocaine Cocaine dilates pupils; so does LSD The combination will affect pupil size Example: Multijurisdictional Counterdrug Task Force Training 99 33 A partnership between The Florida National Guard and St. Petersburg College Multijurisdictional Counterdrug Task Force Training Identifying Drugged Persons Additive Effect Action plus the same action produces reinforced action If two drugs independently affect some indicator in the same way, their use in combination will also affect the indicator and the effect may be reinforced Multijurisdictional Counterdrug Task Force Training 100 Two Drugs in Combination: How Do They Affect Pupil Size? Situation #4 The two drugs affect pupil size in exactly opposite ways Example: heroin and cocaine Cocaine dilates pupils, heroin constricts pupils We can’t predict how the combination will affect pupil size Multijurisdictional Counterdrug Task Force Training 101 Antagonistic Effect Action versus opposite action: can’t predict the outcome If two drugs affect some indicator in exactly opposite ways, their use in combination could affect that indicator in any possible way Multijurisdictional Counterdrug Task Force Training 102 34 A partnership between The Florida National Guard and St. Petersburg College Multijurisdictional Counterdrug Task Force Training Identifying Drugged Persons The Effects of Drug Combinations Null Effect Overlapping Effect Additive Effect Antagonistic Effect Multijurisdictional Counterdrug Task Force Training 103 Common Combinations of Drugs cocaine & heroin cocaine & cannabis PCP & cannabis alcohol & practically anything else Multijurisdictional Counterdrug Task Force Training 104 Sample Drug Influence Evaluation Face Sheet This is NOT a DRE course, although we are using DRE principles This DRE form is only used as an example It is important for you to document, document, document all information observed! Multijurisdictional Counterdrug Task Force Training 105 35 A partnership between The Florida National Guard and St. Petersburg College Multijurisdictional Counterdrug Task Force Training Identifying Drugged Persons DEC Testify Multijurisdictional Counterdrug Task Force Training 106 Components on the Drug Evaluation Narrative Report Location Witnesses Breath Alcohol Test Notification & interview of arresting officer Initial observations of the suspect Medical problems & treatment 1. 2. 3. 4. 5. 6. Multijurisdictional Counterdrug Task Force Training 107 Components on the Drug Evaluation Narrative Report 7. 8. 9. 10. 11. 12. 13. Psychophysical indicators of impairment Clinical indicators of impairment Signs of ingestion Suspect’s statements Officer’s opinion Toxicological sample Miscellaneous Multijurisdictional Counterdrug Task Force Training 108 36 A partnership between The Florida National Guard and St. Petersburg College Multijurisdictional Counterdrug Task Force Training Identifying Drugged Persons Web site Mamasite.net Erowid.org DEA Knoa.org NNOA-National Association Mctft.com Narcotics Officers Multijurisdictional Counterdrug Task Force Training 109 Investigator Tim McClure Ford County Sheriff’s Office Ave. L Dodge City, Ks 67801 Email- [email protected] Phone- 620-227-4590 Cell-m620-255-3141 507 Multijurisdictional Counterdrug Task Force Training 110 For more information about training with MCTFT, call 1-800-243-5550 www.mctft.com 37 A partnership between The Florida National Guard and St. Petersburg College Identifying Drugged Persons Multijurisdictional Counterdrug Task Force Training Identifying Drugged Persons Identifying Drugged Persons The information presented in this MCTFT course represents a multijurisdictional approach to counterdrug efforts. It will not change, modify or supersede any regulations, policies and procedures of your agency or department. **** Print date: July 20, 2007 Multijurisdictional Counterdrug Task Force Training A partnership between The Florida National Guard and St. Petersburg College Multijurisdictional Counterdrug Task Force Training Multijurisdictional Counterdrug Task Force Training (MCTFT) Multijurisdictional Counterdrug Task Force Training (MCTFT) Multijurisdictional A federally funded partnership through the Department of Defense between the Florida National Guard and St. Petersburg College A nationally responsive program located at the Southeastern Public Safety Institute (SEPSI) of St. Petersburg College in St. Petersburg, FL 1-800-243-5550 www.mctft.com Counterdrug Task Force Training (MCTFT) has been established for the purpose of providing a unique, tuitionfree, in-depth series of courses covering all aspects of counterdrug law enforcement. Multijurisdictional Counterdrug Task Force Training 3 Multijurisdictional Counterdrug Task Force Training Course Description Course Description This It session has been designed to improve your ability to recognize individuals who may be medically impaired or under the influence of drugs Multijurisdictional Counterdrug Task Force Training 2 4 is likely you have encountered individuals who were under the influence of drugs rather than alcohol ¾ Depending upon the specific type(s) of drugs the individual has taken, some individuals may appear similar to persons who are under the influence of alcohol ¾ Other individuals will look and behave differently from an alcohol-impaired individual 5 Multijurisdictional Counterdrug Task Force Training 1 A partnership between The Florida National Guard and St. Petersburg College 6 Multijurisdictional Counterdrug Task Force Training Identifying Drugged Persons Course Description Course Description It This is important that you be able to recognize suspects who may be under the influence of drugs so that you will know when to summon assistance from physicians, trained Drug Recognition Experts (DREs) or other appropriate persons Multijurisdictional Counterdrug Task Force Training training program will not qualify you to perform the functions of a DRE; it will, however, assist you in recognizing some of the signs and symptoms associated with drug influence or when an individual needs medical attention 7 Multijurisdictional Counterdrug Task Force Training 8 Course Objectives Define “Drug” As It Relates To Law Enforcement To Recognized define “drug” as it relates to traffic safety recognize impairment associated with drug use To identify the seven categories of drugs and recognize the major observable indicators To successfully document the observable impairment as drugs in United States Pharmacopoeia or National Formulary Intended for use in the diagnosis, cure, mitigation, treatment or prevention of disease in man or animals Other than food, intended to affect the structure or function of the body To Multijurisdictional Counterdrug Task Force Training 9 Multijurisdictional Counterdrug Task Force Training Working Definition of a “DRUG” 10 Illicit Drug Use “A chemical substance, such as a narcotic or hallucinogen, that affects the central nervous system, causing changes in behavior and often addiction” In 2005, an estimated 19.7 million Americans aged 12 or older were current (past month) illicit drug users ¾ ¾ ¾ Used an illicit drug during the month prior to the survey interview Represents 8.1 percent of the population aged 12 years old or older Illicit drugs include marijuana/hashish, cocaine (including crack), heroin, hallucinogens, inhalants, or prescription-type psychotherapeutics used nonmedically Source: SAMHSA, Results from the 2005 National Survey on Drug Use and Health Multijurisdictional Counterdrug Task Force Training 11 Multijurisdictional Counterdrug Task Force Training 2 A partnership between The Florida National Guard and St. Petersburg College 12 Multijurisdictional Counterdrug Task Force Training Identifying Drugged Persons Types of Drugs Used by Past Month Illicit Drug Users Aged 12 or Older: 2005 Marijuana Use Marijuana was the most commonly used illicit drug (14.6 million past month users) Source: SAMHSA, Results from the 2005 National Survey on Drug Use and Health. Multijurisdictional Counterdrug Task Force Training Source: SAMHSA, Results from the 2005 National Survey on Drug Use and Health. 13 Multijurisdictional Counterdrug Task Force Training Types of Drugs Used by Past Month Illicit Drug Users Aged 12 or Older: 2005 Seven Drug Categories Cannabis Hallucinogens CNS Dissociative Stimulants Narcotic Analgesics CNS Depressants Source: SAMHSA, Results from the 2005 National Survey on Drug Use and Health. Multijurisdictional Counterdrug Task Force Training 15 Anesthetics Inhalants Multijurisdictional Counterdrug Task Force Training 16 Central Nervous System Stimulants Cannabis Marijuana Cocaine Hashish Amphetamine Hash Methamphetamine Oil Marinol Multijurisdictional Counterdrug Task Force Training 14 17 Multijurisdictional Counterdrug Task Force Training 3 A partnership between The Florida National Guard and St. Petersburg College 18 Multijurisdictional Counterdrug Task Force Training Identifying Drugged Persons Central Nervous System Depressants Narcotic Analgesics Heroin Alcohol Morphine Barbiturates Codeine Synthetic Valium opiates Chloralhydrate ¾ Demerol ¾ Methadone Multijurisdictional Counterdrug Task Force Training 19 Multijurisdictional Counterdrug Task Force Training Hallucinogens 20 Dissociative Anesthetics LSD PCP Peyote Ketamine Psilocybin DXM Multijurisdictional Counterdrug Task Force Training 21 Multijurisdictional Counterdrug Task Force Training Definitions Associated with DRE Examinations Inhalants Pupil size Nystagmus Convergence Blood pressure Toluene Glue Paint Multijurisdictional Counterdrug Task Force Training 22 23 Pulse rate Body temperature Internal clock Multijurisdictional Counterdrug Task Force Training 4 A partnership between The Florida National Guard and St. Petersburg College 24 Multijurisdictional Counterdrug Task Force Training Identifying Drugged Persons Pupil Size Normal Pupil Size Range ¾ 2.5 to 5.0 mm (room light) ¾ 5.0 to 8.5 mm (near total darkness) ¾ 2.0 to 4.5 mm (direct light) Multijurisdictional Counterdrug Task Force Training 25 Multijurisdictional Counterdrug Task Force Training Mydriasis (Dilated Pupils) Multijurisdictional Counterdrug Task Force Training Miosis (Constricted Pupils) 27 Multijurisdictional Counterdrug Task Force Training Ptosis (Droopy Eyelids) 28 Nystagmus Involuntary Multijurisdictional Counterdrug Task Force Training 26 29 jerking of the eyes Multijurisdictional Counterdrug Task Force Training 5 A partnership between The Florida National Guard and St. Petersburg College 30 Multijurisdictional Counterdrug Task Force Training Identifying Drugged Persons Vital Signs Strabismus A condition in which a person can not align both eyes simultaneously under normal conditions A condition in which the eyes deviate (turn) when looking at the object of regard Convergence Internal Clock: 30 sec +/- 5 sec 60-90 bpm Blood Pressure: 120-140 / 70-90 Body Temp: 98.6 F +/- 1 degree Pulse: Lack of convergence Multijurisdictional Counterdrug Task Force Training 31 Multijurisdictional Counterdrug Task Force Training Observations Suspect’s Breath ¾ Odor of alcohol ¾ Chemical odor ¾ Cannabis odor 32 Observations Suspect’s General Face Appearance ¾ Normal ¾ Flushed Eyes ¾ Normal ¾ Clean ¾ Watery ¾ Orderly ¾ Bloodshot ¾ Pale ¾ Disarranged ¾ Pink/red ¾ Other ¾ Bloody ¾ Vomit ¾ Urine Multijurisdictional Counterdrug Task Force Training 33 Multijurisdictional Counterdrug Task Force Training Observations Observations Attitude ¾ ¾ ¾ ¾ ¾ ¾ ¾ ¾ ¾ ¾ ¾ Anxious Restless Agitated Excited Combative Disinterested Uninhibited Disoriented Drowsy Confused Hallucinating Multijurisdictional Counterdrug Task Force Training 34 ¾ ¾ ¾ ¾ ¾ ¾ ¾ ¾ ¾ ¾ Speech Loss of memory Cyclic mood swings Polite Antagonistic Stuporous Cooperative/indifferent Laughing Insulting Argumentative Fumbling Physical ¾ Talkative ¾ Thick, slurred ¾ Incoherent ¾ Rapid ¾ Slow ¾ Non-communicative ¾ Repetitive 35 Actions ¾ Facial itching ¾ Dry mouth ¾ Nodding ¾ Droopy eyelids ¾ Low, raspy voice ¾ Body tremors ¾ Muscle tone ¾ Grinding of teeth Multijurisdictional Counterdrug Task Force Training 6 A partnership between The Florida National Guard and St. Petersburg College 36 Multijurisdictional Counterdrug Task Force Training Identifying Drugged Persons Observations Observations Other ¾ Nasal redness ¾ Runny nose ¾ Track marks ¾ Perspiring ¾ Warm to the touch ¾ Intense headaches ¾ Residue of paint on person ¾ Debris ¾ Pills ¾ Vials ¾ Syringes ¾ Drug paraphernalia Multijurisdictional Counterdrug Task Force Training 37 Multijurisdictional Counterdrug Task Force Training Psychophysical Exams 38 Rhomberg Test Instructions Demonstration Subject’s Record Multijurisdictional Counterdrug Task Force Training 39 Attempts Results Multijurisdictional Counterdrug Task Force Training Walk and Turn One-Leg Stand Instructions Instructions Demonstration Demonstration Subject’s Subject’s Record Attempts Results ¾ Each Record Multijurisdictional Counterdrug Task Force Training 41 40 Attempts leg Results Multijurisdictional Counterdrug Task Force Training 7 A partnership between The Florida National Guard and St. Petersburg College 42 Multijurisdictional Counterdrug Task Force Training Identifying Drugged Persons Eye Examination: Detecting Signs of Drug Influence Multijurisdictional Counterdrug Task Force Training Cannabis 43 Multijurisdictional Counterdrug Task Force Training Cannabis Cannabis: Methods of Ingestion Schedule Smoking I widely abused illegal drug in the U.S. Derived from the Indian hemp plant Botanical name Cannabis Sativa Grows wild in climates all over the world Most Multijurisdictional Counterdrug Task Force Training Oral 45 Multijurisdictional Counterdrug Task Force Training Cannabis: Effects Horizontal gaze nystagmus - none Vertical nystagmus - none Lack of convergence/strabismus present Pupil size - possibly dilated Multijurisdictional Counterdrug Task Force Training 44 46 Cannabis: Effects Reaction to light - normal Blood pressure - up Body temperature - normal Pulse rate - up Short-term memory loss Paranoia Loss of ambition “Munchies” 47 Multijurisdictional Counterdrug Task Force Training 8 A partnership between The Florida National Guard and St. Petersburg College 48 Multijurisdictional Counterdrug Task Force Training Identifying Drugged Persons Central Nervous System Stimulants Cannabis: General Indicators Diminished inhibitions perception of time/distance Disorientation Body and/or eyelid tremors Reddening of the conjunctiva Possible debris in mouth Impaired Multijurisdictional Counterdrug Task Force Training 49 Multijurisdictional Counterdrug Task Force Training 50 Stimulants Stimulants: Method(s) of Ingestion Drugs Injected Natural: Oral that speed up the body's metabolism caffeine, nicotine, cocaine Synthetic: amphetamine, methamphetamine, methcathinone Multijurisdictional Counterdrug Task Force Training Inhaled Smoked 51 Multijurisdictional Counterdrug Task Force Training Stimulants: General Indicators Stimulants: Effects HGN - none VGN - none Lack of convergence none Pupil size - dilated (mydriasis) Multijurisdictional Counterdrug Task Force Training 52 Pupil reaction to light slow to none visible Pulse rate - up Blood pressure - up Body temperature - up Bruxism Restlessness Euphoria Anxiety Talkativeness Irritability 53 Runny nose Redness to nasal area Leg and eyelid tremors Rigid muscle tone Multijurisdictional Counterdrug Task Force Training 9 A partnership between The Florida National Guard and St. Petersburg College 54 Multijurisdictional Counterdrug Task Force Training Identifying Drugged Persons Meth Use Meth Use 18 months later Multijurisdictional Counterdrug Task Force Training Meth Use 55 Multijurisdictional Counterdrug Task Force Training 56 Methamphetamine Effects 4 Years Later Multijurisdictional Counterdrug Task Force Training 42 years old After just three years and five months of meth use 40 pounds lighter 57 Multijurisdictional Counterdrug Task Force Training Narcotic Analgesics 58 Narcotic Analgesics Strong sleep painkilling drugs that also produce Most drugs in this class are produced from the opium poppy Multijurisdictional Counterdrug Task Force Training 59 Multijurisdictional Counterdrug Task Force Training 10 A partnership between The Florida National Guard and St. Petersburg College 60 Multijurisdictional Counterdrug Task Force Training Identifying Drugged Persons Narcotic Analgesics: Characteristics The Concept of Drug Tolerance Pain The relief (analgesic) withdrawal signs and symptoms (when stopped after chronic administration) Stop withdrawal signs and symptoms (note: other N.A. can be substituted for relief of withdrawal symptoms same dose of the drug will produce diminishing effects A steadily larger dose is needed to produce the same effect Produces Multijurisdictional Counterdrug Task Force Training 61 Multijurisdictional Counterdrug Task Force Training 62 Narcotics: Effects Narcotics: General Indicators HGN Slow reflexes, sluggish movements Slow, low, raspy speech Slow breathing, cold skin - none VGN - none Lack of convergence - none Pupil size - constricted (miosis) Pulse rate - down Blood pressure - lowered Body temperature - down Multijurisdictional Counterdrug Task Force Training 63 “On the nod” Droopy eyelids (ptosis) Dry mouth Euphoria Track marks Multijurisdictional Counterdrug Task Force Training Method(s) of Ingestion 64 CNS Depressants Injected Oral Inhaled Smoked: Heroin, Opium, Morphine Multijurisdictional Counterdrug Task Force Training 65 Multijurisdictional Counterdrug Task Force Training 11 A partnership between The Florida National Guard and St. Petersburg College 66 Multijurisdictional Counterdrug Task Force Training Identifying Drugged Persons Depressants Depressants: General Indicators Drugs Drowsiness Droopy eyelids (ptosis) Thick, slurred speech Lack of coordination Slow, sluggish reactions that slow down the body's metabolism ¾ Barbiturates: sleeping pills anxiety-fighting depressants ¾ Methaqualone: non-barbiturate hypnotic ¾ Tranquilizers: Multijurisdictional Counterdrug Task Force Training 67 Multijurisdictional Counterdrug Task Force Training HGN - present VGN - present Lack of convergence present Pupil size - normal Multijurisdictional Counterdrug Task Force Training Pupil reaction to light slow Pulse rate - down (Qualudes & alcohol) Blood pressure lowered Temperature - normal Oral Injected 69 Multijurisdictional Counterdrug Task Force Training Hallucinogens 70 Notable Hallucinogens Multijurisdictional Counterdrug Task Force Training 68 Depressants: Method(s) of Ingestion Depressants: Effects Flaccid muscle tone Reduced social inhibitions In other words, drunk 71 Lysergic Acid Diethylamide (LSD) Psilocybin Mushrooms Peyote (mescaline) Multijurisdictional Counterdrug Task Force Training 12 A partnership between The Florida National Guard and St. Petersburg College 72 Multijurisdictional Counterdrug Task Force Training Identifying Drugged Persons Hallucinogens Hallucinogens: Effects Drugs HGN - none VGN - none Lack of convergence none Pupil size - dilated that cause distortions of reality This class of drug can alter vision, sense of smell and touch Some Pupil reaction to light normal Pulse rate - up Blood pressure - up Body temperature - up can be absorbed through skin Multijurisdictional Counterdrug Task Force Training 73 Multijurisdictional Counterdrug Task Force Training Hallucinogens: General Indicators Dissociative Anesthetics Dazed PCP appearance tremors Perspiring Rigid muscle tone Difficulty with speech Body Statements suggesting hallucinations Distorted sensory perceptions Multijurisdictional Counterdrug Task Force Training Ketamine DXM 75 Multijurisdictional Counterdrug Task Force Training PCP: General Indicators PCP: General Indicators Slow, slurred speech Disorientation Loss of memory Agitation, excitement Loss Multijurisdictional Counterdrug Task Force Training 74 Blank stare (“1000yard stare”) Non-communicative Rigid muscle tone 76 of a sense of personal identity Sensory distortions Auditory hallucinations A feeling of extreme heat, profuse perspiration Increased pain threshold 77 Multijurisdictional Counterdrug Task Force Training 13 A partnership between The Florida National Guard and St. Petersburg College 78 Multijurisdictional Counterdrug Task Force Training Identifying Drugged Persons PCP: Effects HGN - present (early onset) VGN - present Lack of convergence present Pupil size - normal Inhalants Pupil reaction to light normal Pulse rate - up Blood pressure - up Body temperature - up Multijurisdictional Counterdrug Task Force Training Volatiles ¾ ¾ Aerosols ¾ ¾ 79 paint thinners gasoline Alkyl nitrites Nitrous oxide Schedule IV hair sprays spray paints Multijurisdictional Counterdrug Task Force Training 80 Inhalants: General Indicators Inhalants: Effects Odor HGN - present VGN - present Lack of convergence present Pupil size - normal (may be dilated with certain anesthetic gases) Pupil reaction to light slow of inhaled substance Traces of substance on face, nose, hands, clothing Bloodshot, watery eyes Confused, disoriented appearance Flushed face, possible sweating Slow, thick, slurred speech Multijurisdictional Counterdrug Task Force Training 81 Pulse rate - up Blood pressure - up or down Body temperature up, down, normal Muscle tone - usually normal Multijurisdictional Counterdrug Task Force Training Drugs Which Induce Nystagmus 82 PCP Usually Causes Immediate Onset of Nystagmus CNS Depressants (Most) Inhalants Dissociative Anesthetics Multijurisdictional Counterdrug Task Force Training 83 Multijurisdictional Counterdrug Task Force Training 14 A partnership between The Florida National Guard and St. Petersburg College 84 Multijurisdictional Counterdrug Task Force Training Identifying Drugged Persons Drugs That Cause Lack of Convergence Drugs Which Usually Don’t Affect Pupil Size CNS CNS depressants Depressants Inhalants PCP Inhalants Dissociative anesthetics Cannabis Strabismus Multijurisdictional Counterdrug Task Force Training 85 Multijurisdictional Counterdrug Task Force Training Drugs Which Cause Pupil Dilation 86 Narcotic Analgesics Usually Cause Pupil Constriction CNS stimulants Hallucinogens POSSIBLY Cannabis (slight dilation) Multijurisdictional Counterdrug Task Force Training 87 Multijurisdictional Counterdrug Task Force Training Polydrug Use Field Studies Using Los two or more drugs at the same time Examples: PCP and marijuana; heroin and cocaine; many others Multijurisdictional Counterdrug Task Force Training 88 Angeles Field Study ¾ 72% New of suspects had 2 or more drugs York Certification Training Study ¾ 67% of suspects had 2 or more drug categories other than alcohol 89 Multijurisdictional Counterdrug Task Force Training 15 A partnership between The Florida National Guard and St. Petersburg College 90 Multijurisdictional Counterdrug Task Force Training Identifying Drugged Persons Prevalence of Polydrug Use Two Drugs in Combination: How Do They Affect Pupil Size? P.I.R.E.* Situation DRE database indicates that 25% of all DRE-reported cases revealed two or more drug categories detected (2005) #1 ¾ Neither drug affects pupil size ¾ Example: PCP and Valium ¾ Neither one affects the size of the pupils ¾ The combination will also not affect pupil size *Pacific Institute of Research and Evaluation Multijurisdictional Counterdrug Task Force Training 91 Multijurisdictional Counterdrug Task Force Training Null Effect Two Drugs in Combination: How Do They Affect Pupil Size? No Situation action plus no action equals no action 92 #2 ¾ One drug affects the pupil size, but the other does not ¾ Example: PCP and cocaine ¾ Cocaine dilates pupils, PCP doesn’t affect pupils ¾ The combination will affect pupil size If neither drug affects a particular indicator of impairment, their combination also will not affect that indicator Multijurisdictional Counterdrug Task Force Training 93 Multijurisdictional Counterdrug Task Force Training Overlapping Effect Two Drugs in Combination: How Do They Affect Pupil Size? Action Situation plus no action equals action 94 #3 ¾ The two drugs affect pupil size in the same way LSD and cocaine ¾ Cocaine dilates pupils; so does LSD ¾ The combination will affect pupil size ¾ Example: If one drug affects a particular indicator of impairment, and another drug has no effect on that indicator, the combination of those two drugs will affect the indicator, in the same way as the first drug alone Multijurisdictional Counterdrug Task Force Training 95 Multijurisdictional Counterdrug Task Force Training 16 A partnership between The Florida National Guard and St. Petersburg College 96 Multijurisdictional Counterdrug Task Force Training Identifying Drugged Persons Additive Effect Two Drugs in Combination: How Do They Affect Pupil Size? Action Situation plus the same action produces reinforced action two drugs affect pupil size in exactly opposite ways ¾ Example: heroin and cocaine ¾ Cocaine dilates pupils, heroin constricts pupils ¾ We can’t predict how the combination will affect pupil size If two drugs independently affect some indicator in the same way, their use in combination will also affect the indicator and the effect may be reinforced Multijurisdictional Counterdrug Task Force Training #4 ¾ The 97 Multijurisdictional Counterdrug Task Force Training Antagonistic Effect The Effects of Drug Combinations Action Null versus opposite action: can’t predict the outcome Effect Overlapping Effect Additive Effect Antagonistic Effect If two drugs affect some indicator in exactly opposite ways, their use in combination could affect that indicator in any possible way Multijurisdictional Counterdrug Task Force Training 99 Multijurisdictional Counterdrug Task Force Training cocaine & heroin PCP & cannabis Multijurisdictional Counterdrug Task Force Training 100 Sample Drug Influence Evaluation Face Sheet Common Combinations of Drugs cocaine & cannabis 98 This is NOT a DRE course, although we are using DRE principles This DRE form is only used as an example It is important for you to document, document, document all information observed! alcohol & practically anything else 101 Multijurisdictional Counterdrug Task Force Training 17 A partnership between The Florida National Guard and St. Petersburg College 102 Multijurisdictional Counterdrug Task Force Training Identifying Drugged Persons Components on the Drug Evaluation Narrative Report 1. 2. 3. 4. 5. 6. Components on the Drug Evaluation Narrative Report Location Witnesses Breath Alcohol Test Notification & interview of arresting officer Initial observations of the suspect Medical problems & treatment 7. 8. 9. 10. 11. 12. 13. Multijurisdictional Counterdrug Task Force Training 103 Psychophysical indicators of impairment Clinical indicators of impairment Signs of ingestion Suspect’s statements Officer’s opinion Toxicological sample Miscellaneous Multijurisdictional Counterdrug Task Force Training For more information about training with MCTFT, call 1-800-243-5550 www.mctft.com 18 A partnership between The Florida National Guard and St. Petersburg College 104
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