Léim ar aghaidh chuig an bpríomhábhar
Gnáthamharc

JOINT COMMITTEE ON TRANSPORT díospóireacht -
Wednesday, 24 Jan 2007

Road Safety: Discussion with Medical Bureau of Road Safety.

We will now have a discussion with Professor Denis Cusack, director of the Medical Bureau of Road Safety. I welcome Professor Cusack and Ms Pauline Leavy, chief analyst at the bureau. I draw their attention to the fact that members of the joint committee have absolute privilege but that this same privilege does not apply to witnesses appearing before the committee. Members are reminded of the parliamentary practice that they should not comment on, criticise or make charges against a person outside the Houses or an official either by name or in such a way as to make him or her identifiable. I propose that we hear a short presentation by Professor Cusack which will be followed by a question and answer session. Is that agreed? Agreed.

Professor Denis Cusack

I am grateful to the Chairman and members of the Joint Committee on Transport for their kind invitation to attend and address this meeting. I understand the committee is looking forward to a discussion on the work of the Medical Bureau of Road Safety and generally on the issue of driving under the influence of intoxicants, most particularly drugs. As the Chairman said, I am accompanied by our chief analyst and chief scientist, Ms Pauline Leavy.

Each one of us present is aware of the number of deaths and injuries in Ireland as a result of road traffic crashes. A number of well recognised factors contribute to that tragic human toll. They include speeding, the non-use of safety belts and protective gear, dangerous and careless driving due to fatigue, ill-attention, and driving under the influence of intoxicants, to which I may refer as DUI. To tackle the problem, we must look across the entire spectrum of legislative provisions, enforcement measures, forensic analysis, the prosecution of offences and court outcomes. Our approach on all of these fronts must be evidence based — in jurisprudence, cause analysis, science and medicine, statistical and epidemiological reviews and court case data.

In considering DUI, it is important to emphasise and not lose sight of the fact that alcohol remains the biggest problem as the drug causing intoxication and impaired driving, as studies in the public domain have repeatedly shown. Recent Irish studies by Dr. Declan Bedford's public health group in the north eastern region and also by our UCD forensic unit and the Coroners Court, district of Kildare, confirm this to be the case. I sent the paper in advance to the committee. The gathering and analysis of data from coroners' inquests are vital parts of this information resource. Following this session members will have a discussion on the fitting of mirrors to trucks. I am aware that on this very issue for many years many coroners have indicated that there is a small but significant number of avoidable deaths.

It is important to recognise that drug-impaired driving presents an increasing, real and significant problem. The nationwide study carried out at University College Dublin by the medical bureau and department of public health medicine found that approximately one third of the blood and urine samples taken from drivers arrested on suspicion of intoxicated driving but who were under the limit for alcohol were positive for one or more drugs. We are already looking at a sample of drivers in respect of whom there is a suspicion of intoxication, which is why I say the problem would be larger if we were to include all drivers. The drugs include cannabis, amphetamines, met-amphetamines, benzodiazepines, cocaine, opiates and methadone. In the study approximately one sixth of all drivers, whether under or over the limit for alcohol, showed a pattern of drug positivity. The study and the paper published last month in the international peer reviewed journal, Injury Prevention, are before the committee.

There is much international literature from elsewhere in Europe, particularly the Scandinavian countries which are very much to the fore in this area, North America and Australia, and I am aware presentations were made previously from that part of the world. It confirms that drug driving is a worldwide problem and that the incidence of driving under the influence of drugs may be anywhere from 50% upwards of the number driving under the influence of alcohol. Some studies suggest it may even equal or exceed the number driving under the influence of alcohol. However, these studies must be interpreted with caution, as we must look to the sampling method and the societal and enforcement context.

The forensic analysis of drugs is much more complex than that for alcohol alone. Alcohol is a single drug type. Most forensic units, including the bureau, will analyse specimens for several types or classes of drugs, as I mentioned. It is done in a two-stage process to indicate whether the drug is present in the first instance and, if so, this is confirmed by a second-stage analysis. Unlike alcohol, there are no set limits in law for drugs and driving in this jurisdiction. The offence consists of impairment of driving with the presence of a drug or drugs. Different types of drugs have different effects on the human body and the ability to drive. There is also the issue of licit versus illicit use of drugs and how legislation governing road safety should approach the differentiation between them, if appropriate. There is an emerging consensus that a rational approach would be a zero tolerance for illicit drugs and an impairment test to be continued for the presence of therapeutic drugs taken properly on prescription.

A number of societies, including Aware, raised with us the question of whether people who are on anti-depressants will be worried about taking their medication. It is important to stress that nothing must interfere with the health of drivers. Medications are prescribed to make them better and healthy and therefore to increase the safety of their driving. It must be emphasised that none of these road safety measures should interfere with the well-being of people. It is a matter of getting the right advice and striking the right balance.

There is the added difficulty that at present there is no single reliable roadside device for the screening of oral fluid or saliva for drugs. This has been confirmed in the recent findings of the international study called Rosita-2. Impairment by drugs can also be assessed by formal field impairment testing, FIT, or drug recognition experts, DRE, and the bureau has been in consultation with the Garda Síochána in this regard.

The functions of the bureau are laid down in the Road Traffic Acts 1968-2006 and the regulations under those Acts. Those functions are set out in the 2004 annual report, a copy of which has been sent to the committee. The activities of the Medical Bureau of Road Safety arising from those statutory functions may be classified into the five programmes which are listed in the presentation for the information of members.

In 2005, the bureau certified alcohol concentration results in more than 4,000 blood and urine specimens, 230 of which were taken in hospitals. In that year a total of more than 8,600 breath specimens were certified by the bureau's 64 evidential breath testing instruments installed in Garda stations nationwide. This gives a grand total of more than 12,700 certified alcohol results.

In 2005, 747 specimens were tested for the presence of a drug or drugs. Some 484 of these samples were positive on screening and 424 were confirmed as positive for the presence of drugs other than alcohol. We do not have the figures yet for 2006 as we are still working through them but we anticipate that approximately 1,000 specimens were analysed for the presence of drugs other than alcohol. It is anticipated that the number of specimens for drugs will increase further following the introduction of the mandatory alcohol checkpoints in July 2006 and the issuing of 400 additional electronic roadside alcohol screening devices by the bureau to the Garda Síochána.

The bureau is actively engaged in representing Ireland in the Pompidou group, which is a committee within the Council of Europe, a sub-committee of which is particularly concerned with drugs and driving. To give a flavour of a recent meeting of that group, I have given a summary agenda for the meeting last July to the joint committee.

The bureau is also an active participant in other international and national bodies dealing with drugs and drug driving. The current programme of drug analysis in the bureau will soon expand. As the drug driving problem increases, the bureau, with the Department of Transport and other agencies, must be ready to meet the challenge that this raises. Later this week an advertisement will be placed for a senior scientist specialising in the area of drug toxicology to be appointed to the bureau to lead and expand this area of its statutory work. Coincidentally, as the committee may be aware, the bureau is moving from Earlsfort Terrace, which has long been the home of the UCD school of medicine, to new premises with state-of-the-art laboratory facilities in the new school building, which will be ready in the latter part of this year.

I hope that this opening statement and a brief summary of the current position is of assistance to the members of the joint committee in their overall important work and role and that it may also assist them in understanding another facet of road safety. I would be pleased to address in greater detail any of the issues to which I alluded and any other related and relevant matter in respect of which no doubt I will rely on the expert knowledge and support of Ms Leavy, our chief analyst.

I propose to proceed by taking questions from a number of members. Is that agreed? Agreed. Prior to that I wish to raise one or two questions. Professor Cusack stated that the number of positive drug tests is increasing. Most cases involving driving under the influence of alcohol are dealt with by the old system used by the Garda whereby blood specimens are taken. How can the bureau obtain details from such tests with regard to what Professor Cusack has stated? When the authorities had a blood sample for analysis, it could be analysed for everything, so to speak, but now a breath specimen is being used. Has the bureau any means of detecting by way of the breath specimen testing equipment if an individual may have taken drugs?

Professor Cusack

No, we do not. I suggested in the presentation that if a person appears intoxicated — the gardaí are generally trained to recognise such basic intoxication — and it transpires from the screening device at the roadside or from the evidential breath testing that he or she has a zero or very low level of alcohol, clearly the question must arise as to whether another intoxicant such as a drug could be present and whether we should proceed to obtain a blood and urine sample. Section 49 of the existing legislation provides that it is an offence to drive under the influence of an intoxicant and an intoxicant is alcohol or drugs or a combination of those. I am trying in my vocabulary to move away from using the term "drink driving", which is the popular term, to using the term "intoxicated". The Chairman has raised an important issue. If that is not done, we will not detect or pick up and address the drug driving problem.

Under the new system, there will be very few instances where samples will be taken unless a person is bent over from being under the influence of drugs rather than from alcohol when he or she is brought in for breath testing. Has Professor Cusack any recommendations for saliva or other means of testing everybody in the same way as random testing is carried out now?

Professor Cusack

The Rosita-2 study, of which I can forward a copy, was an international study between Europe and the US. Six European countries and four US states examined nine instruments put forward that were reputed to be able to measure drugs in saliva. Six of them did not even get beyond the first stage and the three that went on to the second stage, following very significant testing, showed that at present the answer to that question is "No". This is a long report that was published last March but only issued in the summer.

Some of these devices will pick up satisfactorily, on an indication basis, two types of drugs, cannabis and amphetamine or methamphetamine. I understand the joint committee had a presentation from an expert in this area from Australia.

Professor Cusack

Two of the states in Australia have moved to what one might call that limited aspect of it, but it is very much in the early stages and is much more open to challenge at present. We must rely on the opinion of the garda involved. Approximately 4,000 blood samples are tested per year. If a blood or urine sample is under the limit for alcohol, it is automatically tested for drugs as well as any other samples sent in by the Garda. The Chairman is correct in pointing out that we need to keep our eye on the ball in this respect. If a person appears intoxicated, or on evidential breath testing appears intoxicated, and the alcohol shows up as a pass, low or zero, then a blood or urine sample should be taken for drug analysis. It is allowed for in the legislation, so new legislation is not required.

However, the Chairman's point may well be that under the old regime, if we can call it that, when only what is termed "forming an opinion" allowed for an arrest, for a garda to be able to stand up to cross examination on how he or she formed an opinion, the driver had to be very intoxicated. Indeed, the samples we have mean blood-alcohol concentration is still around 170 milligrams, which is more than twice the limit. At present when drivers are picked up on the basis of "forming an opinion", a garda must be fairly secure in that opinion. The Chairman's point is well taken.

Professor Cusack more or less answered the question I was going to ask but perhaps he could clarify it a little. There is the breath test at the roadside and then one goes for an evidential breath test. If one passes that, are the gardaí legally entitled to go further and take a blood test?

Professor Cusack

Yes. Ms Leavy has just reminded me that since July, we have been looking to see if we are getting more blood and urine samples in with very low, or zero, alcohol, which we are. It would be speculation on my part to say this may be a sign that the gardaí are sending in samples. We do not know whether they have originated after a breath sample has been taken or whether an opinion has been formed. However, we must remember it has only been six months.

Is a request made to check for drugs as opposed to alcohol?

Professor Cusack

No.

It is just for intoxicants, so it is not known what the gardaí think.

Professor Cusack

We do not know unless the garda has sent in a particular note. That is usually sent in when he or she knows the person is over the limit for alcohol or he or she has got a result for alcohol and asks for an additional test for drugs.

Professor Cusack mentioned the absence of a roadside test for drugs. He mentioned that impairment by drugs can also be assessed by the formal field impairment testing and drug recognition experts. Is that just observation at the roadside or does one buy an actual test kit?

Professor Cusack

It is not an actual test. We have been in consultation with the gardaí and, indeed, Ms Leavy, members of the Garda and I went to the PSNI training session in the North last summer. It is not just a simple observation. For example, there is pupil examination, the size of the pupil, the Romberg test which is seeing whether a person sways, the walk and turn test which is the traditional old test which one may see in the movies where a person is asked to walk and turn, standing on one leg and the finger to nose test. This is not a pass-fail test. It is putting together a picture because some people are just bad at performing things—

I was going to say that.

Professor Cusack

—in the most sober state. It is not just an observation. There are actual tests. There is a training course and booklet, so that the garda can put together an opinion based on the totality of this.

That would determine incompetence due to the presence of some type of intoxicant but would it necessarily distinguish between a legal drug and an illegal one?

Professor Cusack

No. To a certain extent, we all differentiate between legal and illegal drugs. I sometimes refer to licit and illicit use because benzodia, as a tranquilliser, is a legal drug but it may be used illicitly without prescription. We must be aware it is not about whether a drug is licit or illicit. That really concerns the misuse of drugs and the criminality of that aspect. This concerns whether a person is fit, safe and healthy to drive. As I said, it is a rational approach that in the first instance, there should be no doubt about whether a person has taken illicit drugs. A number of countries have opted for zero tolerance in that regard.

If one is found to have cannabis or heroin in one's system while driving, the question of whether one is impaired does not arise. I have asked colleagues abroad and police officers about this and they have said the reality is that in order to come to the attention of a police officer, the person would have to generally show impairment, so it is not quite as divorced from an impairment as it might first appear.

Then there is the question about prescription drugs. Speaking as a doctor, I stress it is important that people do not feel they should not take medications. However, people should be educated and made aware that if their medication is changed, the dose is changed, there is a new drug or if they feel their co-ordination and concentration is, in any way, affected, they should check their medication with their pharmacist or doctor. There is a concentration on illicit drugs, such as cocaine, which we are seeing increasingly in this jurisdiction.

I wish to ask a question not specifically on this issue but related to it. An issue which has always bothered me about road safety is that we know so little about the causes of accidents. Intuitively, we know they are caused by speeding, road conditions and not wearing a safety belt. Professor Cusack said the approach is evidence based. There is very little hard evidence and the medical bureau provides most of it with some being provided by gardaí. Toxicology reports, for instance, testing for the presence of alcohol, are not done automatically in post-mortems. Many pathologists do so for their own information but even if they do so, they are not always available. Studies have been done in individual court areas but much of the information collected is not accessible. For instance, I asked a parliamentary question about the number of accidents that involved provisional licence holders but nobody knew the answer. Although a garda collects that information at the scene of accident and must fill it in on a form, nobody ever collates it.

The bureau would be interested in getting more hard information. Has Professor Cusack made any recommendations to the new Road Safety Authority about the need for evidence to be collected, collated and made available to inform policy rather than doing it on the hoof, that is, saying this week's problem is such-and-such and we must pass a new law rather than have evidence-based legislation?

Professor Cusack

I wish to put on my coroner's hat for a moment as I am coroner for County Kildare. I agree with the Deputy that there has been a lack of evidence. The coroner directs the pathologist to carry out the post-mortem. The Coroners Society is standardising practice and a recommendation by it and by the Council of Europe, to which Ireland was a signatory, in 1999 was that autopsies must also consist of toxicology examinations. These are available at inquest. Every road traffic crash fatality must be the subject of an inquest. That is how I was able to go back over 11 years of tragic road fatalities in the Kildare coroner's district. That information is available.

One of the recommendations in the coroner's review by the Department of Justice, Equality and Law Reform, which set up that committee of which I was a member, was that there should be a national database when this information is collected. I am still waiting for that recommendation to be implemented. At present it lies in 48 individual coroner's offices.

Reform is taking place. However, I have some concerns about the proposed legislation. For example, it does not appear to address the need for research. If we can find out about alcohol levels and so on in all fatalities, not just in road traffic crashes but in accidents at work, this will inform health and road safety policy. One of the recommendations I have made in the context of reform and the new centralised coroner's service is that we have a centralised database. We should provide that the information is then made available.

Gardaí in the Garda traffic bureau collect information as do the Road Safety Authority, through the National Roads Authority, and the coroners. The Deputy is right that it needs to be brought together. I have been in consultation with Mr. Noel Brett, chief executive officer of the Road Safety Authority. I have sent recommendations to him based, more or less, on what I have said. I understand I will be asked to go further because the more information we have about road safety and the more evidence we have on all these matters, we will be better able to go forward with good legislation.

I refer to a challenge to the constitutionality of legislation in regard to morning random breath testing. One of the aspects of our Constitution is the balance between the liberties of the citizen, protection of which is paramount, and proportionality. By a slight intrusion on privacy, can we save lives, decrease the number of injuries and even prevent a person from driving in the morning? Deputy Mitchell is correct. That is why from the work we have done I stress the need for and to continue an evidence based approach. In addition, Dr. Declan Bedford's group, the RSA, has commissioned work from the north-eastern public health area. Dr. Bedford's work, dating from approximately the same time as our own, also gives us this evidence.

I thank Professor Cusack for his presentation. From the figures he has provided I am not entirely clear on what the exact position is; I find it difficult to get an overall picture of his findings. He has spoken of situations where a driver comes to the attention of the Garda, the person is found not to have alcohol in his or her system and is then tested for drugs. In 2005, the last year for which he has accurate figures, what was the total number of tests carried out on persons who had already failed the evidential breath test or were already over the alcohol limit? What percentage had drugs other than alcohol in their system? Of those who were not over the alcohol limit, what percentage had drugs in their system? Does the medical bureau's testing regime allow it to distinguish between prescription drugs and illegal drugs? What are Professor Cusack's findings in that regard?

I realise my next question may be more appropriate to the Garda but can Professor Cusack give us any idea of the success rate in prosecutions for the presence of drugs in a person's system? I find it difficult to obtain any information on prosecutions for drug driving. To date, I have discovered one only. Can Professor Cusack tell us what is happening on that front, where somebody fails the test about which he spoke, not owing to alcohol but purely the presence of drugs in his or her system which makes him or her incapable of driving safely? What is the prosecution rate for such offences?

I have two more brief questions. The Road Traffic Act allows a court to charge the full cost of testing. What does it cost the medical bureau to carry out an analysis of a blood or evidential breath test sample? Why are the courts not seeking to recoup the full cost from the offender because it strikes me that they should at least be hit in his or her pocket as well as in other ways?

What is the reason for the delay in presenting the medical bureau's annual report? We are into 2007 and still speaking about the figures for 2004.

Professor Cusack

On the issue of drugs and driving, the 2000 survey involved 1,000 samples from drivers over the alcohol limit and 1,000 from drivers under the limit. Of the 1,000 under the alcohol limit, approximately one third had drugs other than alcohol in their system. Of the 1,000 over the limit, approximately one in six had drugs, in addition to alcohol, in his or her system. As approximately 90% of the specimens we receive are positive or over the limit for alcohol, with the help of our public health colleagues we give a statistical weighting which gave us an overall outcome of approximately one in six. What we are saying is that the people involved were suspected of having been intoxicated and that if one forgets about their alcohol level, one in six had drugs in his or her system. For those who were under the limit for alcohol, the figure was one in three. This occurred at a time when a garda had to form an opinion and there had to be behaviour which clearly amounted to impaired driving. In a comparison with Norway and other countries, the percentage is somewhere between 50% and 100% for all drivers. Driving under the influence of drugs presents a significant problem.

On prescription drugs, I listed the levels. Of the seven drug types, methadone is a prescription drug used to treat people withdrawing from heroin. Benzodiazepines are sleeping tablets and minor tranquillizers. It is not our function to find out whether they have been prescribed because, for example, they could be prescribed but not taken in accordance with the prescription and because they can be obtained on the black market. We do not look at the issue of whether drugs are prescribable. The law does not do so either. It states that if a drug causes impaired driving, it is an intoxicant, regardless of whether it is a sleeping tablet.

If a person on prescription drugs is found to be impaired, can he or she be prosecuted for driving while under the influence?

Professor Cusack

Yes. Obviously, that is a case in which there may well be considerations of the court if it is found that there was no intent, that it was accidental, etc. It would be proper to take such factors on board.

Deputy Shortall asked about the amount of the charge in court. It was £75 which, I think, correlates with approximately €92. The figure dates back to the early 1990s. I wrote to the Department of the Environment as it then was and later the Department of Transport to state it needed to be reviewed.

Deputy Shortall also asked why the courts were not imposing the charge because it is clear that a judge should impose it unless there are substantial reasons for not doing so. I cannot answer the question. Clearly, it has arisen in other areas.

It is a matter we might pursue separately.

Professor Cusack

The charge does not come to the bureau, although it does occasionally. It goes to the Department of Transport and central Exchequer coffers. We have worked out that to a great extent if charges were imposed, the bureau would be largely self-financing. That is not to say it is a for profit organisation but that in a service for the public good, if the money were recouped, there would be a very small shortfall.

Deputy Shortall asked about the cost of analysis. It varies with the drug and, obviously, the volume involved but the approximate average cost of analysis, screening and confirmation is €300.

Deputy Shortall also asked about prosecutions. The position of the medical bureau is that as a forensic laboratory, our only function is to provide accurate and reliable evidence. Clearly, we have some knowledge of what happens in prosecutions but we do not receive a significant amount of information from the Garda reports because they all are included under the section 49 heading. Therefore, we do not know whether it involves alcohol or drugs or both. Anecdotally, we believe it is a much smaller number than the results we are certifying. We have not been able to get any information on the outcome of prosecutions. Without alluding much to it, there is a difficulty in interpreting the number of samples certified as being over the limit versus the number of proceedings commenced and prosecutions. We have never been able to marry or understand why the figures do not match. Even allowing for the fact that what was analysed in the latter part of 2006 may not come to court until sometime this year, on the carryover from year to year, there should not be a major deficiency. I regret to say I am at a loss. While we have asked, we have not been given an explanation.

Deputy Shortall's final question was about our annual report. I have a copy of the report for 2005. We have staffing resource issues — the matter went to Cabinet — and the Department of Transport has been extremely helpful and supportive. It takes approximately six months into the following year before our data are compiled. It is usually June or July by the time we gather the evidential breath-testing data from Garda stations. This must be presented to the board and translated into Irish. This year it was later than usual because we were obliged to divert staff to deal with other matters such as the issuing of roadside screening devices to the Garda. It is not just a matter of handing these out because they must be checked and recalibrated each month. We asked the Department of Transport and the Garda to indicate where we should focus our resources.

I spoke to our senior administrator and stated someone would inquire about the 2005 report. It is ready but it must be sent to the Minister's office and then laid before the Houses for a number of days before being printed. The latest statistics are available to members. I will ensure Deputy Shortall will receive one of the first copies of the report.

Professor Cusack referred to a detailed analysis of the findings but this related to the 2000 figures. Is such an analysis available in respect of the figures from 2004?

Professor Cusack

No. I approached the Department of the Environment, Heritage and Local Government at the time and indicated that with the introduction of evidential breath testing, there would be a decrease in the number of blood and urine samples. That was the entire purpose. That was the last window because by 2001 we had quite a number of evidential breath testing instruments. Our study in 2000, one of the biggest in Europe, was the final opportunity to obtain a large sample. The figure for blood and urine samples has subsequently decreased to approximately 4,000. We wanted to obtain the largest sample. Deputy McEntee was correct to state evidence must be obtained regarding the drug-driving problem in Ireland. The 2000-01 survey — we spent two years analysing the results — indicates that Ireland, like other countries, has a real and significant drug-driving problem. I am satisfied with the evidence in this regard.

Before legislation relating to any matter comes before the Oireachtas, members must be satisfied that there is a problem and presented with methods with which to deal with it. One of the main purposes in carrying out the survey to which I refer was to ensure the Oireachtas would have proper evidence at its disposal in order that — as is always the case — it could introduce sensible and proper provisions.

I welcome Professor Cusack and Ms Leavy and thank them for their detailed and hugely informative presentation.

I sympathise with Professor Cusack on his well disguised frustration regarding both the system and the bureau's lack of resources. At a time when there is a major increase in the level of resources being invested in other areas relating to road safety, it would be appropriate for the work of the bureau, the keystone in respect of all expansions of the road safety regime because it provides all of the data on which such expansions are based, to be facilitated in every possible way. In the absence of that work, not only could the expansions to which I refer not take place but also the expansions taking place could be misdirected if up-to-date data were not available, particularly to the committee and the various agencies involved in enforcement. I will not be involved but for the future I would advocate a much closer relationship between the committee and the bureau because this would facilitate a much greater public airing of the data available to Professor Cusack and also help to highlight particular areas.

It is important that we obtain information on the number of individuals driving while using anti-depressants. The people concerned may not be aware that they may be contravening the higher enforcement levels relating to the intoxicant driving legislation. Is it likely one drink could push a person taking a standard anti-depressant over the limit? Should there be separate limits for those using anti-depressants? It is important that a clear message is sent in order that people will know where they stand. I understand what Professor Cusack stated, namely, that it is not a matter for the bureau to adjudicate and that it is the responsibility of the courts to be satisfied that anti-depressants were appropriately prescribed and were not, therefore, illicit. What is the likelihood that a person taking a normal dose of a routine, mild anti-depressant would be pushed over the limit by imbibing a level of alcohol which would not otherwise put them over that limit?

Professor Cusack

That is an important point. The modern generation of anti-depressants, namely, selective serotonin re-uptake inhibitors, SSRIs, cause a much lower level of drowsiness than their predecessors. It is important that people on anti-epileptic or anti-depressant drugs continue to take such medication. One of the worst things that could happen would be if people were afraid to take their medication because, on that basis, they would be likely to be less safe drivers. Pharmacists indicate on the labels on bottles of valium that such tablets may cause drowsiness and that those taking them should not operate machinery or imbibe alcohol.

It is a disclaimer.

Professor Cusack

Yes, it is a standard disclaimer.

It lessens the impact.

Professor Cusack

Yes. We need to get the message across. Colleagues in Spain and France have informed me that the authorities in those countries have devised a system whereby drugs can be classified. I emphasised to the NSC, now the RSA, the need to educate doctors, pharmacists and patients in order to get this message across.

Anyone who drives will be aware that if one is tired, if the children are fighting in the back and if — this is now illegal — one is using a mobile phone, driving will become more dangerous because one will be increasingly distracted. The legislation does not refer to penalties. There are graded penalties regarding particular levels of alcohol. For example, if a person has a blood-alcohol level of 100 which is over the limit and if he or she is also found to have taken benzodiazepines, there is no additional graded penalty attaching thereto. It is not the case that a greater penalty is imposed in respect of those found to have imbibed the lower level of alcohol over the limit in combination with a particular drug which would make it more dangerous for them to drive. However, the penalties imposed increase as the level of alcohol imbibed increases.

We must educate people in this regard and are considering ways of doing so. Dr. Mercier-Guyon, a colleague of mine in France, has informed me that there are different penalties in his country and that people found to have taken drugs face the highest endorsement, namely, two years, on their driving licences, rather than one year if they are found to have blood-alcohol levels of between 80 and 100. Dr. Mercier-Guyon also stated pharmaceutical companies had examined the issue and introduced a traffic light system of green, amber and red in respect of the taking of medication and driving. However, it reached such a ridiculous point that cough mixtures for children aged under six were accompanied by the warning, "Do not drive after taking this medication". They are being re-examined because they have become almost meaningless. I was a member of the Irish Sports Council when it drew up the medication warnings for athletes but I do not know whether it will be that easy.

If one is taking medications, one should be aware they may affect one's driving. If medications are changed or another intervention takes place such as a drink is taken, although people should not drink and drive, they should be aware of a cumulative effect. Even though road safety is the issue and not whether a drug is illicit, the reality is we differentiate between drugs that do not have a legitimate medicinal purpose and those that do. I recommend that a policy of zero tolerance be adopted regarding people who have illicit drugs in their system while driving while other cases should be considered in the context of impairment and therapeutics and should be dealt with individually so that a judge in his or her wisdom can decide whether an offence has been committed.

Is that the reason nobody can definitively tackle the issue? Eminent medical opinions from people such as Professor Cusack and Ms Leavy would need to be given in court to determine the position.

Professor Cusack

Norway uses the finding in the blood and-or urine. A medical report is provided by the doctor who assessed the driver at the time and a toxicological interpretation is also provided.

Of what?

Professor Cusack

Of the impairment. As I have written many times, the presumption of innocence is paramount and everybody must properly be able to challenge evidence but driving under the influence offences are probably the most challenged and it would be an enormous undertaking in Garda forensic resources and time to return to the old system of basing alcohol cases on opinion. That is why most countries have adopted a split approach with zero tolerance for illicit drugs and a requirement to prove impairment and extenuating circumstances for the presence of therapeutic drugs. That is a pragmatic and wise balance. Work needs to be done on how drugs are classified and that is one of the recommendations in our report. An educational message is needed and the Road Safety Authority is interested in this.

Professor Cusack's contribution was very interesting but I envisage a great deal of coughing in court in the future. Solicitors will have a field day with this. Members have sat through many meetings where drink driving was debated and we thought we were almost out the gap but, on the basis of what Professor Cusack has outlined, we are only at the start.

Professor Cusack

We are at the start regarding drugs but we should not become complacent about alcohol and driving. I am grateful to Deputy Glennon for his comments. I have been appointed by the Minister to head the forensic laboratory and, like every other body, resources are limited, no matter how wealthy the country has become. We must justify anything we do with evidence. Money should not be invested in anything unless a problem is highlighted but, as Deputy Glennon said — and he is one of the first Oireachtas Members to acknowledge this — the difficulty has been that, as enforcement increases, it feeds into the work of the bureau. If the Garda traffic corps is expanded, the number of samples sent to the laboratory also increases. It is our job to ensure we have sufficient resources and expertise to implement what the Legislature has wisely enacted. The drugs issue must be examined and I am not pessimistic about this. Ireland is not on its own nor is it far behind other states because our officials attend meetings and we keep up with the Pompidou group in Europe. We are ahead of some countries and behind others but everybody recognises this is an increasing problem.

This is the most in-depth resume I have heard on this subject for a long time. If people take illicit drugs, is it fair of them to think the chances of them being caught on the road are slim?

Professor Cusack

I would reverse that proposition because the chances of being caught are increasing.

That is starting from a low level.

Professor Cusack

In the mid-1990s we were analysing for drugs in single figures. We have gone from the low hundreds to 500 two years ago to 750 last year. I agree that, compared with drink driving samples, the numbers are still low. That is why, with the support of the Minister for Transport and his Department, resources are being put into tackling the problem over the next year.

Do the majority of people brought to court to face charges in this regard have a middle class background or are they from other sectors of society?

Professor Cusack

I do not know. One may examine the pattern of drugs but, for example, one important difference over recent years has been that when we conducted our survey, cocaine was near the bottom of the list. However, we know it is now third or fourth. On the basis of work done by universities and medical colleagues, it has been established cocaine use has increased dramatically and that is reflected in what we are seeing. I would not like to say a drug belongs to one strata of society rather than another. If one is knocked down or injured, it will not matter where the driver came from.

It would be important, though, to establish the origin of the drugs.

Professor Cusack

The Garda probably has more information on the misuse of drugs. We receive the samples and we do not know their provenance other than the name and address of the person. That is the only information we have on a day-to-day basis. We do not even know the age of the person. It may well be that such information should be gathered in future.

Professor Cusack referred to the number of positive samples not used in court. Will he elaborate on this?

Professor Cusack

I referred to this in my most recent report on single vehicle collisions in County Kildare and road safety in Ireland. Dr. McGovern, a university lecturer, also works in the forensic unit and we examined these figures a few years ago. We knew from the bureau how many samples were received and certified. We then examined the Garda annual report figures and I spent several days saying this cannot be right.

In the early 2000s, a major challenge was taken to evidential breath testing and a proper point had to be clarified by the High Court and the Supreme Court. We were told the reason there was a discrepancy between the two figures was that a large number of EBT cases were delayed. That hurdle has been cleared. I looked at the bureau figures for 2005 and compared them with the Garda reports. These can be seen on page 16 of the single vehicle crash report. I spent two or three days telling myself I did not believe these figures. I went back over the figures, convinced I was missing something very obvious. I accept that the figures may not be comparable year to year because there may be a hangover. However, overall there has been a continual decline in the number of convictions recorded by the Garda Síochána based on blood and urine samples. The number of convictions based on breath testing has gone up. I have added my own speculative understanding of what may have happened.

I would be concerned to find a 100% conviction rate for any offence. Presumption of innocence and proper testing of evidence, forensic and otherwise, are safeguards for all citizens. One would always expect that a number of cases would not be successful. A 70% to 80% success rate would be normal. One would expect a problem with evidence in up to 30% of cases and the prosecution is expected to prove its case beyond reasonable doubt.

Do these figures show an actual decrease in conviction rates or are they a product of the method of recording court convictions and of how they are categorised and gathered? I could not believe that only 25% of the samples which we know to be over the limit led to a successful prosecution. The bureau has no interest in whether or not someone is convicted. We are equally interested in showing a sample is under the legal limit because we also have a duty to the innocent driver. In fact, it would be horrific if we were to become biased in favour of conviction. However, very few people challenge a result which is under the legal limit.

I could not imagine that happening.

Professor Cusack

I cannot explain those rates and we must examine this matter. The Legislature is enacting good legislation, enforcement in increased, forensic analysis is resourced and Garda prosecutions are proceeding. I do not say we must have prosecutions but we must look at outcomes as part of the spectrum of analysis and to see if we are succeeding. As a doctor, I know that to be found guilty of a drink driving offence has enormous ramifications. However, to put a person who has a drink problem off the road might save the life of that person or of someone else. Preventing such a person from driving is not merely a punitive measure, it is also a public health and safety measure.

I cannot explain the discrepancy in the figures.

We raised this question with the Garda Commissioner when he spoke to the joint committee. I propose that we write to him again requesting a breakdown of figures for the past two years, showing the number of successful prosecutions and the number which have failed — and we accept that there will be failures — and we will then correlate the figures.

Thank you, Professor Cusack and Ms Leavy, for your wide-ranging presentation to the committee. You have given us much information and food for thought. Drug driving has become an equally dangerous menace as drink driving and must be tackled sooner rather than later.

Professor Cusack

I thank the committee for inviting us. We will provide information to any member of the committee or of the Oireachtas who wishes it. We will send our 2005 report to the committee as soon as possible.

Sitting suspended at 4.15 p.m. and resumed at 4.17 p.m.
Barr
Roinn