Seymour, Alison (2004) Drug trends in two forensic populations within Strathclyde and a national ...

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Seymour, Alison (2004) Drug trends in two forensic populations within
Strathclyde and a national evaluation of the field impairment test. PhD
thesis.

http://theses.gla.ac.uk/5574/

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Drug Trends in Two Forensic
Populations within Strathclyde and a
National Evaluation of the Field
Impairment Test
Thesis Submitted in Accordance with the
Requirements of the University of Glasgow
for the Degree of Doctor of Philosophy
By
Alison Seymour
BSc (Hons)
Forensic Medicine and Science
Division of Community Based Sciences
May 2004
Copyright © Alison Seymour 2004
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Acknowledgements
Acknowledgements
Iwould like to thank my supervisor Dr John S. Oliver not only for his guidance throughout
this research but also for encouraging me to pursue what I thought was an impossible task.
I would also like to express my gratitude to Dr Robert Anderson for helpful advice during
my study time.
Throughout my research and working career, I have become acquainted with colleagues
from various professions, which has been both helpful and educational. I would therefore
like to extend my thanks to Dr Jane Jay of the Glasgow Drug Problem Service, Inspector
Paul Fleming, Detective Inspector Brian Auld and Detective Sergeant Kenny Simpson, all
from Strathclyde Police.
Many thanks also to Dr Chris Weir and Mr Harper Gilmour, both of Glasgow University
for help with statistics and preventing me from tearing my hair out when trying to get my
head around statistical tests - never again will I underestimate the power of the letter "p".
Thanks to all at Forensic Medicine and Science, both past and present. My time in the
department has been eventful and I have built friendships that I can truly say will be life
long. On that note, I would like to say a very special thanks to Dr Fiona Wylie and (soon
to be Dr) Hazel Torrance for making me laugh lots, being the best pick-me-up tonic there
is and whisking me off to the pub when I thought I had deleted my whole thesis. Also,
special thanks to Dr Gail Cooper for her friendship and never failing enthusiasm.
Special thanks to my best bud Lynn DePellette and also Jacqueline McCallum for always
being there and believing in me.
Endless thanks to Mum and Dad for their continuous love, support and encouragement; to
Eric, Heather and Kirsten and to Denise, Sean and Trudi for being the best family anyone
could wish for and for always reminding me that there is light at the end of the tunnel.
And, saving the best for last, a huge thanks to Ornar for always believing that I could do
this, for continual support and encouragement but most of alljust for being you.
Contents
Table of Contents
Summary , xii
Abbreviations xvii
1 Introduction 1
2 Drug Misuse 5
2.1 A brief history of Drug Misuse 5
2.2 Drug Legislation 6
2.3 Drug Misuse in Scotland 9
2.3.1 Number ofDrug Addicts in Scotland 10
2.3.2 Trends and Patterns of Drug Misuse in Scotland 11
2.3.3 Drug Treatment Services Available to Drug Misusers 15
3 National Statistic Sources 17
3.1 The Annual Report of the Registrar General for Scotland 17
3.1.1 International Classification of Diseases 17
3.2 The Home Office Addicts Index 18
3.3 The Scottish Drug Misuse Database (SDMD) 18
3.4 The Scottish Drug Enforcement Agency (SDEA) 19
4 Methodology for Drug-Related Deaths 21
4.1 Investigation of a Drug Related Death 22
4.1.1 Standardised medico-legal protocol of the investigation of a drug-related
death 22
4.1.2 Toxicological Examination 25
4.1.3 Retrieval of Cases 27
4.2 Statistics '" 28
5 Drug-related deaths 29
5.1 Why study Drug Related Deaths? 29
5.2 What is a Drug Related Death? 29
5.3 Discrepancies between statistics published from three different sources 33
5.4 Heroin 35
5.4.1 Legal Status 35
5.4.2 Prescribing 36
5.4.3 Identification in samples 36
Contents
5.4.4 Toxicity 37
5.4.5 TheIncidence ofHeroin inDrug RelatedDeaths intheStrathclydePolice
Region ofScotland 38
5.4.6 Results of ToxicologicalAnalyses 53
5.4.7 Contaminatedheroin 57
5.4.8 Discussion 58
5.4.9 Conclusion 67
5.5 Methadone 69
5.5.1 Legal Status 70
5.5.2 Prescribing 70
5.5.3 Identification ofdrugs insamples 73
5.5.4 Toxicity 73
5.5.5 TheIncidence ofMethadone inDrug Related Deaths intheStrathclydePolice
Region ofScotland 74
5.5.6 Results of ToxicologicalAnalyses 82
5.5.7 Discussion 86
5.5.8 Conclusion 89
5.6 Dihydrocodeine (DHC) 90
5.6.1 Legal Status 90
5.6.2 Prescribing 90
5.6.3 Identification inbiologicalsamples 91
5.6.4 Toxicity 92
5.6.5 TheIncidence ofDihydrocodeine inDrug RelatedDeaths intheStrathclyde
PoliceRegion of Scotland 92
5.6.6 Results of ToxicologicalAnalyses 101
5.6. 7 Discussion 104
5.6.8 Conclusion 105
5.7 Cocaine 106
5.7.1 Legal Status 107
5.7.2 Identification inBiological Samples 108
5.7.3 Toxicity 108
5.7.4 TheIncidence of CocaineinDrug RelatedDeaths intheStrathclydePolice
Region ofScotland 109
5.7.5 Results of ToxicologicalInvestigation 115
5.7.6 Discussion 119
5.7.7 Conclusion ····.121
11
Contents
5.8 Chapter Conclusions 122
6 Drugs and Driving 127
6.1 DUID: A world-wide problem 128
6.2 DUID: The Procedure in the UK 129
6.3 Improvements to the Present Procedure 134
6.3.1 TheDECprogramme 136
6.4 The FIT Procedure in the United Kingdom 140
6.4.1 SymptomsofRecentDrugMisuse (DrugRecognition Phase) 140
6.4.2 TheFieldImpairment Tests 143
6.4.3 ThePublic Reaction toFIT andDrugs andDriving 144
6.5 Methodology for Drugs and Driving 145
6.5.1 Drivers Suspected ofDUID 145
6.5.2 FieldImpairment Test 145
6.5.3 Statistics 148
6.5.4 Storage ofData 158
6.5.5 Analysing Data inAccess 158
6.6 An Evaluation of Drug Consumption amongst Suspected Drugged Drivers in the
Strathclyde Police District of Scotland, 1995 - 2001 163
6.6.1 Number ofBiological SamplesReceivedfor Analysis 163
6.6.2 Results of ToxicologicalAnalyses 164
6.6.3 Number ofDrugs Detected inBlood Samples 165
6.6.4 Drugs Found tobePositive inBlood Samples 167
6.6.5 Drugs detected, Concentrationsand Combinations 171
6.6.6 Drugs Found tobePositive in UrineSamples 183
6.7 Discussion 185
6.8 Conclusion 190
6.9 Monitoring the Effectiveness of the Field Impairment Test 191
6.9.1 StudyDesign 191
6.9.2 Force Participation 191
6.9.3 Demographic information 192
6.9.4 Study Sample 193
6.10 Statistical Summary ofField Impairment Testing Procedure 207
6.10.1 Scotland (n = 233) 207
6.11 The Pupillary Examination 208
6.11.1 Summary 209
6.12 The Romberg Test 210
iii
Contents
6.12.1 Summary 212
6.13 The Walk and Tum Test 213
6.13.1 Summary 214
6.14 The One Leg Stand 215
6.14.1 Summary · ·..216
6.15 The Finger to Nose Test 216
6.15.1 Summary 217
6.15.2 Statistical Evaluation 219
6.16 Drug Recognition Skills 220
6.17 Discussion 223
6.18 Conclusion 225
7 Conclusions 226
8 Further Work 229
9 References 230
10 Publications in Support of this Thesis..... 256
iv