Procedure analitiche e valori decisionali ematici per accertare la guida in stato di alterazione psicofisica da sostanze d’abuso
Analytical procedures and blood threshold values to ascertain driving in a stae of psycho-physical impairment from drugs abuse

AUTORI

ABSTRACT

Analytical procedures and blood threshold values to ascertain driving in a stae of psycho-physical impairment from drugs abuse

Driving under the influence of psychoactive substances has been shown to increase the risk of involvement in road traffic collisions. The assumption of these substances may impair the visual, cognitive, and/or motor abilities needed for safe driving. Over the years, countries have developed different strategies in order to face this relevant issue. In Italy the interdiction of driving in a state of psycho-physical impairment after taking narcotic and psychotropic substances is governed by the article of Legislative Decree n. 285/1992 but a series of interpretative and practical application issues leave its application to the different operators and especially to the police, the judicial authorities and the health structures; as a consequence, the results are not compliant . Hence the need to make available a shared technical-scientific document on analytical protocols and threshold values that can be used for the analysis and interpretation of narcotic and psychotropic substances in blood, in order to ascertain a possible psycho-physical impairment state due to the use of such substances in drivers.

BIBLIOGRAFIA

1. Benini L, Di Biase AG. La guida in stato di ebbrezza e sotto l’effetto di stupefacenti. Tribuna Juris, ed. La Tribuna, Piacenza 2009 p. 143
2. Cancellieri A. Audizione alla Camera dei Deputati. Indagine conoscitiva sulle proposte di legge C. 4662 Valducci e abbinate recanti “Delega al Governo per la riforma del Codice della Strada, di cui al D.Lgs. 30 aprile 1992, n. 285”. Roma, 4 aprile 2012. Accessibile a: https://leg16.camera.it/461?stenog=/_dati/leg16/lavori/stencomm/09/indag/codice/2012/0404&pagina=s010 (ultimo accesso: maggio 2023).
3. Cozzi F. Le nuove disposizioni penali in materia di circolazione stradale. Diritto penale e processo 2/2008. IPSOA ed.
4. Pacifici R, Gori P, Martucci L, Pichini S. Considerazioni sulle matrici biologiche idonee alla valutazione dell’“attualitàd’uso di sostanze illecite” ai fini degli articoli 186 e 187 del nuovo Codice della Strada. Biochim Clin 2014;38:27-31.
5. Pichini S, Bucchioni P, Pellegrini M, Pacifici R. Procedure operative per la determinazione delle sostanze d’abuso su sangue. Istituto Superiore di Sanità 2017 https://www.iss.it/documents/20126/0/PROCEDURE-OPERATIVE-sangue.pdf/7d0a5216-ded9-7e23-6609-1deed0df14e1?t=1576349808583 (ultimo accesso: maggio 2023).
6. Commissione Qualità GTFI. Linee guida per la determinazione di sostanze stupefacenti e psicotrope su campioni biologici con finalità tossicologico-forensi e medico-legali. Accessibile a: https://www.gtfi.it/wp-content/uploads/2023/02/LineeGuidaGTFI-MaterialeBiologico-rev06-08giu2022.pdf (ultimo accesso: maggio 2023).
7. Walsh J.M, Verstrate AG, Huestis MA, Morland J. Guidelines for reserch on drugged driving Addiction 2008;103:1258-68.
8. Vindenes V, Jordbru D, Knapskog AB, Kvan E, Mathisrud G, Slørdal L, et al. Impairment based legislative limits for driving under the influence of non-alcohol drugs in Norway. For Sci Int 2012;219:1-11.
9. Reisfield GM, Goldberger BA, Gold MS, DuPont RL. The mirage of impairing drug concentration thresholds: a rationale for zero tolerance per se driving under the influence of drugs laws. J Anal Toxicol 2012;36:353-6.
10. Burch HJ, Clarke EJ, Hubbard AM, Scott-Ham M. Concentrations of drugs determined in blood samples collected from suspected drugged drivers in England and Wales. J Forensic Leg Med 2013;20:278-89.
11. Sverrisdóttir E, Lund TM, Olesen AE, Drewes AM, Christrup LL, Kreilgaard M. A review of morphine and morphine-6-glucuronide’s pharmacokinetic-pharmacodynamic relationships in experimental and clinical pain. Eur J Pharm Sci 2015;74:45-62.
12. Schug SA, Ting S. Fentanyl formulations in the management of pain: an update. Drugs 2017;77:747-76.
13. Shulman M, Wai JM, Nunes EV. Buprenorphine Treatment for Opioid Use Disorder: An Overview. CNS Drugs 2019;33:567-80.
14. Anderson IB, Kearney TE. Use of methadone. West J Med 2000;172:43-6.
15. Schindler SD, Ortner R, Peternell A, Eder H, Opgenoorth E, Fischer G. Maintenance therapy with synthetic opioids and driving aptitude. Eur Addict Res 2004;10:80-7.
16. Soyka M, Horak M, Dittert S, Kagerer S. Less driving impairment on buprenorphine than methadone in drug-dependent patients? J Neuropsychiatry Clin Neurosci 2001;13:527-8.
17. Griffin CE 3rd, Kaye AM, Bueno FR, Kaye AD. Benzodiazepine pharmacology and central nervous system-mediated effects. Ochsner J 2013;13:214-23.
18. O’brien CP. Benzodiazepine use, abuse, and dependence. J Clin Psychiatry 2005;66 Suppl 2:28-33.
19. Sellers EM, Hoornweg K, Busto UE, Romach MK. Risk of drug dependence and abuse posed by barbiturate-containing analgesics. Can J Clin Pharmacol 1999;6:18-2.
20. Oliveira RJD, Magalhães T. Driving under the Influence of psychotropic substances: a technical interpretation . Psychoactives 2022;1:7-15.
21. uri-Bionda R, Bär W, Friedrich-Koch A. Beitrag zur Frage der Fahrfähigkeit/Fahreignung Methadonsubstituierter [Driving fitness/driving capacity of patients treated with methadone]. Schweiz Med Wochenschr 1998;128:1538-47.
22. Brady JE, Li G. Trends in alcohol and other drugs detected in fatally injured drivers in the united states, 1999-2010. Am J Epidemiol 2014;179:692-9.
23. The “Driving under the Influence of Drugs, Alcohol and Medicines” (DRUID) project of the European Commission, findings from the DRUID project. Accessibile a: http://www.emcdda.europa.eu/publications/thematic-papers/druid_en (ultimo accesso: maggio 2023).
24. Lenne MP, Dietze RG, Redman J, Triggs T. The effects of the opioid pharmacotherapies methadone, laam and buprenorphine, alone and in combination with alcohol, on simulated driving. Drug Alcohol Depend 2003;72:271-8
25. European Monitoring Centre for drugs and drug addction. New psychoactive substances in Europe. Accessibile a https://www.emcdda.europa.eu/publications/joint-publications/eurojust/nps-legislation-and-prosecution_en (ultimo accesso: maggio 2023).
26. Pichini S, Pacifici R, Marinelli E, Busardò FP. European drug users at risk from illicit fentanyls mix. Front Pharmacol 2017;8:785.
27. Busardò FP, Pichini S. Molecular Insights on New Psychoactive Substances (NPSs). Int J Mol Sci 2022;23:3282.
28. Soria ML Driving under the influence of new psychoactive substances. Rev Esp Med Legal 2018;44:169-75.
29. Wille SMR, Richeval C, Nachon-Phanithavong M, Gaulier JM, Di Fazio V, Humbert L, et al. Prevalence of new psychoactive substances and prescription drugs in the Belgian driving under the influence of drugs population. Drug Test Anal 2018;10:539-47.
30. Fels H, Herzog J, Skopp G, Holzer A, Paul LD, Graw M, et al. Retrospective analysis of new psychoactive substances in blood samples of German drivers suspected of driving under the influence of drugs. Drug Test Anal 2020;12:1470-6.