David McDonald Director, Social Research & Evaluation Pty Ltd Visiting Fellow National Centre for Epidemiology and Population Health The Australian National University Roadside drug testing in Australia: why have we adopted, with such alacrity, this flawed policy? Dangerous Consumptions 8, Canberra, 2-3 December 2010 Abstract Each of Australia's states and territories now has legislation empowering police to implement roadside drug testing. This initiative commenced in the State of Victoria in 2004, with a recent Victoria Police media release stating that 'Victoria Police was the first jurisdiction to introduce random drug testing for motorise (sic) and is recognised as a world leader in this technology'. The initiative is implemented in all of Australia's states and the Northern Territory, and is expected to commence in the ACT in the near future. I argue, however, that this policy is flawed. Its goals are unclear and the underlying logic model connecting the inputs, activities, outputs and outcomes does not stand up to scrutiny. A policy analysis based on the research evidence leads to the conclusion that roadside drug testing, as implemented in Australia, is not justified. Why, then, has this policy been adopted, across the nation, with such alacrity? Social science theory about how innovations get on the policy agenda and become converted into policy and practice helps answer this question, as does our understanding of the challenges, in public policy terms, involved in applying cost-effectiveness thinking in the context of drug harm reduction. Types of evidence … ‘In 2005, of all drivers involved in fatal accidents 24 per cent tested positive for illicit drugs. ‘Four years later, this figure has dropped by 9 per cent to 15 per cent. This shows that the drug-driving testing program is having an impact and undoubtedly saving lives on our roads.’ (Source: VICPOL media release, ‘Our say: drug testing system working’, Melbourne, 1 Nov 2010) ‘First Ever Analysis of Drug Involvement Among Deceased Drivers in Fatal Crashes’ USA National Highway Safety Administration 30 Nov 2010 63% of people killed in road crashes were tested for the presence of drugs in their bodies (2008) 18 % positive for an illicit drug or a pharmaceutical product ‘The results we are releasing today indicate that drugs were found to be present in post-mortem examinations. Drug involvement does not necessarily imply impairment or indicate that drug use was the cause of the crash. ‘…while many years of real-world observations and empirical evidence have shown a strong relationship between alcohol concentration levels in the blood and impairment and crash correlation, the same evidence is not yet available for drugs.’ A car collides into cyclists participating in a race in Mexico's northern border city of Matamoros, Sunday June 1, 2008. At least one person was killed and 14 injured when a driver slammed into a bicycle race. (AP/Jose Fidelino Vera Hernandez) Applying the key to successful policy analysis … A common-sense way of speaking: ‘Alternative A looks to be the best; therefore let's proceed with it.’ But this phrasing ignores a very important step: the complete formulation is ‘Alternative A will very probably lead to Outcome OA, which we judge to be the best of the possible outcomes; therefore, we judge Alternative A to be the best.’ (Bardach 2005, p. 26) What are we aiming to achieve with RDT? Victorian Gov’t ‘Arrive Alive’ Fact Sheets: • ‘This testing is aimed at making Victoria’s roads safer by reducing the incidence of drug driving.’ Mr John Hargreaves MLA, ACT Minister for Transport & Municipal Services, 8 April 2008: • ‘I needed to be certain that the testing was about road safety and not about catching drug users and punishing them for using drugs rather than endangering other road users. As a Minister, I will do whatever I can to improve road safety but I am not going to be involved in punishing ACT drug users for their addiction. ‘ Canberra Times newspaper poll Source: Canberra Times online, http://www.canberratimes.com.au/polls/, accessed 02 July 2010 Apparent logic model Some people use illegal drugs Some of them drive after doing so Some of the drivers will be impaired by the drugs to the extent that the impairment will cause a crash RDT will reduce the prevalence of drug-impaired driving through general deterrence and specific deterrence This will reduce the incidence of crashes to such an extent as to improve road safety But … is there any evidence that RDT achieves the objective of reducing the incidence of motor vehicle crashes? No conclusive body of literature supports the proposition that DUID enforcement through RDT or other means reduces the incidence or severity of road crashes Victorian drug users: % drove soon after taking a drug, 2004 - 2009: 63, 58, 68, 71, 61, 60 (Kong et al. 2010) Sweden’s zero tolerance policy commenced July 1999 • high levels of detections continue • no reports of reduced crash incidence • high levels of re-arrests: 68% over 4 years; average 3.4 (Holmgren 2008) How did it get on the agenda? Kingdon’s multiple streams model of the policy process: ‘We conceive of three policy streams flowing through the system - streams of problems, policies, and politics. They are largely independent of one another, and each develops according to its own dynamics and rules. But at some critical junctures the three streams are joined, and the greatest policy changes grow out of that coupling of problems, policy proposals, and politics.' (Kingdon 2003, p. 19) Other ways of attaining the road safety goals more effectively? More intense enforcement of RBT? Truly random RBT is promising (Delaney et al. 2006) RDT for the drugs that have been demonstrated to contribute most strongly to road crash incidence, and fatalities Prescribed opioids and benzodiazepines (Engeland et al. 2007) Electronic stability controls Fatal single-vehicle car crashes reduced by 30-50% and SUVs by 50-70% Fatal roll-over crashes reduced by 70-90% (Ferguson 2007) Human rights consideration: ignored? Testing people without reasonable suspicion that the person is impaired is the big human rights issue Key human rights considerations need attention here: 1. the right to freedom from arbitrary arrest 2. the right not to self-incriminate 3. the right not to have medical treatment without consent 4. arbitrary interference with privacy 5 the right to a fair trial 6. the potential impacts on children Proportionality test: the need to weigh the individuals' rights with community rights: • determine if the proposed intervention is in the public interest • determine if the intervention is rationally connected to the objective • determine to what extent the intervention impairs people’s rights to freedom (Watchirs 2008) So how did this intervention get on the agenda and become policy in the absence of evidence of relative cost-effectiveness in attaining traffic safety objectives? The availability of the technology? Everybody else is doing it so we should too? Negative attitudes towards illegal drugs and the people who use them? A societal desire to criminalise non-mainstream behaviour? My proposition for discussion: Roadside drug testing is based on a flawed policy analysis: Unclear goal specification: RDT purports to have as its aim improving traffic safety, i.e. reducing the incidence of crashes, injuries and deaths A program logic analysis suggests that we are unlikely to attain this goal from this intervention The research evidence also suggests that we are unlikely to attain this goal from this intervention We have no evidence of careful consideration of: • the opportunity costs or • the relative cost-effectiveness of other interventions aiming to improve traffic safety. The human rights considerations appear to have been ignored. Perhaps it is driven by the availability of the detection technology combined with skilled police agenda-setting work, rather than the likelihood of achieving traffic safety goals? References Bardach, E 2005, A practical guide for policy analysis: the eightfold path to more effective problem solving, 2nd edn, CQ Press, Washington, D.C. Delaney, A, Diamamtopoulou, K & Cameron, M 2006, Strategic principles of drink-driving enforcement, MUARC Report no. 249, Monash University Accident Research Centre, Clayton, Vic. Engeland, A, Skurtveit, S & Morland, J 2007, 'Risk of road traffic accidents associated with the prescription of drugs: a registrybased cohort study', Annals of Epidemiology, vol. 17, no. 8, pp. 597-602. Ferguson, SA 2007, 'The effectiveness of electronic stability control in reducing real-world crashes: a literature review', Traffic Injury Prevention, vol. 8, no. 4, pp. 329-38. Hall, W & Homel, R 2007, 'Reducing cannabis-impaired driving: is there sufficient evidence for drug testing of drivers?' Addiction, vol. 102, no. 12, pp. 1918-9. Holmgren, A, Holmgren, P, Kugelberg, FC, Jones, AW & Ahlner, J 2008, 'High re-arrest rates among drug-impaired drivers despite zero-tolerance legislation', Accident Analysis and Prevention, vol. 40, no. 2, pp. 534-40. Kennedy, DM 2009, Deterrence and crime prevention: reconsidering the prospect of sanction, Routledge, New York. Kong, F, Dietze, P & McElwee, P 2010, Victorian trends in ecstasy and related drug markets 2009: findings from the Ecstasy and Related Drugs Reporting System (EDRS), Australian Drug Trends Series no. 49, National Drug and Alcohol Research Centre, University of New South Wales, Sydney. Lenné, MG 2007, 'Roadside drug testing: unanswered questions and future challenges', Drug Alcohol Rev, vol. 26, no. 2, pp. 107-8. Prichard, J 2010, 'Net-widening and the diversion of young people from court: a longitudinal analysis with implications for restorative justice', Australian and New Zealand Journal of Criminology, vol. 43, no. 1, pp. 112-29. Watchirs, H 2008, ‘Human rights and random roadside drug testing’, paper presented to Drugs and Driving Forum, University of Canberra, 6 June. Zaal, D 1994, Traffic law enforcement: a review of the literature, Monash University Accident Research Centre Monograph no. 53, Monash University Accident Research Centre, [Clayton, Vic.]. Presenter’s contacts David McDonald Director Social Research & Evaluation Pty Ltd 1004 Norton Road Wamboin NSW 2620 Phone: (02) 6238 3706 Mobile: 0416 231 890 Fax: (02) 9475 4274 Email: david.mcdonald@socialresearch.com.au Web: www.socialresearch.com.au ========================================== Visiting Fellow National Centre for Epidemiology and Population Health The Australian National University Canberra ACT 0200 Email: david.mcdonald@anu.edu.au