Identifying a Drugged Person - Kansas Law Enforcement Training

Transcription

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
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”
3
1
A partnership between The Florida National Guard and St. Petersburg College
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
4
Marijuana Use
 Marijuana
was the most commonly used
illicit drug (14.6 million past month users)
on Drug Use and Health.
5
6
2
7
Seven Drug Categories
 Cannabis
 Hallucinogens
 CNS
 Dissociative
Stimulants
 Narcotic Analgesics
 CNS Depressants
Anesthetics
 Inhalants
8
Cannabis
 Marijuana
 Hashish
 Hash
Oil
 Marinol
9
3
Central Nervous System
Stimulants
 Cocaine
 Amphetamine
 Methamphetamine
10
Narcotic Analgesics
 Heroin
 Morphine
 Codeine
 Synthetic
opiates
 Demerol
 Methadone
11
Depressants
 Alcohol
 Barbiturates
 Valium
 Chloralhydrate
12
4
Hallucinogens
LSD
Peyote
Psilocybin
13
Dissociative Anesthetics
PCP
Ketamine
DXM
14
Inhalants
Toluene
Glue
Paint
15
5
Definitions Associated with
DRE Examinations
 Pupil
size
 Nystagmus
 Convergence
 Blood pressure
 Pulse
rate
 Body temperature
 Internal clock
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)
17
Pupil Size
18
6
Mydriasis (Dilated Pupils)
19
Miosis (Constricted Pupils)
20
Ptosis (Droopy Eyelids)
21
7
Nystagmus
 Involuntary
jerking of the eyes
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
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

24
8
Observations
Suspect’s
Breath
 Odor
of alcohol
 Chemical odor
 Cannabis odor
Suspect’s
Face
 Normal
 Flushed
 Pale
 Other
25
Observations
 General
Appearance
 Eyes
 Normal
 Clean
 Watery
 Orderly
 Bloodshot
 Disarranged
 Pink/red
 Bloody
 Vomit
 Urine
26
Observations

Attitude











Anxious
Restless
Agitated
Excited
Combative
Disinterested
Uninhibited
Disoriented
Drowsy
Confused
Hallucinating










Loss of memory
Cyclic mood swings
Polite
Antagonistic
Stuporous
Cooperative/indifferent
Laughing
Insulting
Argumentative
Fumbling
27
9
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
28
Observations
 Other
 Nasal
redness
nose
 Track marks
 Perspiring
 Warm to the touch
 Intense headaches
 Runny
 Residue
of paint on
person
 Debris
 Pills
 Vials
 Syringes
 Drug paraphernalia
29
Observations
30
10
Psychophysical Exams
31
Walk and Turn
 Instructions
 Demonstration
 Subject’s
 Record
Attempts
Results
32
One-Leg Stand
 Instructions
 Demonstration
 Subject’s
 Each
 Record
Attempts
leg
Results
33
11
Rhomberg Test
 Instructions
 Demonstration
 Subject’s
Attempts
 Record Results
34
35
Cannabis
36
12
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
37
Cannabis:
Methods of Ingestion
 Smoking
 Oral
38
Cannabis: Effects




Horizontal gaze nystagmus
- none
Vertical nystagmus - none
Lack of
convergence/strabismus present
Pupil size - possibly dilated




Reaction to light - normal
Blood pressure - up
Body temperature - normal
Pulse rate - up
39
13
Cannabis: Effects
 Short-term
memory loss
 Paranoia
 Loss
of ambition
 “Munchies”
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
41
Stimulants
42
14
Stimulants
 Drugs
that speed up the body's metabolism
caffeine, nicotine, cocaine
 Synthetic: amphetamine,
methamphetamine, methcathinone
 Natural:
43
Stimulants:
Method(s) of Ingestion
 Injected
 Oral
 Inhaled
 Smoked
44
Stimulants: Effects
HGN - none
VGN - none
 Lack of convergence none
 Pupil size - dilated
(mydriasis)


Pupil reaction to light slow to none visible
 Pulse rate - up
 Blood pressure - up
 Body temperature - up
 Bruxism

45
15
Stimulants: General
Indicators
Restlessness
Euphoria
 Anxiety
 Talkativeness
 Irritability
Runny nose
Redness to nasal area
 Leg and eyelid tremors
 Rigid muscle tone




46
Methamphetamine Effects
47
16
17
18
PET Scan of Long-Term Methamphetamine
Brain Damage
19
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
59
Narcotic Analgesics
60
20
Narcotic Analgesics
 Strong
sleep
painkilling drugs that also produce
 Most
drugs in this class are produced from
the opium poppy
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
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
63
21
Narcotics: Effects
 HGN
- none
- none
 Lack of convergence - none
 Pupil size - constricted (miosis)
 Pulse rate - down
 Blood pressure - lowered
 Body temperature - down
 VGN
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


65
 Injected
 Oral
 Inhaled
 Smoked:
Heroin, Opium, Morphine
66
22
CNS Depressants
67
Depressants
 Drugs
that slow down the body's
metabolism
 Barbiturates:
sleeping pills
anxiety-fighting depressants
 Methaqualone: non-barbiturate hypnotic
 Tranquilizers:
68
Depressants: General
Indicators
Drowsiness
 Thick, slurred speech
 Lack of coordination
 Slow, sluggish
reactions
Flaccid muscle tone
Reduced social
inhibitions
 In other words, drunk




69
23
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

70
Depressants:
 Oral
 Injected
71
Hallucinogens
72
24
Notable Hallucinogens



Lysergic Acid Diethylamide (LSD)
Psilocybin Mushrooms
Peyote (mescaline)
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
74
Hallucinogens: Effects
HGN - none
VGN - none
 Lack of convergence none
 Pupil size - dilated


Pupil reaction to light normal
 Pulse rate - up

75
25
Hallucinogens:
General Indicators
 Dazed
appearance
tremors
 Perspiring
 Difficulty with
speech
 Body
 Statements
suggesting
hallucinations
 Distorted sensory
perceptions
76
PCP
Ketamine
DXM
77
78
26
Coricidan OD clip
79
PCP: General Indicators
Slow, slurred speech
Disorientation
 Loss of memory
 Agitation, excitement


Blank stare (“1000yard stare”)
 Non-communicative

80
 Loss
of a sense of personal identity
 Sensory distortions
 Auditory hallucinations
 A feeling of extreme heat, profuse
perspiration
 Increased pain threshold
81
27
PCP: Effects
HGN - present (early
onset)
 VGN - present
 Pupil size - normal

 Pulse rate - up

82
Inhalants

Volatiles



paint thinners
gasoline
Aerosols


Alkyl nitrites
Nitrous oxide
 Schedule IV


hair sprays
spray paints
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
84
28
Inhalants: Effects
HGN - present
VGN - 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




85
Drugs Which Induce
Nystagmus
 CNS
Depressants
Inhalants
 Dissociative
Anesthetics
 (Most)
86
PCP Usually Causes Immediate
Onset of Nystagmus
87
29
Drugs That Cause Lack of
Convergence
 CNS
depressants
 Inhalants
 Dissociative
anesthetics
 Cannabis
 Strabismus
88
Drugs Which Usually Don’t
Affect Pupil Size
 CNS
Depressants
 Inhalants
 PCP
89
Drugs Which Cause Pupil
Dilation
 CNS
stimulants
 Hallucinogens
 POSSIBLY
Cannabis (slight
dilation)
90
30
Narcotic Analgesics Usually
Cause Pupil Constriction
91
Polydrug Use
 Using
two or more drugs at the same
time
 Examples: PCP and marijuana; heroin
and cocaine; many others
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
93
31
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
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
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
96
32
 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
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
98
 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:
99
33
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
100
 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
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
102
34
The Effects of Drug
Combinations
 Null
Effect
 Overlapping Effect
 Additive Effect
 Antagonistic Effect
103
Common Combinations of Drugs
cocaine & heroin
cocaine & cannabis
PCP & cannabis
alcohol & practically
anything else
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!
105
35
DEC Testify
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.
107
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
108
36
Web site
 Mamasite.net
 Erowid.org
 DEA
 Knoa.org
 NNOA-National
Association
 Mctft.com
Narcotics Officers
109
Investigator Tim McClure
 Ford
County Sheriff’s Office
Ave. L
 Dodge City, Ks 67801
 Email- tmcclure@fordcounty.net
 Phone- 620-227-4590
 Cell-m620-255-3141
 507
110
For more information about
training with MCTFT,
call 1-800-243-5550
www.mctft.com
37
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 (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.
3
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
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
1
6
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
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
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
9
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
on Drug Use and Health
11
2
12
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)
13
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
15
Anesthetics
Inhalants
16
Stimulants
Cannabis
Marijuana
Cocaine
Hashish
Amphetamine
Hash
Methamphetamine
Oil
Marinol
14
17
3
18
Depressants
Narcotic Analgesics
Heroin
Alcohol
Morphine
Barbiturates
Codeine
Synthetic
Valium
opiates
Chloralhydrate
¾ Demerol
¾ Methadone
19
Hallucinogens
20
LSD
PCP
Peyote
Ketamine
Psilocybin
DXM
21
Definitions Associated with
DRE Examinations
Inhalants
Pupil
size
Nystagmus
Convergence
Blood pressure
Toluene
Glue
Paint
22
23
Pulse
rate
Body temperature
Internal clock
4
24
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)
25
Mydriasis (Dilated Pupils)
Miosis (Constricted Pupils)
27
Ptosis (Droopy Eyelids)
28
Nystagmus
Involuntary
26
29
jerking of the eyes
5
30
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
31
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
33
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
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
6
36
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
37
Psychophysical Exams
38
Rhomberg Test
Instructions
Demonstration
Subject’s
Record
39
Attempts
Results
Walk and Turn
One-Leg Stand
Instructions
Instructions
Demonstration
Demonstration
Subject’s
Subject’s
Record
Attempts
Results
¾ Each
Record
41
40
Attempts
leg
Results
7
42
Eye Examination:
Detecting Signs of Drug
Influence
Cannabis
43
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
Oral
45
Cannabis: Effects

Horizontal gaze nystagmus
- none
Vertical nystagmus - none
Lack of
convergence/strabismus present
Pupil size - possibly dilated

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
8
48
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
49
50
Stimulants
Stimulants:
Drugs
Injected
Natural:
Oral
that speed up the body's metabolism
caffeine, nicotine, cocaine
Synthetic: amphetamine,
methamphetamine, methcathinone
Inhaled
Smoked
51
Stimulants: General
Indicators
Stimulants: Effects
HGN - none
VGN - none
Lack of convergence none
Pupil size - dilated
(mydriasis)

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

9
54
Meth Use
Meth Use
18 months later
Meth Use
55
56
Methamphetamine Effects
4 Years Later
42 years old
After just three years
and five months of
meth use
40 pounds lighter
57
Narcotic Analgesics
58
Narcotic Analgesics
Strong
sleep
painkilling drugs that also produce
Most
drugs in this class are produced from
the opium poppy
59
10
60
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
61
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
63
“On the nod”
Dry mouth
Euphoria
Track marks

64
CNS Depressants
Injected
Oral
Inhaled
Smoked:
Heroin, Opium, Morphine
65
11
66
Depressants
Depressants: General
Indicators
Drugs

Drowsiness
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:
67
HGN - present
VGN - present
Lack of convergence present
Pupil size - normal

Pulse rate - down
(Qualudes & alcohol)
Blood pressure lowered
Temperature - normal

Oral
Injected
69
Hallucinogens
70
Notable Hallucinogens

68
Depressants:
Depressants: Effects

Flaccid muscle tone
Reduced social
inhibitions
In other words, drunk
71
Lysergic Acid Diethylamide (LSD)
Psilocybin Mushrooms
Peyote (mescaline)
12
72
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
Pulse rate - up
Blood pressure - up

can be absorbed through skin
73
Hallucinogens:
General Indicators
Dazed
PCP
appearance
tremors
Perspiring
Rigid muscle tone
Difficulty with
speech
Body
Statements
suggesting
hallucinations
Distorted sensory
perceptions
Ketamine
DXM
75
Slow, slurred speech
Disorientation
Loss of memory
Agitation, excitement
Loss

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
13
78
PCP: Effects
HGN - present (early
onset)
VGN - present
Pupil size - normal

Inhalants
Pulse rate - up
Blood pressure - up

Volatiles
¾
¾

Aerosols
¾
¾
79
paint thinners
gasoline
Alkyl nitrites
Nitrous oxide
Schedule IV

hair sprays
spray paints
80
Inhalants: General Indicators
Inhalants: Effects
Odor

HGN - present
VGN - present
Pupil size - normal (may
be dilated with certain
anesthetic gases)
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
81
Pulse rate - up
Blood pressure - up or
down
Body temperature up, down, normal
Muscle tone - usually
normal
Drugs Which Induce
Nystagmus
82
PCP Usually Causes Immediate
Onset of Nystagmus
CNS
Depressants
(Most) Inhalants
Dissociative
Anesthetics
83
14
84
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
85
Drugs Which Cause Pupil
Dilation
86
Narcotic Analgesics Usually
Cause Pupil Constriction
CNS
stimulants
Hallucinogens
POSSIBLY
Cannabis (slight
dilation)
87
Polydrug Use
Field Studies
Using
Los
two or more drugs at the same
time
Examples: PCP and marijuana; heroin
and cocaine; many others
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
15
90
Prevalence of Polydrug Use
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
91
Null Effect
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
93
Overlapping Effect
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
95
16
96
Additive Effect
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
#4
¾ The
97
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
99

cocaine & heroin

PCP & cannabis
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
17
102
1.
2.
3.
4.
5.
6.
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.
103
Psychophysical indicators of impairment
Clinical indicators of impairment
Signs of ingestion
Suspect’s statements
Officer’s opinion
Toxicological sample
Miscellaneous
For more information about
training with MCTFT,
call 1-800-243-5550
www.mctft.com
18
104

Identifying a Drugged Person - Kansas Law Enforcement Training

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