Examination of Witnesses (Questions 206-234)
EAN LEWIS IAN FORCER AND ROB TUNBRIDGE
12 OCTOBER 2010
Q206 Chair: Good
morning and welcome to the Transport Committee. Could I ask our
witnesses please to identify themselves with name and organisation
for our records?
Dr Rob Tunbridge:
I am Rob Tunbridge. I am the independent member of the Panel.
I have been doing drug-driving and drink-driving research for
the last-
Chair: Just your organisation.
Dr Rob Tunbridge:
I am an independent consultant.
Chair: Independent Member.
It is just for our records. That is okay.
Iain Forcer: Iain
Forcer; Concanteno.
Ean Lewin: Ean
Lewin from Dtec International Ltd.
Q207 Chair: Thank
you. Dr Tunbridge, you have said that you think a change in the
drink-drive limit should be a relatively low priority. Why is
that?
Dr Rob Tunbridge:
I certainly think it is important to reduce the limit, but I don't
regard it as the most fundamental problem because of enforcement.
If you compare the situation in Great Britain as with other countries,
we have an 80mg limit, whereas, to give a good example, if you
look at France - like most of the European Union - they have a
50mg limit but they actually have a worse drink-drive record than
Britain. It is a bit technical to go into it, but there is a universal
standard which you can measure right across the world for the
problem with drink-driving, and that is the percentage of drivers
who are killed in accidents who are above a certain limit. The
more enforcement that you have, the less that shows as a problem;
fewer people involved in accidents are killed. That is a universal
measure.
If you look at France, they don't actually take your
licence away for a year until you are at the 200mg level, but
in the UK, if you are two-and-a-half times the limit you lose
your licence for three years and you have to have a medical intervention
to get your licence back. I am definitely supporting a lowering
of the limit, but I think all the evidence suggests that better
enforcement - and one way of doing that would be to bring in roadside
evidential testing - is a more important priority.
Q208 Chair: But do
you support the North proposal on reducing the limit?
Dr Rob Tunbridge:
I certainly support the reduction to the 50mg limit. I am just
saying that I wouldn't regard it as such an important measure
as bringing in evidential testing, which would allow the level
of enforcement to go up. That would almost certainly bring down
drink-driving.
Chair: I just wanted to
clarify the position there.
Q209 Lilian Greenwood:
Dr Tunbridge, in your professional opinion how prevalent and serious
a problem is drug-driving?
Dr Rob Tunbridge:
I was about to introduce that. I have been involved with drug-driving
since the mid '80s when I was at the Transport Research Laboratory.
I ran the first study of the incidence of drugs in road accident
fatalities. The great advantage of doing measures in fatalities
is that obviously people can't refuse to give you a sample; so
providing you do the science properly it does give you an independent
measure of the level of drugs in the road accident population.
We looked at medicinal drugs and illicit drugs. In the '90s I
moved to the Department for Transport, where I was responsible
for research into drink and drug-driving. We carried out another
study about 10 years later, again of fatalities. That showed a
massive increase in the use of illicit drugs from 3% incidence
to 18% incidence.
After that period, the Department then started to
support lots of research into drug-driving. For instance, we did
an experimental study on the effects of cannabis on driving about
10 years ago. That is the only absolute measure, if you like,
of the incidence of drugs. It does show there has been a big increase
between the '80s and the '90s, and has continued. As I think one
of your other witnesses said, there is a tremendous amount of
evidence that over that period as well, if you look at the British
Crime Survey, for instance, which has been going for 25 years
and is anonymous so it does give a good picture of drug uses,
particularly recreational drug use over the time period, the level
of increase of use of cannabis and the incidence of seizures of
cannabis for instance have increased along with that.
It is a reasonable assumption to say that as the
level of drug use in the community goes up, most people drive,
and so, like drinking and driving, when you get a mixture of both
you have a problem. The problem with drug-driving is that we don't
at the moment have a device that can easily measure whether people
have drugs or not, unlike drink-driving. We know a lot of information
about the level of drink-driving because the police have roadside
breath testers. We don't have that situation with drug-driving.
I am sure that is what we will come on to, to be a principal point
of the discussion, but at the moment we can't get that evidence
because we don't have a simple measure. All the indicators of
drug use in the population - surveys of people who are asked whether
they take drugs and drive - are that there is a higher incidence
they do. There is lots and lots of circumstantial evidence, and
some evidence from drugs found in fatalities, but the information
is nothing like as solid as it is with drink-driving.
Q210 Lilian Greenwood:
We know from the previous evidence that there are about 2,500
driving fatalities a year. In how many of those cases were drugs
found? Could you put a number on that?
Dr Rob Tunbridge:
I do not know whether you have had the chance to read the detail
of it. It is what I call the "tip of the iceberg" problem.
Roughly between 600,000 and 800,000 roadside breath tests are
done each year, of which about 100,000 are positive for drink-driving.
That is consistently about 100,000 drink-drivers a year. The police
normally have three reasons for stopping you and giving you a
breath test: first, that they suspect that your driving is impaired
- the way they see you driving; secondly, that you are involved
in an accident and they can test you; or thirdly that you are
involved in a moving traffic offence. For instance, you may jump
a red light or one of your lights is not working.
The work I did at TRL on police records showed that
around about 50% of cases were stopped because the police thought
their driving was impaired. If you look at that 50% and take the
100,000 from the 800,000, you've got, say, 400,000 motorists,
drivers, stopped when the police assumed that they may have been
impaired but, because we don't do routine drug tests as opposed
to routine alcohol tests, you have a small fraction of 1% which
are coming through. They are almost certainly the ones who are
extremely impaired. In fact, the study done by the Forensic Science
Service in the '90s showed that, in cases that were admittedly
suspect, over 90% were positive for at least one drug. That is
suggesting there are a lot, but we can't quantify it at the moment
because we don't have a testing device at the roadside. We are
missing a substantial number of drug-drivers but we can't actually
quantify that number at the moment.
Q211 Lilian Greenwood:
Why do you think the UK is so far behind other countries in tackling
and prosecuting drug-driving?
Dr Rob Tunbridge:
That is a very good question and it is one I have personally been
involved with for a long time. I think there is an attitude, particularly
in the Home Office, that "We are going to do it our way;
we are not going to be told". I am not saying it is necessarily
anti-European, but the Home Office, who are responsible for type-approving
the devices - they would be devices that could be used for drug
testing, as they are for setting standards for roadside drink-driving
- are suggesting we should have a screening device which is of
the same order and standard of scientific quality as you would
get if you took an evidential sample, where somebody has to take
blood from you back at the police station. I think the thing to
remember is that these are only screening devices.
My colleagues can give you chapter and verse on their
accuracy, but it is my view that the main problems in terms of
impairing drugs are with illicit drugs: cannabis, cocaine, heroin
and amphetamines. They make up certainly in excess of 90% of the
problem with impairing drugs. With the devices that are available
at the moment and that are being used in lots of areas of Europe,
and particularly in Australia, which tends to lead the field in
taking road safety forward if you like, we know that in at least
90% of cases you will get a reliable test. At the moment, even
though there is a small possibility that you will get a false
positive result at the roadside, you are not going to prosecute
that person. You are always going to have to take an evidential
sample of blood. At the moment, we have 100% or very close to
100% false negatives because we are not actually testing people.
Q212 Chair: Would
either of our other witnesses like to add their comments?
Dr Rob Tunbridge:
Sorry; I don't want to hog the conversation.
Kwasi Kwarteng: Chair,
I may have to give my apologies. I have to be somewhere else;
I am sorry.
Ean Lewin: Just
to try and put some facts and figures on the magnitude of the
potential problem, as I say, we both work in Australia and we
also then work in different countries where we have won contracts.
An interesting one to me is that last year we took away nearly
35,000 licences in Germany. That is a population very similar
to our population. We all attended a meeting at the Home Office
last week for the introduction of the latest draft of the type
approval, and a figure was put there that it could be 50% of the
size of the alcohol problem, which puts the figure then at 50,000.
What I think Rob was alluding to was, if the police screen 400,000
or 500,000 and only 100,000 are prosecuted, why did the police
officers apprehend that driver in the first place for bad driving,
and did they progress any further with the assessment for impairment,
or did they have the ability to screen for impairment? The feedback
we get is that they would very much like the ability to be able
to assess for impairment and to screen for impairment, and then
take that person further down for the confirmation test at the
laboratory.
Q213 Chair: Mr Forcer,
is there anything you wanted to say?
Iain Forcer: I
think one of the reasons that we are behind other countries with
regards to drug-driving is that the legislation of the countries
that we work in - Australia, Italy and other parts of Europe -
includes an offence where the offence is driving with a named
drug in their system. That is screened at the roadside and then
confirmed in the laboratory. Because our legislation focuses on
impairment, it requires the field impairment test to progress
that driver through the legislative channels. Last Christmas,
there were 223,000 breath alcohol tests in the Christmas campaign
and 489 FIT tests - field impairment tests. The way the legislation
is worded, the enforcement levels aren't adequate to meet that
legislation. There needs to be an increase in the field impairment
testing, and then, where screening can fit into that legislation,
that is how we should progress.
Q214 Paul Maynard:
Mr Forcer just gave a very striking comparison of figures on alcohol
testing and drug testing. Do you have any figures for Germany
or Australia that would illustrate the balance there as well,
just for comparison?
Iain Forcer: I
know the state of Victoria was the first area of Australia to
start roadside drug testing about five years ago. When they began
testing, their expected positive rate on a breath alcohol test
was around one in 250. Because they had been doing breath alcohol
testing for a while there was education awareness similar to here
in the UK. When they started doing the roadside drug testing they
had a positivity rate of around one in 40 or one in 45, just showing
the difference in the driver's perception of essentially whether
they could be caught drink-driving compared with drug-driving.
Since the testing has continued - and they've done hundreds of
thousands of tests - that positivity rate has nearly halved, so
it is around one in 70 or something. The combination of enforcement
and the education and awareness campaigns that they've run - they
do blanket road blocks, so they have these booze buses, drug and
alcohol testing buses, and if they are on the side of the road
you are going to get stopped and you are going to be tested. Now,
the other states of Australia have taken up testing as well. If
you are driving in Victoria you know that testing is prevalent
and there is a good chance that you will be stopped, whether you
are impaired or not. I think that is why their rate of prevalence
has declined.
Dr Rob Tunbridge:
Could I add another point to that? Those numbers represent what
the Australians think are their two most serious problem drugs,
which are cannabis and methamphetamine. They only test for those
two drugs, so that is not including anybody who might be under
the influence of opiates or cocaine. Most of the rest of the countries
that have done drug-driving research pick up people taking those
illicit drugs as well.
Ean Lewin: Could
I add another point to that? Victoria was the first state that
went with the testing. Each of the subsequent states that has
started is following a virtually identical curve on the initial
rates that they see, and the implementation of the awareness and
the roadside deterrent is giving them the same sort of response
curves in halving their occurrence and the rate of positives.
I think there is an awful lot to be seen from their experience.
Q215 Paul Maynard:
In terms of the equipment used, we are told in this country that
the very tight, stringent rules that apply regarding type approval
are a good thing because they protect the individual from potential
inaccuracy or miscarriages of justice. Is there any evidence from
the other countries that you work in that there are particular
problems for the individual driver who finds himself banned unfairly
because of an inaccurate test, or because of some failure of the
equipment or whatever? Does that argument hold any water in your
view?
Iain Forcer: I
think, from speaking to officers in Australia, the first test
is a screening test and they are not evidential and they are not
100% accurate. The police are trained to understand the limitations,
as they are for testing. Anyone who is found positive then has
a further sample taken, and it is screened in a laboratory using
a confirmatory test. That is the only test which could be used
in court. That will tell you both the level of drug and also the
exact compound that has been detected.
From the Australians' point of view, if they are
screening, and eight or nine people out of 10 - their screening
test result is matching the confirmation test - then that is eight
or nine people out of 10 they have brought through their legal
system, increasing the safety on their roads.
Q216 Paul Maynard:
Why do you feel that this country is so slow, therefore, in adopting
this methodology, this equipment and this practice?
Iain Forcer: I
think there is a feeling that maybe, whereas Australians are "glass
half full" and eight or nine out of 10 is pretty good, here
there is a feeling that one or two people might be inconvenienced.
They are looking for maybe a golden bullet that at the moment
doesn't exist, where there is a technology available that would
significantly reduce the incidences of driving under the influence
of drugs.
Q217 Paul Maynard:
It is more than an inconvenience though. You would be losing your
licence for quite some time.
Chair: Dr Tunbridge, do
you agree with them?
Dr Rob Tunbridge:
Absolutely. Can I just add another point which doesn't explain
the reason for it but it is an observation? The attitude of officials
- and I am basically talking about particular civil servants now
rather than Ministers, because the civil servants advise the Ministers
- seems to be much, much tighter. It may well be down the road
of human rights. The Home Office has explained why we weren't
involved with the DRUID project which, as you might have heard,
has taken in 18 countries and tested 11 different roadside devices.
There may be human rights issues of testing, although back in
1998 we conducted roadside trials with what were then prototype
devices - the Cozart device and the DrugWipe. We gave people a
questionnaire. We actually got 60% of questionnaires back from
the roadside, which is a phenomenally high response, and 95% of
those people were in favour of roadside testing. The attitude
of the civil servants, particularly in the Home Office, has hardened.
Just to use a quick analogy - I don't want to be hogging the conversation
- if they had adopted that same attitude back in 1967, although
I don't think any of you are old enough to have experienced roadside
testing -
Chair: Don't take that
for granted.
Dr Rob Tunbridge:
You may remember that the first roadside screening devices - and
you could still buy these in packets at some garages - had a very
simple chemical compound that changed from orange to green when
alcohol was indicated. If it went beyond a certain point that
gave an indication that that person was over the limit. From 1967
to 1983, there really weren't that many tests because, if somebody
blew positive at the roadside, the police then had to get a police
surgeon to come in and take a blood sample. That is the sort of
situation we are now in, if you like, with drugs. It wasn't until
1983 when we brought in evidential testing with a breath-testing
device at the police station that over the course of the next
10 years the number of tests went up by a factor of six.
The point I am making is that that device is actually
still type-approved by the Home Office. In the Highlands and Islands,
some of the officers still only have these devices. So if they
see that somebody has driven off the road or something they can
breath test them and they can still use those devices, which have
been around since the '60s. The point I am making here is that
the accuracy of those devices is worse than what is being offered
for drugs at the moment. It seems that the strictures, the standards,
which the Home Office is setting are much higher than they would
have been then and we would not have had any drink-driving enforcement
for another 15 years.
Q218 Iain Stewart:
I think my question has already been answered, at least in part,
but let me just clarify. With regard to the lessons from the other
countries - Australia and continental Europe - and the screening
for drugs, is that for specific types of drugs? What I am trying
to get at is, is there going to be a device that will test generally
for the presence of drugs, be they legal or illegal, in the bloodstream?
Dr Rob Tunbridge:
No, because they were-
Q219 Iain Stewart:
It actually has to be specifically for-
Chair: Can we have short
answers, please?
Dr Rob Tunbridge:
Sorry. I will get somebody else to answer that because I feel
I am hogging the conversation.
Ean Lewin: Just
going back on the levels, we have to be careful that we look at,
address and set levels at road safety issues, rather than it
being at anti-drug levels. That is why we shouldn't really chase
the levels down too low to the levels that have been asked for
in the UK, which are lower than any other level in any other country
we deal with. That is one of the problems we have. The other issue
is that countries look at a list of drugs related to accidents.
That is a shortlist. It carries 90% to 95% of the accidents and
it can be quite competently managed by several manufacturers in
the industry. That list is controlled in a road safety issue:
for example, in the Department for Transport as opposed to that
list being controlled in a list of illegal drugs. The key thing
there is to detect the drugs that cause the accidents. If we can
solve 90% to 95% of the problem and the only downside is somebody
is detained long enough to give a confirmation sample that proves
negative, then I think we are addressing the glass half full
- I think it is an awful lot more than half full. It is beyond
Pareto - the service that a number of companies could give this
country at the moment.
Q220 Iain Stewart:
Forgive me, I just need to clarify my mind. If, say, you want
to check for cannabis presence in the bloodstream, is it the same
test? By doing one test for cannabis could you also detect other
drugs; for example, these party drugs that are still legal but
clearly have an influence on behaviour? Is it the same physical
test and can you actually do a catch-all service?
Ean Lewin: It is
specified by country. In our experience, different countries say,
"We would like this to be on the list". An interesting
one is benzodiazepines, which have been added by a country recently.
Nobody actually asks us to look for methadone because experience
says that methadone consumption will also be detected by other
drugs that have been consumed at the same time, but it is the
same device that is used.
Q221 Iain Stewart:
But it is the same actual procedure; you still take the same swab
or whatever it is in the machine?
Ean Lewin: Yes.
Q222 Iain Stewart:
It is not that you have to do this test for one drug and then
take another sample for another drug: it can all be done from
that one?
Iain Forcer: The
only difference would be the more drugs there are on the test,
the actual time it takes to carry out the test lengthens slightly.
That would be the only difference.
Dr Rob Tunbridge:
The other issue is that the chemistry is complicated. For the
five drug groups - cocaine, amphetamines, opiates, cannabis and
benzodiazepines which are the tranquillisers like Valium or Mogadon
- the devices, and I don't want to get into showing you what they
look like-
Q223 Chair: Dr Tunbridge,
can you be a bit more concise?
Dr Rob Tunbridge:
In the device for detecting there has to be a chemical marker
on the strip which takes your saliva. A new chemical identifier,
if you like, has to be developed for each new different type of
chemical structure, so at the moment there isn't an immunoassay
to detect mephedrone, which has recently become illegal. There
is always going to be a catch-up process, which requires a need
to show a problem for the manufacturers to put the money in to
developing a test, but at the moment the devices only test for
those five or six groups.
Ean Lewin: I would
just like to push that answer to the next level. The key thing
is there is a screening test and then there is the confirmation.
There is also the zero tolerance. All the countries we work with
have a zero tolerance law which has this specified list. The police
officer always has the country's impairment law. If he still decides
there is impairment there, they can still use the impairment law
to go back and have the samples. What the zero tolerance system
does is it allows that deterrent to be extremely effective, and
that is what reduces the accidents and the person's willingness
to take the risk to drive after having taken drugs. It is the
combination of the two laws, and the combination of the selective
list of, shall we say, going for the Pareto problem - going for
the 80% or 90% on that.
Q224 Kelvin Hopkins:
Very briefly, Dr Tunbridge has reinforced the prejudice I have
had for a long time that British officials, by and large, will
always find reasons for not doing something rather than doing
something.
Dr Rob Tunbridge:
Absolutely, particularly the Home Office.
Q225 Kelvin Hopkins:
What you were saying is that it had to be driven by the politicians.
We would never have had a health service if it weren't for Nye
Bevan and we would never have had the breathalyser if it weren't
for Barbara Castle.
Dr Rob Tunbridge:
Absolutely.
Q226 Kelvin Hopkins:
We have got to drive this.
Dr Rob Tunbridge:
That is why-
Chair: Do you have any
more questions?
Kelvin Hopkins: No.
Q227 Julian Sturdy:
My question has really been partly answered. It was about the
zero tolerance level. Australia and the other countries that are
already doing this testing are doing it at the zero tolerance
level at the moment. Is that what you are saying?
Ean Lewin: All
countries have both, but the highest level of prosecutions tends
to come from the zero tolerance system. They all have the impairment
system, as we have, as a back-up, and it is up to the officer
to decide: is this going to be a zero tolerance or is that person
so impaired that they put them through the impairment route? The
impairment route is also there for your medicines, your illegally
used medicines, your other drugs and medicines that may impair
you and other drugs that come along. With a zero tolerance and
an impairment law, the police officer has 100% ability to catch.
Q228 Lilian Greenwood:
I just want to clarify what exactly the test does, and I apologise
for my ignorance on this. Does it detect the presence of a drug,
or does it detect the level of that drug and therefore you can
make an assumption about impairment as well?
Iain Forcer: The
screening test result that you, as the user, will see will give
you a positive or negative. It will give you an indication that
there is a presence. The test itself is calibrated to a cut-off
level which is set in the legislation. In the countries where
we do roadside testing, if they say that if there is a level of
cannabis, for instance, above a particular cut-off that is a positive
result. The confirmation test will give you a numerical level
at a concentration in nanograms per ml of a particular compound.
Some countries include things like opiates, for instance, on their
screening test - that could be heroin use but it could be codeine
use because someone has a bad back or whatever, which could both
give a positive screening result. The confirmation would then
give a level of the particular opiate compound, and from that
the toxicologist could say, "This is as we would expect for
the medication that they say they are taking", or, "This
is actually from heroin use". There are markers that they
would use to distinguish between the two.
Q229 Lilian Greenwood:
Can I ask a follow-up? When Hamish Meldrum from the BMA was in
earlier, he seemed to suggest that there wasn't a consensus about
what levels of presence of drugs in the body would have an impact
on impairment in the same way that there is for alcohol. How is
it possible to set your levels if there is no consensus about
what level is impairing?
Dr Rob Tunbridge:
That is why most countries have gone for zero tolerance, because
it is extremely difficult, if not impossible, to relate levels
of drugs to impairment levels. I will just give one example that
I always use to show this. The tolerance to drugs is orders of
magnitude, sometimes thousands of times different from the different
levels of tolerance for alcohol. An absolute cracking example
is that people in this country are allowed, if you are terminally
ill, to drive on administration of medical morphine. If you look
at those people and test them in experimental tests that relate
to driving impairment, you would hardly see any noticeable effect
on their driving. If those levels were in any one of our bodies,
we would be dead. It just shows that it is so difficult to come
up with reasons for tolerance and how quickly people's tolerance
changes as they take drugs to excess.
That is why most of the countries have gone to zero
tolerance. You don't worry about whether the person is impaired
or not. If the drug - and I emphasise again - is found in blood
as a confirmation of a screening test, not the screening test
itself, above levels where scientists and toxicologists can say,
"We are 95% certain that that drug is present at a particular
level", that is a confirmatory test, then you have committed
an offence.
Of course, that is a big political issue because
at the moment it is only illegal to possess drugs: it is not illegal
to take drugs. It is entering a whole new political wave, where
you would have a road traffic offence for having the presence
of drugs in your body, whereas somebody walking around in the
same situation and not involved in a traffic offence would not
be in that position. There are political, ethical and human rights
issues in going to zero tolerance.
Q230 Mr Harris: That
is no different from alcohol. You can go round drunk and that
is legal, but you can't drive drunk. What is the difference?
Dr Rob Tunbridge:
Sorry?
Q231 Mr Harris: The
moral and political problem that you are suggesting is no different
from what we already have as regards alcohol. Of course, it is
perfectly legal to drink alcohol and to get drunk, and to be in
a public place drunk. You can do anything you want drunk, but
if you are caught driving while you are drunk then that becomes
an offence.
Dr Rob Tunbridge:
That is a very good point indeed.
Chair: Are there any further
questions?
Q232 Lilian Greenwood:
But isn't there a possibility that there are some people who have
taken, albeit illegal, drugs like cannabis which are going to
be detectable in their bloodstream but wouldn't actually be having
any impact on their ability to drive? Could it unfairly penalise
people?
Ean Lewin: This
is if the level goes too low. At the moment, the control is principally
the type-approval from the Home Office. If we go too low, we end
up in this situation. There are a lot of countries out there that
have been through this situation. They have worked their way through
and they have tried to research this. There is a lot of information
out there, and nobody is going to levels as low as have been proposed
here. This is because they are keeping it as a road safety issue
and the people who will definitely be impaired at those levels
are the ones who are being processed. As technology improves -
we've both probably got several generations we are working on,
as have many other companies out there - we will look to be more
specific on the type of molecule and be more specific on the type
of drug; but also we might be able to be lower on the levels.
Again, the lower you go, the more chance you make this an anti-drugs
issue as opposed to a road safety issue.
Chair: Are there any
further questions from anyone?
Q233 Julian Sturdy:
Are any of the countries we have been talking about doing anything
on prescribed drugs - testing on impairment of the actual prescribed
drugs and enforcing that?
Iain Forcer: There
are countries in Europe. Italy, for example, tests for a panel
of six different drugs, which includes opiates and benzodiazepines,
both of which can be prescribed, and opiates can be bought over
the counter. The confirmatory test is the level. With the prescribed
issues, we can look at the figures from the British Crime Survey,
which as Rob said gives a good indication of recreational drug
use in 16 to 59-year-olds, so it relates quite nicely to drivers.
If you excluded drugs which had medicinal purposes and just looked
at cannabis, cocaine, amphetamines and methamphetamines - so moved
the prescribed issue to one side - that still accounts for about
86% of drug use in this country. I think in the same way as the
Australian idea, if we hit 86%, that is surely better than zero.
Dr Rob Tunbridge:
But medicinal drugs are a particular -
Q234 Chair: Did you
want to add an additional point?
Dr Rob Tunbridge:
Yes.
Chair: Okay, quickly.
Dr Rob Tunbridge:
Sorry, Chair. These sorts of drugs are a particular problem, because
most of the evidence that these are impairing, such as antihistamines
make you drowsy, are taken from young volunteers using males between
the ages of 19 and 25, rather than patient populations. You have
to take into account the effect, particularly the road safety
issues surrounding somebody who is on medicinal drugs. A patient
who is depressed or anxious or if their nose is streaming down
with something might, untreated, be more of a road safety danger.
The drugs are taken as a sort of counter-effect. That makes decisions
on medicinal drugs very difficult.
I know you discussed this with the earlier panel
members, but it does make it a particularly difficult area to
come up with red, green, orange and say what drugs should be labelled
up with this. This is why virtually no countries in the world
have actually adopted these systems. There are lots of myths saying,
"Such-and-such a country has done this," and in fact
they haven't, because of the difficulty in establishing, particularly
for patients rather than young volunteers, what effects those
drugs will have.
Chair: Thank you very much for coming
and answering all of our questions. Thank you.
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