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Evaluation of Drug Recognition Expert Reports in Marijuana Cases Brianna Peterson, Ph.D. and Rod Gullberg, M.S. Washington State Patrol September 20, 2011
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Evaluation of Drug Recognition Expert Reports in Marijuana Cases Brianna Peterson, Ph.D. and Rod Gullberg, M.S. Washington State Patrol September 20, 2011.

Dec 31, 2015

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Page 1: Evaluation of Drug Recognition Expert Reports in Marijuana Cases Brianna Peterson, Ph.D. and Rod Gullberg, M.S. Washington State Patrol September 20, 2011.

Evaluation of Drug Recognition Expert Reports in Marijuana Cases

Brianna Peterson, Ph.D. and Rod Gullberg, M.S.Washington State Patrol

September 20, 2011

Page 2: Evaluation of Drug Recognition Expert Reports in Marijuana Cases Brianna Peterson, Ph.D. and Rod Gullberg, M.S. Washington State Patrol September 20, 2011.

Goal of study

• Determine if DRE indicators for cannabis are present in cases with THC detected

• Compare indicators for subjects with active THC versus THC-COOH only

Page 3: Evaluation of Drug Recognition Expert Reports in Marijuana Cases Brianna Peterson, Ph.D. and Rod Gullberg, M.S. Washington State Patrol September 20, 2011.

size

HorizontalGaze Nystagmus

VerticalGazeNystagmus

Lack ofConvergence

Pupil

Reactionto light

Pulse

BloodPressure

Body Temp

Depressants Inhalants DissociativeAnesthetics

Stimulants Hallucinogens NarcoticAnalgesics

Cannabis

Present Present Present None None None

Present Present Present None None None

Present Present Present None None None

Normal Normal Normal Dilated Dilated Constricted

Slow Slow Normal Slow Normal Little to none

Down Up Up Up Up Down

Down Up/Down Up Up Up Down

Normal Up/Down/Normal

Up

None

None

Present

Dilated

Normal

Up

Up

Normal Up Up Down

DRE Matrix

Page 4: Evaluation of Drug Recognition Expert Reports in Marijuana Cases Brianna Peterson, Ph.D. and Rod Gullberg, M.S. Washington State Patrol September 20, 2011.

DRE indicators for cannabis category

• Lack of convergence (LOC) present• Pupil size normal to dilated• Elevated pulse rate• Elevated blood pressure

• Horizontal gaze nystagmus (HGN) not present• Vertical nystagmus (VGN) not present• Reaction to light is normal• Body temperature is normal

Page 5: Evaluation of Drug Recognition Expert Reports in Marijuana Cases Brianna Peterson, Ph.D. and Rod Gullberg, M.S. Washington State Patrol September 20, 2011.

THC pharmacokinetics

• Highly lipid soluble

• Short half-life– 3 hrs post smoking, THC in serum <5 ng/mL

• Main metabolite: 11-nor-9 carboxy-THC (THC-COOH)

Page 6: Evaluation of Drug Recognition Expert Reports in Marijuana Cases Brianna Peterson, Ph.D. and Rod Gullberg, M.S. Washington State Patrol September 20, 2011.

Methodology• DRE cases from 2007-2009; blood sample

analyzed• Tested for volatiles by Headspace Gas

Chromatography• EMIT drug screen

– Cannabinoids cut off = 10 ng/mL THC-COOH

• THC confirmation by GC/MS (SIM mode)– Limits of Detection

• THC = 1.0 ng/mL• THC-COOH = 5.0 ng/mL

Cases that were only positive for THC or THC-COOH

Page 7: Evaluation of Drug Recognition Expert Reports in Marijuana Cases Brianna Peterson, Ph.D. and Rod Gullberg, M.S. Washington State Patrol September 20, 2011.

Subjects• THC/THC-COOH (n=101)

– 93% male– 78% Caucasian– Average age: 24 (range: 16-70)

• THC-COOH only (n=147)– 79% male– 84% Caucasian– Average age: 27 (range: 14-61)

• Not impaired (n=17)– 76% male– 94% caucasian– Average age: 38 (range: 19-74)

Page 8: Evaluation of Drug Recognition Expert Reports in Marijuana Cases Brianna Peterson, Ph.D. and Rod Gullberg, M.S. Washington State Patrol September 20, 2011.

147 THC/THC-COOH cases

5 10 15 20 30 60 90 120 150 180 210More0

20

40

60

THC-COOH concentration

ng/mL

Fre

qu

ency

Mean = 74.1; median = 61.7

1 2 3 4 5 10 20 30 More0

20

40

60

THC concentration

ng/mL

Fre

qu

ency

Mean = 7.3; median = 5.7

101 THC-COOH only cases

5 10 15 20 30 60 90 120 150 180 210More0

1020

3040

THC-COOH concentration

ng/mL

Fre

qu

ency

Mean = 16.6; median = 13.5

Results

Page 9: Evaluation of Drug Recognition Expert Reports in Marijuana Cases Brianna Peterson, Ph.D. and Rod Gullberg, M.S. Washington State Patrol September 20, 2011.

Lack of convergence

*p=0.003*p=0.003

0

10

20

30

40

50

60

70

YesNo

THC/THC-COOH

Pe

rce

nta

ge

THC-COOH

*

*p=0.003

Page 10: Evaluation of Drug Recognition Expert Reports in Marijuana Cases Brianna Peterson, Ph.D. and Rod Gullberg, M.S. Washington State Patrol September 20, 2011.

Normal range: 2.5 – 5.0 mm

Average pupil size: Room light

0 10 20 30 40 50 60 70 80 900

1

2

3

4

5

6

7

8

9

10

THC/THC-COOH

THC-COOH

ng/mL

56%, 61% above normal range

Page 11: Evaluation of Drug Recognition Expert Reports in Marijuana Cases Brianna Peterson, Ph.D. and Rod Gullberg, M.S. Washington State Patrol September 20, 2011.

Average pupil size: Dark

Normal range: 5.0 - 8.5 mm

0 10 20 30 40 50 60 70 80 900

1

2

3

4

5

6

7

8

9

10

THC/THC-COOH

THC-COOH

ng/mL

60%, 58% above normal range

Page 12: Evaluation of Drug Recognition Expert Reports in Marijuana Cases Brianna Peterson, Ph.D. and Rod Gullberg, M.S. Washington State Patrol September 20, 2011.

0 10 20 30 40 50 60 70 80 900

1

2

3

4

5

6

7

8

9

10

THC/THC-COOHTHC-COOH

ng/mL

Average pupil size: Direct light

49%, 47% above normal range

Normal range: 2.0 – 4.5 mm

Page 13: Evaluation of Drug Recognition Expert Reports in Marijuana Cases Brianna Peterson, Ph.D. and Rod Gullberg, M.S. Washington State Patrol September 20, 2011.

0 10 20 30 40 50 60 70 8040

50

60

70

80

90

100

110

120

130

140

150

THC/THC-COOHTHC-COOH

ng/mL

Average pulseNormal range = 60-90 bpm

57% above normal range

Page 14: Evaluation of Drug Recognition Expert Reports in Marijuana Cases Brianna Peterson, Ph.D. and Rod Gullberg, M.S. Washington State Patrol September 20, 2011.

Systolic blood pressure

0 10 20 30 40 50 60 70 8080

90

100

110

120

130

140

150

160

170

180

190

200

THC/THC-COOHTHC-COOH

ng/mL

Normal range = 120 – 140 mm Hg

45% above normal range

Page 15: Evaluation of Drug Recognition Expert Reports in Marijuana Cases Brianna Peterson, Ph.D. and Rod Gullberg, M.S. Washington State Patrol September 20, 2011.

Body Temperature

Normal range = 98.6 ± 1°F

0 10 20 30 40 50 60 70 8095

95.4

95.8

96.2

96.6

97

97.4

97.8

98.2

98.6

99

99.4

99.8

100.2

100.6

101

THC/THC-COOHTHC-COOH

ng/mL

73, 87% in normal range

Page 16: Evaluation of Drug Recognition Expert Reports in Marijuana Cases Brianna Peterson, Ph.D. and Rod Gullberg, M.S. Washington State Patrol September 20, 2011.

Not impaired: 17 cases from 2007 - 2009

Summary

Cannabisindicator

THC/THC-COOH

THC-COOH

Not impaired

HGN None 9% 11% 6%

VGN None 0 2% 0

Lack of convergence Present 66% 47% 6%

Pupil Size Normal to dilated

55% 55% 15%

Reaction to light Normal 76% 77% 82%

Pulse Elevated 57% 57% 25%

Blood pressure(Systolic/diastolic)

Elevated 45%/22% 45%/25% 41%/12%

Body Temperature Normal 73% 87% 77%

Page 17: Evaluation of Drug Recognition Expert Reports in Marijuana Cases Brianna Peterson, Ph.D. and Rod Gullberg, M.S. Washington State Patrol September 20, 2011.

Summary

THC/THC-COOH

THC-COOH

Bloodshot eyes

Eyelid tremors

2/8 clues on WAT

2/4 clues on OLS

Not impaired

86% 81% 24%

81% 81% 38%

72% 81% 25%

46% 57% 31%

Page 18: Evaluation of Drug Recognition Expert Reports in Marijuana Cases Brianna Peterson, Ph.D. and Rod Gullberg, M.S. Washington State Patrol September 20, 2011.

Other indicators

• Romberg test: estimation of 30 seconds– Normal range = 25 to 35 seconds

THC/THC-COOH THC-COOH Not impaired

60% 51% 47%

Page 19: Evaluation of Drug Recognition Expert Reports in Marijuana Cases Brianna Peterson, Ph.D. and Rod Gullberg, M.S. Washington State Patrol September 20, 2011.

Other indicators

• Rebound Dilation

• Reaction to light– Normal, slow, little

THC/THC-COOH THC-COOH Not impaired

43% 41% 6%

THC/THC-COOH THC-COOH Not impaired

77% 76% 82%

Page 20: Evaluation of Drug Recognition Expert Reports in Marijuana Cases Brianna Peterson, Ph.D. and Rod Gullberg, M.S. Washington State Patrol September 20, 2011.

DRE Opinion

• THC/THC-COOH cases– 97% DRE called cannabis

• Other cases called ‘not impaired’

– 98% subject admitted to marijuana use• THC-COOH only cases

– 97% DRE called cannabis• Stimulant/not impaired

– 88% subject admitted to marijuana use

Page 21: Evaluation of Drug Recognition Expert Reports in Marijuana Cases Brianna Peterson, Ph.D. and Rod Gullberg, M.S. Washington State Patrol September 20, 2011.

Conclusions

• DRE matrix is useful tool for predicting marijuana use

• Similar indicators for THC/THC-COOH and THC-COOH cases– Short half-life, long exam process

Page 22: Evaluation of Drug Recognition Expert Reports in Marijuana Cases Brianna Peterson, Ph.D. and Rod Gullberg, M.S. Washington State Patrol September 20, 2011.

Beasley et al. study

• Examined which indicators best predict substance (n =742)

• Stimulants versus cannabis– Stimulants: less reddening of eyes and

rebound dilation, more likely to have hippus, injection sites, slow reaction to light

– Cannabis: more likely to have lack of convergence

Toward a More Parsimonious Approach to Drug Recognition Expert Evaluations. Traffic Injury Prevention 2009;10:513-518

Page 23: Evaluation of Drug Recognition Expert Reports in Marijuana Cases Brianna Peterson, Ph.D. and Rod Gullberg, M.S. Washington State Patrol September 20, 2011.

Acknowledgments

• Rod Gullberg– Research Analyst, Washington State Patrol