To pick up where we left off two weeks ago, we are going to outline a process of determining the type of impairment and how it affects activities.   I will outline a set of questions to lead us to a conclusion regarding if and how one is impaired when using a specific substance.  This will be used as we explore the various substances in future posts.

A broad definition to start with is the following:

“A state of being diminished, weakened, or damaged, especially mentally or physically.”

 

QUESTION #1         Does ingesting substance ‘X” cause an altered state?

I think we can all agree that the use of certain substances causes some degree of an altered state, otherwise there would be no need to take those substances.  It is a classic Syllogism.

If:                    A person takes a certain substance

And:               A certain substance causes an altered state

Then:             That person is in an altered state

We will determine this by looking at how a specific substance affects the mind or body; and how that could correlated to a specific type of impairment in an average individual.

Here there should be little to no disagreement as the studies are sound through clinical research and trials – In all cases the answer will be “Yes.”

QUESTION #2         Does that state cause impairment in the average person?

We must then look at the impact of someone’s ability to function.  Here we make some general assumptions, as we do with Alcohol.  The same level of alcohol in two individuals does not mean the same level of impairment with each of those individuals.  Until 1983, not all states even had 0.08 as the legal limit.  Furthermore, in a tweet posted earlier this year, the NTSB reiterated what is has proposed the past three years.

“Safety is a journey, not a destination,” the NTSB tweeted. “Reducing BAC limit to .05 is one of many steps to end substance impairment in transportatio

This question is highly debated, but should not be, given the studies around the substances.  These debates around certain substances can be contributed to a lack of studies undertaken to correlate between a level of a substance being in the body and the corresponding level of impairment in that individual?  And even when these studies exist, it will be more a matter of public policy to determine as to what the level, like that of alcohol.  So again this is a “Yes or “No” question as we will not parse through the anecdotal evidence supporting each side.

QUESTION #3         What functions are specifically impaired?

We also need to see what functions are impaired, (i.e. spatial or depth perception, reflexes, etc.)

Another question of little debate, because it is based upon empirical repeatable studies.  Again, as to what degree is debatable as it depends upon the individual.

QUESTION #4         What are the activities affected by this type of impairment?

Next, we need to understand the activities that are affected by impairment.  The spectrum ranges from sleeping to balancing on a high wire between two buildings.  In between are such things as watching a movie, slicing with a knife, slicing with a deli slicer, operating a car or a forklift or picking out recyclables off a very fast-moving belt-yes that is a job.  Here is where the debate comes in and there is no agreement

I believe, again, there is little debate here as to the affect, but there is plenty of debate as to what degree of affect.  Again, this is due to a lack of repeatable studies using scientific methodology.

QUESTION #5         Does an impairment in performing that specific activity cause harm to oneself or others?

Intuitively, it makes sense that if failure to perform a certain activity can cause injury or death to oneself or another, the answer is yes.

As to at where along the spectrum of activities potential harm exists will be constantly debated by both sides and it will be up to public policy.  Many times, it will take a significant event to drive that new policy.  For now, many states have defined safety sensitive functions similar to the Connecticut Department of Labor.

http://www.ctdol.state.ct.us/wgwkstnd/highrisk.htm

 

If you read each of these positions, you will see that many of those same functions apply to us in everyday life activities.

At the end of the day, as substances such as Cannabinoids are legalized and more Pharmaceuticals become available, public policy will rule the day and create a standard for all to live by.  Government agencies at the state and federal levels will weigh the potential benefits as well as the potential costs in creating the laws.

What will be considered is the same as is with all public policy around anything to do with public or private  safety or security, whether it be terrorism, guns, or impairment.  How much freedom and civil liberties do we allow in exchange for safety or security of our individual citizens, or our nation.

That is a decision to be made by us voting citizens and our representative government entities; but it can, and should be, an individual decision as well.  It is my hope in the coming weeks is to arm you with information around the 2 A’s of Addiction and Affects of various substances.  The goal is to enable you to make the best decision about substance use; not just for yourself, but for your family and your co-workers.