Impairment: The new kid on the block?

Written By Ken Fichtler

The topic of impairment, as it relates to public and workplace safety, is one that has a long history. Based on the current conversation, one might think we’re igniting discussion that is novel and progressive. However, if we dig into the history of impairment, it becomes clear that we are retelling a familiar story, but in a slightly different way.

Looking all the way back to 1910, we find New York became the first state to pass laws that criminalized the act of driving while intoxicated (impaired). Although there was no way to objectively measure how intoxicated an individual was, we had the piece of mind to understand that with the proliferation of the automobile a safety measure had to be established. It wasn’t until 1936 when Dr. Harger invented and patented the Drunkometer (yeah, it was really called that), did we begin to measure blood alcohol concentrations. After this, the impairment revolution took off over the next 60 or so years as seen by the series of events below:

  • 1938 - 0.15 became the first widely accepted legal blood alcohol concentration limit.

  • 1953 - Robert Borkenstein invented the Breathalyzer.

  • 1979 - LAPD implements DRE Protocol for identifying impairment to test proof of concept.

  • 1984 - The National Minimum Drinking Age Act raised the legal drinking age to 21.

  • 1987 - NHTSA initiated DEC (Drug Evaluation and Classification) pilot programs in Arizona, Colorado, New York and Virginia leading to national adoption of DRE (Drug Recognition Expert) Protocol.

  • 1998 - The legal limit for blood alcohol concentration changed to .08.

  • 2000 - Congress adopted .08 BAC as the national illegal limit for impaired driving.

  • 2012 - Alabama became the last state to pass and execute an ignition interlock law for those arrested and/or convicted of impaired driving.

Fast forward to the present day and we can supplement this list with the latest legal and societal shifts which have been focused on substances beyond alcohol.

  • 1996 - California becomes the first state to legalize medical cannabis.

  • 1990’s - early 2000’s - Recreational synthetic drugs become more prolific globally.

  • 2010 - Opioid crisis accelerates as synthetic and semi-synthetic substances come to market (Oxycontin, Fentanyl, Tramadol).

  • 2012 - Colorado and Washington become the first two states to legalize cannabis.

  • 2014 - Present - The District of Columbia and 39 states legalize medical cannabis, of those the District of Columbia and 21 states legalize recreational use of cannabis.

Throughout this 100+ year history, we’ve worked hard to understand the science around the intoxicating effects of all substance classifications. As the science became clear, new technology such as metabolite-based drug tests were developed as a response. Additionally, advancements in the worlds of neuroscience, ophthalmology and mental health are helping us understand more about the brain and how it is affected cognitively by factors beyond intoxicating substances.

What’s becoming very clear is that our eyes are quite possibly the best organ to diagnostically test if we want to quickly understand what’s happening with our brain. We are witnessing the proliferation of this science in all walks of life. Eye tests have become ubiquitous when evaluating and screening an individual who may be suffering from brain trauma (concussion or TBI). When our cognitive abilities are compromised, our eyes typically tell the story. This holds true when we are impaired via consumption of an intoxicating substance.

If we truly want to ensure we are taking steps that speak to increased safety outcomes both publicly and in the workplace, the focus should continue to be on impairment. Let’s not lose sight of the fact that this was the focus 100+ years ago and should continue to be the focus today and beyond.

Ken Fichtler
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