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Heroin use has powerful effects on the body. It clouds judgment, and causes alternating states of alertness and drowsiness when in use. While the initial effects of heroin (euphoria, flushing and heaviness in hands and feet) take only seconds to feel, the effects from one dose can last for hours.
Rates of past month illicit drug use varied with age. Through the adolescent years from 12 to 17, the rates of current illicit drug use in 2008 increased from 3.3 percent at ages 12 or 13 to 8.6 percent at ages 14 or 15 to 15.2 percent at ages 16 or 17. The highest rate was among persons aged 18 to 20 (21.5 percent). The rate was 18.4 percent among those aged 21 to 25, and it was 13.0 percent among those aged 26 to 29. Among persons aged 65 or older, the rate was 1.0 percent.
Adderall® is the brand name for an amphetamine formulation that is prescribed for the treatment of Attention Deficit Hyperactivity Disorder (ADHD) and for narcolepsy. Under the Controlled Substance Act, Adderall® is classified as a Schedule II drug because of its high potential for abuse and dependence. Data for this report on Adderall® was collected as part of SAMHSA's National Survey on Drug Use and Health module on nonmedical use of prescription-type stimulants. Among persons aged 18 to 22, full-time college students were twice as likely to use Adderall® nonmedically in the past year as those who had not been in college at all or were only part-time students. Nearly 90% of the full-time college students who had used Adderall® nonmedically in the past year also were past month binge alcohol drinkers and more than half were heavy alcohol users. In the past year, full-time college students who had used Adderall® nonmedically in the past year were more likely to have used illicit drugs than their non Adderall® using counterparts: almost 3 times more likely to use marijuana (79.9% vs. 27.2%), 8 times more likely to use cocaine (28.9% vs. 3.6%), 8 times more likely to use tranquilizers nonmedically (24.5% vs. 3%) and 5 times more likely to use pain relievers nonmedically (44.9% vs. 8.7%).
The rate of SMI in 2008 was higher among adults who were unemployed (8.0 percent) than those who were employed full time (3.5 percent) or part time (4.8 percent).
 

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Massachusetts: Ignition interlock devices will stall drunk drivers, save lives


Massachusetts: A new technology that requires the measurement of drivers' blood alcohol level before they can start their cars is now available on Martha's Vineyard. In keeping with tougher penalties for impaired driving offenses in Massachusetts, repeat drunk drivers must use an ignition interlock device (IID), an in-car breath screening device that prevents a vehicle from starting if it detects a certain level of blood alcohol concentration.

Melanie's Law, which stiffened penalties for drunk driving offenses, took effect in Massachusetts in October 2005. Named after Melanie Powell, a 13-year-old killed in an accident by a repeat drunk driver, the law included a requirement for creating a state-run ignition interlock program by January 1, 2006.

Under Melanie's Law, a person with two or more Operating Under the Influence (OUI) convictions for alcohol or controlled substances who is eligible for a hardship license or is eligible for license reinstatement must use an ignition interlock, installed at his or her own expense.

Although the court system is supposed to notify the Registry of Motor Vehicles (RMV) when a driver is convicted of a second OUI offense, a recent case highlights flaws that remain in the process. On June 30, C. W. Tolbert Jr., a driver who had been convicted twice of drunken driving, struck Milton firefighter Antonio Pickens, who was aiding motorists involved in a car crash in front of the fire station where he works. Mr. Pickens suffered massive injuries. The court system had not notified the RMV to put a restriction on Mr. Tolbert's license, an oversight state officials vowed to review and correct.


Interlock ignition devices are installed in cars on-Island by Larry Conroy, owner of Courtesy Motors in Vineyard Haven. Photo by Susan Safford. Click photo for larger version.With the enactment of Melanie's Law, the RMV tightened up its policy regarding hardship licenses. In order to be eligible for one, an OUI offender must prove he or she does not have access to public transportation, and must have an IID installed.

Individuals with this restriction receive a "Z" designation on their licenses, making it illegal for them to operate a vehicle not equipped with an IID.

The IID

To comply with the provision in Melanie's Law to set up a state-run ignition interlock program, the Registry of Motor Vehicles researched IIDs, recruited vendors, and trained staff to oversee the new ignition interlock program. There are currently five companies that install and maintain the IIDs at 30 locations throughout Massachusetts.

One of them, a company called Smart Start, based in Irving, Texas, developed its IID in 1994 and is franchised in about 30 states, including Massachusetts as of a year ago. As part of its role as a franchisee, Smart Start makes sure there are adequate points of service to cover each state.

Earlier this year, the company made a "cold call" to Larry Conroy, owner of Courtesy Motors on Beach Street in Vineyard Haven, to ask if he would be interested in installing and servicing the devices. He quickly agreed. "I think it's a wonderful thing," Mr. Conroy said.


A volunteer demonstrates how the ignition interlock device works. Photo courtesy of Smart Start. Click photo for larger version.According to Jim Ballard, Smart Start's president, the device costs about $70 a month, depending on the price set by the franchisee. Legislation varies between states as to how someone is ordered to use an IID, Mr. Ballard said. Sometimes the devices are court-ordered through a court officer or judge, and other times through the department of motor vehicles. The IID will not be installed on motorcycles.

"The interlock is typically placed on the vehicle of someone who is going to have a problem - they have a history," Mr. Ballard said. "It's definitely a good tool for those who need a little reminder to separate drinking from driving."

Blow and go - or no go

While waiting for Mr. Conroy to install an IID, a driver watches a DVD to understand how it works. The device measures about two by five inches. To use it, a driver turns on the ignition and blows into a disposable plastic tube at the top. If he or she passes the initial breath test, the IID will read "pass" and the vehicle will start. If the driver fails the test with a blood alcohol concentration (BAC) of greater than .02, the IID will read "fail" and the vehicle won't start.

To put this in terms of alcohol consumption, a BAC calculator provided by Smart Start estimates that a 160-lb. driver who consumes one drink containing 1 ounce of 86-proof alcohol or approximately 12 ounces of beer in 1 hour might register a .02 BAC. The rate of absorption may be affected by many factors, including an individual's personal metabolism of alcohol, food in the stomach, and medications.

If a driver fails the start-up breath test twice during a 30-day service period, the vehicle goes into lockout and the driver has 48 hours to return to the vendor, who uploads the data and resets the IID.

Drivers who pass the initial breath test and are able to start their vehicles will be subject to rolling re-tests at random intervals while driving. When it is time for a re-test, the IID beeps, which signals the driver he or she has five minutes to take the test, preferably after pulling over to the side of the road. The rolling re-test is supposed to safeguard against the possibility of a drunk person driving a car after getting a sober person to start it.

Penalties and consequences

A brochure provided by the RMV spells out the penalties for lockouts, failed rolling re-tests and other infractions related to using the IID, including the loss of a driver's license for 10 years - or for life.

Upon notification of a second lockout, the RMV will schedule a hearing. A driver found responsible for missing up to two rolling re-tests that result in a lockout in a 30-day service period will receive a 10-year license revocation. A driver who fails a rolling re-test with a BAC between .02 and.05 resulting in a lockout faces a 10-year license revocation the first time and license revocation for life for the second. A driver who fails a rolling re-test with a BAC greater than .05 any one time faces a 10-year license revocation and loss of a license for life for a second failed test.

The IID records all of the test results and vehicle activity. Every 30 days, the driver must return to the vendor for monthly maintenance. At that time, vendors such as Mr. Conroy upload the data and transmit it to the RMV. As part of his responsibility as a vendor, Mr. Conroy is very conscientious about referring questions to the RMV and maintaining confidentiality about the numbers and identities of those using the IIDs.

Although the Massachusetts 10-year license revocation is the stiffest penalty among states where Smart Start is franchised, Mr. Ballard said, the state's participation has been good.

An IID for everyone?

In addition to proving useful for regulating OUI offenders, ignition interlocks are being ordered by judges in many states in child custody cases where the non-custodial parent has a drinking problem, and in family violence cases and child abuse and sexual abuse cases where alcohol is a factor.

In listing other applications for ignition interlocks, Smart Start suggests employers may want to use the devices to ensure that their employees are operating company vehicles responsibly.

Although it would seem that parents of teenage drivers might be in the market for IIDs, Mr. Ballard said only a very low percentage of them are leasing the devices. Smart Start tested the teen market for a little while by lowering prices and offering free installations to see if there was an interest. "A lot of parents love the idea - for the kid that lives next door - but they don't want it on their kid's car," he said with a laugh. Some parents felt that installing the device would imply they didn't trust their teen, Mr. Ballard said.

So far, the device has not taken off in the commercial market, Mr. Ballard said, because although many people like the idea of supporting safe driving, they aren't ready to install an IID on their own cars.

There are still a lot of negative associations with having one, he explained. "It is an intrusion, blowing into it on average 6 to 10 times a day," said Mr. Ballard. "It can be embarrassing if you're at the grocery store - there are those kinds of challenges to overcome in making it attractive to the average person."

The technology continues to evolve, however. Smart Start currently is working on a device that will take a photo to identify the user. "We're trying to tweak night picture clarity," Mr. Ballard said. "The idea there is that a few arguments occur in the courts and at the RMV. We want to make sure that the person we're reporting on is the actual person driving the vehicle, especially in matters of prosecution."

In addition to IIDs and other stricter drunken driving penalties, Massachusetts periodically launches statewide campaigns to crack down on impaired driving involving the use of alcohol or other drugs.

Legislators also are looking at closing other loopholes in laws affecting drunk drivers, such as the right of a motorist involved in a suspected drunk driving accident to refuse a breathalyzer test.

According to a State House News Service report on Nov. 5, Rep. Karyn Polito (R-Shrewsbury) and Sen. Edward Augustus (D-Worcester) co-sponsored a bill that would require mandatory breathalyzer tests at the scene of an accident, to prevent drunk drivers from putting the test off until their blood-alcohol level is lower.

The bill also would require labeling the breathalyzer results with the time the test was taken rather than the time of the accident, to account for the fact that blood alcohol levels may have decreased in the interim. In addition, the bill would make refusing a breathalyzer test a separate crime, resulting in a mandatory six-month driver's license suspension.

Currently, if a motorist refuses a breathalyzer or blood test, a police officer is required to take away the person's license on the spot and provide a notice of suspension, effective immediately. If convicted for OUI, drivers over age 21 with no previous OUI offenses receive a 180-day license suspension for refusing a chemical test.


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