Request for Comments on Barriers and Solutions for Submitting Toxicology Data to the Fatality Analysis Reporting System Pursuant to Recommendations for Toxicological Investigation of Drug-Impaired Driving and Motor Vehicle Fatalities

Request for Comments on Barriers and Solutions for Submitting Toxicology Data to the Fatality Analysis Reporting System Pursuant to Recommendations for Toxicological Investigation of Drug-Impaired Driving and Motor Vehicle Fatalities

Publication: Federal Register
Agency: National Highway Traffic Safety Administration
Byline: Nanda Narayanan Srinivasan
Date: 25 April 2022
Subjects: American Government

, Safety

[Federal Register Volume 87, Number 79 (Monday, April 25, 2022)]
[Notices]
[Pages 24390-24394]
From the Federal Register Online via the Government Publishing Office [www.gpo.gov]
[FR Doc No: 2022-08776]

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DEPARTMENT OF TRANSPORTATION

National Highway Traffic Safety Administration

[Docket No. NHTSA-2022-0007]

AGENCY: National Highway Traffic Safety Administration (NHTSA),
Department of Transportation (DOT).

ACTION: Request for comments on barriers to and solutions for providing
toxicological data on drug-impaired driving investigations of motor
vehicle fatalities to the Fatality Analysis

[[Page 24391]]

Reporting System (FARS) that meet the recommendations described in
Recommendations for Toxicological Investigations of Drug-Impaired
Driving and Motor Vehicle Fatalities--2021 Update.

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SUMMARY: Section 25025 of the Infrastructure Investment and Jobs Act
requires NHTSA to submit a report to Congress that, in accordance with
recommendations made in Recommendations for Toxicological
Investigations of Drug-Impaired Driving and Motor Vehicle Fatalities--
2021 Update, (1) ``identifies any barriers the States encounter in
submitting alcohol and drug toxicology results to the Fatality Analysis
Reporting System;'' and (2) ``provides recommendations on how to
address the barriers identified'' pursuant to providing the data
described in the above recommendations for toxicological
investigations. This notice requests public comments on any barriers
that States may encounter that would affect their ability to provide
the toxicological data described in the 2021 Update of the
Recommendations document to FARS, as well as recommendations to address
those barriers identified.

DATES: The request for comments is effective on April 25, 2022.

ADDRESSES: You may submit comments identified by DOT Docket ID Number
NHTSA-2022-0007 using any of the following methods:
Electronic submissions: Go to https://www.regulations.gov. Follow
the on-line instructions for submitting comments.
Mail: Docket Management Facility, M-30, U.S. Department of
Transportation, 1200 New Jersey Avenue SE, West Building Ground Floor,
Room W12-140, Washington, DC 20590.
Hand Delivery: West Building Ground Floor, Room W12-140, 1200 New
Jersey Avenue SE, Washington, DC, between 9 a.m. and 5 p.m., Monday
through Friday, except Federal holidays.
Fax: 1-202-493-2251.
Instructions: Each submission must include the Agency name and the
Docket number for this Notice. Note that all comments received will be
posted without change to https://www.regulations.gov including any
personal information provided.

FOR FURTHER INFORMATION CONTACT: For more information, contact Dr.
Randolph Atkins, Jr., Chief, Behavioral Research Division, NPD-310,
National Highway Traffic Safety Administration, 1200 New Jersey Avenue
SE, Washington, DC 20590; Telephone number: (202) 366-5597; Email:
randolph.atkins@dot.gov.

SUPPLEMENTARY INFORMATION:

Background

There is a growing concern with drug impaired driving in the United
States and around the globe. While alcohol is the drug most often
linked to impaired driving and crashes, there are many other drugs that
can impair driving ability and contribute to crashes.\i\ Other
potentially impairing drugs include some over-the-counter (OTC) drugs,
some prescription drugs, and most illegal drugs. The use of drugs other
than alcohol and in combination with alcohol is widespread. The
National Survey on Drug Use and Health (NSDUH) estimated that 53.2
million people in the United States used illegal drugs in 2018, an
increase of 2 million people since 2017. The 2018 survey also found
that 16.9 million people reported misusing psychotherapeutics in 2018,
and 12.6 million people reported driving under the influence of illegal
drugs.\ii\ The 2020 NSDUH found use of illicit drugs in the past year
had increased to 59.3 million people or 21.4% of the U.S. population
age 12 or older,\iii\ and an increase of 6.1 million people since 2018.
NHTSA's 2013-2014 National Roadside Survey of Alcohol and Drug Use
by Drivers reported that 20.1% of all drivers surveyed on weekend
nights tested positive for the presence of some drug, legal and/or
illegal, other than alcohol, a statistically significant increase from
the 16.3% of drug-positive drivers found in the 2007 survey.\iv\
NHTSA's study of drug prevalence in road users with serious or fatal
injuries admitted to five Level-1 trauma centers or their corresponding
Medical Examiner's offices, found that in the months just prior to the
current pandemic 50.8% of the drivers in the study had at least one
drug in their system (including alcohol) with 17.6% having multiple
drugs in their systems. This increased to 64.7% and 25.3%,
respectively, during the pandemic in the second quarter of 2020. During
this time cannabis presence increased from 20.8% to 32.7% and opioid
presence increased from 7.5% to 13.9% in this sample of drivers.\v\
Clearly, many drivers on the roads today pose a potential danger to
themselves and others because of potentially impairing drugs in their
systems.
Prescription and OTC drug use is quite common in America. The
National Center for Health Statistics estimated that, from 2015-2018,
48.6% of Americans used at least one prescription medication in the
past 30 days, with 24% using three or more prescription medications in
the last 30 days and 12.8% using five or more prescription medications
in the last 30 days. The most frequently prescribed drugs were
analgesics,\vi\ which is reflected in the current opioid epidemic.
Drivers increase the risk of drug-impaired driving because they may not
be able to distinguish between prescription drugs that are impairing
and those that are not.\vii\ Furthermore, the simultaneous use of
multiple therapeutic drugs or combining therapeutics with alcohol
increases the risk of motor vehicle crashes because of the potential
for interaction effects.\viii\
Another trend fueling concerns about drug-impaired driving is the
shift in use, social acceptance, and policies regarding the use of
marijuana. Marijuana is defined here as ``all substances containing
tetrahydrocannabinol.'' \ix\ The terms marijuana and cannabis are used
interchangeably in this document. From 2001-2002 to 2012-2013, the use
of marijuana doubled from 4.1% to 9.5% of the U.S. adult population,
with 30% of these users meeting the criteria for marijuana use
disorder.\x\ In 2020, 17.9% of Americans 12 years or older reported
using cannabis in the past year (approximately 49.6 million people),
and an estimated 5.1% of people 12 and older (approximately 14.2
million people) had a cannabis use disorder.\xi\ Though marijuana is
still illegal under federal law, eighteen States and the District of
Columbia have now legalized both recreational and medical use of
marijuana and seventeen States have legalized the use of medical
marijuana. Another thirteen states have legalized marijuana for
specific medical conditions.\xii\ In 2018, Canada legalized the
recreational use of marijuana at the national level, and Mexico passed
a bill legalizing recreational cannabis in 2021. This trend towards
legalization has been accompanied by an increase in the presence of
marijuana found in drivers. NHTSA's National Roadside Survey found
tetrahydrocannabinol (THC) presence in 12.7% of surveyed drivers in
2013-2014, up from 8.7% in the 2007 survey. In a 2018 study by
Washington State, 39.1% of drivers admitted to driving within 3 hours
of using marijuana at least once in the previous year, and the
biological results from the survey indicated that the presence of
marijuana in surveyed drivers had doubled, from approximately 10%, to
20% of all drivers after the state's implementation of retail marijuana
sales.\xiii\ A NHTSA roadside survey in Washington State found similar
results, with 7.8% of drivers testing positive for presence of THC
prior to the

[[Page 24392]]

implementation of legal marijuana in the state. NHTSA found significant
increases in THC presence in drivers six months (18.4%) and one year
(18.9%) after legalization.\xiv\ While linking the level of marijuana
present in biological samples with level of impairment remains
challenging, well-established evidence shows that marijuana use
detrimentally affects driving-related skills. Marijuana use slows
driver reaction time, creates problems with road tracking and
maintaining lane position, and decreases cognitive performance and
driver attention maintenance. Marijuana use in conjunction with other
drugs, such as alcohol, can also have a compounding effect on
impairment.\xv\ The current shifts in policy and marijuana use increase
the public health concerns regarding drug-impaired driving.
The lack of adequate data to determine the scope and magnitude of
the drug impaired driving problem presents a major challenge in
addressing the issue of drug-impaired driving.xi xvi
Estimates show that comprehensive societal costs for alcohol-impaired
driving were approximately $194 billion in 2010; \xvii\ however, the
data required for conducting similar analyses for the comprehensive
societal costs of drug-impaired driving are lacking. The data currently
available on drug-impaired driving and motor vehicle crashes have many
shortcomings.\xviii\ These include inconsistent drug testing policies
and procedures across jurisdictions, such as considerable variability
in who is tested, what drugs are tested for, detection capabilities of
the laboratory, and what specimen matrices (blood, oral fluid, urine,
etc.) are used.
In 2009,\xii\ and again in 2017,\xi\ NHTSA recommended that States
provide separate statutes for alcohol- and drug-impaired offenses, to
provide incentive for ``law enforcement officers to pursue a possible
drug-impaired driving charge even when a BAC equal to or above the
limit of .08 g/dL has already been established,'' but few states
currently have such statutes. Many jurisdictions only test for drugs
when alcohol levels are below per se limits that indicate a driver, by
law, is intoxicated by alcohol, and forego drug testing when alcohol
per se limits are met. However, high percentages of specimens in
impaired driving cases that were tested only for alcohol are often
positive for other drugs, too.\xix\ Some jurisdictions do not perform
any drug testing for motor vehicle crashes. Reporting of the toxicology
findings is also inconsistent and often lacks sufficient specificity
regarding whether it is reporting a screening test or a confirmation
test, and other critical information, such as the drug panels and
thresholds of detection used, is often left out. This widespread
inconsistency in drug testing and lack of detail in reporting of
toxicology on reports of motor vehicle crashes and fatalities creates
significant problems for policy makers and traffic safety professionals
trying to address the problem of drug-impaired driving.
In many States, the large number of laboratories conducting post-
mortem drug testing (typically ordered at the county level by the
coroner or medical examiner) often do not look for the same core list
of drugs and do not use comparable testing techniques with similar
thresholds of detection because there is a lack of standardization
regarding the drug panels and detection thresholds used for motor
vehicle crashes. This prevents data from different laboratories from
being combined to get a clear picture of drug use within the State.
Similarly, in many States, individual law enforcement agencies contract
with different laboratories which do not screen for the same set of
core drugs, nor use comparable testing techniques with similar
thresholds of detection. This limits the ability to characterize and
monitor/conduct surveillance and better understand the issue of
statewide driver drug use. ``Currently, the limitations (in the drugged
driving data) severely constrain interpretation of the data.
Comparisons across labs, States, or years are problematic.'' This is
reflected at the national level in the FARS data.\xx\
A recent expert panel on the impact of marijuana on the driving
while intoxicated (DWI) system, which included various experts from
divisions in the departments of motor vehicles, law enforcement, and
the courts and corrections departments as well as government data
systems, reported a serious need for more and better data on drug use
by drivers as well as standardized laboratory practices for drug
toxicology, including which drugs are tested for, what detection
thresholds of the drugs are used, confirmation testing results, and
comprehensive reporting on the tests conducted and the matrices
used.\xxi\ Recent reports from the Governors Highway Safety Association
(GHSA) have stressed the urgent need for better, more comprehensive
toxicology testing and reporting of toxicology test results for motor
vehicle crashes.xxii xxiii This need was also emphasized in
NHTSA's reports to Congress on marijuana-impaired driving (2017) \xi\
and drug-impaired driving (2009),\xii\ and two National Transportation
Safety Board (NTSB) reports on impaired driving.xxiv xxv

Recommendations and Request for Comments

The Center for Forensic Science Research & Education (CFSRE) and
the National Safety Council Alcohol, Drugs and Impairment Division
(NSC-ADID) report, Updates for Recommendations for Drug Testing in DUID
& Traffic Fatality Investigations (2016), summarized a survey it
conducted of toxicology laboratories from across the country. The
survey identified ``current practices, capabilities, research needs and
gathered information regarding the scope and sensitivity of testing.''
\xxvi\ Subsequently, the Drugs, Technology, Pharmacology and Toxicology
Section of the National Safety Council's Alcohol, Drugs and Impairment
Division reviewed the survey results and updated their 2013 published
recommendations for the toxicology community,\xxvii\ which were
published as ``Recommendations for Toxicological Investigation of Drug-
Impaired Driving and Motor Vehicle Fatalities--2017 Update'' in the
Journal of Analytical Toxicology.\xxviii\ These recommendations are
referenced in Section 25025 of Public Law 117-58. The CFRSE and NSC-
ADID conducted a follow-up survey of laboratories in 2020, after which
the recommendations were updated and published as ``Recommendations for
Toxicological Investigation of Drug-Impaired Driving and Motor Vehicle
Fatalities--2021 Update'' in the Journal of Analytical
Toxicology.\xxix\ These recommendations address the identified
toxicology needs for drug-impaired driving cases. Coupled with
comprehensive reporting of the toxicology findings, the widespread use
of these toxicology recommendations could greatly enhance understanding
of the scope and magnitude of drug-impaired driving and help traffic
safety professionals better address this vital public health
issue.\xxx\ The toxicology recommendations in the 2021 Update are
available, free of charge, online at: https://pubmed.ncbi.nlm.nih.gov/34086916/.
Given the growing national concern over drug-impaired driving and
the clear need for standardized drug-impaired driving toxicological
testing and comprehensive reporting on the toxicological results, NHTSA
is preparing a Report to Congress on Drug-Impaired Driving Data
Collection that identifies the barriers to States in providing the
toxicological data to FARS as described in the NSC-ADID document,
recommends solutions to overcome those barriers, and describes

[[Page 24393]]

the steps the Department of Transportation and NHTSA will take to
assist States in improving toxicology testing in cases of motor vehicle
crashes and reporting of alcohol and drug toxicology results in cases
of motor vehicle crashes provided to FARS. Our first step in producing
this report is the collection of information from the public on
barriers and possible solutions. NHTSA therefore seeks public comment
on any barriers that States may have to adopting these recommendations,
and any comments on what is needed to overcome these barriers.
As previously noted, the Recommendations for Toxicological
Investigation of Drug-Impaired Driving and Motor Vehicle Fatalities--
2021 Update were developed by an expert panel of toxicologists based on
the results of a national survey of toxicology laboratories. These
voluntary recommendations are for forensic toxicological drug testing
and reporting for all drivers, motorcycle and moped operators,
bicyclists and pedestrians involved in fatal motor vehicle crashes, and
all drivers who are arrested or convicted for impaired operation of
motor vehicles, regardless of their tested Blood Alcohol Concentration
(BAC) or Breath Alcohol Concentration (BrAC). The recommendations
provide standardized lists of drugs, matrices (blood, oral fluid,
urine, etc.), and detection threshold levels for testing. The
guidelines include two tiers of drugs for testing: Tier 1 drugs (Table
II in the document) are drugs that are found throughout the country and
that should be tested for in all jurisdictions; Tier 2 drugs (Table III
in the document) are less common or predominantly found in specific
areas of the country, so they may only need to be routinely tested for
in those localities or on a case-by-case basis. NHTSA believes that the
voluntary adoption of these toxicology guidelines would greatly improve
data collection, and support future initiatives by a wide variety of
traffic safety stakeholders using this toxicological data to help
reduce drug-impaired driving. It is critical that comprehensive and
consistent data on this vital public health issue are available for use
in all parts of the impaired-driving system, from law enforcement to
adjudication and treatment to public policy.
Drug impaired driving is a growing concern; however, the
information currently available on the scope and magnitude of drug
impaired driving is unclear. Today, there is great variation across the
country regarding which drivers are tested for drug use, what specimens
are collected for testing, what drugs are tested for, and what
threshold detection levels are used for drug tests. Comprehensive and
consistent toxicological data is needed to better inform the public and
public policy on this growing public health problem. This testing and
data are also essential to increasing the effectiveness of law
enforcement and adjudication efforts in drug-impaired driving cases and
to making America's roads safer for the driving public.
In support of our efforts to improve the toxicological data
provided to FARS and the States, reduce the problem of drug-impaired
driving, and ``assist States in their efforts to increase public
awareness of the dangers of drug-impaired driving,'' \xxxi\ NHTSA
hereby requests public comment on the following:
(1) Identification of any barriers or challenges that States
currently encounter in submitting alcohol and drug toxicology results
to the Fatality Analysis Reporting System (FARS).
(2) Suggestions for overcoming those current barriers and
challenges identified to improve the delivery of data to the FARS.
(3) Identification of any barriers or challenges that States may
encounter in collecting the toxicology data as described in
Recommendations for Toxicological Investigation of Drug-Impaired
Driving and Motor Vehicle Fatalities--2021 Update (https://pubmed.ncbi.nlm.nih.gov/34086916/) and submitting those alcohol and
drug toxicology results to the Fatality Analysis Reporting System
(FARS).
(4) Suggestions for overcoming those barriers and challenges
identified for collecting the toxicological data as described in the
Recommendations for Toxicological Investigation of Drug-Impaired
Driving and Motor Vehicle Fatalities--2021 Update to improve the
delivery of the data to the FARS.

Notes

\i\ Couper, F. and Logan, B. 2004. Drugs and Human Performance.
DOT HS 809 725. National Highway Traffic Safety Administration.
Washington, DC. https://www.wsp.wa.gov/breathtest/docs/webdms/DRE_Forms/Publications/drug/Human_Performance_Drug_Fact_Sheets-NHTSA.pdf.
\ii\ Center for Behavioral Health Statistics and Quality. 2019.
Results from the 2018 National Survey on Drug Use and Health.
SAMHSA, Rockville, MD. https://www.samhsa.gov/data/report/2018-nsduh-detailed-tables.
\iii\ Substance Abuse and Mental Health Services Administration.
(2021). Key substance use and mental health indicators in the United
States: Results from the 2020 National Survey on Drug Use and Health
(HHS Publication No. PEP21-07-01-003, NSDUH Series H-56). Rockville,
MD: Center for Behavioral Health Statistics and Quality, Substance
Abuse and Mental Health Services Administration. Retrieved from
https://www.samhsa.gov/data/.
\iv\ Kelley-Baker, T., Berning, A., Ramirez, A., Lacey, J.,
Carr, K., Waeher, G., Moore, C. Pell, K., Yao, J., and Compton, R.
2017. 2013-2014 National Roadside Survey of Alcohol and Drug Use by
Drivers: Drug Results. DOT HS 812 411. National Highway Traffic
Safety Administration. Washington, DC. https://www.nhtsa.gov/sites/nhtsa.dot.gov/files/documents/13013-nrs_drug_092917_v6_tag.pdf.
\v\ Thomas, F.D., Berning, A., Darrah, J., Graham, L., Blomberg,
R., Griggs, C., Crandall, M., Schulman, C., Kozar, R., Neavyn, M.,
Cunningham, K., Ehsani, J., Fell, J., Whitehill, J., Babu, K., Lai,
J., and Rayner, M. (2020, October). Drug and alcohol prevalence in
seriously and fatally injured road users before and during the
COVID-19 public health emergency (Report No. DOT HS 813 018).
National Highway Traffic Safety Administration.
\vi\ Centers for Disease Control and Prevention. 2019. National
Center for Health Statistics. Therapeutic Drug Use. https://www.cdc.gov/nchs/fastats/drug-use-therapeutic.htm.
\vii\ Smith, R., Turturici, M. and Camden, M. 2018.
Countermeasures Against Prescription and Over-the-Counter-Impaired
Driving. AAA Foundation for Traffic Safety. Washington, DC. http://aaafoundation.org/wp-content/uploads/2018/10/VTTI_Rx_OTC_FinalReport_VTTI-FINAL-complete-9.20.pdf.
\viii\ Alda, A., Pharm, D., and Morse, M. 2008. Multiple
Medications and vehicle Crashes: Analysis of Databases. DOT HS 810
858. National Highway Traffic Safety Administration. Washington, DC.
\ix\ Current legislation (Section 25025, Pub. L. 17-58)
references the definition of marijuana in the F.A.S.T. Act, Section
4008 (d). https://www.govinfo.gov/content/pkg/PLAW-114publ94/html/PLAW-114publ94.htm.
\x\ National Institutes of Health. 2015. Prevalence of Marijuana
Use Among U.S. Adults Doubles Over Past Decade. https://www.nih.gov/news-events/news-releases/prevalence-marijuana-use-among-us-adults-doubles-over-past-decade.
\xi\ National Institutes of Health. 2022. https://www.drugabuse.gov/publications/research-reports/marijuana/what-scope-marijuana-use-in-united-states.
\xii\ Insurance Institute for Highway Safety. Alcohol and drugs:
Marijuana laws. https://www.iihs.org/topics/alcohol-and-drugs.
\xiii\ Grondel, D., Hoff, S., and Doane, D. Marijuana Use,
Alcohol Use and Driving in Washington State. 2018.Washington Traffic
Safety Commission. http://wtsc.wa.gov/wp-content/uploads/dlm_uploads/2018/05/Marijuana-and-Alcohol-Involvement-in-Fatal-Crashes-in-WA_FINAL.pdf.
\xiv\ Ramirez, A., Berning, A., Carr, K., Schere, M., Lacey, J.,
Kelley-Baker, T., and Fisher, D. 2016. Marijuana, Other Drugs, and
Alcohol Use by Drivers in Washington State. DOT HS 812 299. National
Highway Traffic Safety Administration. Washington, DC. https://www.nhtsa.gov/sites/nhtsa.dot.gov/files/812299-washingtonstatedrugstudy.pdf.

[[Page 24394]]

\xv\ Compton, R. 2017. Marijuana-Impaired Driving: A Report to
Congress. DOT HS 812 440. National Highway Traffic Safety
Administration. Washington, DC. https://www.nhtsa.gov/sites/nhtsa.dot.gov/files/documents/812440-marijuana-impaired-driving-report-to-congress.pdf.
\xvi\ Compton, R., Vegega, M., and Smither, D. 2009. Drug-
Impaired Driving: Understanding the Problem and Ways to Reduce It--A
Report to Congress. DOT HS 811 268. National Highway Traffic Safety
Administration. Washington, DC. https://rosap.ntl.bts.gov/view/dot/1949.
\xvii\ Blincoe, L.J., Miller, T.R., Zaloshnja, E., & Lawrence,
B.A. (2015, May). The economic and societal impact of motor vehicle
crashes, 2010 (Revised) (Report No. DOT HS 812 013). Washington, DC:
National Highway Traffic Safety Administration.
\xviii\ Berning, A. and Smither, D. 2014. Understanding the
Limitations of Drug Test Information, Reporting, and Testing
Practices in Fatal Crashes. Traffic Safety Facts Research Note DOT
HS 812 072. National Highway Traffic Safety Administration.
Washington, DC. https://www.nhtsa.gov/sites/nhtsa.dot.gov/files/812072-understandlimitsdrugtest-researchnote.pdf.
\xix\ Limoges, J., Tandy, A., and Brown, H. 2009. A
Retrospective Study of Drug Prevalence in Alcohol Related Driving
Arrests. Presented at the annual meeting of the American Academy of
Forensic Sciences.
\xx\ Berning, A., Smith, R.C., Drexler, M., & Wochinger, K.
(2022, March). Drug testing and traffic safety: What you need to
know (Report No. DOT HS 813 264). National Highway Traffic Safety
Administration.
\xxi\ National Highway Traffic Safety Administration, Governors
Highway Safety Association, and Volpe National Transportation
Systems Center. 2017. Impact of the Legalization and
Decriminalization of Marijuana on the DWI System: Highlights from
the Expert Panel Meeting. National Highway Traffic Safety
Administration. Washington, DC. https://www.nhtsa.gov/sites/nhtsa.dot.gov/files/documents/expert_dwi_panel.pdf.
\xxii\ Hedlund, J. 2017. Drug-Impaired Driving: A Guide for the
States. Governors Highway Safety Association and Foundation for
Advancing Alcohol Responsibility. https://www.ghsa.org/resources/drugged-driving-2017.
\xxiii\ Hedlund, J. 2018. Drug-Impaired Driving: Marijuana and
Opioids Raise Critical Issues for States. Governors Highway Safety
Association and Foundation for Advancing Alcohol Responsibility.
https://www.ghsa.org/resources/DUID18.
\xxiv\ 2013 NTSB Report, Reaching Zero: Actions to Eliminate
Alcohol-Impaired Driving (https://www.ntsb.gov/safety/safety-studies/Documents/SR1301.pdf).
\xxv\ 2018 NTSB Report, Pickup Truck Centerline Crossover
Collision With Medium Size Bus on US Highway 83, Concan, Texas,
March 29, 2017 (https://www.ntsb.gov/investigations/AccidentReports/Reports/HAR1802.pdf).
\xxvi\ D'Orazio, A., Scott, K., Mohr, A. and Logan, B. 2016.
Updates for Recommendations for Drug testing in DUID & Traffic
Fatality Investigations. The Center for Forensic Science Research &
Education at the Frederic Rieders Family Foundation, 2300 Stratford
Avenue, Willow Grove, PA 19090. https://www.forensicscienceeducation.org/wp-content/uploads/2016/04/Full-Survey-Report.pdf.
\xxvii\ Logan, B., Lowrie, K., Turri, J., Yeakel, Limoges, J.,
Miles, A., Scarneo, C., Kerrigan, S., and Farrell, L. 2013.
Recommendations for Toxicological Investigation of Drug-Impaired
Driving and Motor Vehicle Fatalities. Journal of Analytical
Toxicology. Volume 37. August 2013, Pages 552-558.
\xxviii\ Logan, B., D'Orazio, A., Mohr, A., Limoges, J., Miles,
A., Scarneo, C., Kerrigan, S., Liddicoat, L., Scott, K., and
Huestis, M. 2018. Recommendations for Toxicological Investigation of
Drug-Impaired Driving and Motor Vehicle Fatalities--2017 Update.
Journal of Analytical Toxicology. Volume 42. Issue 2. March 2018,
Pages 63-68. https://academic.oup.com/jat/article/42/2/63/4653729.
\xxix\ D'Orazio, A., Mohr, A., Chan-Hosokawa, A., Harper, C.,
Huestis, M., Limoges, J., Miles, A., Scarno, C., Kerrigan, S.,
Liddicoat, L., Scott, K., Logan, B. Recommendations for
Toxicological Investigation of Drug-Impaired Driving and Motor
Vehicle Fatalities--2021 Update. Journal of Analytical Toxicology.
July, 2021. 45(6):529-536. https://pubmed.ncbi.nlm.nih.gov/34086916/.
\xxx\ Watson, M.W. and Mann, R.E. 2018. Harm reduction and drug-
impaired driving: sharing the road?. Drugs: Education Prevention and
Policy. 25:2, 105-108. https://doi.org/10.1080/09687637.2017.1344620.
\xxxi\ Fixing America's Surface Transportation Act, Public Law
114-94, 4009 (2015).

Authority: 44 U.S.C. Section 3506(c)(2)(A).

Issued in Washington, DC.
Nanda Narayanan Srinivasan,
Associate Administrator, Research and Program Development.
[FR Doc. 2022-08776 Filed 4-22-22; 8:45 am]
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