Accurate drug impairment testing is something that people on all sides of the drug policy debate can agree is an essential tool for a society with any level of drug use. Currently, however, drug testing practices and technologies are not fit for purpose, often unable to provide accurate information as to whether someone is actually impaired by the drugs detected in their system. Considering the serious consequences that can come with a positive drug test result, the lack of accurate cannabis impairment testing technologies represents an issue that can have life-changing implications.

The issues with existing cannabis impairment tests

The first major pitfall of available drug tests is that they often can’t even accurately measure impairment. In regards to drug driving—which is one key application of impairment tests—existing tests in the UK are similar to many other jurisdictions. Police officers carry out a field impairment assessment involving a pupillary examination and a series of tests measuring markers including balance and vital signs. However, according to The Faculty of Forensic and Legal Medicine (who withdrew their support for existing impairment tests in the US, which are similar to those in the UK) these tests are inadequate. They have never been scientifically or statistically calibrated, there is no benchmark for pass or failure, and there is no scoring system to indicate relative success, leaving officers to make subjective interpretations of what they see; this evidence is then very difficult to authenticate in court. In fact, this series of tests has reportedly been failed by police officers in perfectly lit conditions in training classrooms

Notably, these procedures can easily be used consciously or subconsciously in a discriminatory way; considering the ongoing racism in the policing of drug policies, a test for impairment relying so heavily on officers’ subjectivity creates a system well primed for abuse and social injustice

Also, the tests that exist to measure THC levels cannot accurately discern whether the THC detected is actually causing intoxication, or if it is simply leftover in their system from days ago. Drug driving suspects must undertake a roadside drug test to screen for the presence of cannabis and cocaine in their system, followed by a urine or blood test at a police station if it returns a positive result. However, compared to the much stronger relationship between blood alcohol concentrations and driving impairment, THC in blood and saliva are poor and inconsistent measures of cannabis impairment. The accuracy also depends on how regularly the person uses cannabis, with tests being less accurate for people who use cannabis regularly. THC can be detected in saliva tests for around 12 hours after use in occasional cannabis users, whilst for regular users it can be detected for around 30 hours, long after any impairing effects have worn off. Moreover, urine testing—which is often used in workplace drug testing—can detect THC for up to 30 days after cannabis consumption, which is far too large of a window to determine someone’s impairment levels. 

Of course, the risks of people driving and working whilst impaired is a growing and valid concern. Although both workplace drug testing and medical cannabis usage are more widespread in the US, drug testing does take place in UK workplaces, with 21% of employers maintaining a zero-tolerance drug policy. Moreover, according to the DVLA, drug driving is becoming a bigger issue than drunk driving in some areas of the UK, with cases reaching 13,732 last year. However, whilst these statistics are worrying, they are skewed by the inclusion of those being unfairly punished for trace levels of potentially day-old THC. 

This issue is especially acute for medical cannabis users, 56% of whom do so daily, who risk being excluded from workplaces with zero-tolerance drug policies or charged for drug driving even when they are not impaired at work or on the roads. This can create barriers to entering and sustaining certain jobs, discourage people from using medical cannabis, and even drive people to opt for more dangerous drugs such as opioids. Aside from infringing on the rights of medical cannabis patients that rely on cannabis for their condition, existing testing systems directly discriminate against both recreational and medical cannabis users who do so in their own time. This serves to uphold outdated and harmful perceptions of people who use drugs, moralizing cannabis use as ‘deviant’ and ‘wrong’; this zero-tolerance attitude to drug use has proven to be stigmatising, ineffective and dangerous. Ultimately, if people are not intoxicated on the job, what they decide to do outside of work should not be the business of their employers. 

It’s also important to keep in mind that the penalty for returning a positive result in a workplace drug test is usually termination, and the penalties for drug driving can be severe and life-changing, including a minimum 1-year driving ban, an unlimited fine, up to 6 months in prison and a criminal record. An offence with such serious consequences demands objective and accurate testing techniques to make sure the law is enforced fairly. Furthermore, with the UK’s medical cannabis market projected to expand to reach around 340,000 patients in 2024, there is a clear need for cannabis impairment testing to keep up with the rapid changes in the policy landscape and the increased acceptance of cannabis use. 

How science and technology is helping to address the problem

There are a number of groups working on technological solutions to address accurate drug testing. We spoke to the biotechnology start-up Bloonics who are developing systems that could revolutionise testing by providing quick and accurate measures of cannabis impairment, something which can contribute to more effective enforcement of drug policy in the workplace, reduce the margins for discrimination in policing and uphold the rights of all cannabis users.

Speaking about solutions to drug testing, Bloonics co-founder, Daniel Cohen said “We recognise the harmful consequences of current drug testing systems. At Bloonics we are working on solutions that reduce harm by ensuring cannabis users are not stigmatized or criminalized due to unfair testing systems.” 

Daniel told us about one technology in particular the ‘LuciX platform’, which measures levels of impairment and provides detailed information about the cannabinoids present in someone’s system.

Daniel discussed the benefits of the LuciX system on detecting synthetic cannabinoids as well. 

“The platform has a monitoring system that uses cannabinoid receptors—including the CB1 receptor—as the primary sensing modality to see which agents from a sample bind to the receptor but it excludes any inactive metabolites that are no longer impairing a person. This technology, which will be optimized through machine learning, uses the profile of endocannabinoids that are naturally present in someone’s system to determine whether that picture has changed. It can paint a time window as to when someone has likely taken in a product and accurately determine the probability that they are impaired. This device can be used outside of the lab, making it a practical tool for quick and precise roadside testing.”

Going further, Daniel told us that in the US at the moment roadside screening involves looking into someone’s eye to ascertain intoxication.

“We’re developing technology that allows for a far more accurate version of the eye screening tests used in roadside drug testing. As things stand, these are performed manually using an officer’s own eyeball estimation, making them very difficult to perform accurately, even with training. The Bloonics eye-scanning device measures vital and neurological signs through tiny changes in pupil diameter and position in response to a stimulus. The technology uses a small infrared light that differentiates between the iris and the pupil regardless of colour and it uses a machine learning model that allows for diversity in eye shapes, meaning that ethnicity and skin colour do not make a difference in the accuracy of the test. 

It’s vital that we move beyond what are currently rather primitive systems for roadside testing, instead incorporating science and technology.”

How can this technology help?

The benefits of introducing this type of technology are substantial. Reducing reliance on officers’ subjectivity is an important step towards ensuring drug driving policies are enforced fairly, with a huge benefit being that it reduces the risk of racial prejudice and other biases in the policing of drug offences, something which is central to efforts for drug policy reform. Furthermore, people who use medical cannabis will be able to continue their use without limiting their employment options to workplaces without zero-tolerance drug policies. Employers will also benefit financially by increasing their labour market access to people who use cannabis regularly and reducing costs incurred through legal fees; multiple court cases in the US have ruled against employers, concluding with the verdict that cannabis drug tests are insufficient for determining active impairment or violate the rights of medical cannabis patients. 

Platforms like that of LuciX can also help to shift people towards medical cannabis and away from medications that are relatively more harmful and addictive. Many individuals suffering from chronic pain, for example, opt for prescription opiates, rather than cannabis, to avoid testing positive on a workplace or roadside drug test. Despite being more harmful and having a higher abuse potential than cannabis, these are not prohibited under most drug policies if the user is not impaired on the job. A recent study has also outlined how workplace drug testing can drive people to use dangerous synthetic cannabinoids, which—although detectable by the Bloonics system—are non-detectable in urine drug screens.  By rolling-out accurate impairment testing technology, workers will maintain the right to use medical cannabis in their own time, reduce reliance on opioids and other drugs for pain relief, and reduce workplace costs associated with the opioid crisis, which stood at an estimated total of nearly $150billion from 2015 to 2018 in the US.

Finally, technology like this can help to reduce the stigma around people who use drugs. Penalising people who use cannabis in their own time, despite not being impaired whilst working or driving, contributes to the framing of cannabis use as immoral and incompatible with being a functioning member of society. This technology, therefore, will not only have direct practical benefits but will also contribute to a wider ideological shift in how people who use cannabis are perceived. 

As the recreational and medical use of cannabis increases across multiple jurisdictions worldwide, huge improvements in cannabis impairment testing are essential.  The technology being offered by Bloonics aims to do just that by simultaneously protecting the public, upholding the rights of cannabis users and reducing discriminatory policing.  

This piece was written by Volteface Research Officer Nicole Borgers. Tweets @NicoleBorgers

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