Doctors for Road Safety propose graded tests to detect different stages of impairment

The NGO explained that for drugs predominantly used for medical purposes, such as benzodiazepines, amphetamines, and opiates, the proposed protocol specifies that a positive roadside oral fluid test (OFT) would necessitate an impairment test. If this impairment test yields a positive result, the driver would then be immediately required to undergo a blood test. An offense would be recorded if the blood test results exceed the legally defined acceptable limit.

If the blood limit is not exceeded, or if the impairment test is negative, the driver would still be obligated to produce a valid prescription or other proof of medical use. Should this proof not be provided, the authorities would then determine whether to require another blood test or to consider an offense to have been committed.

D4RS explains how in the case of cannabis, a positive roadside OFT would also trigger an impairment test. If impairment is detected, a blood test would become mandatory, and an offense would be deemed committed if the acceptable limit is exceeded. However, if the blood limit is not exceeded, or if the impairment test is negative, the report indicates that no offense would be recorded. 

The report highlights that blood THC levels alone often cannot differentiate between medicinal and recreational use due to similar concentrations found in various cannabis products, presenting a significant challenge for enforcement.

For drugs like cocaine or ketamine, the approach is much stricter; any positive OFT would directly lead to a mandatory blood test, and the detection of any trace of these substances would automatically result in an offense.

The report also outlines exceptions to these protocols. In the event of a road traffic crash resulting in bodily injury, loss of life, or property damage, a positive roadside OFT will require a blood test to inform further investigations. 

Beyond the specific enforcement mechanisms, the report offers a broader set of strategic recommendations for Malta. 

This includes the adoption of per se blood limits for common recreational drugs, suggesting a range of 0.6-3ng/ml whole blood for cannabis, and maintaining zero alcohol tolerance when psychoactive drugs are used. 

The report also calls for comprehensive officer training, particularly in standardized field sobriety tests (SFST) and drug recognition expert (DRE) evaluations. They also recommend the systematic use of video documentation through body cameras and dashboard recording systems to strengthen court cases and ensure fair treatment.