Morphine, Heroin and the Horizontal Gaze Nystagmus
In the past years, my office has seen an increase in the number of “drugged” driving cases we receive. While arrests for marijuana make up the vast majority of those cases, we are also seeing a dramatic rise in prescription drug cases along with traffic stops implicating harder drugs such morphine and heroin.
As with other impaired driving cases, it is vital that you know the observations that would be consistent with impairment by that drug. It is also vital that you determine if the “standardized field sobriety test” protocol adopted in Ohio is applicable in recognizing clues of impairment due to that specific drug. The National Highway Traffic Safety Administration (hereinafter NHTSA) has been at the forefront in research to this very point. The information in this article is derived from the NHTSA Drug and Human Performance Fact Sheet.
Heroin and Morphine are both classified as narcotic analgesics. Morphine is a naturally occurring substance extracted from the seedpod of the poppy plant, Papavar somniferum. The milky resin that seeps from incisions made in the unripe seedpod is dried and powdered to make opium, which contains a number of alkaloids including morphine. Morphine concentration in opium can range from 4-21%. An alternate method of harvesting morphine is by the industrial poppy straw process of extracting alkaloids from the mature dried plant, which produces a fine brownish powder. Morphine is a schedule II controlled substance and is available in a variety of prescription forms: injectables (0.5-25 mg/mL strength); oral solutions (2-20 mg/mL); immediate and controlled release tablets and capsules (15-200 mg); and suppositories (5-30 mg). Heroin is a schedule I controlled substance and is produced from morphine by acetylation at the 3 and 6 positions. The majority of heroin sold in the U. S. originates from Southeast Asia, South America (Columbia) and Mexico. Low purity Mexican black tar heroin is most common on the West coast, while high purity Columbian heroin dominates in the East and most mid-western states.
Depending on the morphine dose and the route of administration, onset of effects is within 15-60 minutes and effects may last 4-6 hours. The duration of analgesia increases progressively with age although the degree of analgesia remains unchanged. Following heroin use, the intense euphoria lasts from 45 seconds to several minutes, peak effects last 1-2 hours, and the overall effects wear off in 3-5 hours, depending on dose.
The drug manufacturer states that morphine may impair the mental and/or physical abilities needed to perform potentially hazardous activities such as driving a car, and patients must be cautioned accordingly. Driving ability in cancer patients receiving long-term morphine analgesia (mean 209 mg daily) was considered not to be impaired by the sedative effects of morphine to an extent that accidents might occur. There were no significant differences between the morphine treated cancer patients and a control group in vigilance, concentration, motor reactions, or divided attention. A small but significant slowing of reaction time was observed at 3 hours. In several driving under the influence case reports, where the subjects tested positive for morphine and/or 6-acetylmorphine, observations included slow driving, weaving, poor vehicle control, poor coordination, slow response to stimuli, delayed reactions, difficultly in following instructions, and falling asleep at the wheel. Classification of risk depends on tolerance, dose, time of exposure, acute or chronic use, presence or absence of underlying pain, physiological status of individual, and the presence of other drugs: moderately to severely impairing in non-tolerant individuals; mild to moderately impairing if morphine is used as medication on a regular basis for chronic pain; severely impairing in acute situations if used orally, or as an intravenous medication, or if either drug is taken illicitly.
With regard to the standardized field sobriety tests, law enforcement will be required to rely on the coordination tests rather than the horizontal gaze nystagmus test. Horizontal gaze nystagmus is not present; vertical gaze nystagmus is not present; lack of convergence is not present; pupil size is constricted; little or no reaction to light; pulse rate down; blood pressure down; body temperature down. Other characteristic indicators may include presence of fresh injection marks, track marks, flaccid muscle tone, droopy eyelids, drowsiness or “on-the-nod”, and low raspy slow speech.
Charles M. Rowland II has dedicated his practice to representing the accused drunk driver. His commitment includes continuous study of the forensic sciences and legal strategies that will help you win your DUI case. If you find yourself in need of a qualified and experienced Ohio OVI attorney, CONTACT Charles M. Rowland II at (937) 318-1DUI or 1-888-ROWLAND.
- What shows up as heroin in a drug test (wiki.answers.com)
- Standardized Field Sobriety Tests & Marijuana (daytondui.com)
- Bloodshot and Glassy Eyes Are Not Clues of Impairment (daytondui.com)
- What shows up on a drug test (wiki.answers.com)
- Arrested for DUI in Dayton, Ohio? (daytondui.com)