You may remember from week one that the point of the DRE is to determine whether someone is impaired, whether the impairment is caused by a drug or medical condition, and what class or category of drugs is the cause of the impairment. But at this stage of the evaluation, the IACP’s description of the test skips an important step: the medical rule-out.
Yes, on their own information about the test they state the following:
Based on the totality of the evaluation, the DRE forms an opinion as to whether or not the subject is impaired. If the DRE determines that the subject is impaired, the DRE will indicate what category or categories of drugs may have contributed to the subject’s impairment.
Thus, the IACP has already given away the whole point of this exercise, which is to conclude that the impairment is by a drug regardless of rational medical explanations for the symptoms observed.
The problem is that it is rare, if ever, that a person presents with all the symptoms expected for a certain class or category of drug. While someone may have constricted pupils, which is symptomatic of a narcotic analgesic, the person may also present with an elevated pulse rate and horizontal gaze nystagmus, both of which are not expected with narcotics. What does the DRE officer do when there are conflicting symptoms present?
The answer is simple. And no, if you’ve been paying attention this far you know it isn’t: “conclude it’s medical impairment!” Nope. The training is to identify which drugs — plural — are present. So whatever doesn’t fit must be caused by a different class or category of drug.
The justification for this thinking is that many drug users, apparently, use multiple drugs. This is sometimes true. Heroin, methamphetamine, and cocaine may be used in combination as each counteracts the negative effects of the other. But that is generally only done in circumstances of serious addiction where one would not need a DRE evaluation to determine that was the case.
But the DRE is a cyncial exam, and the cynicism leads to the thinking that even recreational users or infrequent users will use several drugs at once.
The reality is that if you are subject to a DRE evaluation it is very likely that something will be identified in the evaluation as the likely cause of the impairment. Which is why next week’s final step, the toxicological evaluation, is so important.
