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Source: The Conversation – USA (3) – By Margaret Riley, Professor of Law, Public Health Sciences, and Public Policy, University of Virginia

On Sept. 10, 2025, a federal judge blocked the Department of Justice’s attempt to subpoena medical records and other private health information on minors receiving hormone therapy and other gender affirming care at Boston Children’s Hospital.

The move is the first public legal decision after the Department of Justice, in July, issued more than 20 subpoenas to doctors and clinics treating transgender patients under age 19.

A subpoena to Children’s Hospital of Philadelphia, made public by The Washington Post on Aug. 20, demanded documents that are related to virtually any aspect of the care provided, including highly confidential documents like psychotherapy notes.

According to news reports, the Justice Department subpoenas have sown fear and concern, both among people whose information is sought and among the doctors and other providers who offer such care. Some health providers have reportedly decided to no longer provide gender-affirming care to minors as a result of the inquiries, even in states where that care is legal.

I’m a law professor at the University of Virginia specializing in health law. I spend a lot of time teaching future lawyers and medical professionals how medical privacy laws work. Normally, subpoenas demand information relating to specific crimes. But these subpoenas are unusual in how much information they seek, while giving no inkling of any alleged crimes that may have been committed.

The subpoenas also push against the bounds of legal protections on health information.

What is HIPAA and why did Congress pass the legislation?

In the 1990s, growing use of the internet made it increasingly easier to violate people’s health care privacy. Some notorious breaches of privacy involving celebrities, such as USA Today’s revelation that tennis champion Arthur Ashe had AIDS, drove the point home. Genetic testing was also becoming prevalent in clinical care, raising concerns about the privacy of peoples’ genetic information.

In response, Congress passed the Health Insurance Portability and Accountability Act, or HIPAA, in 1996. The legislation required the Department of Health and Human Services to develop a set of privacy regulations specific to health care. These regulations went into force in 2003.

HIPAA prohibits health care providers and people working with them, such as administrative staff, laboratories, pharmacies and health insurers, as well as businesses, from disclosing patients’ health information without their permission. The regulations cover everything in a patient’s medical record as well as any documents or information kept by their health provider relating to their health care.

Most if not all of the information sought by Justice Department subpoenas is the type of information typically covered by HIPAA, meaning that it would generally be illegal for health care providers to disclose it.

Does HIPAA constrain providers’ response to subpoenas?

HIPAA’s privacy rule has a few exceptions, however – and responding to a subpoena is one of them.

The regulations permit but do not require health care providers to disclose protected health information in response to a subpoena. In other words, providers may choose not to comply with a subpoena. Notably, however, they may face consequences for doing so. For example, a court might find a provider in contempt if it does not disclose the requested information. That can leave health care providers in a difficult position, caught between their interests in protecting their patients and obligations demanded by courts or law enforcement.

If health care providers do choose to share HIPAA-protected health information in response to a subpoena, the regulations outline certain requirements that both providers and, in this case, the government, must follow. Providers must get written authorization from patients before disclosing some types of information, such as psychotherapy notes.

The government, meanwhile, must notify patients whose health information it seeks and provide them with enough information about the crimes or other legal violations that it is investigating so that they can decide whether they want to object to the subpoena. It must also give patients enough time to do so.

The government must also wait until after that time period ends before taking any action on providers’ compliance with the subpoenas. And it must certify to providers that it has followed these rules and that the court has resolved any objections patients may have filed.

Finally, HIPAA requires that when health care providers do disclose protected health information, they disclose the “minimum necessary” to accomplish the intended purpose of the subpoena or other legal request. In the context of a subpoena, that means the health care provider must ascertain the purpose, accuracy and legality of the subpoena before disclosing any information.

The subpoena to the Children’s Hospital of Pennsylvania provides very little information about the government’s allegations, so without more information, the health care providers would be unable to determine the minimum necessary here.

How might shield laws affect privacy protections?

HIPAA acts as a floor for privacy protections. In other words, states cannot pass laws that reduce those privacy protections. But they can introduce laws that offer more protection. Eighteen states and the District of Columbia have so-called shield laws that offer protections both for those providing and those receiving gender-affirming care.

Shield laws are state laws that protect individuals from being required to reveal specific types of information. In the context of gender-affirming care, most of these laws are designed to limit the effect another state’s laws might have on care performed in the state with the shield law. For example, if someone travels from a state where gender-affirming care is banned and receives that care in another state where it is legal, a shield law may protect the people who received or provided the care against civil or criminal charges from the state where the care is banned.

Some state shield laws may offer additional privacy protections. For example, Washington law on protected health services does not permit health care providers to respond to any requests for information from out of state that are related to investigations or proceedings relating to services lawfully provided in Washington.

It remains to be seen whether the federal courts will uphold these shield laws, and it is not clear whether they apply at all against a federal subpoena.

How will this play out?

Both the health care providers that have been subpoenaed and the individuals whose health information has been requested may raise objections to the subpoenas.

At this point, the Justice Department has not revealed the underlying claims it intends to pursue. Based on its press release, which mentions “health care fraud,” it seems likely that the government intends to pursue claims under the federal health care fraud statute and the False Claims Act for failing to meet federal requirements or for providing fraudulent billing or claims.

The government may decide to proceed under the Food, Drug, and Cosmetic Act, perhaps alleging that physicians somehow used a drug or device for a prohibited purpose. Given that the press release about the subpoenas refers to “mutilated children,” it is even possible that in some instances, the government might allege violations of a federal law against female genital mutilation. That law was passed to prohibit the removal of female genitals for nonmedical, usually cultural, reasons.

Before any of the subpoenaed health care providers or the people whose health information the government requested can determine how to respond to the subpoenas, they will need more information about the underlying claims. Their lawyers may move to dismiss or modify the subpoenas because they are so broad, arguing that they amount to a fishing expedition rather than a targeted investigation – as Boston Children’s Hospital has done.

These issues will undoubtedly continue to be decided in the courts, and their resolution may take some time. More broadly, however, medical privacy laws were passed to help patients feel comfortable seeking medical care – and the government’s intrusion on medical privacy is likely to make that harder.

Margaret Riley does not work for, consult, own shares in or receive funding from any company or organization that would benefit from this article, and has disclosed no relevant affiliations beyond their academic appointment.

– ref. Federal subpoenas for transgender care records raise medical privacy concerns and put providers in a legal bind – a health law expert explains what’s at stake – https://theconversation.com/federal-subpoenas-for-transgender-care-records-raise-medical-privacy-concerns-and-put-providers-in-a-legal-bind-a-health-law-expert-explains-whats-at-stake-264120

Source: The Conversation – USA – By Jayde N. Hirniak, Ph.D. Candidate in Archaeology, Arizona State University

If you were lucky 74,000 years ago, you would have survived the Toba supereruption, one of the largest catastrophic events that Earth has seen in the past 2.5 million years.

While the volcano is located in what’s now Indonesia, living organisms across the entire globe were potentially affected. As an archaeologist who specializes in studying volcanic eruptions of the past, I often think about how incredible it is that humans survived this extinction-level event that was over 10,000 times larger than the 1980 Mount St. Helens eruption.

The Toba supereruption ejected 672 cubic miles (2,800 km³) of volcanic ash into the stratosphere, producing an enormous crater roughly 1,000 football fields in length (62 x 18 miles, or 100 x 30 kilometers). An eruption this size would have produced black skies blocking most of the sunlight, potentially causing years of global cooling. Closer to the volcano, acid rain would have contaminated water supplies, and thick layers of ash would have buried animals and vegetation.

With all those odds stacked against Homo sapiens as a species, how did we survive to piece together the story today?

Survival amid the ashes

Human populations living in close proximity to the Toba volcano were probably completely wiped out. Whether people on other parts of the globe were affected is a question that scientists are still investigating.

The Toba catastrophe hypothesis was one prominent school of thought for many years. It proposes that the Toba supereruption caused a global cooling event that lasted up to six years. Its effects, according to the hypothesis, caused human population sizes to plummet to fewer than 10,000 individual people living on Earth.

This scenario is supported by genetic evidence found in the genomes of people alive today. Our DNA suggests that modern humans spread into separate regions around 100,000 years ago and then shortly after that experienced what scientists call a genetic bottleneck: an event, such as a natural disaster or disease outbreak, that leads to a large decline in population sizes. These calamities drastically reduce the genetic diversity in a group.

Whether this apparent reduction in human population size resulted from the Toba supereruption or some other factor is heavily debated. As scientists collect more data from climate, environmental and archaeological records, we can begin to understand what conditions were most important for human survival.

How to study a supereruption’s impact

To piece together what happened 74,000 years ago, scientists have one direct line of evidence they can use: the rock and ash ejected from the volcanic eruption itself. This material is referred to as tephra. Scientists can trace the layers of tephra across the landscape both visually and chemically.

Microscopic volcanic glass called cryptotephra travels the farthest, making it important for understanding the true extent of an eruption. Because cryptotephra is not visible to the naked eye, it can be really challenging to identify. Researchers like me carefully separate out the tiny glass shards by sifting through the dirt and using a micromanipulator, a tool that can pick up and move microscopic grains. This process can feel like looking for a needle in a haystack and can take months to complete for one site.

Every volcanic eruption has a unique chemistry, which scientists can use to determine which eruption a particular sample of volcanic material originated from. For instance, tephra from one eruption might have more iron in it compared to tephra from another eruption. With this knowledge, we can begin to understand how large past eruptions were and who they directly affected.

When I work in the field, I look for cryptotephra that settled on archaeological sites – places with traces of past human activity such as tools, art or even buried remains. I collect samples from areas of the site that have been excavated and bring them back to the lab to extract the microscopic volcanic glass out of the dirt. Then I chemically analyze the glass to figure out the volcanic fingerprint.

But even if I determine that a certain sample from an archaeological site is from the Toba supereruption, what does that reveal about whether people survived the blast?

Once we identify a tephra or cryptotephra layer, the next step is to look closely at what’s preserved in the archaeological record before and after that eruption. In some cases, people change their behavior after an eruption, such as using a new stone tool technology or eating something different. Sometimes, people even abandon a site, leaving no trace of human activity after a catastrophic event.

Studying volcanic deposits on archaeological sites fills in only one piece of the puzzle, though. Environmental and climate records preserve information on how the local vegetation or global temperatures changed at the time of the eruption. This information helps scientists understand why people made the changes they did.

What does the archaeological evidence reveal?

Given the size and intensity of the Toba supereruption, it almost seems inevitable that humans across the globe would have suffered immensely. However, most archaeological sites tell a story of resilience.

In places such as South Africa, humans not only survived this catastrophic event but thrived. At archaeological site Pinnacle Point 5-6, evidence of cryptotephra from Toba shows that humans occupied the site before, during and after the eruption. In fact, human activity increased and new technological innovations appeared shortly after, demonstrating humans’ adaptability.

This miraculous result was not restricted to South Africa. Similar evidence is also preserved at archaeological site Shinfa-Metema 1 in the lowlands of Ethiopia, where cryptotephra from Toba was present in layers that also preserve human activity.

Here, past humans adapted to changes in the local environment by following seasonal rivers and fishing in small, shallow waterholes present during long dry seasons. Around the time of the Toba supereruption, humans in this region also adopted bow-and-arrow technology. This behavioral flexibility allowed people to survive the intense arid conditions and other potential effects of the Toba supereruption.

Through the years, archaeologists have found similar results at many other sites in Indonesia, India and China. As the evidence accumulates, it appears that people were able to survive and continue to be productive after Toba blew its stack. This suggests that this eruption might not have been the main cause of the population bottleneck originally suggested in the Toba catastrophe hypothesis.

While Toba might not help scientists understand what caused ancient human populations to plummet to 10,000 individuals, it does help us understand how humans have adapted to catastrophic events in the past and what that means for our future.

What could a future disaster mean?

The good news is that we are a lot more prepared now than people were 74,000 years ago, and even then, they were able to adapt and find new solutions in the wake of devastating events. Today, programs such as the USGS Volcanic Hazards Program and the Global Volcanism Program focus on preparation by monitoring active volcanoes through a variety of techniques. In fact, you can check out what volcanoes are currently erupting at any time.

Aside from our increased preparedness, humans are defined by our adaptability to almost any condition, even cataclysmic events. By studying the impact of volcanic eruptions in the archaeological record, we can better understand what conditions were key for human survival in the past and apply these lessons to the future.

Jayde N. Hirniak has received funding from the Hyde Family Foundation, Institute of Human Origins, Geological Society of America, Society for Archaeological Sciences, and the Cave Research Foundation for work related to this topic. This work also involves a collaboration between Arizona State University and the University of Nevada Las Vegas.

– ref. A massive eruption 74,000 years ago affected the whole planet – archaeologists use volcanic glass to figure out how people survived – https://theconversation.com/a-massive-eruption-74-000-years-ago-affected-the-whole-planet-archaeologists-use-volcanic-glass-to-figure-out-how-people-survived-254782

Source: The Conversation – USA (2) – By Elizabeth Castaldo Lundén, Kluge Fellow at the Library of Congress, University of Southern California

The death of Giorgio Armani marks the passing of one of Italy’s most influential fashion designers.

As someone who studies the intersection of fashion, media and entertainment, I think one of the designer’s most impressive feats is how he harnessed Hollywood to extend the global reach of his brand.

Born in Piacenza in 1934, Armani abandoned medical school in 1954 to work at Milan’s La Rinascente department store. There, he developed a passion for fabrics and first learned about fashion licensing, a business strategy that allowed brands to sell luxury designs at affordable prices to middle-class customers.

Observing how the licensed lines of fashion designer Pierre Cardin retailed at La Rinascente at lower prices, Armani came to understand that diversifying a brand to appeal to different customer groups could be a profitable strategy for global expansion.

When he went off on his own in 1975 to co-found his own brand with architect Sergio Galeotti, Armani soon found success by executing simple, relaxed tailoring that rejected the stiff formality of traditional suits.

In 1978, he signed an agreement with Gruppo Finanziario Tessile to produce luxury, ready-to-wear clothing under his close supervision. That deal gave rise to the Giorgio Armani Corporation and its multiple lines aimed at international markets.

Introducing affordable luxury to America

Armani’s first ready-to-wear line debuted in the U.S. in 1979.

The designer had appointed Edward Glantz, a former employee at Barney’s New York, as the product development coordinator for Giorgio Armani U.S.

Glantz was tasked with adapting Armani’s products for Americans, who were accustomed to low-maintenance, affordable clothing. He worked to ensure the designs retained their relaxed elegance by using permanent-press fabrics, which require less ironing than natural fibers, while incorporating cheaper materials to reduce costs.

In Milan, Armani’s jackets retailed for US$600, while his suits went for $800. In the U.S., prices for his sports and formal-wear lines ranged from $150 to $450, and could be found at department stores such as Bergdorf Goodman and Nan Dusking.

But many Americans encountered Armani’s clothes for the first time while watching the 1980 film “American Gigolo.” The protagonist, Julian Kay, a high-priced escort played by Richard Gere, wears lightweight Armani suits that can be worn with a tie for a formal look or paired with jeans and a polo shirt for a more casual style. Part of the trick for this relaxed look involved using softer textiles that were commonly used for womenswear.

As fashion scholar John Potvin noted, “The film introduced American audiences to a visual style which has been much imitated since. Its wardrobe launched Giorgio Armani in the U.S. and … consolidated Richard Gere’s sex symbol image.”

The designs featured in the film came from the white label Armani Collezioni – Armani’s more affordable line targeted at American consumers – meaning audiences could watch Julian’s wardrobe on screen and purchase the similar pieces in stores.

Over the course of the decade, power dressing – donning outfits that communicate authority, competence and confidence – was in vogue, further fueling the popularity of Armani’s sleek, broad-shouldered suits. In 1982, Armani became just the second designer in history to appear on the cover of Time magazine.

But Hollywood is where he continued to flex his brand’s muscles. Over the years, he outfitted characters in more than 200 films.

Titles such as “The Untouchables” (1987) and, more recently, “The Wolf of Wall Street” (2013) featured hard-charging leads who donned Armani suits, reinforcing the brand’s reputation as a symbol of style and power. During this time, Armani managed to earn a reputation as a master tailor, even though his suits were 70% machine-made and partially manufactured in Hong Kong.

Selling ‘prestige and dreams’

Recognizing the importance of celebrity exposure, Armani hired Wanda McDaniel in 1988 as his West Coast liaison to coordinate Hollywood A-listers’ wardrobes for on- and off-screen appearances.

A former journalist turned Hollywood housewife, McDaniel had observed how entrepreneur Fred Hayman had pampered clients at his Rodeo Drive boutique, Giorgio Beverly Hills – no relation to Armani – making him the go-to outfitter for Hollywood elites.

She worked to apply that same VIP treatment for clients at Armani’s newly inaugurated Rodeo Drive flagship store, which opened in August 1988 to cater to Hollywood celebrities and what the Los Angeles Times described as “the generic working rich.”

In the 1990s, McDaniel became the president of the Rodeo Drive Committee, a nonprofit organization for local business and property owners to shape and promote the shopping district. It had been founded by Hayman, who was also serving as the Oscars’ fashion coordinator.

Armani soon became regularly name-dropped during media coverage of the red carpet, with commentators gushing over the Armani dresses – and, sometimes, unisex suits – that actresses donned as they posed for the cameras. Armani later said that the gowns worn at the Oscars were always the first to sell out in his collections.

The designer’s awareness of the entertainment industry’s promotional power only grew over time, with the company’s Entertainment Industry Relations department – which is still active – overseeing celebrity relationships and styling for the company’s various lines. This paved the way for other fashion houses to establish their own in-house VIP teams.

Reflecting on the significance of the red carpet to his career, Armani once said, “It is about prestige and dreams, but those lead to dollars and cents.”

Elizabeth Castaldo Lundén receives funding from Fulbright and The Kluge Center.

– ref. How Giorgio Armani mastered the art of outfitting Hollywood stars to sell clothes to the masses – https://theconversation.com/how-giorgio-armani-mastered-the-art-of-outfitting-hollywood-stars-to-sell-clothes-to-the-masses-264730

Source: The Conversation – USA (2) – By Nick Marx, Professor of Film and Media Studies, Colorado State University

The Season 27 premiere of “South Park” in July 2025 began like so many of the show’s episodes: Resident bigot Eric Cartman is pissed off. He directs his ire at the Trump administration, which had recently pulled federal funding for NPR, because he enjoyed hearing liberals “whine about stuff.” In other words, Cartman is irate that Trump has stolen his hateful, vindictive shtick.

As the episode goes on, other South Park residents join Cartman in rallying against Donald Trump. In the show’s infamously over-the-top style, the president is depicted as thin-skinned, deceitful – and, well, sexually ill-equipped. The episode ends with a surreal, graphic deepfake scene of a totally nude Donald Trump stumbling around a desert.

The White House immediately blasted “South Park” as irrelevant and “desperate for attention.”

The ratings tell a different story. The season premiere scored 6 million viewers across Comedy Central and Paramount+, with even more tuning in two weeks later for the follow-up. Each ensuing episode has further skewered Trump and his administration.

“South Park” has long targeted ineffectual authority figures with ripped-from-the-headlines timeliness, which is made possible by its weekly production schedule. Whereas most animated television shows require months of production lead time, series co-creators Trey Parker and Matt Stone need just a week or two to write, voice and animate an entire episode.

While the ever-churning news cycle has made it more difficult to hold those in power accountable, the cartoon’s timely satire still galvanizes viewer attention. This makes it uniquely suited to channel rage toward Trump and other political leaders – and, perhaps, influence an audience that has recently proved elusive to Democrats.

A history of poking the powerful

The appeal of “South Park” doesn’t necessarily lie in partisan attacks on Republicans.

Its politics have always been all over the map, with both liberals and conservatives railing against the show at various points.

The 2006 episode “ManBearPig” ridiculed former Democratic Vice President Al Gore’s climate activism. In 2014, liberal critics decried an episode titled “Mr. Garrison’s Fancy New Vagina” for deploying transphobic tropes. And “The Pandemic Special,” which aired in 2020, mocked the restrictive vaccine policies promoted by progressives.

Meanwhile, conservative watchdog groups such as the Parents Television and Media Council have long targeted “South Park” for its allegedly harmful influence on children. The none-too-subtly titled 1999 movie “South Park: Bigger, Longer & Uncut” satirized these efforts: Throughout the movie, Kyle’s mom, Sheila, tries to censor the graphic children’s cartoon characters Terrance and Phillip.

That movie also marks one of the earliest appearances of the Iraqi despot Saddam Hussein. It portrays him as a crazed, lecherous supervillain hellbent on taking over the world alongside his gay lover, Satan.

The current “South Park” season has animated Trump with the same cutout, stop-motion style as it did with Hussein, implying direct parallels between their dictatorial desires. Behind the scenes, Trump has reportedly been “seething” over the depiction.

In the 2006 two-part episode “Cartoon Wars,” Parker and Stone warred with Comedy Central over the right to show an animated depiction of the Muslim prophet Muhammad.

The network rejected the idea after political violence followed in the wake of a Danish newspaper’s publication of a cartoon featuring Muhammad. Eventually, censored animations of Muhammad aired with disclaimers from Comedy Central, but only after Parker and Stone’s refusal to address the issue before broadcast.

The cartoon continues to relish poking its corporate benefactors. The current season premiered hours after Trump’s Federal Communications Commission approved a merger for the show’s parent company, Paramount. The administration delayed the transaction in order to settle its lawsuit against the Paramount-owned news show “60 Minutes,” which Trump had accused of favorably editing an interview with former Vice President Kamala Harris while she was running as the Democratic nominee for president.

That same day also saw the announcement of a new US$1.5 billion deal keeping “South Park” at Paramount. Parker and Stone’s skewering of Trump sends a message to Paramount in the wake of the “60 Minutes” settlement and the cancellation of “The Late Show with Stephen Colbert”: Let politics dictate your content at your own risk.

Reaching the right voters

As the Democratic Party’s establishment struggles to appeal to young, internet-savvy, male voters – look no further than party strategists’ attempts to find “a liberal Joe Rogan” – “South Park” is garnering record viewership with young audiences.

The rest of the season, meanwhile, has provided a timely, steady drumbeat of Trump mockery.

The second episode of the current season calls out the Trump administration’s illegal ICE raids. The next episode lampoons Trump’s affinity for lavish gifts and compliments. In it, tech CEOs and world leaders obsequiously note that Trump “does not have a small penis.” The fourth episode depicts him as a negligent and emotionally abusive lover to Satan, further connecting him to the show’s previous portrayals of Saddam Hussein.

Despite its penchant for outrageous and, at times, scattershot satire, “South Park” has an important lesson to teach Trump’s political opponents.

The appeal of both Trump and “South Park” to many young men is not in the positive ideas they offer, but in the way they both humiliate their opponents. I research comedy on the right, and I’ve written about how right-wing humor has long thrived on “owning the libs.” Now, “South Park” is owning Trump, and with each new lurid reveal in the Jeffrey Epstein saga, it will have plenty of fodder as the season progresses.

Simply calling attention to Trump’s hypocrisies and corruption – long the forte of media figures such as Jon Stewart, John Oliver and the hosts of the podcast “Pod Save America” – becomes white noise after a while.

But actually animating the sitting president with a micropenis? Making a mockery of the self-serving business deals of the “dealmaker in chief” and his spineless corporate cronies?

Well, those things won’t win an election on their own. But they inadvertently could help Democrats lure back some of the young men who drifted to Trump in 2024.

Nick Marx does not work for, consult, own shares in or receive funding from any company or organization that would benefit from this article, and has disclosed no relevant affiliations beyond their academic appointment.

– ref. How ‘South Park’ could help Democrats win back the young voters the party lost to Trump – https://theconversation.com/how-south-park-could-help-democrats-win-back-the-young-voters-the-party-lost-to-trump-263488

Source: The Conversation – USA (3) – By Andrew Yockey, Assistant Professor of Public Health, University of Mississippi

In October 2023, an unthinkable tragedy unfolded in Coleman, Wisconsin: An 8‑month‑old girl lost her life when a driver, impaired by cannabis, ran a stop sign and crashed into another vehicle. In February 2025, the driver pleaded guilty to negligent vehicular homicide and drugged driving with a minor passenger – and now faces up to 10 years behind bars.

These preventable circumstances highlight a stark reality: Drugged driving can be just as deadly as alcohol-impaired driving. Meanwhile, driving under the influence of drugs is becoming increasingly common across the United States.

Yet public awareness and policy responses continue to lag behind.

I study the prevalence and risk factors of drugged driving. Although public health messaging in the U.S. has long emphasized the dangers of alcohol-impaired driving, far less attention has been paid to the risks posed by other substances — even as drug-impaired driving becomes more widespread and complex.

Whether the substance is illegal, like methamphetamine, or legal but still impairing – like cannabis, sedating sleep aids or certain prescription drugs like benzodiazepines and pain killers – the result is the same: impaired judgment, dulled reflexes and devastating outcomes on the road.

A different form of impairment

In 2020, an estimated 12.6 million people ages 16 and up drove after using illicit drugs. Of that total, roughly 11.7 million were under the influence of cannabis. In 2018, some 2.3 million people in the United States reported driving under the influence of illicit drugs other than marijuana during the previous 12 months. Globally, roadside surveys worldwide find that between 3.9% and 20% of drivers tested positive for drugs.

While alcohol typically impairs coordination and reaction time, drugs present a more complex picture. Cannabis, for example, slows reaction time and affects spatial awareness. Opioids can cause drowsiness and dizziness. Stimulants like cocaine or methamphetamine may lead to overconfidence and aggressive driving. When drugs are mixed — or combined with alcohol — the risks increase dramatically.

Cannabis, in particular, presents a unique challenge: It’s the most commonly used federally illegal drug in the United States, and public perception often downplays its risks behind the wheel.

Research from the AAA Foundation for Traffic Safety reveals that over 80% of cannabis users admit to driving just hours after using the drug, and nearly 20% believe their driving got much better. Multiple studies have found that drivers with THC, the primary psychoactive compound in cannabis, in their bloodstream are about twice as likely to be involved in a fatal crash – either as the cause or as a victim – compared with those who haven’t used drugs or alcohol. For alcohol, with a blood alcohol content of 0.08%, the odds of dying in a motor vehicle crash are approximately 13 times higher than sober drivers.

Outdated laws and patchy enforcement

Every U.S. state has laws prohibiting drug-impaired driving, but enforcement varies dramatically.

Some states, such as Texas and California, use “impairment-based” laws, which rely on observable signs of impairment. Others, such as Ohio and Wisconsin, use per se laws, setting thresholds for drugs like THC — such as 5 nanograms per milliliter of blood.

Then there are zero-tolerance laws, in states like Georgia and Rhode Island, which penalize drivers for having any trace of a controlled substance while behind the wheel, regardless of whether they’re impaired at the time.

These inconsistencies create legal gray areas in how the laws are interpreted and enforced. For instance, in Illinois, it is a crime to drive with any trace of a controlled substance in your system, even if you are not impaired — and even if the drug was legally prescribed. In Arizona, medical cannabis patients cannot be convicted solely based on THC presence, but prosecutors can still argue impairment.

Detection is the biggest hurdle

A significant factor in the inconsistency from state to state is that there is no standardized way to measure drug impairment as there is with blood alcohol content.

While alcohol can be tested on the spot using a breathalyzer, detecting drug use is far more complicated. THC and other substances can linger in the body long after their impairing effects have worn off. Meanwhile, newer synthetic drugs such as spice or bath salts may not be detected at all without specialized equipment.

To address this, many states are turning to oral fluid testing — or saliva tests — which can detect recent drug use more quickly. As of late 2023, 27 states had authorized some form of roadside oral fluid screening.

Public misconceptions and potential solutions

Unlike alcohol, where there’s a clear legal limit of 0.08% blood alcohol concentration, there’s no easy-to-understand number for cannabis. Laws around driving after cannabis use vary widely and can be confusing. Scientists are still figuring out how much THC it takes to affect a person’s driving skills and to what degree, so it stands to reason that people don’t know how to judge it for themselves.

Another twist is that the roadside tests that cops use to spot drunk drivers don’t work as well for drug impairment. THC can linger in the body long after the high fades, so a test might not tell the whole story. New testing tools, like saliva swabs and eye-tracking, are being developed, but are not yet ready for application in real-life scenarios.

So what can you do? The big takeaway is that if you feel “different,” you’re probably driving differently, too. The National Highway Traffic Safety Administration’s “If You Feel Different, You Drive Different” campaign is a helpful reminder that even if you think you’re fine, your driving might not be.

If you’re riding with friends, don’t be shy about speaking up if someone looks or behaves as if they are impaired. Planning ahead with a designated driver or ride-share can make all the difference.

At the end of the day, it’s about making smart, safer choices – and being honest with ourselves and each other about what it really means to be safe on the road.

Andrew Yockey does not work for, consult, own shares in or receive funding from any company or organization that would benefit from this article, and has disclosed no relevant affiliations beyond their academic appointment.

– ref. Drugged driving – including under the influence of cannabis and prescription drugs – is quietly becoming one of the most dangerous road hazards – https://theconversation.com/drugged-driving-including-under-the-influence-of-cannabis-and-prescription-drugs-is-quietly-becoming-one-of-the-most-dangerous-road-hazards-263410