title: Butalbital and driving impairment.
abstract: Butalbital (Fiorinal(®)), used in the treatment of migraines and muscle pain, is the most commonly encountered barbiturate in impaired driving cases. It has central nervous system (CNS) depressant properties, including sedation, drowsiness, and feelings of intoxication, which can contribute to driving impairment. Twenty-six driving under the influence cases are reviewed including results from field sobriety tests and toxicology testing. Blood samples were screened using enzyme multiplied immunoassay technique immunoassay, and the presence of butalbital was confirmed and quantified using gas chromatography/mass spectrometry, gas chromatography with flame ionization detection, or gas chromatography nitrogen/phosphorus detection. Butalbital concentrations ranged from 1.0 to 30.2 mg/L, with a mean and median of 16.0 mg/L. General impairment indicators in these cases included horizontal and vertical nystagmus, lack of convergence, poor motor coordination, and balance and speech problems, which are common to CNS depressant intoxication, similar to that associated with alcohol. These findings indicate the importance of toxicological testing for butalbital in cases where CNS depressants are indicated.
authors.affiliation: The Center for Forensic Science Research and Education, The Fredric Rieders Family Renaissance Foundation, 2300 Stratford Ave, Willow Grove, PA 19090, USA.
authors.forename: Jillian K
authors.initials: JK
authors.lastname: Yeakel
authors.forename: Barry K
authors.initials: BK
authors.lastname: Logan
mesh_terms: D000328:Adult; D001259:Ataxia / Q000139:chemically induced; D001334:Automobile Driving / Q000331:legislation & jurisprudence*; D001463:Barbiturates / Q000009:adverse effects* / Q000097:blood; D005260:Female; D053593:Forensic Toxicology; D008401:Gas Chromatography-Mass Spectrometry; D006801:Humans; D007118:Immunoassay; D035846:Law Enforcement; D008297:Male; D008875:Middle Aged; D009759:Nystagmus, Pathologic / Q000139:chemically induced; D004856:Postural Balance / Q000187:drug effects; D013064:Speech Disorders / Q000139:chemically induced
chemical_list: D001463:Barbiturates; C004470:butalbital
keywords: barbiturates; butalbital; driving impairment; forensic science; nystagmus; toxicology