Procedures for the Determination of Alcohol Concentration in the Blood and Exhaled Air and the Detection of the Influence of Narcotic and Other Intoxicating Substances

Issued pursuant to
Section 43.⁵, Paragraphs one and two
the Road Traffic Law

I. General Provision

1. This Regulation prescribes the procedures, by which the alcohol concentration in the blood and exhaled air shall be determined, as well as the influence of narcotic and other substances shall be detected.

II. Test of Alcohol Concentration in the Exhaled Air

2. Alcohol concentration in the exhaled air of a driver shall be tested by the State Police employee or - on the State border - by the State Border Guard employee (hereinafter - employee), using portable device for the determination of the alcohol concentration (hereinafter - meter). The alcohol concentration in the exhaled air displayed by the meter shall comply with the blood alcohol concentration.

3. The testing of a driver of shall be performed by his or her oral consent.

4. If it is not possible to perform the testing of a driver for determination of the alcohol concentration in the exhaled air or if the driver does not agree to the performance of the test or the results thereof, an employee shall make the relevant entry in the report referred to in Paragraph 8 of this Regulation and the relevant person shall be delivered to the nearest medical treatment institution referred to in Annex 1 to this Regulation within two hours for the performance of medical check-up.

5. If medical aid has been provided to a driver at the place of accident, he or she shall be delivered to medical treatment institution for the performance of medical check-up without performance of the test for alcohol concentration in the exhaled air.

6. The testing of a driver shall be performed by taking two measurements with an interval of 15-20 minutes.

7. If during the first measurement it is determined that the alcohol concentration in the exhaled air is less than the blood alcohol concentration specified in the Road Traffic Law, by reaching which driving a vehicle is prohibited, the second measurement shall not be performed and the report shall not be drawn up.

8. If during the measurements it is determined that the alcohol concentration in the exhaled air is equal to or exceeds the blood alcohol concentration specified in the Road Traffic Law by reaching which driving a vehicle is prohibited, an employee shall complete and sign a report regarding check-up of the driver (hereinafter - report) (Annex 2). Print-outs of the meter attesting to the measurements indicated in the report shall be attached to the report.

9. The signature of a driver on the report completed by an employee shall attest that the relevant driver agrees with the results of the check-up performed.

10. If in accordance with the performed measurements the alcohol concentration in the exhaled air is less than the blood alcohol concentration specified in the Road Traffic Law by reaching which driving a vehicle is prohibited, the expenses of check-up shall not be covered by the driver.

11. If in accordance with the performed measurements the alcohol concentration in the exhaled air is equal to or exceeds the blood alcohol concentration specified in the Road Traffic Law by reaching which driving a vehicle is prohibited, the driver shall cover the expenses of check-up in amount of 11 lats.

[18 December 2007]

III. Procedures for Medical Check-up

12. A medical check-up is the determination of alcohol concentration in the blood or exhaled air of a driver or the detection of the influence of narcotic or other intoxicating substances for a driver in any of the medical treatment institutions referred to in Annex 1 to this Regulation (hereinafter - medical treatment institution) or in specialised medicinal autolaboratories of these medical treatment institutions.

[22 December 2009]

13. A medical check-up shall include:

13.1. check-up of the fact of use of alcoholic, narcotic or other intoxicating substances or medicinal products according to the words of the driver to be checked-up;

13.2. check-up of the outer appearance (including presence or absence of bodily injuries), mental and emotional condition, behaviour, speech, vegetative-somatic condition and movement coordination; and

13.3. determination of the alcohol concentration in the exhaled air, as well as laboratory detection of the fact of use of alcohol, narcotic or other intoxicating substances or medicinal products and registration of the results of medical check-up in a check-up report in accordance with the regulatory enactments regarding the procedures for check-up of the influence of alcohol, narcotic, psychotropic or toxic substances.

[16 January 2007; 22 December 2009]

14. Medical check-up, on the basis of a referral (Annex 3) issued by an employee, shall be performed in the following cases:

14.1. if the employee has reasonable suspicions regarding driving a vehicle under the influence of narcotic or other intoxicating substances; or

14.2. in accordance with Paragraphs 4 and 5 of this Regulation.

15. Medicinal check-up shall be performed by a certified narcologist or a physician of another speciality who:

15.1. has acquired the relevant method of medical check-up for determination of the blood alcohol concentration and detection of the influence of narcotic or intoxicating substances in any of the medical treatment institutions referred to in Annex 1 to this Regulation, in which it is possible to perform investigations, using enzymatic immune method, gas chromatography method and the method of chemical-toxicological investigation and where the chemical-toxicological expert-examination is performed by certified forensic experts (hereinafter - specialised medical treatment institution);

15.2. in accordance with the procedures specified in the regulatory enactments regarding certification of medical practitioners, has acquired the relevant certificate of medicinal and diagnostic methods (hereinafter - physician). (Sub-paragraph 15.2 shall come into force on 1 January 2009).

[15 April 2008; 22 December 2009]

16. Prior to the carrying out of medical check-up a physician shall, on the basis of personal identification documents, driver's licence or information obtained by an employee, verify the identity of the driver to be checked.

16.¹ In determining alcohol concentration in the exhaled air, two measurements with the interval of 15-20 minutes shall be made. Taking into account the conditions that are referred to in the regulatory enactments regarding requirements specified for meters, the alcohol concentration displayed by the meter in the exhaled air shall be equalled to the blood alcohol concentration.

[22 December 2009]

17. In order to determine the blood alcohol concentration by laboratory means, the enzymatic immune method or gas chromatography method shall be used.

18. Material samples (except urine) for laboratory investigations in accordance with Annex 4 to this Regulation shall be taken by medical practitioners and in the presence of an employee. Urine samples shall be taken under the supervision of laboratory assistant.

19. If the drive to be checked refuses from medical check-up, refuses to give samples of the biologic environment (blood, urine or saliva) for laboratory investigations or tries to perform activities which may change the final result of the medical check-up, the physician shall enter such fact in the medical check-up report. An opinion shall be provided, taking into account the results of clinical investigation, and it shall be indicated that the opinion is based on the clinical symptomatic.

[16 January 2007; 22 December 2009]

20. In order to determine the influence of narcotic or other intoxicating substances, the clinical symptoms shall be determined and laboratory investigations of the biological environment shall be performed during the medical check-up.

[22 December 2009]

21. In order to determine narcotic or other intoxicating substances qualitatively in the biological environment, certified forensic experts shall perform chemical-toxicological expert-examination, using the chemical-toxicological investigation methods.

[22 December 2009]

22. If a medical check-up for determination of the influence of narcotic or other intoxicating substances cannot be performed to the full extent or the determination of the clinical symptoms of the influence of narcotic or other intoxicating substances is difficult due to general condition of the driver to be checked, the detectable clinical symptoms shall be assessed and laboratory investigations shall be performed in two different biological environments.

23. Data regarding sampling of materials shall be entered in the register of facts of medical check-up.

24. In order to determine alcohol concentration in the biological environment, samples of materials for laboratory investigation shall be transferred together with a referral for determination of alcohol in the biological environment (Annex 5) in which the given name, surname, personal identity number or year of birth, address of the driver to be checked, circumstances of the matter, name of the sample taken, serial number of the sample (according to the register), date and time of sample taking, type of skin treatment, sample storage conditions, the given name and surname of the medical practitioner who took the sample, as well as the name of referring institution shall be indicated.

25. Samples of materials for chemical-toxicological investigation shall be given together with a referral for chemical-toxicological investigation (Annex 6) in which the given name, surname, personal identity number or year of birth, address of the driver to be examined, the name of the referring institution, the given name and surname of the medical practitioner who took sample, list of materials, short description of the circumstances of the matter, the results of medical examination, clinical diagnosis, the number of the report and the address to which the reply is to be sent, shall be indicated.

26. The physician who has performed the medical check-up shall, after receipt of the results of analysis, provide the final opinion, draw up a medical check-up report (in two copies), assign a number thereto, as well as make an entry in the register of the facts of medical check-up. If the driver to whom medical check-up has been performed does not agree with the results of analysis, the final opinion shall be provided and a medical check-up report shall be drawn up after performance of repeated analysis of material samples.

27. The results obtained in performing the actions referred to in Paragraphs 13, 20 and 22 of this Regulation shall be described in detail and one of the following conditions of the examined person shall be approved in the medical check-up report:

27.1. any blood alcohol concentration has not been detected;

27.2. the influence of narcotic or other intoxicating substances has not been detected;

27.3. blood alcohol concentration (indicating per mille) has been detected;

27.4. the influence of narcotic or other intoxicating substances (indicating whether the influence has been detected clinically or in laboratory investigations) has been detected;

27.5. any blood alcohol concentration or the influence of narcotic or other intoxicating substances has not been detected, but disorders of functional condition are observed, thus driving a vehicle is not recommended;

27.6. both the blood alcohol concentration (indicating per mille) and the influence of narcotic or other intoxicating substances (concurrently) has been detected; or

27.7. the fact of use of a particular substance has been detected, but the influence of narcotic or other intoxicating substances has not been detected.

[22 December 2009]

28. The results of a medical check-up shall be notified orally to the driver to be checked. A written opinion of the medical check-up (statement) shall be issued upon an oral request of the driver to be checked.

29. The driver to be checked shall confirm with a signature in the medical check-up report that his or her medical check-up has been performed. If the driver to be checked refuses or is not capable to sign, the physician shall make a relevant entry in the medical check-up report.

30. If the driver to be checked does not agree with the results of the medical check-up, samples of materials shall be sent to a specialised medical treatment institution in order to perform repeated laboratory investigations. If the first check-up has been performed in a specialised medical treatment institution, samples of materials shall be investigated repeatedly in a laboratory and the final opinion shall be provided by another physician of this medical treatment institution.

[15 April 2008]

31. The medical treatment institution shall transfer one copy of the medical check-up report to the State Police or the State Border Guard, but the other shall be stored for five years.

32. Expenses for medical check-up shall be covered by the institution the employee of which has sent the driver to a medical check-up.

[18 December 2007]

33. If during a medical check-up the blood alcohol concentration specified in the Road Traffic Law, by reaching which driving a vehicle is prohibited, or the condition referred to in Sub-paragraph 27.4 or 27.6 of this Regulation is detected or a driver, the expenses for the medical check-up shall be covered by the driver, paying the amount of money in the budget account of the institution the employee of which has sent the driver to the medical check-up.

[18 December 2007]

34. The transfer of resources into the account of the relevant medical treatment institution shall be ensured by the head of the institution the employee of which has sent the driver to the medical check-up.

IV. Closing Provision

35. If a check-up of alcohol concentration in the exhaled air is performed for a driver and the blood alcohol concentration specified in the Road Traffic Law is not detected during a medical check-up by reaching which driving a vehicle is prohibited, the expenses for the check-up referred to in Paragraph 11 of this Regulation shall not be covered by the driver.

36. Sub-paragraph 15.2 of this Regulation shall come into force on 1 January 2009.

[15 April 2008]

Prime Minister A. Kalvītis

Minister for Health G. Bērziņš

[16 January 2007; 15 April 2008]

Annex 1
Cabinet Regulation No. 15
11 January 2005

Medical Treatment Institutions in which Medical Check-up for Determination of the Blood Alcohol Concentration and for Detection of Influence of Narcotic and Other Intoxicating Substances is Performed

1. Medical treatment institutions in which medical check-up for determination of the blood alcohol concentration and for detection of influence of narcotic and other intoxicating substances is performed:

1.1. the State limited liability company Rīgas psihiatrijas un narkoloģijas centrs [Riga Centre of Psychiatry and Addiction Disorders];

1.2. the State limited liability company Daugavas slimnīca;

1.3. the State limited liability company Slimnīca "Ģintermuiža";

1.4. the limited liability company Jūrmalas slimnīca;

1.5. the limited liability company Liepājas reģionālā slimnīca;

1.6. the local government limited liability company Rēzeknes slimnīca;

1.7. the local government limited liability company Ventspils slimnīca;

1.8. the limited liability company Aizkraukles slimnīca;

1.9. the limited liability company Alūksnes slimnīca;

1.10. the agency of the local government of Balvi district Balvu slimnīca;

1.11. the limited liability company Bauskas slimnīca;

1.12. the State limited liability company Straupes narkoloģiskā slimnīca;

1.13. the agency of the local government of Cēsis district Cēsu rajona slimnīca;

1.14. the limited liability company Dobeles un apkārtnes slimnīca;

1.15. the limited liability company of the local government of Gulbene district Gulbenes slimnīca;

1.16. the limited liability company Jēkabpils rajona centrālā slimnīca;

1.17. the limited liability company Krāslavas slimnīca;

1.18. the limited liability company Kuldīgas slimnīca;

1.19. the limited liability company Priekules slimnīca;

1.20. the limited liability company Limbažu slimnīca;

1.21. the limited liability company Ludzas rajona slimnīca;

1.22. the limited liability company of the local government of Madona district Madonas slimnīca;

1.23. the limited liability company Ogres rajona slimnīca;

1.24. the limited liability company Preiļu slimnīca;

1.25. the limited liability company of the local government of the council of Līvāni county Līvānu slimnīca;

1.26. the limited liability company of the local government of Riga district Rīgas rajona slimnīca;

1.27. the limited liability company Saldus medicīnas centrs;

1.28. the stock company of the local government of Talsi district Talsu slimnīca;

1.29. the agency of the council of Tukums district Tukuma slimnīca;

1.30. [15 April 2008];

1.31. [15 April 2008];

1.32. the limited liability company Sarkanā Krusta Smiltenes slimnīca;

1.33. the limited liability company Vidzemes slimnīca; or

1.34. [15 April 2008].

2. Medical treatment institutions in which medical check-up for determination of the blood alcohol concentration and for detection of influence of narcotic and other intoxicating substances shall be performed only in cases when the driver does not have any injury:

2.1. the limited liability company Rīgas Austrumu klīniskā universitātes slimnīca;

2.2. the State limited liability company Paula Stradiņa klīniskā universitātes slimnīca;

2.3. the limited liability company Klīniskā universitātes slimnīca "Gaiļezers";

2.4. the local government of Riga limited liability company Rīgas 1. slimnīca;

2.5. the local government of Riga limited liability company Rīgas 2. slimnīca;

2.6. the stock company Latvijas Jūras medicīnas centrs; or

2.7. the limited liability company Jelgavas pilsētas slimnīca.

Minister for Health G. Bērziņš

Annex 2
Cabinet Regulation No. 15
11 January 2005

Report Regarding Check-up of the Driver No.______

personal identity number       -     ,

The first measurement: was started on ___ _____________ 20__ (date) at_____ (time)

finished on ___ _____________ 20__ (date) at_____ (time)

Meter reading _____________ per mille

The second measurement: was started on ___ _____________ 20__ (date) at_____ (time)

finished on ___ _____________ 20__ (date) at_____ (time)

Meter reading _____________ per mille

Print-outs No.____ and No.____ of measurements of the meter have been attached to the report

Minister for Health G. Bērziņš

Annex 3
Cabinet Regulation No. 15
11 January 2005

Referral of a Driver of the Vehicle to Medical Check-up

In accordance with Paragraph 14 of the Cabinet Regulation No. 15 of 11 January 2005, Procedures for the Determination of Alcohol Concentration in the Blood and Exhaled Air and the Detection of the Influence of Narcotic and Other Intoxicating Substances, please, carry out medical check-up for

personal identity number       -     .

Reasons for the performance of medical check-up:

the driver refuses from check-up of the driver

the driver does not agree with the results of the check-up of the driver

a road traffic accident has occurred in which a person (or persons) has (have) suffered

other reason
	(specify)

Please, issue the report of medical check-up after performance of the medical check-up to

Minister for Health G. Bērziņš

Annex 4
Cabinet Regulation No. 15
11 January 2005

Taking of Samples of Materials for
Laboratory Investigations and Storage Thereof

I. Taking of samples of materials for the determination of alcohol in the biological environment and storage thereof

1. 15-20 ml of blood shall be taken for the blood sample from the superficial vein in vacutainer which has been treated with heparin.

2. The skin at the place of puncture shall be treated with furaciline solution (1:5000), rivanol solution (1:500) or other disinfecting solution not containing alcohol. It is prohibited to treat the skin with ether and other alcohol solutions.

3. Immediately after taking of the blood sample the content of vacutainer shall be shaken slightly several times.

4. 15-20 ml of urine shall be taken in a dry disposable container for urine sample, leaving as less air above the surface of the sample as possible. The container shall be hermetically sealed off.

5. 10 ml of saliva shall be taken in a dry disposable container for saliva sample, leaving as less air above the surface of the sample as possible. The container shall be hermetically sealed off.

6. Containers and vacutainers with samples shall be stamped and stored in a refrigerator where the temperature is not higher than 4^oC.

7. There shall be a label on each container with the sample number, the date and time of sampling, the given name, surname, the year of birth or personal identity number of the person to be checked and the given name and surname of the medical practitioner who took the sample.

8. The part of the sample left after laboratory investigations shall be hermetically covered and stored for 35 days in a refrigerator where the temperature is not higher than 4°C for the purpose of possible investigations. The sample shall be destroyed after the referred to period of time and a deed regarding writing off shall be drawn up.

II. Taking of Samples of Materials for
Chemical-toxicological Investigation and Storage Thereof

9. 100-200 ml of urine shall be taken in a dry disposable container for urine sample. Container shall be covered with a lid. Preservatives are not necessary for urine samples.

10. 20-30 ml of blood shall be taken for the blood sample from the superficial vein in vacutainer which has been treated with heparin.

11. The skin at the place of puncture shall be treated with furaciline solution (1:5000), rivanol solution (1:500) or other disinfecting solution, not containing alcohol. It is prohibited to treat the skin with ether and other alcohol solutions.

12. Immediately after taking of the blood sample the content of vacutainer shall be shaken slightly several times.

13. 10 ml of saliva shall be taken for a saliva sample from the person regarding which there are suspicions regarding smoking of narcotic substances or contact with narcotic substances.

14. The mouth cavity shall be rinsed with 10-20 ml of 70 % ethyl alcohol after taking of the saliva sample (in order to prevent swallowing, the alcohol shall be saturated with sodium chloride).

15. Saliva and rinsing substance referred to in Paragraph 14 of this Annex shall be mixed in one container.

16. In the case referred to in Paragraph 13 of this Annex the rinsing substance shall also be taken from hands of the person checked. The rinsing substance from palm and fingers shall be obtained by scrubbing them with a wad immersed in a 70 % ethyl alcohol.

17. The wad shall be packaged separately from the rinsing substances and saliva (a clean wad which has been packaged separately shall also be sent for investigation).

18. A sample of saliva and rinsing substances shall be taken after investigation of the person and after taking of samples for the determination of alcohol concentration.

19. Containers and vacutainers with samples shall be stored in a refrigerator where the temperature does not exceed than 4 °C. If longer storage is necessary, the samples of materials shall be stored in the freezer of the refrigerator.

20. Samples, which are investigated in order to determine cocaine, tranquillizers and tropane alkaloids, shall be immediately frozen and stored in the freezer.

21. There shall be a label on each container and vacutainer with the sample number, the date and time of sampling, the given name, surname, the year of birth or personal identity number of the person to be checked, the referral report number, the name of the substance, for the determination of which the investigation is intended, and the given name and surname of the medical practitioner who took the sample.

Minister for Health G. Bērziņš

Annex 5
Cabinet Regulation No. 15
11 January 2005

Referral for Determination of Alcohol in the Biological Environment

Please, investigate the blood urine saliva

Physician's report No.______, drawn up on ___ _____________ 20__

Alcohol concentration detected in the exhaled air ______ ‰

Samples were stored in room temperature/refrigerator (underline as appropriate)

Minister for Health G. Bērziņš

Annex 6
Cabinet Regulation No. 15
11 January 2005

Referral for Chemical-toxicological Investigation

Physician's report No._____, drawn up on ___ ___________ 20__, case-record No. _____

Samples were stored in room temperature/refrigerator (underline as appropriate)

Minister for Health G. Bērziņš

Translation © 2010 Valsts valodas centrs (State Language Centre)