Lesson 2 · Foundations ~9 min

Impairment Fingerprints

Same word — "impaired" — but alcohol, cannabis, and fatigue leave different marks. This lesson turns the domain map from Lesson 1 into three distinct patterns, and shows why a battery can sometimes name the cause, not just flag it.

Why this matters for your build If every impairer degraded the same domains by the same amount, your assessment could only ever answer "impaired: yes/no." Because they don't, a well-chosen battery can lean toward "impaired, and it looks like fatigue" vs. "…looks like cannabis." That extra signal is a product differentiator — but only if you pick tasks that expose the differences.

Recall first

Before new material — retrieve Lesson 1. Don't peek.

Why can't a single task detect "impairment" in general?

Three fingerprints

Each cause hits a characteristic set of domains, over a characteristic time course, with a characteristic behavioral tell. Bar length = how strongly that domain is hit.

Alcohol — the dose-coupled depressant

Divided attn
hit first, low dose
Inhibition
strong at higher dose
Reaction time
slows with dose
Working mem
Distinctive trait: tightly dose-coupled — BAC predicts impairment well.[1]

Divided attention fails at the lowest doses; inhibition and working memory go as the dose climbs — which is why intoxicated people make impulsive errors.[1] The behavioral tell is dangerous: at higher BAC people underestimate their own impairment.[2]

Cannabis — the memory-and-time distorter

Working mem
hit hard
Time perception
near-signature
Attention
Reaction time
Distinctive trait: time-perception distortion + poor blood-level correlation.[3]

It overlaps alcohol on working memory, attention, and RT — but adds time-perception distortion, which most other impairers don't touch, making it close to a signature.[3] Time course: onset 30–60 min, peak ~90 min–2 h, largely gone by ~4–5 h; shorter in frequent users due to tolerance.[4] Behavioral tell — the opposite of alcohol: cannabis users tend to overestimate impairment and compensate (slow down).[2] And crucially, blood THC tracks impairment poorly — so a behavioral test is more defensible than a chemical one here.[2]

Sleep deprivation — the vigilance breaker

Vigilance
hit first & hardest
RT variability
lapses, not slowing
Working mem
later
Higher-order
spared until late
Distinctive trait: wake-state instability — erratic lapses, not uniform slowdown.[5]

This is the most distinct fingerprint. Fatigue doesn't slow everything evenly — it makes performance erratic: mostly-normal responses punctuated by sudden lapses ("wake-state instability").[5] The severity is startling: roughly 17 h awake ≈ 0.05% BAC, and 24 h awake ≈ 0.10% BAC on performance.[6] This is why variability and lapse count — not average reaction time — are the signals to compute for fatigue.

The comparison at a glance

CauseDomains hit hardestBehavioral tellTracks a chemical marker?
AlcoholDivided attn → inhibition → RTUnderestimates; impulsiveYes — BAC predicts well
CannabisWorking mem + time perceptionOverestimates; compensatesNo — blood THC ≠ impairment
Sleep lossVigilance (lapses, variability)Micro-lapses; state instabilityNo chemical marker at all
The design takeaway To discriminate these — not just detect — your battery wants: a sustained-attention / PVT-style task scored on lapses & variability (catches fatigue's signature), a divided-attention or Go/No-Go task (catches alcohol's inhibition loss), and a time-estimation task (catches cannabis's near-signature). Average reaction time alone would blur all three together.

The honest limit

Fingerprints have smudges. The depressant family overlaps: benzodiazepines produce an alcohol-like profile (slowed psychomotor speed, impaired attention and working memory), so telling alcohol from benzos on cognition alone is the hardest case.[7] And stimulants can invert the logic — they may transiently sharpen simple reaction time while impairing judgment and inhibition, so an unexpected improvement on one metric is itself a fingerprint worth flagging, not ignoring.

Check yourself

Which metric best exposes fatigue specifically?

A user overestimates their impairment and slows down. Best guess?

Behavioral testing is especially valuable for cannabis because...

Your single win

You can now sketch three fingerprints from memory — alcohol (dose-coupled, inhibition, underestimates), cannabis (working memory + time distortion, overestimates), fatigue (vigilance lapses, variability) — and say which task and which metric exposes each. That's the raw material for a battery that discriminates. Lesson 3 asks the harder question: how do you know your detector is actually trustworthy and not just noise dressed up as a game?

Primary source — read this next Dawson & Reid, Fatigue, alcohol and performance impairment, Nature (1997). Two pages, iconic: the study that put fatigue and alcohol on the same ruler (17 h awake ≈ 0.05% BAC). Read it to feel viscerally why fatigue belongs in an impairment assessment at all.
I'm your teacher — ask me anything. Want to war-game a specific case — "our users test at 6 a.m., could we be catching fatigue and mislabeling it?" — or figure out which of your current tasks maps to which fingerprint? Bring it to the chat.

References

  1. [1] Dose-Related Effects of Alcohol on Cognitive Functioning, PLOS ONE (2013).
  2. [2] Pearlson et al., Cannabis and Driving (2021) — alcohol vs. cannabis behavioral contrast & THC–impairment dissociation.
  3. [3] Figueiredo et al., Cannabis and Cognitive Functioning, Frontiers in Psychiatry (2021).
  4. [4] McCartney et al., Duration of Neurocognitive Impairment With Cannabis, Frontiers in Psychiatry (2021).
  5. [5] Van Dongen et al., The cumulative cost of additional wakefulness, Sleep (2003); Alhola & Polo-Kantola (2007).
  6. [6] Dawson & Reid, Fatigue, alcohol and performance impairment, Nature (1997).
  7. [7] Crowe & Stranks, Benzodiazepines & Cognition, Frontiers in Psychiatry (2020).
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