Drinking & Driving

Driving while either intoxicated or drunk is dangerous and drivers with high blood alcohol content (BAC) are at increased risk of car accidents, highway injuries and vehicular deaths. Prevention measures evaluated include license suspension or revocation, impounding or confiscating vehicle plates, enforcing open container bans, increasing penalties such as fines or jail for drunk driving, mandating education for young people, and lowering legal BACs. Also discussed are safety seat belts, air bags, designated drivers, and effective practical ways to stay sober.

THE PROBLEM

Every single injury and death caused by drunk driving is totally preventable. Unfortunately, over twenty percent of all traffic fatalities in the United State each year are caused by drunk drivers. 1 Thus, drunk driving remains a serious national problem that tragically affects thousands of victims annually.

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THE FACTS

Most drivers who have had something to drink have low blood alcohol content or concentration (BAC) and few are involved in fatal crashes. On the other hand, while only a few drivers have BACs higher than .15, many of those drivers have fatal crashes. 2

• The average BAC among fatally injured drinking drivers is .17. 3
• Almost half of fatally injured drinking drivers have a BAC of .20 or over (which is twice the legal limit in most jurisdictions). 4

High BAC drivers tend to be male, aged 25-35, and have a history of DWI convictions and polydrug abuse. 5

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THE SOLUTION

Drunk driving, like most other social problems, resists simple solutions. However, there are a number of actions, each of which can contribute toward a reduction of the problem:

• Automatic license revocation appears to be the single most effective measure to reduce drunk driving. 6 Not only is license revocation effective, but we should remember that driving is a privilege, not a right. Just as we do not license those who lack eyesight, we should not hesitate to revoke the licenses of those who lack the good judgment not to drive drunk.
• Automatic license revocation along with a mandatory jail sentence appears to be even more effective than just automatic license revocation. 7
• Passing mandatory alcohol and drug testing in fatal crashes would promote successful prosecution of drunk and drugged drivers.

The National Highway Traffic Safety Administration estimates that 18-20% of injured drivers are using drugs and although drinking is on the decline, drugging is on the increase. 8 However, this figure appears to be much too low. For example:

• A study by the Addiction Research Foundation of vehicle crash victims who tested positive for either legal or illegal substances found that just 15% had consumed only alcohol. 9
• A Tennessee study found that over half of reckless drivers not intoxicated by alcohol were intoxicated by other substances and noted that "Studies of injured drivers suggest that driving under the influence of drugs other than alcohol is a growing cause of traffic injuries in the United States." 10

Promising but inadequately evaluated measures include:

• Marking the license plate to indicate ownership in the family of someone whose driver's license is suspended or revoked for alcohol offenses. 11
• Impounding or confiscating the plates of vehicles used in the offense of drunk driving. 12
• Impounding and confiscating vehicles used in the commission of drunk driving. 13
• Passing and enforcing bans on open containers would reduce drunk driving by deterring drinking while driving. Surprisingly, 22 states have no open container laws. 14
• Imposing graded or multi-tiered penalties based on BAC at the time of arrest. 15
• Expanding alcohol server training programs. 16
• Restricting nighttime driving by young people. This appears to be effective in those states with such restrictions. 17
• Requiring every state to provide adequate information on alcohol and driving to prospective drivers and adequately testing them on the subject in their driver's exams. In too many states, the subject is given only brief mention and seven states do not include any information or testing in the process of obtaining a driver's license. 18

All of these very promising measures should be rigorously evaluated scientifically to determine their potential contribution to improving safety.

Measures of little or no value:

• Jail or prison sentences for alcohol offenses, in spite of their great popularity, appear to be of little value in deterring high BAC drivers. 19
• Such sentences may deter low BAC drinkers, but such drivers are not the problem. Incarceration is probably ineffective with high BAC drivers, who tend to be alcohol dependent individuals with very serious problems who need treatment. 20
• The perception of swift and certain punishment is more important than severity. 21
• Large fines (for example $500) would have little deterrent effect, according to a nation-wide study. 22
• Increasing the cost of alcohol with a ten percent tax would have virtually no impact on reducing drunk driving. 23 Why would it? Both research and common sense suggest that heavy drinkers are not deterred by cost. However, increasing the cost would tend to discriminate against lower income consumers and create other problems of unknown magnitude. 24

Improved roads and vehicles can contribute significantly to increased highway safety. Technological improvements include raised lane markers, which are easier to see and also emit a startling sound when a tire wanders over them. Similarly corrugations along the edges of roads emit a sound when driven over, thus alerting inattentive drivers to their inappropriate location. Wider roads, improved street and highway lighting, break-away sign posts, brake lights positioned at eye level, door crash bars, and many other improvements can save lives and are cost-effective.

PROTECT YOURSELF

While society has done much to improve highway safety, you can do much to protect yourself.

Don't drink and drive and don't ride with anyone who has too much to drink. Remember, it is usually themselves and their passengers who are harmed by drunk drivers. 25 The risk of collision for high BAC drivers is several hundred times higher than for a non-drinking driver. 26

Volunteer to be a designated driver.

Always use a safety seat belt.

Use four-lane highways whenever possible.

Avoid rural roads.

Avoid travel after midnight (especially on Fridays and Saturdays).

Drive defensively.

Choose vehicles with airbags.

Refer to safety ratings before selecting your next vehicle. See "Buying a Safer Car" (www.nhtsa.dot.gov/cars/testing/NCAP). "Buying A Safer Car" includes safety ratings of cars, vans, and sport utility vehicles by year, make, and model.

Never use illegal drugs. Illicit drugs are involved in a large proportion of traffic fatalities.

Never drive when fatigued. The dangers posed when fatigued are similar to those when intoxicated. A drunk or fatigued driver has slowed reactions and impaired judgment. And a driver who nods off at the wheel has no reactions and no judgment! Drivers who drift off cause about 72,500 injuries and deaths each and every year. 28

Don't use a car phone, put on make-up, comb your hair, or eat while driving. Drivers using cellular phones are four times more likely to have an accident than other drivers. 29

Steer clear of aggressive drivers. Aggressive drivers may be responsible for more deaths than drunk drivers.

If you must drive after drinking, stay completely sober: 30

• Don't be fooled. The contents of the typical bottle or can of beer, glass of wine, or liquor drink (mixed drink or straight liquor) each contain virtually identical amounts of pure alcohol. When it comes to alcohol, a drink is a drink is a drink and are all the same to a breathalyzer. 31 For more, visit Standard Drinks.
• Know your limit. If you are not sure, experiment at home with your spouse or some other responsible individual. Explain what you are attempting to learn. Most people find that they can consume one drink per hour without any ill effects. Also, experiment with the Drink Wheel, which is very informative.
• Eat food while you drink. Food, especially high protein food such as meat, cheese and peanuts, will help slow the absorption of alcohol into your body.
• Sip your drink. If you gulp a drink, you lose the pleasure of savoring its flavors and aromas.
• Don't participate in "chugging" contests or other drinking games. 32
• Accept a drink only when you really want one. If someone tries to force a drink on you, ask for a non-alcohol beverage instead. If that doesn't work, "lose" your drink by setting it down somewhere and leaving it.
• Skip a drink now and then. Having a non-alcoholic drink between alcoholic ones will help keep your blood alcohol content level down, as does spacing out your alcoholic drinks
• A good general guideline for most people is to limit
  consumption of alcohol beverages to one drink (beer, wine or spirits) per hour.
• Keep active; don't just sit around and drink. If you stay active you tend to drink less and to be more aware of any effects alcohol may be having on you.
• Beware of unfamiliar drinks. Some drinks, such as zombies and other fruit drinks, can be deceiving as the alcohol content is not detectable. Therefore, it is difficult to space them properly.
• Use alcohol carefully in connection with pharmaceuticals. Ask your physician or pharmacist about any precautions or prohibitions and follow any advice received.

PROTECT OTHERS

Volunteer to be a designated driver.

Never condone or approve of excessive alcohol consumption. Intoxicated behavior is potentially dangerous and never amusing.

Don't ever let your friends drive drunk. Take their keys, have them stay the night, have them ride home with someone else, call a cab, or do whatever else is necessary - but don't let them drive! 33

Be a good host:

Create a setting conducive to easy, comfortable socializing: soft, gentle music; low levels of noise; comfortable seating. This encourages conversation and social interaction rather than heavy drinking. 34

Serve food before beginning to serve drinks. This de-emphasizes the importance of alcohol and also sends the message that intoxication is not desirable. 35

Have a responsible bartender. If you plan to ask a friend or relative to act as bartender, make sure that person is not a drink pusher who encourages excessive consumption.

Don't have an "open bar." A responsible person needs to supervise consumption to ensure that no one drinks too much. You have both a moral and a legal responsibility to make sure that none of your guests drink too much.

Pace the drinks. Serve drinks at regular reasonable intervals. A drink-an-hour schedule is a good guide.

Push snacks. Make sure that people are eating.

Be sure to offer a diversity of attractive non-alcohol drinks. (For numerous non-alcohol drink recipes, see www.idrink.com).

Respect anyone's choice not to drink. Remember that about one-third of American adults choose not to drink and that a guest's reason for not drinking is the business of the guest only, not of the host. Never put anyone on the defense for not drinking.

End your gathering properly. Decide when you want the party to end and stop serving drinks well before that time. Then begin serving coffee along with substantial snacks. This provides essential non-drinking time before your guests leave.

Protect others and yourself by never driving if you think, or anyone else thinks, that you might have had too much to drink. It's always best to use a designated driver.

THE GOOD NEWS

We can do it! While we must do even more to reduce drunk driving, we have already accomplished a great deal.

• The U.S. has a low traffic fatality rate (drunk , as well as sober) and is a very safe nation in which to drive. And it's been getting safer for decades There is now only about one death (including the deaths of bicyclists, motorcyclists, pedestrians, auto drivers, and auto passengers) per fifty million vehicle miles traveled. 37
• Alcohol-related traffic fatalities have dropped from 60% of all traffic deaths in 1982 down to 41% in 2002 (the most recent year for which such statistics are available). 38
  
• Alcohol-related traffic fatalities per vehicle miles driven has also dropped dramatically -- from 1.64 deaths per 100 million miles traveled in 1982 down to 0.61 in 2002 (the latest year for which such statistics are available). 39
  
• Alcohol-related crash fatalities have fallen 1/3 since 1982, but traffic deaths NOT associated with alcohol have jumped 43% during the same time. We’re winning the battle against alcohol-related traffic fatalities, but losing the fight against traffic deaths that are not alcohol-related. 40
  

We can and must do even better

Remember, don't ever, ever drive if you, or anyone else, thinks that you may have had too much to drink. And don't let anyone else. That includes reporting drivers who may be drunk. It's always safest not to drink and drive.

For more on designated driving, visit Doctors for Designated Driving.

NOTE: The "Drink Safely" (thumb up) designs is a registered trademark of Coors Brewing Company and used with its permission.