Alcohol Problems

Solutions

Some Topics

Alcohol and Car Crashes

Young, male adolescents have the highest risk of dying in car crashes. Intoxication with alcohol and other drugs increases their risk. In my neighborhood, the police consider accidents caused by drunk drivers to be the most serious and preventable drinking hazard. They routinely employ road blocks to screen all drivers for intoxication. If anyone is found with blood alcohol above the legal limit, their car is impounded and their driver’s license is suspended on the spot.

In a US survey, about 1 in 7 Americans aged 12 or older in 2002 (14.2 percent, or 33.5 million persons) drove under the influence of alcohol at least once in the 12 months prior to the interview. Males were nearly twice as likely as females (18.8 vs. 9.9 percent, respectively) to have driven under the influence of alcohol. More than 1 in 4 (26.6 percent) young adults aged 18 to 25 reported driving under the influence of alcohol at least once in the prior year.

Ramsey suggested: “It used to be believed that you drove better after a few drinks. This misconception was staunchly held despite proof that alcohol, a central nervous system depressant, retards and interferes with the performance of complex motor skills. The alcohol myth was finally refuted in a 1969 Michigan study that introduced a phenomenon since called "the Borkenstein curve." The curve demonstrated that the likelihood of a motorist's having a motor vehicle accident increased proportionately to increased levels blood alcohol content (BAC). The curve also revealed a marked difference in risk at the 0.08 BAC level (i.e., 0.08 g of alcohol per 100 mL of blood). At the time this study was released, legislators in many countries were trying to determine appropriate BAC levels for impaired driving offences. A Canadian parliamentary committee chose .08 and incorporated it into the Criminal Code. Authorities around the world still disagree, however, on what the BAC limit should be. European nations have set limits between 0.02 and 0.05, Australia at 0.05, and most American states at 0.10.

Mercersuggested: “The role of both alcohol and other drugs in traffic crashes has probably been seriously underestimated. Society awoke some years ago to the problem of drinking and driving… the numbers of alcohol-caused crashes are likely underestimated. Except for coroner reports, most of our information about impairment and traffic crashes comes from police reports. Since many crashes are not reported to the police, however, and since the police attend only about half of those that are reported, the role of alcohol is almost certainly greater than the statistics suggest. A B.C. study involving the RCMP and the provincial coroner's office analyzed the blood and crash reports of all fatally injured drivers in 1991. It found that about 57% had alcohol and/or other drugs in their blood at the time of the crash. The investigation also revealed that, of the fatally injured drivers, 38% tested positive for alcohol alone, 11% for alcohol and other drugs, and 8% for non-alcoholic drugs alone. The most common drugs present besides alcohol were cannabis (13%), central nervous system depressants such as tranquilizers (7%), and cocaine (4%). A recent U.S. study examined the role of alcohol in crashes; 18% of crashes with property damage only and 28% of non-fatal injury cases involved alcohol and/or other drugs.”

Trauma Centers

Trauma surgeon, Gentilello, reported that fifty percent of patients admitted to a to a trauma center are intoxicated by alcohol and suggested that a serious injury represents a crisis. Attending surgeons can, in theory, inspire their injured, alcoholic patient to address their drinking problem. Patient re-education interventions begun in trauma centers can reduce subsequent injury rates by 50%, drunk driving arrests by 66%, and save $4 in healthcare costs for every dollar invested.

However, MDs in trauma centers are reluctant to document elevated blood alcohol levels because of insurance and legal liabilities. In the US antiquated laws sometimes penalize trauma surgeons who document levels of blood alcohol. Gentilello stated: “I've been taking trauma calls for 20 years, and I can tell you: The next time an intoxicated patient crashes their car it may be into you, your spouse, or your child. A recent survey of trauma surgeons documented that 82% would be willing to start an alcohol screening and intervention program in their center if the insurance obstacles were removed.


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