Indiana University Bloomington

Indiana Prevention Resource Center (IPRC)

December is Drunk and Drugged Driving Prevention Month

December is Drunk and Drugged Driving Prevention Month. *   Alcohol and other drugs can make driving a dangerous situation for everyone who crosses the path of the intoxicated driver.    In 2012 over 10,000 individuals lost their lives in alcohol-related crashes, one per 51 minutes, at an estimated cost of $37 billion dollars.   (NHTSA, “Impaired Driving,” 2014).  Using data from the 2010 Behavioral Risk Factor Surveillance System survey the CDC calculated current incidence of and trends in alcohol-impaired driving. During 2010 an estimated 4 million adults reported a total of 114 million incidents of drunk driving -- nearly one for every two adults in the U.S. (CDC, MMWR 60/39, 2011).   Among high school students impaired driving and/or riding with an impaired driver was strongly associated with binge drinking and illicit drug use. (Li, Kaigang, et al, “Impaired Driving Prevalence among US High School Students:  Associations with Substance Use and Risky Driving Behaviors,” AJPH 103/111, 2013)  

Source: http://www.healthy.ohio.gov/ataglance/~/media/6E29AB292AA04563BDA20D70380BF6EE.ashx

The coordination and skills required for driving are impacted long before other signs of intoxication become evident.   The combination of alcohol sedative effect and late night fours increase the risk of losing control.   Caffeine does not repair lost decision-making skills or coordination.  Only time can do that as the body metabolizes the alcohol.    Sometimes people become aggressive when drinking, which further increases risks on the road.   The brain, judgment and coordination can be affected for hours, since it takes time for alcohol to enter the bloodstream from the stomach and intestine and move through the body.   Sluggishness can continue even the following day.

According to the National Highway Traffic Safety administration, a third of all fatal crashes in Indiana involve alcohol.  In 2012, 779 persons died in fatal crashes, of which 259 involved alcohol.   Of these 259 alcohol-related crashes, 228 involved a driver with a blood alcohol concentration of 0.08 or above, another 31 involved a driver with a blood alcohol concentration between 0.01 and 0.07. (NHTSA, FARS, 2014).

Most Dangerous Times of Day

The times of day when alcohol-related crashes are most likely to occur are between midnight and 6 am, with 62% of fatal crashes involving a BAC of .08 or above between midnight and 3 am, and 55% between 3 am and 6 am.    The hours from 9 pm to midnight are close behind, at 45%.   (NHTSA, FARS, 2014). 

Progress in Indiana

Indiana’s efforts to-date have paid off, and progress has been made.  The Indiana Criminal Justice Institute reports that targets have been met for several impaired driving goals, including reducing the number and percent of fatalities in collisions involving an alcohol-impaired driver or motorcycle operator, reducing the rate of alcohol-related fatalities per 100 miles VMT, and reducing the number of fatalities in collisions involving an alcohol-impaired motorcycle operator.   We have, however, a long way to go.   For 2013 the number of alcohol-impaired fatalities in Indiana was over 100.   (ICJI, Indiana’s Annual Traffic Safety Report, FY 2013, 2013)

Community Actions Contributing to Reductions in Impaired Driving

SBIRT

Most alcohol-related injuries and misconducts are seen in people who are not alcohol dependent, but are high-risk drinkers. For many of these individuals, a brief intervention is enough to make a small but significant change in their behavior.  SBIRT is evidence-based and beneficial.  Our current care model for substance abuse focuses on diagnosing and treating the small percentage of the population (about 4%) who have a clear substance abuse disorder, and ignoring the much larger group (about 25%) who are drinking or using drugs in potentially risky ways. It's this 25% who are responsible for most of the societal harms and medical costs related to drug or alcohol use.   One way to help monitor people’s status on the spectrum from harmless to harmful use of alcohol is by the use of screening, brief intervention and referral to treatment, known as SBIRT.

An 8 minute video from IU’s TV program, “Sound Medicine” (2013) by Dr. David Crabb, provides an excellent overview of this highly cost effective prevention tool. In “Doc Chat: Diagnosing Alcohol Abuse,”, Dr. Crabb relays how traditional methods used by doctors to gauge patient’s possible alcohol problems are unreliable. Instead, he promotes use of SBIRT at the start of each doctor’s visit. Just 3-10 quick questions, he says, will indicate whether the person’s drinking patterns fall outside safe, recommended limits. Then he explains how a brief intervention (follow-up discussion) can yield significant benefits and at an extremely low cost.   Often just making a person aware that their drinking is approaching the danger zone can inspire them to be more cautious and better control their alcohol intake.  (For more information on SBIRT visit www.indianasbirt.org or search for “Screening Brief Intervention” in the IPRC HOME library database, http://www.drugs.indiana.edu/search/home-library.aspx.)

Among the methods used by the Indiana State Police and local law enforcement that contributed to reductions in impaired driving in Indiana were the use of sobriety checkpoints, stepped up enforcement, and media and communications campaigns.  Media campaigns included the Safe Family Travel campaign, “Drive Sober or Get Pulled Over”(promoted by NHTSA) and “Buzzed Driving is Drunk Driving”  In addition, the Indiana State Excise Police conducted two program initiatives targeting underage drinkers:  Stop Underage Drinking and Sales (SUDS) and Cops in Shops (CIS).   By restricting the availability of alcohol to underage persons, fewer drunk drivers end up on the roadways.   SUDS details were carried out at large scale events on the IU campus, at the Indy 500, at concerts and festivals(ICJI, Indiana’s Annual Traffic Safety Report, FY 2013, 2013, )

The Indiana Students Against Destructive Decisions (SADD) organization crisscrossed the state, visiting schools, community events, and educating various members of the community about SADD and young driver traffic safety.  (ICJI, Indiana’s Annual Traffic Safety Report, FY 2013, 2013)

An evidence based program used to help prevent recidivism by impaired driving offenders is PRIME for Life, a motivational intervention that is used in group settings for alcohol and other drug affected drivers who have been court-referred.  Another evidence-based program, Interactive Journaling, uses self-reflective writing, the principles of motivational interviewing, and cognitive-behavioral interventions to influence behavior change.   It has been found effective to reduce recidivism for impaired driving with a large variety of target populations.  (SAMHSA, NREPP, 2014)

Other strategies suggested by the National Highway Safety Administration include ignition Interlock systems and screening for risk and needs using the Impaired Driving Assessment, a screening tool developed by NHTSA in cooperation with the American Probation and Parole Association (APPA).  (NHTSA,”Screening for Risk and Needs Using the Impaired Driving Assessment,” 2013.)

Just as we have learned to recognize the connection between high blood pressure and stroke, we need to be aware and proactive with regard to the connection between substance abuse and mental health problems, particularly how feelings of loneliness, anxiety, and depression can contribute to alcohol use or increased heavy drinking.

Holiday Blues

For many the holidays are far from joyful.   Holidays can trigger the “blues” or more serious depression.   During the holiday season, many people suffer from holiday stress, including those with social anxiety and those experiencing loneliness or loss, like military personnel and their families during deployment.      The strains of the season can put people at higher risk of using substances when they ordinarily would not, or to use them in greater quantity or with greater frequency.  

If the holidays affect you in this way, think about circumstances that have been associated with or triggered the holiday “blues” for you in the past and try to avoid them.  Drinking alcohol can be such a trigger, as can lack of exercise.   Writing about your feelings can help, for example, writing for 15 minutes each day for several days (WEB MD, 2014).   Things that can contribute to your experiencing the holiday “blues” include fatigue, sadness, insomnia, extreme pessimism, feelings of loss (a relationship, a loved one, a job), financial stress, seasonal affective disorder, and unrealistic expectations.   

Tips (from WEB MD) for dealing with depression or the holiday “blues” include:

  • Acknowledging your emotions
  • Honoring lost loved ones
  • Seeking support from others
  • Being realistic
  • Leaning to say “no”
  • Plan your activities
  • Ask for help
  • Schedule down time
  • Limit or forego alcohol intake
  • Maintain a healthy habits
  • Develop a budget.

The above steps can help you to avoid the kinds of feelings that sometimes lead people to overindulge in substances that, in turn, are associated with drunk and drugged driving.   If you drink, pace yourself and keep track of how much you have drunk.   Use a designated driver.

*[For more resources on the topics covered in this article, see the IPRC HOME library e-Resources accessible from IPRC homepage or at http://www.drugs.indiana.edu/search/home-library.aspx].



By Barbara Seitz de Martinez, 12/3/2014