Data: Drinking and driving don't mix
By J. E. Brody - NYT News Service (12/30/88)

Chances are that during the holidays you will go to a party where you will consume one or more alcoholic drinks, after which you will drive home or to another party. And chances are that even if you do not drink and then drive, several other guests at the party will.

Perhaps you plan to be the host of a party.

When guests arrive, you almost certainly will not routinely ask, "Who's driving?" and then offer the driver non-alcoholic drinks. And knowing that a guest has consumed one too many for the road, you surely will not infringe on his privacy by insisting that he not drive, instead finding him a ride, calling a taxi or keeping him at your house for the night.

While few Americans would publicly assert that people who have been drinking should then drive, very few take steps to guarantee that alcohol-impaired drivers stay off the streets.

Indeed, most seem to consider drinking and driving a symbol of machismo and would not dream of embarrassing themselves or friends by suggesting that anyone was too drunk to handle a motor vehicle.

Even among intimate friends, the question put to a driver who has been drinking is usually, "Are you all right?" and the answer is almost invariably, "Of course."

Few couples start an evening with a decision about who will drive and therefore who will not drink, or at least time their drinking so that little if any alcohol is in their blood when they again get behind the wheel.

As H. Laurence Ross pointed out at a conference on highway safety in 1984: "Drunken driving is normal in this society. It is a natural product of our social institutions in particular our patterns of drinking and recreational activities and our patterns of transportation."

Ross, a sociologist at the University of New Mexico cited as an ironic example a professional conference he attended on drunken boating.

After the meeting, the conferees attended a two-hour cocktail party followed by a 10-mile drive to a banquet at a restaurant where many continued to consume alcohol.

While it is the rare person who does not know at least one family that has been struck by a drunken driving tragedy, it has long been our tendency to believe that it will not happen to us or that the amount we drink does not impair our driving.

Still, thanks to the efforts of groups like MADD, SADD and RID, there is a growing awareness of the toll alcohol takes on our nation's highways and a slowly emerging social consciousness that condemns drivers who drink.

It is an attitude that has already become the social norm in Sweden, where a "designated driver" who does not drink is routinely determined before social outings or where party-goers who plan to drink take taxis.

One 25-year-old Swedish reveler told Jay A. Winsten, director of the Harvard Center for Health Communication, that if he were to get drunk and then drive, "My friends wouldn't speak to me and my brother would beat me up."

A Swedish television star told Winsten, "To be arrested and convicted for drunk driving is a social and personal catastrophe." Winsten is overseeing a Harvard project seeking ways to curb drunken driving and alcohol abuse.

About 40% of Americans will be involved in an alcohol-related accident at some point in their lives. And 2 million alcohol-related crashes occur annually at a cost of 510 billion to $15 billion.

Those figures were cited last summer in a letter to the surgeon general, Dr. C. Everett Koop, that was endorsed by every member of the U.S. Senate. The senators wrote to call attention to the problem after a fatal collision last May between a church bus with a pickup truck driven by a drunken driver.

No doubt you're familiar with the statement that half of the nation's traffic fatalities are related to alcohol. That would mean 24,000 deaths, 560,000 injuries and 43,000 serious injuries each year.

But there is good reason to believe that these statistics vastly underestimate the enormity of the problem.

Many of the nation's medical examiners have found that drinking is a factor in 80-90% of traffic fatalities.

Dr. Donald J. Nollet, medical examiner in St. Louis County, Ml, analyzed 31 accidents in 1981 and found that there were only 3 in which no one involved had been drinking. Of the 28 people killed, only 6 had no alcohol in their blood. His records showed similar statistics for 1982 and 1983.

A study in the Atlanta area of 48 accidents in which BACs were measured disclosed 91% of the drivers had been drinking and 68% were legally intoxicated.

Dr. Joseph C. Rupp, medical examiner for Nueces County, TX, said of his area, "If you consider only the driver at fault in fatal accidents and single-vehicle accident fatalities, we would approach 90 to 100% alcohol-related incidents."

Driving is a complex task that demands alertness to traffic and road conditions, an ability to see well day and night and to the sides as well as straight ahead. A driver must also be able to make fast and prudent decisions to avoid or safely handle dangerous situations and be able to react quickly and precisely.

Doctors have found that alcohol dulls areas of the brain that enable people to make sensible decisions. It slows reaction time by interfering with reflexes and coordination.

It causes drowsiness and loss of alertness and concentration. And it reduces peripheral vision and can cause double or multiple vision and blurring.

In most states, you are legally drunk if you have a BAC of 0.1%, meaning that you have had about 6 drinks in 2 hours.

But you don't have to be drunk or even feel drunk to suffer any or all of these adverse effects.

The amount of alcohol that seriously interfere with driving skills varies from person to person, and even an individual's tolerance can vary from time to time.

In general, however, impairment increases with each drink and subsequent rise in BAC. As little as one drink, especially if you do not drink regularly or if you drink on an empty stomach, can make you an unsafe driver.

Young people who are less experienced at driving and drinking are more likely to become highway alcohol fatalities than older drivers.

Tests by the Southern CA Research Institute among 10 men who were moderate drinkers showed evidence of impairment beginning at 0.015% blood alcohol (one drink in two hours).

Most seriously impaired was the ability to pay attention to more than one thing at a time, a skill critical to safe driving.

The CA researchers concluded that, contrary to popular belief, "There is no evidence that low or very low BAC's improve performance of driving-related skills."

A Swedish study showed that, even the morning after an intoxicated night, when alcohol is gone from the blood, there is a 20% decline in driving ability in the hangover period.

Ross said the American penchant for trying to solve public problems by passing laws is unlikely to succeed in curbing drunken driving.

Laws do not change attitudes and behavior.

Studies of the effects of stiffer drunken-driving penalties and enforcement crackdowns show that they do decrease the number of intoxicated drivers and alcohol related accidents temporarily, but the effect wears off in a matter of months.

Just about the only law that has been shown to have a lasting effect, at least in one age group is the one raising the legal drinking age from 18 to 21.

In TN, for example, drivers age 19 and 20 apparently ignored increased penalties for drunken driving. But when the drinking age was raised to 21 alcohol-related motor vehicle deaths in this age group fell 38%, researchers from Vanderbilt University School of Medicine reported last month in the JAMA.

Furthermore, Ross pointed out, the most dangerous drunken drivers are problem drinkers, and they are the least susceptible to deterrent threats.

Probably nothing in our society will change until vast numbers of people decide that drinking and driving is antisocial behavior that cannot be tolerated.

Such a change in attitude requires nationwide efforts to make people aware of the dangers. This would include persuasive education in schools and on the job.

Safety efforts will require structural changes that thwart drinking and driving, like providing transportation to and from drinking sites.