Wednesday, December 4, 2013

10,000 deaths, 100 percent preventable

Bookended by Thanksgiving and New Year's Day – the two deadliest days on the road – is National Impaired Driving Awareness Month. During the entire year, an average of 25 people are killed each day by intoxicated motorists. During the holidays, the average jumps to 45 per day. All are preventable with existing technology.

National Highway Traffic Safety Administration (NHTSA) is a sponsor of the campaign, along with Mothers Against Drunk Drivers (MADD) and the Governors’ Highway Safety Association. In the United States the NHTSA estimates the nearly 10,000 people killed in alcohol-related collisions, represented a third of total traffic deaths. One out of every 10 arrests for all crimes in the U.S. were for Operating While Impaired (OWI), accounting for 1 out of every 80 licensed drivers. The death toll is higher than the previous year, despite tougher penalties and more enforcement.

Most addiction professionals prefer the term “Operating While Impaired” over “Drunk Driving” because often “drunk” is a subjective term, but there's an objective legal standard for impairment. No distinction is ever assessed whether the driver is an alcohol abuser or has the disease of alcoholism: If you are impaired, you are under arrest.

Drunk or buzzed driving is the act of operating or driving a motor vehicle while under the influence of alcohol or drugs while motor skills are impaired. In the United States, the point of impairment is pegged at .08 Blood Alcohol Concentration (BAC). However, studies have demonstrated that motor-skill impairment begins at much lower BACs. Reaction time is 1/5 of a second for an unimpaired driver. With alcohol in the system, reaction time is slowed to 4/5 of a second at .06 BAC. At 60 mph, a second means 88 feet. A fifth of a second is 17.5 feet, 4/5 of a second is 70.4 feet. The Jetta slamming on the brakes in front of an impaired driver is 53 feet closer, reaction-time wise, compared to an unimpaired driver.

The specific criminal offense is usually called driving under the influence (DUI), and in some states driving while intoxicated (DWI), operating while impaired (OWI), or operating a vehicle under the influence (OVI). The first jurisdiction in the adopt laws against drunk driving was New York in 1910, with California and others following. Early laws simply prohibited driving while intoxicated, requiring proof of a state of intoxication with no specific definition of what level of intoxication qualified.

The first generally-accepted legal BAC limit was .15. In the US, most of the laws and penalties were greatly enhanced starting in the late 1970s, and through the 1990s, largely due to pressure from groups like MADD, leading to a national standard of .08 as the definition of impairment.

A May 2013 hearing by the National Transportation Safety Board (NTSB) produced ideas for reducing drinking and driving deaths, among the ideas, lowering the limit legal for driving from .08 to .05 BAC. One hundred other countries have lower BAC limits for driving than the U.S. The idea is being debated around the country because the board has no authority to make the recommendation a law.

The last time the NTSB recommended a BAC change, from .10 to .08, it took two decades and the threat of Congress withholding highway funds for the idea to become law in all 50 states. An Indiana state legislator, Senator Michael Crider, R-Greenfield, predicts that is what it will take again. "If you look at the percentile drops, it's a pretty significant drop in the legal driving limit for drunk driving. It's going to be something not necessarily real popular, based on what I saw last time."

MADD, an expected ally of the proposed lower limit, is not behind it, instead focusing on its own three-pronged agenda for reducing impaired driving. The NHTSA also opposes the change to .05. Republican leaders on Capitol Hill say, "Leave it to the states to decide."

The states so far have voiced resistance. The Governors Highway Safety Association, which represents state highway safety offices, says expect push back because, “It was very difficult to get .08 in most states so lowering it again won’t be popular,” according to Jonathan Adkins, an official with the states' group. “The focus in the states is on high content offenders as well as repeat offenders. We expect industry will also be very vocal about keeping the limit at .08.”

The industry, via the American Beverage Institute, expectedly called the proposal "ludicrous."

Wyoming Gov. Matt Mead told the Associated Press he would prefer to increase penalties for drunken drivers, but he is willing to study the recommendation. However, Mike Moser, of the State Liquor Association, said the change could criminalize social drinking. Moser said it makes more sense to crack down on heavy drinkers who are more dangerous behind the wheel, an idea that does not register with a Chicago trauma surgeon who notes impairment begins far earlier than severe intoxication. Dr. Thomas Esposito, chief of the Division of Trauma, Surgical Critical Care and Burns in the Department of Surgery at Loyola University Medical Center, says, "The rationalization by critics that it penalizes the person who only occasionally has 'one too many' or who only drinks 'socially' makes no sense. One too many is just that; it's about impairment, not the number of drinks."

Lab research indicates at 0.02 to 0.05 BAC, the ability to see or locate moving lights correctly is reduced as is reaction time and the ability to judge distance. Even if not obviously impaired, at 0.05 BAC drivers are twice as likely to have a crash as before they started drinking...At 0.08 BAC drivers are five times more likely to have a crash than before they started drinking. Over .08, the crash likelihood jumps to 10 times that of a sober driver.

Highway alcohol-related deaths are 100 percent preventable. Passive alcohol detectors can measure a driver's BAC before starting the vehicle and render it unable to start. If the driver is intoxicated, he isn't driving. Critics claim the technology has not been perfected. However, the technology already exists for the non-invasive technique (see related examiner article), although the public appetite for the device does not.

Mandating these in-car alcohol detectors – the way seatbelts and airbags are required in U.S. cars – was among the 20 ideas the NTSB proposed at the same time as lowering the BAC threshold for drinking and driving. Detroit automakers have been testing in-dash systems since June 2012. The idea was suggested three years ago in the book What the Early Worm Gets as the way to conclusively eliminate all drinking and driving accidents.

“Our goal is to get to zero deaths because each alcohol-impaired death is preventable,” NTSB Chairman Deborah Hersman said. “They can and should be prevented. The tools exist. What is needed is the will.”

In 2011, 9,858 people were killed, 350,000 injured and $132 billion spent as a result of "alcohol-related" crashes. To Esposito's point, such classification does not mean the driver was over the .08 BAC limit, although usually that is the case, only that alcohol was present at the scene or detected on the breath or blood. No determination has to be made regarding level of intoxication, alcohol abuse or the disease of alcoholism but 4 million motorists admit to driving while impaired, according to NTSB estimates.
--from (See full article)

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