Evidenced-Based Effective Strategies for Alcohol Related Injury

Intermediate Injury Prevention Course

Indian Health Service

Evidenced-Based Effective Strategies

Goal:

Understand effective strategies for reducing alcohol-impaired driving, alcohol policy, and deterrence.

Framework to Consider Impaired Driving Strategies

Reduce Driving in a Driving Society.

General Deterrence

Reduce Drinking in a Drinking Society.

Injury Prevention

Alcohol Policy Transportation Policy

Law Enforcement

Reduce the risk of injury when drinking and driving

happens.

Alcohol-Impaired Driving

The greatest number of motor vehicle injury hospitalizations occurred among Alaska natives aged 20-29

The motor vehicle injury hospitalization rate declined by 11.4 percent between 1991 and 2003

45% of all motor vehicle-related injury hospitalizations in Alaska were documented as alcohol-related

Impaired Driving Group Exercise

What Is the Goal of Impaired Driving Laws?

Is it only to arrest and punish impaired drivers?

What is deterrence regarding impaired driving and why is it Important?

Law Enforcement

Developing an atmosphere where people know that if you drink and drive, punishment will be,

Swift, Certain, and Severe

Alcohol-related Crashes

Fatal and NonfatalInjuries

•Minimum LegalDrinking Age Laws

•Server InterventionTraining

•Lower BAC Laws•Sobriety Checkpoints

AlcoholConsumption

Perceived Risk of Arrest

Social NormsRegarding

Drinking and Driving

Drinking andDriving

Conceptual Framework for Alcohol-Related Motor Vehicle Crashes

Source: Shults RA, et al, reducing injuries to motor

vehicle occupants. AmJ Prev Med 2001;21 (66-87)

Seat Belts, Child Restraints

Effective Strategies for Reducing Alcohol-Impaired Driving

Minimum Legal Drinking Age laws: Specify an age below which the purchase or consumption of alcohol beverages are not permitted

Research findings showed if the MLDA is raised, death and injury rates decline (avg. 16%) and if the MLDA is lowered, injury and death rates increase (avg. 10%).

Effective Strategies for Reducing Alcohol-Impaired Driving

Server Intervention Training:

11 states have established training programs.

Requires intensive (4-6 hours), high quality training with active management support to be effective.

.08 Blood Alcohol Concentration Laws:

-All 50 states and the District of Columbia have .08 blood alcohol concentration laws.

-Lowers the BAC at which it is illegal to drive a motor vehicle from 0.10 g/dL to 0.08g/dL (0.08%).

-Alcohol-related fatal crash outcomes: -7% (-15% to -4%), 25 measures.

-It is estimated that 400 to 600 lives are saved each year because of 0.08% BAC laws.

Effective Strategies for Reducing Alcohol-Impaired Driving

Lower Blood Alcohol Concentration for Young and Inexperience Drivers:

-Young drivers at 0.08 BAC= 24 times greater risk dying in a crash.

-Lower BAC Laws (“Zero Tolerance”): .02 BAC laws for young drivers estimated to reduce young driver deaths by up to 24%.

-All 50 states now have lower BAC laws for young drivers; Tribes could pass these as well.

Effective Strategies for Reducing Alcohol-Impaired Driving

Effective Strategies for Reducing Alcohol-Impaired Driving

Sobriety Checkpoints: -At sobriety checkpoints, law enforcement officers systematically stop drivers to assess their level of

alcohol impairment.

-The goal is to deter alcohol-impaired driving by increasing driver’s perceived risk of arrest.

-Reduce alcohol-related crashes and deaths by 17-25%.

Administrative License Revocation Laws

Effective Sobriety Checkpoints

Public Awareness

High Visibility Enforcement

Media

Regular Checkpoints

Are Sobriety Checkpoints Legal

1990 US Supreme Court Decision Upheld Checkpoints

11 States Prohibit Checkpoints

Changing Social Norms

Designated DriverMADDSADDSobriety Pledges by Elected Officials

Promising, not Proven…

Alcohol Policy

Reduce Access to Alcohol.

Reduce Acceptance of Alcohol use.

Increase Availability and Access of Substance Abuse Treatment.

Alcohol Policy Considerations

Price: consumption of alcohol is very price sensitive.

Increase in taxes: significant impact on consumption, resulting in declines in alcohol-related injury, and alcohol-related problems

Tribes should implement taxes on alcohol at retail and wholesale level

Alcohol Strategies Review

Reduce Driving in a Driving Society.

General Deterrence

Reduce Drinking in a Drinking Society.

Injury Prevention

Alcohol Policy Transportation Policy

Law Enforcement

Reduce the risk of injury when drinking and driving

happens.

Alcohol and Injury Summary

Alcohol is a complex problem requiring multi-disciplined approach: there is no one “magic bullet”

Become involved: understand alcohol policies and where effective strategies could be implemented in your community

Impaired Driving Prevention Resources

• Motor Vehicle Occupant Injury: Strategies for Increasing Use of Child Safety Seats, Increasing Use of Safety Belts, and Reducing Alcohol-Impaired Driving. A Report on Recommendations of the Task Force on Community Preventive Services. CDC, MMWR 2001;50(No RR-7). http://www.cdc.gov/mmwr

Impaired Driving Prevention Resources

• The full report of the findings of the Task Force on Community Preventive Services for impaired driving was published as a American Journal of Preventive Medicine (AJPM) Supplement in November 2001. www.thecommunityguide.org/mvoi/default.htm

• Insurance Institute for Highway Safety: www.hwysafety.org

Impaired Driving Prevention Resources

• Mother’s Against Drunk Driving:

www.madd.org

• National Highway Traffic Safety Administration:

www.nhtsa.org