Research studies in the area of substance abuse often lead to new strategies for treatment, or the tossing out of treatments that are proven ineffective. Research is also used to show how trends in the use of certain substances change over time, or among different segments of the population. Public policy requires information that accurately reflects the trends in substance use in order to establish laws and regulations that discourage substance abuse. A study illustrates the inaccuracies that plague state reporting agencies when determining the cause of death in a traffic accident.

According to the study by National Institute on Alcohol Abuse and Alcoholism (NIAAA) researchers there were more than 450,000 U.S. traffic deaths between 1999 and 2009. In many of these cases alcohol was involved but was not referenced on the death certificates as cause of death. While correct causes of death on death certificates may seem trivial, injuries remain the leading cause of death in the U.S. for individuals under the age of 45, according to the Centers for Disease Control and Prevention.

Importance Of Understanding Alcohol’s Role In Car Accidents

Study leader Ralph Hingson, Sc.D. of the NIAAA stresses the importance of having a clear understanding of alcohol’s role in the leading cause of death for an age group. Only with correct information can officials determine whether policies aimed at reducing alcohol-related deaths are effective. The size of the problem must be measured, tracked and then assessed in order to best create prevention and intervention measures.

The researchers started by looking at all traffic deaths because the records are more accurate when compared with other types of accidental death. In approximately half of all U.S. states there is a requirement that the fatally injured driver be tested for blood alcohol levels. This information is then entered into the National Highway Traffic Safety Administration’s Fatality Analysis Reporting System database. The database results were then compared with death certificates from across the U.S.

The researchers found that the role of alcohol in traffic deaths in the decade studied was significantly underreported. Only three percent of the death certificates listed alcohol as a contributing cause of death, while the database rated 21 percent of deaths as legally drunk.

States Reporting Alcohol In Accidents Differs – Importance Of Best Practices

The findings were not consistent from state to state. In some states alcohol was rarely included on death certificate information, such as in Maryland, New Hampshire, Nevada and New Jersey. Other states, including Iowa, Minnesota, Kansas and Delaware, were better about accurately reporting alcohol’s role in the death.

The researchers noted that the discrepancy in reporting could be due to long waiting periods for receiving blood alcohol level test results. In most cases a coroner or medical examiner is required to file a death certificate within three to five days, which may be sooner than a toxicology report can be received.

The researchers stressed the importance of determining which practices are followed by states that seem to be reporting more accurately. Establishing best practices for other states to follow may make reporting on traffic fatalities involving alcohol more accurate.

Having laws in place requiring alcohol testing did not seem to result in better reporting. However, Hingson says that the results illustrate the wide gap between the number of accidental deaths related to alcohol consumption and those that are reported.

The long-term risks for teens that abuse substances are increased likelihoods of adult addiction, developing certain cancers or heart disease and engaging in dangerous sexual behaviors that could result in contracting a sexually transmitted disease and/or an unplanned pregnancy. But there are also serious short-term risks, with the most serious being the increased likelihood of getting into a vehicular accident.

In addition, while many teens are advised not to drive a car while under the influence they may not use enough caution when considering the sobriety of another driver.

A recent study highlights the risk teens take when they drive a car or enter the car of a driver that is under the influence. Conducted by researchers at the Mailman School of Public Health at Columbia University, the study examined the risk of drug use and the risk of drug use combined with alcohol use and how such use impacted the risk of a fatal crash.

Drastic Increases In Fatal Crashes When Drugs Are Involved

The researchers found that there was a drastically increased risk of experiencing a fatal crash when drugs were involved in an accident, and this was particularly true when the drugs were used in addition to alcohol.

The study’s data was pulled from two national databases commissioned by the National Highway Traffic Safety Administration: the 2007 National Roadside Survey of Alcohol and Drug Use by Drivers and the Fatality Analysis Reporting System (FARS). FARS compiles investigation information for all vehicular crashes that resulted in a fatality within 30 days of the crash occurring on a public road.

This study is unique in its use of the two databases together to compile information about circumstances surrounding events, such as the individuals and vehicles involved.

The study, led by Guohua Li, MD, DrPH, professor of Epidemiology and director of the Center for Injury Epidemiology and Prevention, found that 31.9 percent of all drivers implicated in fatal crashes tested positive for at least one drug. Of those interviewed at roadside, 13.7 percent tested positive for at least one drug. Overall, drivers that test positive were three times more likely to be involved in a fatal car crash, with the highest risk associated with depressants followed by stimulants.

The study also showed that blood alcohol levels were increased in 57 percent of those involved in fatal crashes, while 8.8 percent of the roadside interviews had an elevated blood alcohol level. Approximately 20 percent of the fatal crash drivers tested positive for alcohol consumption and one or more additional drugs. Among the roadside interviews, 2.2 percent tested positive for alcohol and another drug.

Alcohol Increases Fatal Car Crashes By 13 Times!

The risk of involvement in a fatal car crash increased 13 times for those that tested positive for alcohol only, two times for those that were drug-positive and 23 times for drivers that were under the influence of both drugs and alcohol.

The authors of the study note that drugs may be detectable in a driver’s blood test that may not be causing impairment. In addition, the authors say that the study does not account for various levels of tolerance that may be exhibited among individual drivers, making it difficult to measure drug impairment.

Decreased Risks When Parents Talk With Their Teens

The findings highlight the importance of talking with teens about the risks of driving a vehicle while under the influence or entering a vehicle in which the driver has been using.

Parents that explain the risks and dangers can help their child make an informed decision.

On May 14, 1988, a drunk driver going the wrong way on an interstate highway just outside Carrollton, Kentucky, collided head on with a school bus full of children. In total, 24 children and three adults were killed in this horrific accident, making it the most deadly alcohol-related automobile crash in U.S. history. In commemoration of the 25^th anniversary of this tragic event, on May 14of this year the National Transportation Safety Board issued a new report urging all 50 states to lower the legal limit of intoxication for anyone operating a motor vehicle from .08 blood-alcohol content to .05, a standard that is already in place in about 100 other countries around the world.

Referring to the approximately 10,000 deaths that occur in the United States each year in alcohol-related automobile accidents as “a national epidemic,” NTSB Chairman Deborah Hersman expressed her organization’s concern that the ongoing campaign to reduce drunken driving fatalities had reached a point of diminishing returns. The NTSB’s recommendation that blood-alcohol level restrictions for drivers be tightened is in accordance with the latest scientific findings, which show that a person with a BAC of .05 will experience “reduced coordination, reduced ability to track moving objects, difficulty steering, and reduced response to emergency driving situations” (quoted from a chart published by the National Highway Traffic Safety Administration). The NTSB estimates that if this new standard were universally adopted, it could lead to a 10 percent annual decrease in the number of people killed by drunken drivers, and it is urging the National Highway Traffic Safety Administration to offer financial incentives to any state that will agree to make the switch from .08 to .05.

 Sensible Caution or Mindless Prohibition?

As recently as the early 1980s, people who had been drinking were legally allowed to get behind the wheel of an automobile in many states as long as their blood-alcohol content did not rise above .15. But in response to rising public and political awareness of the true costs of drunk driving, legal standards began to evolve and by 2004 all 50 states had adopted the far more stringent .08 standard that still reigns supreme today. Since the heyday of .15, annual casualties from alcohol-related automobile accidents have dropped from 20,000 per year to just under 10,000, but drunken driving still accounts for about one-third of all highway deaths in the United States, more than any other single factor. Over the years, legal penalties for driving under the influence have become more severe in concurrence with the tightening of the BAC, and bars, clubs, and restaurants by all accounts have become more responsible about serving alcohol to customers who may be intoxicated. Nevertheless, drunk driving has remained stubbornly and discouragingly prevalent, and its consequences have continued to leave a long trail of broken bodies lying in the wrecked and smoldering ruins of crashed automobiles each and every year.

Not surprisingly, the alcohol and hospitality industries have responded to the .05 recommendation negatively, calling it unnecessary, excessive, and bad for the economy.  Others have pointed out that current laws already allow police officers to arrest drivers who appear intoxicated regardless of what their blood-alcohol levels might be, and they claim that the only people who will be taken into custody under these new restrictions will be those with BACs of .05 who show no actual signs of being impaired. Even some people involved in the fight against drunk driving have expressed skepticism about the idea of reducing the allowable BAC, believing that it will create a backlash that may ultimately hurt the anti-drunk driving cause by linking it to draconian laws that will not be popular with most people. Skeptics also argue that this new law would be all but unenforceable, since police would be expected to somehow know intuitively that drivers had reached the legal limit for intoxication and needed to be pulled over, even though in most cases their driving performances would appear to fall entirely within the range of normal.

 The Power of Prevention

Some of these criticisms could very well prove to be legitimate, if the new standards are eventually adopted. However, government regulatory and safety agencies can only base their policies and recommendation for change on what the latest research shows, and in this case the science is clear: at .05 BAC the reflexes and perceptions of human beings are altered dramatically, and regardless of whether a person shows obvious signs of drunkenness, their ability to drive will be impaired if they have been drinking enough to reach this level of intoxification, thereby putting themselves, their passengers, and everyone else on the roadways at risk. While there may indeed be some backlash in the short-term against a move to .05, if there is any chance at all that such a move will discourage drinking and driving then this new proposal by the NTSB clearly has merit.

During the time when BAC driving requirements were being progressively tightened, from approximately 1980 through 2004, drunken driving-related casualty levels declined significantly and no one can reasonably argue that this is just a coincidence. Based on past precedent it appears very likely that these new recommendations will in fact be adopted at some point, and if and when that happens we can only hope that from then on fewer families will be forced to confront the premature loss of cherished loved ones as a result of a tragic—and entirely preventable—alcohol-fueled automobile crash.