Conference Proceedings and Papers
Proceedings of all the major conference have been published amounting to thousands of pages of materials which provide a history of the development of research and policy over the past five decades in alcohol, drugs and traffic safety. After many years of work and effort by both current and previous ICADTS Executive Board members, the Council is delighted to make available all available conference papers in electronic form.
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Search results for: 21st_T2016_Gramado
Alcohol and drugs in general road traffic and crashes
Background: Road traffic crashes (RTCs) kill about 1.25 million people and injure up to 50 million every year worldwide. More than 80 percent of the deaths occur in low and middle income countries (LMIC). The number of fatalities has increased in LMIC while they have decreased in high income countries (HIC) during recent years.
Alcohol involvement in fatally injured drivers in the United Sates 1982 - 2014.
Since 1982, the United States has been tracking the blood alcohol concentrations (BACs) of drivers fatally injured in traffic crashes. Aim: Using the U.S. Fatality Analysis Reporting System (FARS) and five National Roadside Surveys of U.S. drivers, we (a) examined the 0and (b) examined the trends of alcohol and other drugs in drivers on U.S. roads ontrends from 1982 to 2014 for BACs in fatally injured drivers week-end nights.
An evaluation of Nova Scotias Alcohol Ignition Interlock Program
Ignition Interlock, drinking driving, program evaluation.
In 2008 Nova Scotia implemented an Alcohol Ignition Interlock Program (AIIP). This study evaluated this program. Different types of data were used including conviction and crash records of individual participants; provincial monthly counts of charges, convictions and crashes; and, interlock logged events. The data were analyzed using several methods including descriptive statistics, survival analysis and time series analysis. With respect to specific deterrence (i.e., preventing recidivism) there was a 90% reduction in recidivism among the experimental group since participation in the program and a 79% reduction after participants in this group exited from the program. With respect to general deterrence (i.e., referring to a preventative effect on the entire population of drivers in Nova Scotia) there was a temporary decrease in the number of alcohol-related charges (13.32%) and
Assessment of national Motor Traffic and Transport Directorate (MTTD) on road safety capacity and enforcement
The MTTD an agency under the Ghana Police Service (GPS) is legally mandated to tackle road traffic issues in Ghana, however there are gaps with respect to capacity which is hampering effective enforcement of road traffic laws.
Breathalyzer Test - results and refusals to take the test of drivers intercepted in Rio de Janiero
Alcoholic beverage consumption consumption, Traffic accidents,Toxicity tests, Public policies, Law enforcement
This working paper involved a cross-sectional study that evaluated the results and refusals to take the breathalyzer test among drivers intercepted by the Driving Under the Influence (DUI) Spot-Check Campaign in the capital of Rio de Janeiro and Baixada Fluminense. It was conducted using data provided by the State Government which were collected from drivers intercepted in the months of December 2013 and January 2014. Descriptive analysis was conducted of the sample and of the association between gender, age and location variables with the result of the breathalyzer test and refusal to take the test using a logistic regression model. Of the 4756 (100%) drivers intercepted, 59 (1.2%) failed the breathalyzer test and 229 (4.8%) refused to take it. Only the location of interception variable was statistically significant with greater chances of failing (OR=4.01) and refusal to take the test (OR=5.14) among drivers intercepted in the Baixada Fluminense. Systematic monitoring actions taken by the DUI Spot-Check Campaign that have occurred for longer in the capital appear to have a positive impact on the drinking and driving behavior of drivers.
Determinents of alcohol use among road users and the relationship between positive BAC and casualty hospitalisation in Northern Ghana
Background: Alcohol use is pervasive in Ghana, however, the extent to which alcohol impairment is implicated in road traffic injuries has not been adequately elucidated through research in Ghana and many developing countries. This study highlights the determinants of alcohol use among pedestrians, cyclists, motorcyclists and drivers and recommends countermeasures to minimise alcohol related road traffic injuries in Ghana. Objectives: The objectives of this study were: (1) to assess the significant predictors of detecting positive alcohol among injured accident victims; and (2) to determine the association between alcohol use and injury severity among road traffic crash casualties in the Emergency Departments (EDs) of Northern Ghana. Method: An epidemiological research was conducted in the EDs of two level III trauma centres in Northern Ghana. Crash victims seeking for treatment relating to their most recent road injuries were screened with breathalysers to determine whether they consumed any alcohol prior to their crash. The breath alcohol levels were converted to Blood Alcohol Concentrations. Results: Thirty-four percent of injured road users who were screened for alcohol tested positive upon their arrival at the EDs. Pre-hospital care for injured casualties was minimal as over 90% of all casualties arrived in the EDs in transport modes other than ambulances. A significant association was found between testing positive for alcohol and traffic injury severity. Road traffic victims who tested positive for alcohol were 2 times more likely to be hospitalised for road injuries compared with sober road users (AOR=2.04: p=0.025, 95% CI=1.11 to 3.76). Gender and locale were two significant predictors which together accounted for 20% of the proportion of variance explained in testing positive for alcohol in the emergency departments. Compared with casualties in the Upper East Regional Hospital, Wa, crash victims in the Upper East Regional Hospital, Bolgatanga were about 4 times more likely to test positive for alcohol (AOR=3.7, p=0.001, 95% CI=1.75 to 7.74). Male casualties were also 15 times more likely to test positive for alcohol in the EDs compared with female casualties (AOR=14.9: p<0.001, 95% CI= 4.1 to 54.5). Conclusion: There was a high prevalence of recent alcohol use among road traffic casualties in the study area. Alcohol use appears to exacerbate hospitalisations related to road crashes in Northern Ghana. Therefore, alcohol consumption guideline and road safety education with emphasis on reducing or eliminating alcohol consumption before road use are recommended. Enhanced enforcement of the BAC limit among motorists is highly recommended to counteract alcohol related road injuries in Ghana. It is also recommended that ambulance and emergency medical services should be improved to prevent improper transportation of injured road traffic crash victims which might aggravate the injury situations of casualties.
Drink driving initiatives in low- and middle-income countries -- effective and promising approaches and challenges
drink driving, capacity building, multi-stakeholder, promising practices, low- middle-income countries
Background: Road safety is not only a major international public health concern but also a development priority in middle- and low-income countries with limited resources and expertise to address this public health problem. In addition, the SDGs have set a very ambitious target of reducing road traffic deaths and injuries by 50% by 2020. Given that the Brasilia declaration demands multi-stakeholder collaboration, and encourages civil society, academia, private sector and philanthropic foundations to strengthen their commitments to road safety actions, IARD is sharing this overview of its efforts to implement drink driving programs in low- and middle-income countries to share lessons learned and convey the importance of working in partnerships with the best available evidence. Aim: IARD will be presenting both processes and outcomes of programs initiated in 2010 with the implementation of drink driving programs in six low- and middle-income countries: China, Colombia, Mexico, Nigeria, Russia, and Vietnam. Additionally IARD will be presenting some of the preliminary findings of our work in a second round of priority countries addressing drinking and driving: Argentina, Cambodia, Dominican Republic, Namibia, South Africa, and Thailand. Results: The courses of action taken by IARD and its programs under the Beer, Wine and Spirits Producers’ Commitments to prevent drink driving have moved towards evidence-based interventions, as highlighted in the Drinking and Driving: a road safety manual for decision-makers and practitioners published by the GRSP in 2007. Conclusion: The beverage alcohol industry, like other actors such as NGOs and local and national organizations, have been more consistently including evaluation and capacity building components in its programs. Initially these assessments were mostly process evaluations, but as the different implementers and partners become more sophisticated, and the interventions refined, the focus has shifted towards outcome evaluation in countries in which the drink- driving prevention programs have acquired a level of sustainability that allows for longitudinal studies that can measure behavior change. The capacity building component is largely oriented towards institutional building of lead agencies at local and national jurisdictions, and emphasizes data collection and analysis in order to measure the impact of the programs. These data needs to be collected so that the most promising approaches can be considered for dissemination, adaptation, and scaling up.
Drinking and driving - behaviour of motorcyclists stopped at the 'Operation Dry Law'
Automobile driving; Motorcycles; Traffic accidents; Alcohol drinking; Descriptive epidemiology
Background: Traffic accidents are a severe public health problem. Around the world, more than 1.2 million people are killed each year due to this problem, representing more than 2.1% of the global mortality. In 2008, the Brazilian government enacted Law 11.705 on 6/19/2008, which determines zero alcohol use to drive any motor vehicle. Aim: The objective of this study was to describe drinking-and-driving behaviors among motorcyclists stopped by the Operation Dry Law (Operação Lei Seca), an antidrink driving campaign. Method: A descriptive study was conducted with a nonprobabilistic sample of motorcyclists stopped in the city of Rio de Janeiro in 2012, who answered a socio-demographic questionnaire about alcohol use, involvement in traffic accidents and their drink-driving behavior before and after the enactment of the Dry Law (Lei Seca). Results: Of the 94 motorcyclists interviewed, 61 answered that they had already been involved in a traffic accident and 11 of them had consumed alcohol prior to the accident. There was a decline of the drink-driving behavior by 81% after the enactment of the Dry Law.Conclusion: Therefore, it is possible that the enforcement actions of Operation Dry Law may have contributed to the decline of the drink-driving behavior.
Driving under the influence of alcohol and drigs - current legislation and Turkish statistics
Drunk driving; Turkish Legislation; Turkish DUI statistics.
Background: Driving under the influence of alcohol and/or drugs increasingly continues to lead to accidents resulting in substantial damage, injury, and death in Turkey. Aim: At this study, it is aimed to present current legislations and statistical data on driving under
Drtiving while impaired and impulsivity - similarities between alclhol and cocaine-crack users
Alcohol, Crack-Cocaine, Driving While Impaired, Impulsivity, Traffic Safety
Impulsivity is frequently associated with higher vulnerability to develop a substance use disorder (SUD), as well as to engage in risky behaviors such as driving while impaired (DWI) under effect of psychoactive substances. Previous studies have shown the high prevalence of DWI and traffic accidents among alcohol users. Nevertheless, few studies have investigated this behavior among crack-cocaine users, so the aim this study was to compare impulsive manifestations and prevalence of DWI among alcohol and crack-cocaine users. The sample consisted of a total of 183 men with a SUD (42 alcohol users and 141 crack-cocaine users), aged between 18 and 60, that were referred of psychiatric emergency services to a public hospital specialized in addiction. Data were drawn from a cross-sectional study whose aim was evaluate alteration of TBARS and BDNF levels among crack-cocaine users during early drug withdrawal and its relationship to severity of drug use. Sociodemographic data and recent history of DWI were assessed through the Addiction Severity Index, 6th version (ASI-6) while impulsivity was assessed through the Barrat Impulsiveness Scale (BIS-11). The prevalence of recent history of DWI among alcohol and crack-cocaine users was compared by the Chi-Square test. Quantitative variables with symmetric distribution were compared by the T-Student test. We found a higher prevalence of drivers and automobile owners among crackcocaine users (33.6%) than among alcohol users (15.2%, p=0.017). From the overall sample, 40 subjects (21.9%) reported history of DWI in the last six months, without differences between alcohol users and crack-cocaine users (21.4% vs 22%, p=0.939). There were no differences regarding impulsivity score in both groups (77.73 ±8.27 x 79.73 ±6.77, p=0.150), or between subjects with and without history of DWI (79.29±7.27 x 79.10±6.88, p=0.885). Both alcohol and crack cocaine users engaged in DWI behavior and they both presented high levels of impulsivity. These findings challenge the popular belief that only alcohol users represent a risky population for DWI. However, there are limitations to consider, regarding characteristics of the sample (such as, the majority of them consisted of cases with great severity of SUD and their socio-economic status may represent a bias regarding having access to an automobile or not) and data collection (all questionnaires were completed with the presence of an interviewer, what may have contributed to biased answers regarding a deviant behavior such as DWI. Besides that, it is also important to consider that DWI can be associated with other cognitive processes rather than impulsiveness that were not included in these analyses. Notwithstanding, the findings highlight the importance of further investigating other personality characteristics that may influence the decision to DWI and the importance of implementing new ways of screening for psychoactive substances other than alcohol among Brazilian drivers.
Effects of a responsible beverage service training and enforcement program
responsible beverage service training; alcohol policy enforcement; overservice of alcohol; bar patron intoxication; young adult drivers; alcohol impaired driving.
Background. Studies of risk factors associated with a wide range of harmful alcohol-related incidents (violence, injury, motor vehicle crashes, illness) suggest that the most significant risk factors are the amount of alcohol consumed and whether obviously intoxicated customers continue to be served. Aim: Two communities—Monroe County, New York and Cleveland, Ohio—participated in a demonstration program and evaluation. The intervention integrated responsible beverage service (RBS) training, targeted enforcement, and, as necessary, implementation of corrective actions by the enforcement agency to a random sample of identified problem bars. The immediate goal of the RBS/enforcement program was to reduce the practice of overserving and serving to obviously intoxicated individuals. Method: Data were collected over three waves (preintervention; during-intervention; post intervention) on bar serving practices, bar patron intoxication, drinking and driving, and other alcohol-related harm from intervention and control bars or treatment and comparison communities, depending on the outcome. Results: Overall, there were indications in both intervention communities that RBS training plus enforcement reduced the incidence of bar patron intoxication (and potential impaired driving). In Monroe County, New York, the percent of intervention bar patrons who were intoxicated decreased from 44% to 27% and the average blood alcohol concentration (BAC) of patrons decreased from .097 g/dL to .059 g/dL. In Cleveland, Ohio, the percent of pseudo-intoxicated patrons who were denied service in the intervention bars increased from 6% to 29%. Conclusion: It appears that when bar managers and owners are aware of the program and the enforcement of it, and servers are properly trained in RBS, fewer patrons become highly intoxicated (i.e., overserved) and an effort is made to deny service to obviously intoxicated patrons. Given that about half of arrested impaired drivers are coming from licensed establishments in any given community, if this strategy is implemented on a widespread basis, it could have a significant impact onimpaired driving. RBS training, followed up with visible and sustained enforcement, may be an important strategy to combat impaired driving and other injuries associated with excessive drinking. There were many findings consistent with expectations regarding the intervention’s influence on alcohol intoxication in thisstudy. The cumulative evidence points to a positive effect in reducing intoxication of bar patrons. These findings validate prior research on RBS as a countermeasure to prevent excessive drinking and overservice practices. More widespread implementation in communities, although not easily accomplished, could have an effect not only on impaired driving, but other alcohol-attributable harm.
Enhancing the apacity of low and middle income countries to address drink driving
drink driving; low and middle income countries; capacity development; enforcement; alcohol control policy.
Drink driving is a significant road safety issue in many low and middle income countries (LMICs). This reflects a continuing lack of capacity to address drink driving in spite of efforts to develop such capacity. It is argued that the concept of a country’s “capacity to address drink driving” needs to be better articulated as an important step towards enhancing capacity. In particular, drink driving can be best understood in a broader context of economic, institutional, social and cultural factors, rather than simply as an illegal behaviour. This paper uses a different approach – the Road Safety Space Model – as a means of identifying drink driving capacity needs in Ghana.
Evaluation of an individual psychological rehabilitation program ofr habitual traffic offenders
Rehabilitation program, alcohol, drugs, evaluation, assessment.
Background. Before driving privileges are reinstated, German offenders need to pass a medical psychological assessment (MPA) (“Medizinisch-Psychologische Untersuchung: MPU”). The purpose of the MPA is to assess whether the offender is fit to operate vehicles again. Aim. In this prand Conclusions It has become apparent that the overwhelming majority of offenders could restore their fitness to operate vehicles by means of the traffic psychological therapy.ocess, the offenders willing to restore their fitness can be expertly guided by a traffic psychologist. They have to realize the scope of their problems (alcohol, drugs, speeding, etc.) and implement changes in their attitude and behavior. A traffic psychological rehabilitation method has been developed and evaluated on the basis of MPA results. We would like to introduce the rehabilitation and the result of the evaluation. Method The AFN (Association for Education, Advanced Training and Further Education) developed a “traffic psychological therapy” based on Alfred Adler's individual psychology. Using the focal lifestyle analysis, each participant revises the background of their own individual problem. Results 182 subjects took part in the evaluation. They completed the traffic psychological therapy between 2013 and 2015. Of all the therapy participants, 85 % obtained a positive result in the MPA, 7 % were recommended additional courses and 8 % obtained a negative result. Discussion
Experimental proof-of-principle of in-vehicle passive breath alcohol estimation
Automotive Safety, Unobtrusive Breath Alcohol Analyzer, Infrared Gas Sensor, Passive Gas Measurement
The reported work is highly related to the DADSS (driver alcohol detection system for safety3) program, and other related initiatives aiming at the prevention of drunk driving. The possibility of breath alcohol estimation in highly diluted breath samples in a vehicle cabin by using carbon dioxide as a tracer gas to compensate for the dilution has been demonstrated and evaluated elsewhere.4-12 The infrared sensor technology developed by SenseAir AB, Sweden, is enabling unprecedented sensor performance.9 However, passive breath alcohol detection requiring no cooperation from the driver has remained a major technological challenge. The aim of the present investigation is to obtain experimental proof-of-principle of completely passive, in-vehicle estimation of breath alcohol concentration. A prototype sensor system has been integrated with the casing of the upper steering column within a vehicle. Human subjects, some of them intoxicated by alcohol, are instructed to enter the vehicle and perform a simulated driving task while breathing normally. Sensor signals corresponding to alcohol and CO2 concentration at the sensor position are recorded and analyzed off-line. The sensor CO2 signal pattern includes peaks corresponding to increasing CO2 concentration in expired air reaching the sensor position after leaving the subject’s mouth or nose. These peaks will coincide with peaks in the alcohol signal from an intoxicated subject. From the peak magnitudes an algorithm for breath alcohol estimation has been devised. The results indicate that peaks from normal breathing are readily detectable and quantifiable by the sensors, although the dilution factor DF (ratio between expired and actual concentration measured by the sensor) may be as high as several hundred at the steering column sensor position.
Final results of a safe road for youth project
Drunk driving, prevention, social norms, cultural factors.
The SAFE ROADS 4 YOUTH (SR4Y) project is an international project, led from 2012 to 2016, with the objective to implement and evaluate drink driving prevention actions using a common conceptual framework in three developing countries over three continents: Vietnam, South Africa and Argentina. It aimed to determine what types of community programs are most effective in preventing drink driving and how their effect varies across countries, traffic policy contexts and cultures.
How do drivers respond to random breath testing in Brazil - insights from the Bloomberg Initiative for Global Road Safety Project conducted in the city of Sao Paolo
alcohol; drink and driving; law; road.
Background: Denying a breath test during a driving under the influence of alcohol (DUI) investigation in Brazil is punished by an administrative sanction. However, it also avoids harsher penalties (such as imprisonment) by making it more difficult to prove the blood alcohol concentration (BAC) that is usually required for the application of criminal DUI penalties. Aims: To evaluate drivers’ behaviors when stopped at a random DUI screening, such as compliance to current legislation and acceptance of confirmatory breathalyzers, as well as estimate current drunk driving in a large urban center in Brazil. Method: Between July and August 2015, we observed 1,057 drivers who were stopped by routine random DUI checkpoints in six different locations in Sao Paulo from Friday to Sunday. We utilized data collection procedures established by the Johns Hopkins International Injury Research Unit for the international multi-city Bloomberg Initiative for Global Road Safety Project. Drivers were submitted to a screening breathalyzer test, and, if positive, were asked to do a confirmatory quantitative test. BAC results were analyzed in combination with drivers’ demographics and vehicles’ characteristics. Results: Women were less likely to test positive for the screening breathalyzer than men. However, 86 drivers (8.1% of drivers stopped; or 57.4% of those who tested positive for the screening breathalyzer) refused to take the confirmatory test. Of those who agreed, 43 (68.3%) tested above the legal limit (0.01% v/w) for a traffic violation, of which 6 (14.0%) were above the limit for a traffic criminal sanction (0.06% v/w). Conclusion: The present results show that, while DUI checkpoints are effective in correctly identifying potential driving infractions, the current Brazilian law allows for drivers to refuse taking a confirmatory breathalyzer, thus escaping potential harsher sanctions. This suggests that field sobriety tests or alternative confirmatory procedures should be studied in order to correctly identify and implement sanctions to drink and driving in Brazil
International approaches to Cannabis and driving - a review of the evidence and research needs
cannabis/marijuana, law, driving, drug, DUIC
Driving under the influence of cannabis (DUIC) has important public health implications for many jurisdictions worldwide, especially those that have legally regulated or are debating regulation of cannabis sales for personal use. While the legality of cannabis is shifting, legal and policy responses to DUIC are evolving as well. However, there are gaps in our knowledge regarding the effectiveness of different approaches designed to prevent, deter, and reduce DUIC. Alcohol per se laws that make it an offence to drive with blood alcohol content over a particular level have proven to be effective in reducing driving under the influence of alcohol. Thus, much interest has been generated in developing per se laws that would set fixed limits for cannabis (e.g., 5 ng/mL of tetrahydrocannabinol in blood serum) and could prevent DUIC. Other legal approaches to preventing DUIC include zero tolerance laws which make it an offence to drive if any amount of cannabis is detected in the driver, behaviourally-based laws that sanction drivers found to show behavioural evidence of cannabis-related impairment, and restrictions introduced in the context of graduated licensing systems. We sought to comprehensively review international literature on laws that address cannabis use and driving, and to identify where and how DUIC laws have been evaluated. The following databases were systematically searched from 1995 to present: Medline, Embase, PsycINFO, CINAHL, Sociological Abstracts, and Criminal Justice Abstracts. Hand searching of relevant documents, internet searches for grey literature, and review of ongoing email alerts from Medline, PsycINFO, and Web of Science were conducted to capture any emerging literature and relevant trends. Numerous jurisdictions are considering or have already introduced a variety of legal measures designed to prevent or deter DUIC. There are different ways in which these laws can be evaluated including measuring arrests, self-reported DUIC in population surveys, rates of drivers found to be DUIC in roadside surveys, and traffic collisions, injuries, and fatalities associated with cannabis use. Promising results have appeared in some contexts, different jurisdictions have established or are considering a range of DUIC laws based on per se limits and impairment, relatively few evaluations of such laws have appeared in the empirical literature. Although some promising results have been reported, it is premature to draw firm conclusions regarding the impact of DUIC laws. This review points to the need for a long-term commitment to evaluate, using multiple methods, the impact of these laws. The extensive experience with evaluation of drink-driving laws also indicates a need to take many aspects of DUIC laws into account when considering their impact, including enforcement levels, public opinion, and public awareness of the laws.
Managing Health Inteventions with interlock devices
impaired driving, interlocks, alcohol abuse treatment.
The objective of this study was to evaluate a special feature of an interlock program in Florida that uses the number of lockouts (failed breath tests) to identify offenders in need of alcohol use disorder treatment. Lockouts are an indicator of a failure to adapt to the interlock and have been shown to predict an offender’s recidivism following removal of the device. Methods: In this study, we used two statistical methods—time series analysis and odds ratio tests—to contrast the recidivism rates of offenders who met the lockout criteria for treatment before the policy was in place and treatment was required with offenders who met the lockout criteria after the treatment requirement was initiated. Results: Offenders who were treated had 34% to 57%—depending on the method of analysis (time series or odds ratio tests)—lower recidivism rates than those not subject to treatment. Conclusions: Interlock (lockout) performance can identify offenders who will benefit from substance abuse treatment and the application of the intervention is associated with a reduction in recidivism.
Marijuana, Alcohol and driving - a survey of US drivers
Marijuana; Cannabis; Alcohol; Impaired Driving.
Background: The issue of drugs and driving is receiving increased attention in the United States, as some states have legalized marijuana or are considering it. There is some evidence, based on limited questions on national surveys, that public opinion on marijuana legalization is becoming more favorable even though most people still view driving after using marijuana as a serious problem. Aim: The goal was to gauge current U.S. attitudes and behaviors related to driving after using alcohol and marijuana and how these vary by state laws on marijuana. Method: During July-October 2015, drivers 18 and older completed telephone interviews about their opinions on marijuana, alcohol, and driving, and their marijuana and alcohol use and driving. The study included representative samples of 1,508 drivers in three states with legalized marijuana for recreational use (Colorado, Oregon, and Washington), 2,510 drivers in five comparison states without legalized marijuana for recreational use (Idaho, Montana, Nebraska, Utah, and Wyoming), and 507 drivers in other states and the District of Columbia. Young people ages 18-29 were oversampled (25% of the sample). Results: Overall, drivers were more likely to say that drinking and driving is a problem in their community than driving after using marijuana (64% vs. 29%). Compared with alcohol, 46% of drivers thought marijuana’s effects on driving are about the same, 34% thought the effects are better, and 9% thought the effects are worse. A large majority (80%) supported legalizing marijuana for medical use, and 42% supported legalizing it for recreational use by people 21 and older. Drivers who supported legalized recreational marijuana were much less likely to see driving after using marijuana as a problem than those who opposed legalization (30% vs. 61% in recreational marijuana states; 17% vs. 35% in comparison states). Reported alcohol use (57%) was far more prevalent than marijuana use (9%) within the past year. A bigger proportion said they had driven within 2 hours of drinking (19%) compared with using marijuana (3%) during the past year. Drivers in states with legal recreational marijuana, relative to those in comparison states, more often said driving after using marijuana is a problem (43% vs. 28%), were twice as likely to report using marijuana within the past year (16% vs. 8%), more often were drinkers (60% vs. 46%), more often had driven within 2 hours of using marijuana (6% vs. 3%) or drinking (21% vs. 15%), more often reported increasing marijuana use during the past 3 years (3% vs. <1%), and more often reported a decrease in drinking (18% vs. 14%) during the past 3 years. Discussion/Conclusion: Drivers more often perceived drinking and driving as a problem than driving after using marijuana; however, attitudes and reported behaviors differed between drivers in states with legal recreational marijuana and drivers in comparison states. In recreational marijuana states, driving after using marijuana was much more likely to be perceived as a problem, and these states had higher reported prevalence of both drinking and driving and driving after using marijuana, compared with comparison states.
Measuring changes in drinking needed to adapt to the interlock
Alcohol ignition interlocks, alcohol biomarkers, subject recruitment, controlled drinking, impaired driving.
In the United States, drunk driving offenders are often required to install alcohol ignition interlocks that require the driver to provide a breath sample in order to start the vehicle. If the sample indicates that the driver has a blood alcohol concentration (BAC) greater than .02, a “lockout” occurs and prevents the vehicle from starting. During the 6 months to 2 or more years that the interlock is installed, most offenders learn how to reduce lockouts. Aim: The objective of this 5-year study is to determine how heavy drinkers adjust their alcohol consumption and driving in order to have BACs below the interlock lockout point whenever they attempt to start their vehicles. Do they reduce drinking, reduce driving, or learn to control each sufficiently to avoid combining them? Method: In Erie County, NY, 500 driving while intoxicated (DWI) offenders will be studied for 6 to 12 months while on the interlock and for 6 to 24 months following removal of the device. Each participant is interviewed on three occasions: (1) when the interlock is first installed, (2) when it is removed, and (3) 6 months following removal. A large set of variables is being collected to assess the characteristics of the offenders, including age, gender, ethnicity, socioeconomic status (SES), treatment history, trauma history, social support, social media involvement, and both pre- and post-interlock driver records. Timeline follow-back reports on alcohol use, drug use, and driving behaviors are being collected to be related to DWI recidivism later in the study. Participants also provide hair samples and blood or oral fluid samples at each of the three interviews. Later in the study, data from the interlock data log records (time, date, and BAC of every ignition start and random retests) will be correlated to changes in drinking and driving habits and to recidivism. A special mobile office/lab for collecting biological samples and conducting interviews has been created to make three data collection visits more convenient for participants and to increase participation and follow-up rates. Results: Preliminary results based on the first 65 participants are provided. The special procedures developed for identifying and recruiting participants, the technologies involved in collecting and analysing biological measures, and the development and use of the mobile office/lab are described. The interrelationships between biological and self-report data on alcohol and drug use and the predictive relation of these measures to interlock performance will be available later in the study. Discussion/Conclusion: Despite a New York law requiring all first-time DWI offenders to install interlocks, up to 75% do not have the device installed. The low number of interlock installations in Erie County required the development of special recruiting efforts. Participant recruitment required flexibility including offering the option to interview participants near their home localities and removing the blood sample requirement from the recruitment flyer.