REDUCING THE INCIDENCE OF IMPAIRED DRIVING THROUGH
GLOBALLY EFFECTIVE COUNTERMEASURES
Danielle Comeau
Alcohol Countermeasure Systems Corp
60 International Boulevard, Toronto, Ontario, M9W 6J2 CANADA Phone: +1 416 619 3500 Email: dycomeau@acs-‐corp.com.
Co-‐authors: Felix J.E. Comeau, Denise Connerty, Alcohol Countermeasure Systems Corp.
Road trafSic injuries and fatalities are a global public health concern, and the leading cause of death, worldwide. According to the World Health Organization, 47% of all countries do not have drink-‐driving laws based on best practices. Stricter impaired driving legislation is a start, but associated countermeasures such as increased public awareness and social support, random roadside sobriety testing, and remedial support for the convicted driver, have been proven to make these laws more effective in reducing trafSic fatalities and recidivism.
Bloomberg Philanthropies funded a consortium of partners to improve road safety in 10 coun-‐ tries over 5 years spanning 2010 – 2014. Brazil was one of the countries chosen for this initial phase of the Global Road Safety Partnership as it has one of the highest rates of trafSic fatalities in the world. Building on their initial success, this year began the start of the next Sive-‐year phase, spanning 2015 – 2019. During this phase, 10 cities and 5 countries were chosen to re-‐ ceive support and intervention. Three of the ten cities are in South America, indicating their commitment to improve road safety.
Education is key for a successful road safety initiative. Education of the judges regarding the sanctions and efSicacy of the technology utilized, viz, roadside (portable) breath tester, alcohol interlocks, continuous alcohol monitoring, and oral Sluid drug testers. Areas where there is doubt about the reliability of a technology used for detection, or a lack of knowledge regarding the technology, show a reduction in conviction rates. Judges who are familiar with and trust the results of the technology are more likely to convict offenders and support an integrated ap-‐ proach to dealing with drink-‐driving.
Education of the public regarding the detection and enforcement measures, as well as the conse-‐ quences of being apprehended has proven to be effective in supporting a road safety initiative. Studies have shown that increased public awareness of enforcement leads to the fear of being caught, which then leads to a reduction in the occurrence of such offences.
Education of the public at large is important, regarding the effects of drugs and alcohol on dri-‐ ving, especially with young drivers. This sub-‐group of drivers is the highest risk for road trafSic crashes, especially when under the combined inSluence of drugs and alcohol. Many countries have adopted a zero tolerance for alcohol as well as graduated licensing for this high-‐risk group. Both of these measures have resulted in lower rates of alcohol-‐related injuries and deaths. A study by the Canadian Centre on Substance Abuse shows that many youth believe drugged dri-‐ ving is less dangerous than drunk driving. These youth also believe that cannabis is not a harm-‐ ful drug, and that it actually improves their driving ability; therefore early education regarding the risks and harm of cannabis is key, as these beliefs are formed often before high school ac-‐ cording to the study.
Training of law enforcement personnel as well as judicial and remedial support personnel is im-‐ portant to ensure a consistent message. Detection methods include random sobriety check-‐ points, utilizing the Standard Field Sobriety Tests, and Portable Breath Testers using improved technology such as infrared sensing instruments. Enforcement needs to be consistent, strict and swift. In areas where this is the case, they have seen a reduction in alcohol related trafSic crash-‐ es. Drug detection at the roadside is being implemented with more frequency as laws are enact-‐ ed to allow for roadside drug screening. Training of law enforcement in using drug screeners as well as drug-‐speciSic Sield sobriety testing is essential to detect those who are both drug and al-‐
cohol impaired, as their BAC level may be within an “acceptable” range according to legislation but their level of impairment is at a dangerous level.
Monitoring methods such as alcohol interlocks have proven effective in reducing recidivism for those convicted of drink-‐driving. When utilized, alcohol interlocks result in 64% reduction in recidivism.
Alcohol interlocks are effective at preventing a person under the inSluence of alcohol from oper-‐ ating a motor vehicle. They do not, however, change the underlying behaviour associated with drinking and driving. For best results, a combined approach of alcohol interlock programs, to-‐ gether with remedial support to deal with the underlying issues associated with their behaviour, and close monitoring to ensure compliance, are all necessary measures. Probation requirements in some jurisdictions include continuous alcohol monitoring and/or drug patches to ensure compliance with a no drug or alcohol condition. Others are instituting a home arrest condition, combining continuous alcohol monitoring with monitored daily alcohol breath tests. While these remedial measures assist in monitoring daily alcohol intake, only an alcohol interlock di-‐ rectly prevents an individual from drink driving.
To be truly effective, countermeasure strategies should take into account the differing character-‐ istics of age and gender subgroups, and tailor the education, rehabilitation and legislative initia-‐ tives accordingly. The group with the highest rates of alcohol related trafSic injuries/deaths is younger male drivers (25-‐35 years). Graduated licensing and zero tolerance for young drivers (under 21 years) is one such targeted measure. While much is known about the male drink-‐dri-‐ ver, not as much is known about the characteristics of the female impaired driver. According to TIRF’s study on Female Drunk Drivers, they tend to be single, separated or divorced, have chil-‐ dren for whom they are solely responsible, and have a concurrent mental health diagnosis such as anxiety or depression. Making gender-‐speciSic treatment programs available has shown to be more effective in treating female impaired drivers.
Public perception has a strong inSluence on behaviour. Statistics from the United States indicate that 84% of the general public favours the mandatory use of alcohol interlocks in the vehicles of convicted drink-‐driving offenders. Social campaigns are a relatively inexpensive way to educate the public about the jurisdiction’s impaired driving laws, and the consequences of breaking those laws; the harmful effects of alcohol and drugs on the body, especially in youth and women; allowing for a gradual changing of public perception in favour of stricter enforcement in the in-‐ terests of public safety. It can also help shape the culture surrounding drinking and driving in countries that have not previously adopted a formal policy on the subject.
Australia has the most successful Random Breath Test (RBT) program worldwide. One report determined that RBT in Australia led to a 33% reduction in alcohol-‐related fatalities. Having be-‐ gun their RBT programs in the 1980s, they have a wealth of data to support their best practice recommendations. These include ensuring RBT is perceived by the community as being truly random, and therefore ever present, unpredictable and there must be penalties associated with it. It must be consistent throughout the jurisdiction, strategically deployed, strictly enforced, and well publicized. There must also be a treatment/rehabilitation program for repeat offenders. In areas where all of the best practices are implemented, a reduction in alcohol-‐related injuries and fatalities has been demonstrated.
Technology can be a valuable tool in any road safety plan. When utilized properly and consis-‐ tently, devices such as the alcohol interlock and the roadside breath
alcohol test screener are able to accurately and safely identify drivers who are either driving while under the inSluence, or attempting to do so. This has the direct effect of immediately removing and preventing future injuries and fatalities due to alcohol-‐related crashes.
Along with drink-‐driving, drugged driving is becoming a public concern. The DRUID project tested oral Sluid screening devices and although some European countries and Australia are us-‐ ing them in their roadside screening programs, more research is required to establish threshold levels for determination of intoxication of the various drugs as well as their effects on driving habits. Oral Sluid screeners are useful and accurate for determining recent consumption of cer-‐ tain drug classes, and may therefore be useful for determining which drivers are under the inSlu-‐ ence of both alcohol and drugs when combined with alcohol breath test screeners during Ran-‐
dom Breath Test stops. These are the drivers who are at the highest risk of causing trafSic acci-‐ dents resulting in serious injury or death. Because of the rapid metabolism of some drugs, such as THC, it is suggested to perform the test at the roadside rather than wait 30 to 90 minutes for a blood sample at the police station.
Enforcement is currently tailored to the highest frequency of drink driving convictions, namely late nights and weekends. The frequency of drug driving, however, has been found to be equally distributed throughout the weekdays and weekends, and hence enforcement should be in-‐ creased to match this group, ensuring that drug testing is used to the same degree as alcohol testing at the roadside, or at crash sites. Looking at subgroup distribution, it is found that fe-‐ males are more likely to test positive for CNS depressants, while cannabis and narcotic anal-‐ gesics were more commonly found in males. Training more law enforcement personnel in the signs of drug impairment would broaden the scope of assessment for impaired driving.
Based on observations of governments with longstanding impaired driving legislation, the fol-‐ lowing conclusions can be drawn: In order for countermeasures to be effective, a government must have a law or legislation in place that clearly deSines the parameters of impaired driving, the Sines and alternative programs available (eg. alcohol interlock), incentives for choosing re-‐ medial programs (reduction in Sines, shortened license suspension), and programs based on technology that has proven efSicacy such as alcohol interlocks. Assigning a ministry or depart-‐ ment within the government to be responsible and accountable for coordination of the program, and collection of data, is crucial for its success.
Drawing from best practices in countries that have successfully improved road safety, it appears that the most effective plan should include the following countermeasures: effective road side screening; accurate, reliable and precise technology; education and public awareness; and reme-‐ dial support for the convicted driver to reduce recidivism rates, especially those involving both drink and drugged driving. Utilizing these countermeasures in an integrated program has proven to be effective in reducing injuries and related costs associated with impaired driving. REFERENCES
Beirness, D.J., Beasley, E.E. (2009). Alcohol and drug use among drivers: British Columbia Roadside Survey 2008. Ottawa: Canadian Centre on Substance Abuse.
Beasley, E.E., Beirness, D.J., Porath-‐Waller, A.J. (2011). A Comparison of Drug and Alcohol involved Motor Vehicle Driver Fatalities. Ottawa: Canadian Centre on Substance Abuse.
Blencowe, Tom, Pehrsson, Anna and Lillsunde, Pirjo. Alcohol and Drug Analytics Unit, National Institute for Health and Welfare (THL), Finland, DRUID Report; Analytical evaluation of oral Cluid
screening devices and preceding selection procedures. http://www.druid-‐project.eu/Druid/EN/
deliverales-‐list/downloads/Deliverable_3_2_2.pdf?__blob=publicationFile&v=1
Bloomberg Philanthropies, Leading the Worldwide Movement to Improve Road Safety, http:// www.grsproadsafety.org/sites/grsp.drupalgardens.com/Siles/201302/RS10_Brox.pdf
Canadian Centre on Substance Abuse. 2014. Random Breath Testing, Policy Brief.
Foundation for Alcohol Research and Education (March 2015). A national examination of Ran-‐ dom Breath Testing and alcohol-‐related trafCic crash rates (2000-‐2012).
Governors Highway Safety Association (2015). Drug-‐Impaired Driving, A Guide For What States Can Do.
Guangqing Chia, Xuan Zhoua, Timothy E. McClure, Paul A. Gilbert, Arthur G. Cosby, Li Zhang, An-‐ gela A. Robertson, David Levinson. (2011) Gasoline prices and their relationship to drunk-‐driving crashes. Accident Analysis and Prevention. 43, 194-‐203
National Highway TrafSic Safety Association, (2013) Countermeasures That Work: A Highway Safety Countermeasure Guide For State Highway Safety OfCices, Seventh Edition.
Neavyn, M.J., Blohm, E., Babu, K., Bird, S.B. (2014) Medical Marijuana and Driving: A Review, Jour-‐ nal of Medical Toxicology, 10, 269-‐279
Porath-‐Waller, A.J., Brown, J.E., Frigon, A.P., Clark, H. (2013). What Canadian Youth Think about Cannabis: Technical Report. Ottawa: Canadian Centre on Substance Abuse.
Robertson, R.D., Holmes, E., Marcoux, K. (2013) Female Drunk Drivers: A Qualitative Study, Histo-‐ ry and Experiences in the System. TrafSic Injury Research Foundation.
Schulze, H., Schumacher, M., Urmeew, R., and Auerback, K (2012). DRUID Final Report; Work Per-‐ formed, Main Results and Recommendations. BerSisch Gladbach, Federal Republic of Germany; Federal Highway Research Institute (BASt). http://www.druid-‐project.eu/Druid/EN/Dissemina-‐ tion/downloads_and_links/Final_Report.html.
Vanlaar, Ward. “Drinking and Driving: Countermeasures that work.” Simposio de Accidentalidad Vial y Alcohol, Bogota, Colombia. 19 November 2013
World Health Organization, Global Status Report on Road Safety, 2013, http://www.who.int/vio-‐ lence_injury_prevention/road_safety_status/2013/en/
World Health Organization, Global Status Report on Road Safety, 2015,
