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Drunk Driving and Public Health Overview

Drunk Driving and Public Health Overview. Martin Donohoe, MD, FACP. Drunk Driving- Epidemiology. MVAs the #1 cause of death age 6-33 2/5 people in the US will be involved in an alcohol-related MVA during their lifetimes 39.3% if the 42,000 traffic fatalities in 1997 were alcohol - related

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Drunk Driving and Public Health Overview

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  1. Drunk Driving and Public Health Overview Martin Donohoe, MD, FACP

  2. Drunk Driving- Epidemiology • MVAs the #1 cause of death age 6-33 • 2/5 people in the US will be involved in an alcohol-related MVA during their lifetimes • 39.3% if the 42,000 traffic fatalities in 1997 were alcohol - related • 1.2 x 106 alcohol-related MVA injuries/yr. - one every 26 seconds

  3. Drunk Driving- Epidemiology • 51% of U.S. drivers acknowledge drinking alcohol • 2.5% of adults over 18 admitted to an average of 26 episodes of driving while intoxicated in 1993 • total = 1.23 million episodes/yr. for the entire U.S. • 18% of high school students admit to driving after drinking during two-week study period in 1997 • 12% drove after 5 or more drinks

  4. Drunk Driving- Epidemiology • Chance of arrest/drunk driving episode = 1/50 - 1/2000 • Conviction rates for impaired drivers requiring admission to a hospital or trauma center range from 4 - 51% (avg. = 24%) • Conviction rates are higher for impaired drivers who are not injured

  5. Drunk Driving- Epidemiology • Of those arrested and convicted, 1/5 - 1/3 will be arrested again • persons with 1 drunk driving conviction have 9x the baseline population mortality rate; 2 convictions  36x • both have higher rates of subsequent traumatic injury, # of hospital days, and health care costs • intoxicated patients with no traumatic injury are 3x more likely to get substance abuse counseling than intoxicated, injured patients

  6. Reasons for Lax Enforcement • Inability of police to identify legally - intoxicated drivers (50% at sobriety checkpoints) • Chain of evidence problems • Time constraints • Sensitivity toward injured driver

  7. Drunk Driving- Epidemiology • Direct Economic impact of alcohol-related crashes was $46.1 billion in 1990 • 78% of ER physicians favor mandated reporting laws

  8. Other Key Points • Physicians under-recognize EtOH abuse (up to 25% of hospitalized patients meet criteria for alcohol abuse. • Drivers often impaired due to other illegal substances • of injured motorists in Illinois, 32% were legally drunk, 23% has positive urine drug screens (9% cocaine), 45% overall impaired, only 16.5% of those were cited.

  9. Other Key Points • Other factors can impair driving ability • seizure disorders, dysrhythmias, AICD misfirings, syncope, vision impairment, dementia, youthful irresponsibility • Alcohol is involved in 67% of homicides, 69% of assaults, and 56% of domestic violence episodes

  10. Other Key Points • Tackling the problems of impaired drivers requires a multi-pronged approach: •  alcohol availability •  alcohol taxes (equitable) • P-care screening • treatment programs • law enforcement

  11. Other Mandated Reporting Laws • infectious disease • criminal violence • child abuse, elder abuse, domestic violence • disorders causing lapses of consciousness • occupational injuries and pesticide poisoning • patient neglect or abuse in another facility • substance abuse in pregnant women • sexual abuse by other physicians/therapists

  12. Contact Information Public Health and Social Justice Website http://www.phsj.org martindonohoe@phsj.org

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