Evidenced-Based Effective Strategies for Alcohol Related Injury

1. Evidenced-Based Effective Strategies for Alcohol Related Injury Intermediate Injury Prevention Course Indian Health Service

2. Evidenced-Based Effective Strategies Goal: Understand effective strategies for reducing alcohol-impaired driving, alcohol policy, and deterrence.

3. Framework to Consider Impaired Driving Strategies Alcohol Policy Transportation Policy Reduce Drinking in a Drinking Society. Reduce Driving in a Driving Society. Law Enforcement Injury Prevention Reduce the risk of injury when drinking and driving happens. General Deterrence

4. 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

5. 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?

6. Law Enforcement Developing an atmosphere where people know that if you drink and drive, punishment will be, Swift, Certain, and Severe

7. Conceptual Framework for Alcohol-Related Motor Vehicle Crashes • Minimum Legal • Drinking Age Laws • Server Intervention • Training Alcohol Consumption Social Norms Regarding Drinking and Driving Alcohol-related Crashes Fatal and Nonfatal Injuries Drinking and Driving Seat Belts, Child Restraints • Lower BAC • Laws • Sobriety • Checkpoints Perceived Risk of Arrest Source: Shults RA, et al, reducing injuries to motor vehicle occupants. AmJ Prev Med 2001;21 (66-87)

8. 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%).

9. 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.

10. Effective Strategies for Reducing Alcohol-Impaired Driving • .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.

11. 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.

12. 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

13. Effective Sobriety Checkpoints • Public Awareness • High Visibility Enforcement • Media • Regular Checkpoints

14. Are Sobriety Checkpoints Legal • 1990 US Supreme Court Decision Upheld Checkpoints • 11 States Prohibit Checkpoints

15. Changing Social Norms • Designated Driver • MADD • SADD • Sobriety Pledges by Elected Officials • Promising, not Proven…

16. Alcohol Policy • Reduce Access to Alcohol. • Reduce Acceptance of Alcohol use. • Increase Availability and Access of Substance Abuse Treatment.

17. 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

18. Alcohol Strategies Review Alcohol Policy Transportation Policy Reduce Drinking in a Drinking Society. Reduce Driving in a Driving Society. Law Enforcement Injury Prevention Reduce the risk of injury when drinking and driving happens. General Deterrence

19. Alcohol and InjurySummary • 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

20. 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

21. 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

22. Impaired Driving Prevention Resources • Mother’s Against Drunk Driving: www.madd.org • National Highway Traffic Safety Administration: www.nhtsa.org