Drugged Driving: Michigan Supreme Court Upholds State DUID Law — Now You
Don’t Even Have to Be High to Get Busted 6/23/06

If you smoke a joint Friday night and drive to work bright-eyed and
bushy-tailed Monday morning in Michigan, you can be arrested, charged,
and convicted as a drugged driver because inactive chemical traces of
THC, or metabolites, remain in your bloodstream. The Michigan Supreme
Court ruled Wednesday that motorists can be convicted of Driving Under
the Influence of Drugs (DUID) even if they are not under the influence of
drugs. According to the Supreme Court opinion in the consolidated cases
Derror v. Michigan and Kurts v. Michigan authored by Justice Maura
Corrigan, actual innocence of driving while impaired is “irrelevant.”

In both cases, authorities charged the defendants under the Michigan
DUID law based on the presence of cannabis metabolites, an inert
byproduct of the body’s breakdown of THC, in their blood. The presence of
metabolites does not indicate impairment or being “under the influence”;
it only indicates that someone ingested THC at some time in the past, as
the state Supreme Court acknowledged in its ruling. Both trial courts
held that the metabolite was not “marijuana” and thus a controlled
substance under state law, a position upheld on appeal.

Both a majority on the Supreme Court disagreed. Neither the DUID nor
the controlled substances law “requires that a substance have
pharmacological properties to constitute a schedule I controlled
substance,” the majority held. Neither does the DUID law “require that a
defendant be impaired while driving. Rather, it punishes for the
operation of a motor vehicle with any amount of schedule I controlled
substance in the body.”

Then, breathtakingly, Justice Corrigan wrote, “It is irrelevant that a
person who is no longer ‘under the influence’ of marijuana could be
prosecuted under the statute. If the Legislature had intended to
prosecute only people who were under the influence while driving, it
could have written the statute accordingly.”

Now, any Michigan driver who has smoked marijuana in the last few days
or, in the case of heavier smokers, up to three or four weeks, is subject
to a DUID arrest based on the presence of inert leftover metabolites that
do not actually indicate impairment. In a harsh dissent, Justice Michael
Cavanaugh warned the court it would criminalize a huge class of
people.

“Today’s holding now makes criminals out of numerous Michigan citizens
who, before today, were considered law-abiding, productive members of our
community,” he wrote. “Now, if a person has ever actively or passively
ingested marijuana and drives, he is [unknowingly] breaking the law,
because if any amount of [cannabis metabolites] can be detected — no
matter when [the marijuana] was previously ingested — he is committing a
crime. The majority’s interpretation, which has no rational relationship
to the Legislature’s genuine concerns about operating a motor vehicle
while impaired, violates the United States Constitution and the Michigan
Constitution.”

The ruling could have an impact beyond Michigan. Twelve other states
have enacted laws making it a criminal offense to drive under the
influence of drugs. They use standards similar to those upheld this week
— the presence of trace levels of drugs or metabolites — to assume
impairment. Unlike drunk driving laws, which assume a certain blood
alcohol level after which one is considered impaired, the DUID laws
assume that the presence of any metabolite or trace proves
impairment.

Source: http://stopthedrugwar.org/

National Institute on Alcohol Abuse and Alcoholism

No. 23 PH 347 January 1994

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Alcohol and Minorities

Do blacks, Hispanics, American Indians, and Asians and Pacific
Islanders in the United States drink more or less than whites drink? Do
they have more alcohol-related medical problems? Do they receive
treatment in proportion to their problems? In 1990, 68.3 percent of
whites, 64.5 percent of Hispanics, and 55.6 percent of blacks used
alcohol (1). Although these percentages appear similar, different
patterns of use and abuse and varying prevalence of alcohol-related
problems underlie the numbers (2-9). This Alcohol Alert considers why
some minorities have more medical problems than others and whether
minorities receive adequate treatment and prevention services. It
examines genetic and environmental factors that may put minorities at
risk for or protect them from alcohol problems. It also reviews research
on screening to identify those at risk for alcoholism or alcohol
abuse.

Medical Consequences and Alcohol-Related
Trauma

Given major underreporting of alcohol-related diagnoses, minimum
estimates from one survey of non-Federal, short-stay hospitals in 1991
found 54.5 patient discharges for alcohol-related diagnoses for every
10,000 people in the United States over age 15 (10). The rate for whites
was 48.2 per 10,000; however, the rate for blacks was 102.9 per 10,000
population (10). Because it is not known whether the rates of
underreporting are equal among ethnic groups, it is difficult to
interpret the meaning of such reported differences.

A study of alcohol-related mortality in California showed that blacks
and Hispanics had higher rates of mortality from alcoholic cirrhosis than
did whites or Asian-Americans. Nationwide, death rates attributed to
alcohol dependence syndrome also were highest for blacks, although a
higher percentage of blacks than whites abstain from using alcohol
(5,11). The high rates of medical problems seen in blacks thus occur
among a smaller percentage of the black population when compared with
whites.

The California study suggests that for many alcohol-related causes of
death such as alcohol dependence syndrome and alcoholic hepatitis,
Hispanics had either similar or lower mortality rates compared with
whites. However, the mortality rate among Hispanics from alcohol-related
motor vehicle crashes was 9.16 per 100,000, significantly higher than the
rates for whites (8.15) or blacks (8.02) (11).

The group identified as “Asian/Other” in the California study had
lower rates of alcohol-related mortality than any other group for most
causes of death. Their mortality rate from motor vehicle crashes, for
example, was 5.39 per 100,000 (11). Asians tend to have lower rates of
drinking and alcohol abuse than whites (2).

Although highly variable among tribes, alcohol abuse is a factor in
five leading causes of death for American Indians, including motor
vehicle crashes, alcoholism, cirrhosis, suicide, and homicide. Mortality
rates for crashes and alcoholism are 5.5 and 3.8 times higher,
respectively, among American Indians than among the general population.
Among tribes with high rates of alcoholism, reports estimate that 75
percent of all accidents, the leading cause of death among American
Indians, are alcohol related (7).

Fetal Alcohol Syndrome (FAS)

The prevalence of FAS among select groups of Navajo, Pueblo, and
Southwestern Plains Indians has been studied. Among two populations of
Southwestern Plains Indians ages newborn to 14 years, 10.7 of every 1,000
children were born with FAS. This was compared with 2.2 per 1,000 for
Pueblo Indians and 1.6 for Navajo (12). Overall rates for FAS in the Un
ited States range from 1 to 3 per 1,000 (15). Cultural influences,
patterns of alcohol consumption, nutrition, and differing rates of
alcohol metabolism or other innate physiological differences may account
for the varying FAS rates among Indian communities (13).

The incidence of FAS among blacks appears to be about seven times
higher than among whites, although more blacks than whites abstain from
drinking (5,14,15). The reasons for this difference in FAS rates are not
yet known (14,15). Paradoxically, one study has found that black women
believe drinking is acceptable in fewer social situations than do white
women (6). Ten percent of black compared with 23 percent of white women
surveyed said that drinking more than one or two drinks at a bar with
friends is acceptable (6). This attitudinal difference could help to
explain why fewer black women are frequent, high-quantity drinkers than
are white women (6). Nevertheless, FAS seems to be more prevalent among
blacks than among whites.

Genetic Influences

Certain minority groups may possess genetic traits that either
predispose them to or protect them from becoming alcoholic. Few such
traits have so far been discovered. However, the flushing reaction, found
in the highest concentrations among people of Asian ancestry, is one
example.

Flushing has been linked to variants of genes for enzymes involved in
alcohol metabolism. It involves a reddening of the face and neck due to
increased blood flow to those areas and can be accompanied by headaches,
nausea, and other symptoms. Flushing can occur when even small amounts of
alcohol are consumed (16).

Japanese-Americans living in Los Angeles have been studied. Among
those with quick flushing responses (flushing occurs after one drink or
less), fewer consumed alcohol than did those with no or with slow
flushing responses (flushing occurs after two or more drinks)(17). In
another group of Japanese-American students in Los Angeles, flushing was
far less correlated with abstention from alcohol than it was in the first
group (17). Thus, although flushing appears to deter alcohol use, people
with the trait may nevertheless consume alcohol.

Another genetic difference between ethnic groups occurs among other
enzymes involved in metabolizing alcohol in the liver. Variations have
been observed between the structures and activity levels of the enzymes
prevalent among Asians, blacks, and whites (18). One enzyme found in
Japanese, for example, has been associated with faster elimination of
alcohol from the body when compared with whites (19). Interesting leads
relating these varying rates of alcohol metabolism among minorities to
medical complications of alcoholism, such as liver disease, are now being
followed.

Influence of Acculturation

Acculturation has a dramatic effect on drinking patterns among
immigrants to the United States and successive generations. Comparisons
of drinking among immigrant and second and third generation
Mexican-American women reveal that drinking rates of successive
generations approach those of the general population of American women.
Seventy-five percent of Mexican immigrant women in one study abstained
from alcohol; only 38 percent of third generation Mexican-American women
abstained. This rate is close to the 36-percent abstention rate for women
in the general U.S. population (20). Rates of alcohol-related problems
also may be affected by acculturation. A study has found that Hispanic
women who are at least second generation Americans have higher rates of
social and personal problems than either foreign born or first generation
Hispanic women (3). Studies of Asian-Americans have suggested that their
drinking rates conform to those of the U.S. population as acculturation
occurs (17,21).

Identification and Treatment

Do screening instruments for alcohol-relat ed problems, validated in
primarily white populations, accurately detect alcohol problems among
minorities? One study evaluated the Self-Administered Alcoholism
Screening Test (SAAST), translated into Spanish, in Mexico City and the
original English version in Rochester, MN. The Spanish translation
identified alcoholics and nonalcoholics at rates comparable to those of
the English version. The study found that the questions that best
predicted alcoholism were the same in both versions (22). This study
suggests that translations or other revisions of screening tools may be
just as accurate as the original instruments, but more studies are needed
before firm conclusions can be drawn.

It is not known whether all treatment programs are effective for
members of minority groups. Among minority patients who enter treatment
programs for the general population, success rates are equal to those of
whites in the same programs (23,24). Also, despite the existence of
programs designed to treat specific minority groups, no evidence exists
that either supports or denies their ability to produce improved outcomes
(25,26).

Do minorities have the same access to alcoholism treatment as do
whites? Access to treatment for minorities has not been assessed widely,
but several factors have been studied. There is evidence that not
everyone in these groups who needs treatment receives it. For example,
Hispanics and blacks are less likely to have health insurance and more
likely to be below the poverty level than whites, factors that may
decrease their access to treatment (24,27,28).

No studies focus on access to alcoholism treatment for the U.S.
Hispanic population as a whole (28). Some culturally sensitive programs
exist for Hispanics and are often aimed at specific cultures within this
group, such as Puerto Ricans. These programs have not been evaluated
(24,28).

Prevention

Prevention efforts that work among the general population have been
shown to be effective among some minorities (29). However, it is unclear
whether interventions designed for specific minorities also would be
beneficial. For example, programs incorporating peer counseling,
enhancing adolescents’ coping skills, and alcohol education appear to be
effective among American Indians. One study has demonstrated that
specific populations of American Indian adolescents who completed such a
program used less alcohol when compared with their peers 6 months after
completion of the program (29). A second study showed that American
Indian participants in another program decreased their own use of alcohol
when evaluated 12 months after the program’s completion (30).

The effectiveness of warning labels on alcoholic beverage containers
has been evaluated in a group of black women (31). A study showed that 6
months after the label was mandated by law, pregnant black women who were
light drinkers slightly reduced their drinking during pregnancy, whereas
black women who were heavier drinkers did not change their drinking
habits (31).

———————————————————————-

Alcohol and Minorities–A Commentary by
NIAAA Director Enoch Gordis, M.D.

The increasing number of studies of alcohol problems among minorities
has produced both important findings and new questions to answer. Higher
abstention rates among African-Americans coexist with higher cirrhosis
mortality. Native American groups vary greatly in their drinking
practices, but the specific contributions of social, cultural, and
genetic influences to these variations are not yet known. We need to
understand why acculturation seems to increase drinking among successive
generations of Hispanics and diminishes the “protective” effect of the
flushing reaction among succeeding generations of Asian-Americans.
Finally, we need to know more about disparities in access to treatment
and prevention among minority groups and whether culturally relevant
treatment appr oaches improve treatment outcome.

———————————————————————-

All material contained in the Alcohol Alert is in the public
domain and may be used or reproduced without permission from NIAAA.
Citation of the source is appreciated.

Copies of the Alcohol Alert are available free of charge from
the Scientific Communications Branch, Office of Scientific Affairs,
NIAAA, 6000 Executive Boulevard, Room 409, Rockville, MD
20892-7003.Telephone: 301-443-3860.

———————————————————————-

U.S. DEPARTMENT OF HEALTH AND HUMAN SERVICES

Public Health Service * National Institutes of Health

FACTS ON: Alcohol, Drugs and Domestic Violence

By Robert Mackey, Ph.D., C.A.C., DVS

Statistics on the positive correlation between domestic violence and
addiction range from forty-four percent, according to the New Jersey
Uniform Crime Report of 1989, to more than eighty percent in some
research studies. According to the National Woman Abuse Prevention
Project in Washington, D.C., alcoholism and battering share the following
characteristics: Both are inter-generational, involve denial and
minimization of the problem, and involve isolation of the family.
Considering this, any intervention with either of these problems should
consider the implications and presence of the other.

The topic of domestic violence and its association with addiction has
received increased attention over the past decade. In a report by
Schuerger and Reigle (1988), personality and background data were
obtained on two-hundred fifty men enrolled in a group treatment program
for spouse abuse. The major conclusions of this investigation verified
the prevalence of alcoholism, drug abuse, and violence in the family of
origin of abusive men. Fitch and Papantonio (1983) found violence between
the batterer’s parents, abuse of the batterer as a child, alcohol and
drug abuse, and economic stress to be highly correlated to spouse abuse.
Data from the New York based program, Abused Women’s Aid In Crisis,
indicate that alcohol abuse on the part of the husband was a factor in
over eighty percent of their cases. Other findings cited by these authors
came from a survey involving interviews of one hundred wives of
alcoholics who had identified themselves as victims of abuse. Seventy-two
percent of these women indicated they had been threatened physically,
forty-five percent had been physically attacked, and twenty-seven percent
had experienced potentially lethal attacks. None of these women had
sought help as victims of battering, suggesting that alcohol abuse is not
only a factor in many cases of domestic violence, but that wife battering
may be very common in families of alcoholics.

Lehmann and Krupp (1984) surveyed one thousand five hundred cases of
women calling a hotline for abused women in Philadelphia, and fifty-five
percent of these women said that their husbands became abusive when
drinking. Lehman and Krupp asserted that although the association between
alcoholism and domestic violence is clear, “most existing research
supports the conclusion that alcohol abuse does not cause domestic
violence.” A final portion of this research involved interviews with ten
alcoholism counselors and ten workers specializing in the field of
domestic violence. Contrary to the research literature, workers in both
fields believed that alcoholism was, in fact, the primary cause of the
violence. These findings support the need for collaboration between the
fields of addiction treatment and domestic violence as well as for
professional training on the subject.

In summary, research on alcohol abuse and domestic violence makes it
clear that men with drinking problems are at high risk to be abusive
toward their spouses. However, it is also clear that many men who have
drinking problems do not abuse their wives, and that some men who don’t
have drinking problems do abuse their wives. Therefore, the conclusion
that there is no direct causal relationship between drinking and spouse
abuse, a position supported by most of the researchers in this area,
appears irrefutable.

There are a few important points to consider when intervening with the
problems of alcohol abuse and domestic violence. First, there is no
causal relationship between the two, therefore recovering from one of the
problems does not assure resolution of the other. Treatment of the
addiction should precede treatment for the battering; however, in many
cases counseling for battering can be initiated concurrently or can be
instituted initially to assist in confronting the denial of the
addiction. In either case, the violence must be addressed immediately,
either through counseling or through legal sanctions and restraints, to
assure the safety of the victim(s). Victims of domestic violence, whether
alcoholism is involved or not, should receive the benefit of counseling
and education about the cycles and dynamics of battering. Victims should
also be given the opportunity to investigate family-of-origin issues,
beliefs, behavioral patterns, and role expectancies that increase
vulnerability to abusive types of relationships through disempowerment.
The goal of intervention is to assure safety and to empower both victim
and abuser to act independently in their best interests. While family
therapy can be an important aspect of addiction recovery, it is
contraindicated in the presence of domestic violence. Early recovery,
where both problems exist, should focus on individual self-management and
should incorporate marital or family treatment as an adjunct therapy
later in the therapeutic process. Domestic violence creates an extreme
imbalance of power in the relationship which prohibits effective
negotiation. This “disempowerment” requires a reasonable degree of
resolution before the effective assertion of the victim’s needs can be
realized.

It is recommended that the following components be incorporated in
treatment programs for battering, in order of priority:

1. Instruct and support the alcoholic-batterer in abstaining from
   alcohol use and violence through direct appeal, and through appropriate
   treatment modalities (or through legal or formal sanctions such as
   restraining orders, job jeopardy, etc.)
2. Confront denial and projection of responsibility.
3. Incorporate recovery programs for addiction concomitant with anger
   management and self-control techniques.
4. Address relapse issues common to both problems, such as resentment,
   self-pity, and self-defeating patterns of behavior.
5. Teach assertive communication skills.
6. Educate all parties on the techniques of effective problem-solving,
   thereby empowering each individual in the system to behave in his or
   her personal best interest.
7. Address the needs of the family system. These are
   inter-generational problems, and prevention is a primary
   objective.

Domestic violence and addiction can be a lethal mix. The loss of
control and effects of alcohol and drug abuse contribute significantly to
the severity of beatings in abusive relationships. FBI statistics
indicate that thirty percent of female homicide victims are killed by
their husbands or boyfriends. Battering, unlike the disease of addiction,
is a socially learned behavior which can be reversed if the motivation
for change is realized. Techniques to conrol one’s behavior and social
skills can be relearned to eliminate the violent behavior, just as life
manageability can be attained through a commitment to recovery. Just as
abstinence from a drug is alone insufficient for true recovery,
elimination of violent behavior is just the first of many steps toward
breaking the cycle of domestic violence.

Suggestions for Abusers

1. Seek professional help for addiction and/or aggression control.
   This may require involvement in appropriate 12-step meetings and in
   anger management counseling; addressing one problem will not
   necessarily solve the other.
2. Understand that both battering (physical and psychological) and
   addiction are progressive. The longer you deny the problems, the more
   dangerous they become.
3. Resentment, denial, self-pity, and loss of control are
   characteristic of alcoholism and battering. Be willing to get
   honest.
4. Alcoholism and family violence tend to be inter-generational; be
   prepared for long-term care. Be supportive and encourage help for your
   children and family. 5.You canêt avoid influencing others,
   but you can’t afford to control anyone but yourself.

Suggestions for Battered Persons

1. Define yourself as a survivor of violence rather than a victim;
   it’s more empowering.
2. Reach out to support groups; isolation is one of your greatest
   enemies.
3. Trust that ultimately you know whatês in your best
   interest, and act accordingly.
4. Realize that you are not the cause of another’s behavior; you
   cannot change someone else, so focus on yourself.
5. Develop a safety plan for you and your children in the event that
   you need to act quickly. A local domestic violence service can assist
   you in developing your options and advise you of your rights.

References ans Suggestions for Further
Reading

Banerjee Associates. (1994). Secret wounds: Working with child
observers of family violence [Video]. Princeton NJ:
Producer/Director.

Eberle, P.A. (1982). Alcohol abusers and non-users: Discriminant
analysis of differences between two subgroups of batterers. Journal
of Health and Social Behavior, 23, 260-271.

Fitch, F.J., & Papantonio, A. (1983). Men who batter: Some
personality characteristics. Journal of Nervous and Mental Disease,
171(3), 190-192. Forward,S., & Torres, J. (1986). Men who hate
women & the women who love them. New York, NY: Bantam Books.

Lehmann, N., & Krupp, S. (1984). Alcohol-related domestic
violence: Clinical implications and intervention strategies. Alcohol
Treatment Quarterly, 1(4), 111-115.

Martin, D. (1981).Battered wives. San Francisco, CA: Volcano
Press, Inc. National Woman Abuse Prevention Project, 2000 P Street, NW,
Suite 508, Washington, D.C. 20036.

New Jersey Battered Women’s Coalition. (1995). Relationships and
power (R.A.P.). Trenton, NJ: Author. Roberts, A.R. (1988). Substance
abuse among men who batter their mates. Journal of Substance Abuse
Treatment, 5, 83-87.

Schuerger, J.M., & Reigle, N. (1988). Personality and biographic
data that characterize men who abuse their wives. Journal of Clinical
Psychology, 44(1), 75-81.

Sonkin, D.J., & Durphy, M. (1982). Learning to live without
violence. San Francisco, CA: Volcano Press, Inc.

Weisinger,H. (1985). Dr. Weisinger’s anger workout book. New
York, NY: Quill.

———————————————————————-

Drinking and Driving Costs California Businesses More Than $2.5 Billion
Annually

Contact: Dawn Brogan (916) 444-8014
E-mail: [email protected]

——————————————————————————–

(SACRAMENTO–September 6, 1995) — Drinking and driving will cost
California businesses more than $2.5 billion this year, according to a
study released today by the California Coalition Against Driving Under
the Influence (CaDUI).

The study — conducted by a business school professor at California
State University, Sacramento — looked at a wide range of bottom line
impacts associated with injuries, deaths and property damage caused by
driving under the influence (DUI).

“DUI inflicts tragedy on society and extracts a tremendous cost from
the state’s employers and economy,” said Lisa Dunn, corporate relations
manager with Mitsubishi Motor Sales of America and CaDUI chair. CaDUI is
a coalition of public and private sector groups allied in the fight
against DUI.

More than 50,000 Californians were killed or injured last year in
alcohol-related collisions. Most of these were employed.

“To put this in perspective,” said Dunn, “The $2.5 billion loss is
equal to $3,337 for every business in California, or $180 for every
employee in the state. This is an unnecessary, preventable cost to
businesses that hurts their bottom line profitability and
competitiveness.”

The study included costs for health and life insurance, lost
productivity, higher recruitment and retraining expenses, workers
compensation, sick leave, motor vehicle insurance, and other legal and
liability costs.

While public attention has understandably focused on the tragic social
consequences of DUI injuries and deaths, according to CaDUI, the economic
impact on employers has been largely ignored. Unless an organization has
a large driving fleet, DUI is often seen as an “off the job” problem and
not part of the employer’s business, even though employers pick up the
high tab in health care costs, lost productivity, higher insurance, and
other costs.

Since this is such an enormous problem for not only employers, but
employees as well, the CaDUI is supportive of today’s statewide launch of
the Network of Employers for Traffic Safety (NETS). NETS, a
public-private partnership dedicated to reducing traffic deaths and
injuries within our nation’s workforce, is being offered as a partial
solution to reducing the high cost of DUIs to businesses. NETS California
will provide employers with tools for promoting traffic safety messages
at the work site.

“Blue Cross of California has always been dedicated to the philosophy
that education and prevention go a long way toward saving money and
averting tragedy,” said Leonard D. Schaeffer, Chairman and CEO, Blue
Cross of California, and NETS California member.

CaDUI urges employers to adopt strict anti-drinking and driving
policies, and to educate employees and dependents about the dangers of
DUI.

The CaDUI is a coalition that provides leadership, coordination and
support to California’s war against drinking and driving, and is
comprised of government, private sector and citizen’s advocacy groups.
This economic study was paid for by a grant from the California Office of
Traffic Safety.

Secretary Peša: Motor Vehicle Crashes Cost America $150
Billion Each Year

FOR IMMEDIATE RELEASE
Thursday, August 7, 1996

NHTSA 43-96
Contact: Barry McCahill
Tel. No. (202) 366-9550

Secretary of Transportation Federico Peša today released
a new study of the economic impact of motor vehicle crashes on the U.S.
economy, detailing a staggering $150.5 billion cost in 1994 alone.

“While one cannot measure in dollars the pain and anguish caused by
the loss or injury of loved ones, the annual economic impact of motor
vehicle crashes alone is the equivalent of $580 for every American,”
Secretary Peša said in a Washington, D.C., meeting with
businesses, safety experts and law enforcement officers. “We need every
driver to follow the rules of the road and all motorists to wear their
safety belts and make sure children are in properly installed child
safety seats.”

“President Clinton and I made transportation safety our top priority,
and there is progress to report, including reductions in drunken driving
and more safety belt use, but we must continue to do all we can to make
our highways safer,” Secretary PeÅ¡a said. “All of us have a
responsibility when it comes to highway safety and together we can meet
that challenge.”

Crash costs funded through public revenues cost taxpayers $13.8
billion in 1994, the equivalent of $144 taken from the taxes paid by
every household in the United States, according to the study conducted by
the National Highway Traffic Safety Administration.

According to the study, less than a third of crash costs are paid by
those involved in the crash. The remaining costs are spread among the
general population through insurance premiums (55 percent), public tax
revenues (9 percent), or other sources such as charities or medical
providers (7 percent). Public tax revenues pay for an even higher
portion, 24 percent, of first-year medical care costs.

Secretary Peša pointed out that crash costs are typically
thought of in terms of hospital bills, but medical care accounts for just
11 percent of the total cost. The biggest share of cost comes from
property damage, which accounts for 35 percent of the total. Although
property damage is a relatively small cost on a per-case basis, the sheer
volume of low speed crashes that involve no injury makes them a
significant economic cost. Other costs include lost productivity,
emergency services, legal and court expenses, insurance administration,
vocational rehabilitation, workplace costs, and travel delay.

Secretary Peša said that while the costs are staggering,
there is progress. He cited gains in the fight against drunk driving and
in safety belt and child seat use, and said that costs, if adjusted for
inflation, actually have declined since 1990.

He also noted the following found in the study:

The number of vehicle miles traveled rose by 9.5 percent since 1990,
but the rate of injury has declined during the same period. If fatality
and injury rates had remained at the higher 1990 levels, 1994 crash costs
would have been nearly $30 billion (or 20 percent) higher than the $150.5
billion that actually occurred.

Between 1990 and 1994, safety belt use rose from 49 percent to 67
percent, and the portion of fatalities that occurred in alcohol-involved
crashes dropped from 50 percent to 41 percent.

During the same time, there was a steady increase in the portion of
the vehicle fleet with improved safety features such as air bags, rear
seat lap/shoulder belts, and center high mounted brake lights.

The analysis, done by the department’s National Highway Traffic Safety
Administration, covered costs resulting from 40,716 deaths, 5.2 million
injuries, and 27 million damaged vehicles during the year.

Alcohol Related Injury

Alcohol and Trauma

The combination of drinking and driving results in one injury every
minute, and one death every 22 minutes.

The nation’s trauma centers are overwhelmed by the number of
intoxicated drivers each week. A stroll through the hallways of their
emergency rooms each weekend, make it clear just how big a problem
alcohol related injury is. The majority of those injured have either been
drinking or were injured by someone who was drinking at the time. The
cost to society is staggering…….costing the United States around 50
billion dollars/year.

In spite of these facts, drinking and driving continues to be very
common. Judges and juries are lax where punishment is concerned….almost
certainly because they have been guilty of drinking and driving, or at
least have friends who drink and drive. This is an issue of personal
responsibility, which should not be viewed lightly by society or the
courts. If you drink you should not drive, and if you get caught then
swift, sure and effective punishment should be imposed. The cost in human
lives and dollars demands action.

Lucas CE, Joseph AL, Ledgerwood AM.

Alcohol and Drugs. In Trauma 2nd Ed., Moore EE, Mattox KL, Feliciano
DV. eds.

Accident Facts, National Safety Council, Chicago, 1988.

Harvard Study Finds More Binge Drinking, Abstinence

Updated 12:00 PM ET March 15, 2000

By Francesca Di Meglio

U-WIRE

(U-WIRE) WASHINGTON — Frequent binge drinking increased on college
campuses in 1999, according to a Harvard School of Public Health study
released Tuesday.

But as the number of frequent binge drinkers rose, so did the number
of students who abstain from drinking alcohol. According to the study,
one in five college students reported they refrained from drinking in
1999, an increase from 15 percent in 1993 and 19 percent last year.

“Excess is not necessarily part of college life,” said Ed McGlothlin,
a Florida State University student who abstains from drinking
alcohol.

McGlothlin criticized local bars that target young people by
advertising cheep beer specials.

“For a reason I can’t understand, Tuesday and Thursday nights have
become party nights,” he said.

Henry Wechsler, the director of the College Alcohol Studies Program at
Harvard, said local bars should not be the sole source of blame.

Wechsler and his colleagues defined binge drinkers as “men who had
five or more and women who had four or more drinks in a row at least once
in the two weeks before taking the survey.” Frequent binge drinkers are
students who had consumed these amounts at least three times in the two
weeks before answering the survey questions.

Frequent binge drinkers are seven times more likely to miss class,
five times more likely to forget where they have been and 10 times more
likely to damage property, Wechsler said.

Joel Wiegert, a former binge drinker from the University of Nebraska
at Lincoln, said he wanted to tell the story of a “young man who got
wrapped up in the experimental alcohol culture that we see on
campus.”

Wiegert reformed his ways after analyzing the pros and cons of
excessive drinking, he said.

“I’ve yet to come up with one benefit to high-risk drinking,” Wiegert
said. He remembers his freshman year when his experimentation with
alcohol began.

“I was pushing the limits — it was kind of a scary time,” he
said.

But Wiegert said the temptation to drink is prevalent, and students
have misconceptions about what things are necessary for socializing.

“A party without beer doesn’t make much sense in that culture,”
Wiegert said.

Now Wiegert stresses moderation, he said.

“I think drinking is fun, and I like to have a beer with friends after
class,” he said. “But five or six is not for me.”

Wiegert is a member of the Golden Key National Honor Society, Omicron
Delta Kappa Leadership and a member of Beta Theta Pi fraternity.The study
found that binge drinking among students who live in a fraternity or
sorority house has remained about the same since the first study
conducted in 1993, but the number is still high. About 79 percent of
students living in Greek-letter houses reported that they binge
drink.

Colleges and universities are taking action to minimize high-risk
drinking on campus, the study found. Since the second Harvard study in
1997, many schools increased initiatives by offering alcohol-free
housing, special alcohol-free nighttime events and some sort of alcohol
prevention education.

About 51 percent of the respondents in 1999 said administrators
prohibited advertisements on campus for local bars and clubs.

Wechsler said he was disappointed because administrators have taken
action against the alcohol culture and little has changed. He said
educators must warn students and offer anti-alcohol programs at an
earlier age, at least in high school.

“Alcohol is the drug of choice for most young people and needs to be
considered that,” Wechsler said.

Mary Sue Coleman, president of the University of Iowa at Iowa City,
said the responsibility of minimizing high-risk drinking lies with
everyone.

“We all suffer the harmful effects of excessive drinking,” she
said.

(C) 2000 U-WIRE via U-WIRE

A New Method for Identifying Problem Drinkers

By Randall Mikkelsen

PHILADELPHIA, Nov 14 (Reuter) – A new method for identifying problem
drinkers can lead to earlier, more effective treatment and could double
the number of people receiving help, researchers said on Thursday.
11-14-96

The method, tested with success in Cambridge, Ontario, relies on
indirect questioning to identify potential drinking problems and a modest
level of “lifestyle counseling” to limit alcohol use.

“We could markedly reduce the cost of alcohol abuse in the U.S.A. by
implementing a very simple system like the one that we’ve applied,” said
Yedi Israel, a professor at Thomas Jefferson University’s medical school
and lead author of a research report on the method. “If you are a
(alcohol) dependent person, it’s like a declaration of independence.”

In the United States, where only about one million of an estimated 10
million problem drinkers are receiving treatment, another one million
people yearly could be helped through the new screening and treatment
techniques, Israel said.

The report is to be published in the Nov. 15 issue of “Alcoholism:
Clinical and Experimental Research.” It was based on a study of 15,000
people in Cambridge, a city of 90,000.

The method begins with a series of four questions asked of patients in
their doctors’ waiting rooms on whether they have had any injuries or
fights in the previous five years. This is based on research showing
about half of all injuries are alcohol-related and other research showing
both doctors and patients resist screening techniques in which every
patient is asked directly about alcohol abuse, Israel said.

In addition, he said, doctors often are not trained in treating
alcohol problems and share with their patients an aversion, because of
the stigma, to referring people to alcohol-treatment professionals until
it is too late.

“We have not had systems that allow intervention early on where the
patient — the problem drinker — doesn’t have to define herself or
himself as alcoholic,” he said. “Alcoholism is not a disease in the early
stages but it ends up being a disease at the very end, where the person
doesn’t have absolute control over drinking.”

Patients in the study were asked in the waiting-room questionnaire
whether they had broken or dislocated any bones or joints, been injured
in a traffic accident, received a head injury or been in a fight or
assault. Those who answered “yes” to two or more questions — about one
in seven — were then asked by their doctors about their alcohol
consumption and any alcohol-related problems.

About 3.5 percent of the total number of patients were identified as
problem drinkers. In this way, doctors were able to identify 70 percent
of the problem drinkers that could be expected in a group of this size,
the study said.

Patients who qualified for treatment and accepted were then given
either three hours of counseling over a year with a trained nurse or
simple advice to reduce their drinking.

Those who received the counseling, which helped drinkers to identify
and control situations in which they were likely to drink, showed
significant declines in alcohol consumption and related problems. Those
who received simple advice reported that they drank less often but that
physical and social problems related to drinking did not decline.

Israel said the screening method is inexpensive, less than $1 per
patient, and predicted its use would increase. It will be implemented in
the Philadelphia area though the Jefferson health system and he has been
teaching it to a New York health maintenance organization with 22 million
members, he said.

15:47 11-14-96