Child passengers killed in reckless and alcohol-related motor vehicle crashes

INTRODUCTION

About 20years ago, concern was raised about the dangers that children face when driven by drinking drivers in the United States. During the last decade, the pace of research on this topic subsided. Yet in 2010, every day three children younger than age 15 were killed, and 469 were injured in motor-vehicle crashes.

METHOD

The aim of this effort is to describe the status of the problem in the United States and suggest lines of research. From the Fatality Analysis Reporting System (FARS), we selected crashes in which a driver aged 21 or older was driving at least one child younger than age 15. We identified crashes that occurred at different times of the day in which the driver was speeding, ran a red light, or was alcohol positive. We described the drivers' demographics and examined how they relate to the different crash types.

RESULTS

We found that, although driving a child seems to protect against the studied forms of risky driving, such protection varies sharply depending upon the drivers' and children's demographics and the crash type. There is no clear reason to explain the drivers' decision to endanger the children that they drive. The percent of children killed in speeding-related and red-light running motor-vehicle crashes has remained relatively stable during the last decade. Future research must (a) examine the effectiveness of current child endangerment laws; (b) examine crashes other than fatal; and (c) be more targeted, looking at specific drivers' age and gender, specific children's ages, the time of the crash, and the type of crash.

PRACTICAL APPLICATIONS

Significant attention needs to be given towards improving state laws on child endangerment. Policymakers' reaction to this problem is tentative because of our limited understanding of the problem; therefore, further research is needed. With unfocused countermeasures and prevention efforts, we have been restricted in our ability to evaluate these responses. The findings of this report should be informative to policy makers.

Comparing drug detection in oral fluid and blood: data from a national sample of nighttime drivers

OBJECTIVE

The National Roadside Survey is a study undertaken in the United States to determine the prevalence of alcohol and drugs in randomly selected drivers. Following the success of a 2006 pilot study, the 2007 survey incorporated, for the first time, the collection of biological specimens for drug analysis. This article compares the results obtained from blinded analyses of pairs of oral fluid and blood samples obtained from the same subject.

METHODS

During the 2007 survey, more than 7000 nighttime drivers were randomly stopped and surveyed for their self-reported drug use and were requested to donate an oral fluid specimen using the Quantisal (Immunalysis Corporation, Pomona, CA) device and a blood sample. Overall, 5869 oral fluid specimens were collected from nighttime drivers with 3236 corresponding blood samples.

RESULTS

Biological specimens were analyzed for a wide range of drugs. At nighttime, 14.4 percent of the drivers were positive for drugs in oral fluid, with just over half of those having marijuana present (7.6%). Of the 3236 pairs of specimens, 2676 were negative for all drugs, and 326 matched pairs of samples were both positive, out of which 247 (75.8%) were an exact match for all drug classes and 70 (21.5%) were positive for at least one common drug class.

CONCLUSIONS

Oral fluid and blood samples provided very similar information regarding recent drug intake by randomly tested drivers and oral fluid yielded a higher detection rate for one drug (cocaine) than blood. Oral fluid can be considered a reliable alternative to blood as a matrix for drug testing.

How necessary is monitoring to interlock program success?

OBJECTIVE

Numerous studies have demonstrated that vehicle alcohol ignition interlocks installed on the cars of impaired-driving offenders reduce recidivism by approximately two-thirds in comparison to similar offenders whose licenses have been suspended. An unresolved issue is the extent to which the effectiveness of interlock programs can be improved by close monitoring of the offenders' performance while in the program. This article describes 5 types of monitoring currently being used in interlock programs in the United States.

METHODS

The programs reviewed vary from those that simply ensure that the interlock is on the offender's vehicle and functioning, to those that use the interlock log data to extend the length of time the offender is required to be in the interlock program, and those that use the interlock data to initiate special monitoring and treatment programs that must be completed before removal of the interlock device. The strengths and limitations of each type of program are described. Also reviewed are current technological developments that appear to be leading to the development of fully automated interlock monitoring systems.

RESULTS

Initial evidence shows that more intensive monitoring provides benefits in improved performance on the interlock, as indicated by fewer high blood alcohol concentration (BAC) breath tests when attempting to drive. Although effective, supervision that is more intensive increases government program costs.

CONCLUSIONS

The relative cost-effectiveness of the differing types of monitoring requires investigation. Treatment programs need to be integrated with the interlock installation period. New technologies can potentially reduce interlock offender monitoring costs and effectiveness. Integrating treatment with the interlock could have postinterlock benefits.

Field testing of the Alere DDS2 Mobile Test System for drugs in oral fluid

A preliminary field evaluation of a second-generation handheld oral fluid testing device, the Alere DDS2 Mobile Test System (DDS2), is described. As part of a larger study, drivers were randomly stopped at various locations across California (in 2012) and asked to submit voluntarily to a questionnaire regarding their drug and alcohol use, a breath alcohol test and collection of oral fluid with the Quantisal device. The Quantisal-collected oral fluid samples were sent for laboratory-based analyses. At one location, 50 drivers were asked to submit an additional oral fluid sample using the DDS2 collection device; these samples were analyzed by using the DDS2 mobile test system. Thirty-eight donors (76%) provided specimens that were successfully run on the mobile system; in 12 cases (24%), the device failed to provide a valid result. Thirty-two of the 38 collected samples were negative for all drugs; five were positive for tetrahydrocannabinol and one was positive for methamphetamine using the mobile device. These results corresponded exactly with the laboratory-based results from the Quantisal oral fluid collection.

Drinking and driving in the United States: comparing results from the 2007 and 1996 National Roadside Surveys

OBJECTIVES

The objectives of this study were to (a) use data from the 2007 National Roadside Survey (NRS) to determine the characteristics of weekend nighttime drivers with positive blood alcohol concentrations (BACs) on U.S. roads in 2007; (b) determine the relationship of the driving environment and trip characteristics associated with drinking drivers; and (c) compare the findings for the 2007 NRS with those for the 1996 NRS.

METHODS

Like the 1996 NRS, the 2007 NRS used a stratified random national roadside survey sample of the contiguous 48 states and collected nighttime data on Fridays and Saturdays between 10 p.m. and 3 a.m. Officers directed 8384 drivers into off-road parking areas where our research team asked them to participate in the survey.

RESULTS

Of those approached, 7159 (85.4%) provided a breath test. Results revealed that 12 percent of the nighttime drivers had positive BACs, and of those, 2 percent were higher than the 0.08 BAC illegal limit in the United States. Since the 1996 NRS, we found significant reductions in the percentage of BAC-positive drivers across different demographic groups. Age was among the most significant factors associated with a weekend driver having a positive BAC. The probability that a driver would be drinking peaked in the 21- to 25-year-old age group. Male drivers were more likely than female drivers to be drinking, and Asian and Hispanic drivers were less likely than white drivers to be drinking. Drinking drivers were more likely to be driving short distances (5 or fewer miles) late at night (between 1 and 3 a.m.) and to be coming from a bar or restaurant. Finally, 26 percent of the drivers who reported that they would drive less than 5 miles on the night of the survey had positive BACs, compared to only 16 percent who indicated that they would drive between 6 and 20 miles and 10 percent who planned to drive more than 20 miles.

CONCLUSIONS

The 2007 NRS provides another benchmark in the 4-decade record of drinking drivers on American roads and provides a basis for measuring progress in combating driving under the influence during the coming decade.

Passengers of impaired drivers

INTRODUCTION

The aims of this study are: (a) to estimate the prevalence of passengers riding with alcohol-impaired drivers; (b) to investigate the role of demographic factors (age, gender, race/ethnicity, educational status) and relevant driving conditions (time of the day, trip origin, vehicle ownership) on shaping the likelihood of alcohol-impaired driving; (c) to identify and estimate the prevalence of passengers as alternative drivers (PADs); and (d) to examine the role that vehicle ownership plays in shaping the occurrence of PADs.

METHOD

Data came from a unique convenience sample of passengers obtained from the 2007 National Roadside Survey, a random sample of drivers from the 48 contiguous states.

RESULTS

The prevalence of PADs in the targeted population (mostly weekend night vehicles) was higher with drivers at .00 Collapse

Key Words

• nrs
• passengers
• alternative drivers
• drinking and driving
• designated driver

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MESH Headings

• Accidents, Traffic/prevention & control
• Adolescent
• Adult
• Alcoholic Intoxication
• Automobile Driving/statistics & numerical data
• Female
• Humans
• Likelihood Functions
• Male
• Middle Aged
• Motor Vehicles
• Social Responsibility
• Young Adult

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Grants

• 27301C0040 NIEHS NIH HHS
• P20 AA017831 NIAAA NIH HHS
• R21 AA018265 NIAAA NIH HHS

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The prevalence of cannabis-involved driving in California

BACKGROUND

Various national surveys suggest that cannabis use is rising nationally and many States have passed legislation that has potential to increase usage even further. This presents a problem for public roadways, as research suggests that cannabis impairs driving ability.

METHODS

Anonymous oral fluid samples and breath tests were obtained from more than 900 weekend nighttime drivers randomly sampled from six jurisdictions in California. Oral fluid samples were assayed for the presence of Schedule I drugs. Drivers also completed information on self-reported drug use and possession of a medical cannabis permit. Data from the 2007 National Roadside Survey (collected using comparable methods) were used as a comparison.

RESULTS

Using the 2010 data, a total of 14.4% of weekend nighttime drivers tested positive for illegal drugs, with 8.5% testing positive for delta-9-tetrahydrocannabinol (THC). THC-positive rates varied considerably among jurisdictions, from a low of 4.3% in Fresno to a high of 18.3% in Eureka. A comparison with the 2007 NRS data found an increase in THC-positive drivers in 2010, but no increase in illegal drugs other than cannabis. Drivers who reported having a medical cannabis permit were significantly more likely to test positive for THC.

CONCLUSIONS

Cannabis-involved driving has increased in California since 2007. Nearly 1-in-10 weekend, nighttime drivers tested positive for THC, and in some jurisdictions, the rate was nearly 1-in-5. The possible contribution of cannabis legislation, such as decriminalization and medical cannabis usage, is discussed.

Interpretation of oxycodone concentrations in oral fluid

OBJECTIVE

The purpose of this retrospective study was to compare oxycodone concentrations in saliva and whole blood with a view to propose therapeutic concentrations in oral fluid. Oral fluid is an easy specimen to collect with several advantages over urine, including ease of collection and difficulty of adulteration. As oral fluid is a reflection of free drug circulating in the blood, drug concentrations in saliva are more closely related to blood levels than urine concentrations. The number of testing laboratories offering the analysis of prescription pain medications in urine has increased significantly over the last few years, along with the overuse and abuse of pain killing drugs, specifically oxycodone. Hence, the utility of oral fluid analysis in this field was assessed.

DESIGN

Paired specimens of blood and oral fluid were retrospectively studied in an attempt to establish a range for oxycodone concentrations in oral fluid reflective of therapeutic intake. Twenty-three paired oral fluid-blood specimens were studied. Oral fluid samples had been collected with the Quantisal™ oral fluid device, stored cold and shipped overnight to the laboratory prior to testing. Blood specimens were collected simultaneously in gray top tubes.

RESULTS

From 23 pairs of samples, the median concentration in oral fluid was 524 μg/L and blood was 53 μg/L. The whole blood to plasma ratio for oxycodone was 1.3, so the median plasma concentration was 41 μg/L projecting a saliva to plasma ratio (S:P ratio) of 12. The comparison of oral fluid-blood concentrations allowed the projection of a S:P ratio for oxycodone and the development of a potential therapeutic range for oxycodone in oral fluid.

CONCLUSION

Saliva drug concentrations in pain management are more closely related to blood levels than urine so can be more easily interpreted. These data provide a foundation for interpretative advances; however, further research surrounding other pain medications and controlled studies are necessary.

Alcohol- and drug-involved driving in the United States: methodology for the 2007 National Roadside Survey

This article describes the methodology used in the 2007 U.S. National Roadside Survey to estimate the prevalence of alcohol- and drug-impaired driving and alcohol- and drug-involved driving. This study involved randomly stopping drivers at 300 locations across the 48 continental U.S. states at sites selected through a stratified random sampling procedure. Data were collected during a 2-hr Friday daytime session at 60 locations and during 2-hr nighttime weekend periods at 240 locations. Both self-report and biological measures were taken. Biological measures included breath alcohol measurements from 9,413 respondents, oral fluid samples from 7,719 respondents, and blood samples from 3,276 respondents.

Crossing a border for a low-cost, high-risk environment: smoking status and excessive drinking among young adults in Tijuana

This study examines the drinking and smoking behavior of 2,311 college-age adults traveling from San Diego, California, to Tijuana, Mexico (December 2006 to December 2008). We describe this Border sample's drinking history and smoking status and estimate multivariate models of evening drinking participation and, conditional on drinking, blood alcohol concentration. Noting limitations, we present implications for identifying young adults at high risk for alcohol and tobacco use, particularly females, and lay the foundation for further research examining young adults? alcohol and tobacco use in reduced price scenarios.

Sexual assault histories and evening drinking among young american men in a high-risk drinking environment

This study surveyed young American men traveling to Tijuana, Mexico from San Diego, California for a weekend night out, collecting responses both southbound at the outset of the evening and northbound upon return at the end of the evening. Among 650 males, we examined the relationship between sexual histories and attitudes and alcohol use, both historically and on their night in Tijuana. Respondents with a history of coercing sex drank more in Tijuana and were more likely to binge drink. Although estimating sexual assaults committed by these males on the evening in question was not possible, this research establishes the link between a history of sexual assault and the blood alcohol concentration of young men resulting from an evening in a timeout environment.

Preventing victimization among young women: The SafeNights intervention

OBJECTIVE

We examined the effect of a brief intervention, titled SafeNights, to reduce victimization among young college-aged females.

PARTICIPANTS

A total of 1,048 women participated; 496 participants in the control and 552 in the experimental condition.

METHOD

Young Americans crossing the U.S. border to patronize Tijuana bars were randomly assigned to an intervention as they traveled into Tijuana. Upon returning to the United States, participants provided a breath sample and were interviewed.

RESULTS

SafeNights was significantly associated with reductions in reported victimization independent of alcohol consumption.

CONCLUSIONS

The intervention will be refined for a broader spectrum of collegiate settings at high risk for heavy drinking and potential victimization.

Female involvement in U.S. nonfatal crashes under a three-level hierarchical crash model

Men have long held the lead in motor-vehicle crashes; however, research indicates that women are closing the gap. To further investigate this problem, we applied a hierarchical model to investigate female involvement in fatal crashes in the United States. The hierarchical model recognizes that decisions at higher levels affect the decisions at lower levels. At the top level, the model assumes that the driver's condition (e.g., inattention, fatigue, impairment) affects the next level (e.g., speeding or other failures to obey traffic laws), which subsequently affects the basic maneuvering skills (i.e., the lowest level) were either nonexistent, or largely explained by gender differences in alcohol consumption. We found that although female involvement in skill-related crashes was not different from that of males, females were more likely than males to apply wrong maneuvers when speeding was involved. We also found that the most important contributing factor to gender differences in nonfatal crashes can be traced back to gender-based differences in alcohol consumption.

Toward national estimates of alcohol use disorders among drivers: results from the National Roadside Survey Pilot Program

OBJECTIVE

To determine whether drivers contacted at the roadside can be screened for alcohol use disorders (AUDs). Secondarily, to produce preliminary estimates of AUDs among drivers and estimate the relationship between AUD status and BAC measured at the roadside.

METHODS

A two-phase survey program was undertaken. In phase 1, 206 motorists were interviewed at the roadside using a 15-item AUD Survey derived from a condensed version of the AUDADIS and the AUDIT-C. One hundred sixty-seven of these motorists were invited, for a $25 incentive, to call the research team within 48 h of the roadside assessment to repeat the questionnaire and complete a more detailed AUD assessment. Phase 2 involved a 6-state pilot test of the AUD Survey as an add-on to the 2005 National Roadside Survey Pilot Program. The setting for both phases of the survey program was US roadways on weekends between 10 p.m. and 3 a.m.

RESULTS

Ninety-seven percent of all eligible drivers completed the AUD questionnaire. The correlation between roadside and telephone interview results was 0.3 for alcohol abuse, 0.6 for alcohol dependence and heavy drinking, and 0.7 for binge drinking. Alcohol abuse and dependence diagnoses had 0.6 and 0.7 correlations with diagnoses derived from the full AUDADIS and the AUDIT-C had a 0.8 correlation with the full AUDIT. There was also a statistically significant and positive relationship between having a positive BAC at the roadside and meeting criteria for heavy drinking.

CONCLUSIONS

AUD status can be effectively measured at the roadside. The poor reliability for alcohol abuse is related to underreporting of drinking and driving during roadside assessments, compared to telephone follow-up. Other measures of hazardous alcohol use should be used in the roadside context to measure alcohol abuse.

Implied-consent laws: a review of the literature and examination of current problems and related statutes

PROBLEM

A substantial proportion of drivers arrested for DUI refuse the BAC test, thereby reducing the likelihood that they will be convicted and potentially increasing the number of high-risk multiple offenders contributing to alcohol-related crashes.

METHOD

This paper reviews the information on the current status of implied-consent laws (which impose a sanction on offenders who refuse the BAC test) in the 50 states and the other relevant traffic safety laws and policies that may influence state refusal rates.

RESULTS

Although there appears to be only a weak relationship between state refusal rates and crash rates, there is strong evidence that BAC test refusals significantly compromise the arrest, prosecution, and sentencing of DUI suspects and the overall enforcement of DUI laws in the United States.

DISCUSSION

Laws and policies that may reduce the number of refusals are discussed.

IMPACT ON INDUSTRY

Alcohol-related crash injuries are an important cost problem for U.S. industry because of property damage from crashes, crash injuries to employees that raise health costs, or the reduction of time on the job resulting from a highway injury.

The consequences of providing drinkers with blood alcohol concentration information on assessments of alcohol impairment and drunk-driving risk

OBJECTIVE

We examined the effect of providing drinkers with blood alcohol concentration (BAC) information on subjective assessments of alcohol impairment and drunk-driving risk.

METHOD

We sampled 959 drinking participants from a natural drinking environment and asked them to self-administer a personal saliva-based alcohol test. Participants then were asked to rate their alcohol impairment and to indicate whether they could drive legally under one of four BAC feedback conditions (assigned at random): (1) control condition (no BAC feedback provided before the ratings); (2) categorical BAC information (low, high, and highest risk) from the saliva test; (3) categorical BAC information corroborated by a calibrated police breath alcohol analyzer; and (4) precise (three-digit) BAC information from the breath alcohol analyzer.

RESULTS

Both control participants and participants who received precise BAC feedback gave subjective impairment ratings that correlated with actual BACs. For participants who received categorical BAC information from the saliva test, subjective impairment did not correlate with the actual BAC. Providing drinkers with BAC information, however, did help them predict more accurately if their BAC was higher than the legal BAC driving limit.

CONCLUSIONS

Although BAC information can influence drinkers' assessments of alcohol impairment and drunk-driving risk, there is no strong evidence that personal saliva-based alcohol tests are particularly useful.

Female involvement in fatal crashes: increasingly riskier or increasingly exposed?

Men have long held the lead in motor-vehicle crashes. However, recent research from a variety of countries indicates that women are closing the gap. The relative increase in females involved in crashes has been associated with an increase in crash exposure. But is it simply that there are more women driving that is causing this increase? Or are there other mediating factors? The main goal of this research effort was to shed some light on this controversy. We found evidence that most of the observed increase in female drivers' fatalities was due to a parallel increase in female driving exposure but that some groups of female drivers (mainly underage female drivers) have become more vulnerable to some risk-taking driving behaviors than others.

Licensing teenagers: nontraffic risks and benefits in the transition to driving status

OBJECTIVE

The initiation of teen driving, which occurs between ages 15 and 17, has generally been studied primarily in relation to crash injury reduction. However, it may be the most important period influencing development between puberty and emerging adulthood because, once the teens are driving on their own or riding with other teens, parental control over social behavior is greatly reduced and opportunities for risk-taking are substantially increased. The noncrash risks and benefits of licensing during this critical transition period are the subject of this paper.

METHODS

We identify "transition teens" as a subgroup of all 15-to 17-year-olds who reside in middle-class suburban and rural areas where families can afford a car and where a vehicle is needed for reasonable mobility. In this paper, we review recent studies on the effect of driving on non-traffic-related behaviors of teen drivers. Our analysis suggests that there are two environments that affect behavior and development: the home environment and the extended environment. Before driving age, the home environment influences are omnipresent in the life of the developing child. However, once teens can move more readily within the community and travel outside the home environment on their own or with a peer, they have access to locations where many or all the local controls on risky behavior may be absent.

RESULTS AND CONCLUSIONS

This article introduces the concept of "transitional teens" and provides a rough model that explains the possible risks encountered by this group when they begin to drive a vehicle or to ride with a peer. We offer this model to the research community with a challenge to hypothesize, test, and explore this proposed transitional period so that we can better understand and mitigate its associated risks.

A Night in Tijuana: Female Victimization in a High-Risk Environment

We examine the epidemiology of victimization among females crossing the U.S. border to drink in Tijuana, Mexico, with the purpose of creating a framework for an intervention to improve safety among female youth in drinking settings. Drinking history, history of victimization, evening drinking experience, and environmental factors are assessed.Among female crossers surveyed in 2005-2006, 53% reported experiencing some type of victimization, with 29% experiencing moderate physical aggression and 38% experiencing unwanted moderate sexual incidents. Youth and reported history of verbal abuse were consistently associated with victimization with more participants frequently reporting incidents of victimization. Predictors of victimization among young females (aged 16-20) generally included environmental factors, whereas evening drinking was associated with victimization among women aged 21 and older.

Multimethod measurement of high-risk drinking locations: extending the portal survey method with follow-up telephone interviews

Portal survey techniques involve multimodal assessments (e.g., self-report, biologic, and observational) in high-risk drinking and drug-use settings. Our investigation expanded the portal survey methodology to include follow-up assessments of emerging adult women recruited at the border as they cross to and from Mexico south of San Diego, California. The feasibility of the follow-up procedure was established, and the limitations of the technique clarified. Follow-up participants and nonparticipants did not differ by age or reported victimization. Data indicated that 8% of women experience negative events on their return to the United States after a night of binge drinking. These experiences could only be captured in a follow-up survey, as they happened after participants left the border area.

Alcohol involvement in fatal crashes under three crash exposure measures

OBJECTIVE

A common method of normalizing crash fatality data for comparing subgroups of drivers has been the estimated vehicle miles traveled (VMT). Unfortunately, the VMT method fails to provide for exposure to risks such as those related to alcohol consumption (among others). Recently, the "crash incidence ratio" (CIR) has been introduced to address some of these limitations. The goals of this study are first, to show that the CIR method is intrinsically similar to an increasingly popular quasi-induced method: the relative accident involvement ratio (RAIR); second, to compare the VMT-based, the CIR, and the RAIR methods when applied to the evaluation of alcohol-related crash fatalities across racial/ethnic groups.

METHODS

We use the 1990-1996 Fatal Accident Reporting System (FARS) with information on the drivers' race/ethnicity and alcohol involvement (BAC). Descriptive and statistical ratio tests were applied.

RESULTS

The RAIR and CIR are indeed closely related measures that, when used for comparisons against a reference group, yield exactly the same numerical estimates. Strikingly different outcomes were obtained depending on using the VMT or the CIR/RAIR.

CONCLUSION

Choosing one measure over another should depend on the questions to be answered. The implication of this finding for researchers and policy makers is discussed.

Preventing alcohol-related convictions: the effect of a novel curriculum for first-time offenders on DUI recidivism

OBJECTIVE

To determine whether DUI offenders can better avoid future drinking and driving by controlling their vehicle usage rather than by controlling their drinking.

METHODS

Using a randomized experimental post-test only design, 9,571 first-time DUI offenders were randomly assigned to receive one of two 12-hour educational programs: a traditional DUI curriculum or the PARC (Preventing Alcohol-Related Convictions) curriculum, which uses a novel theoretical approach to preventing DUI recidivism. Whereas traditional programs focus on participants controlling their drinking to avoid future drinking and driving, the PARC curriculum focuses on participants controlling their driving. Instead of trying to control alcohol consumption after driving to a drinking venue (previously found to be a flawed strategy), PARC teaches students to make a decision before leaving home not to drive to a drinking event, thus greatly limiting the possibility of drinking and driving. Driving records were obtained from the Florida Department of Motor Vehicles using driver's license numbers to assess DUI recidivism rates among the students in the PARC and Traditional curricula for the first year following program participation and again at 2 years post-intervention.

RESULTS

Binary logistic regression analyses revealed that offenders receiving the PARC curriculum exhibited significantly lower 1-year and 2-year recidivism rates than those receiving the Traditional curriculum. The effect was consistent across two different measures of recidivism, and across gender, race, ethnicity, and location.

CONCLUSION

Results suggest that the PARC educational approach may be more effective than the traditional approach in reducing DUI recidivism.

A partial ban on sales to reduce high-risk drinking South of the border: seven years later

OBJECTIVE

On weekend evenings, thousands of youths (ages 20 and younger) and young adults (ages 21-25) residing in communities along the U.S. border cross into Mexico to patronize all-night bars where the drinking age is 18, rather than 21, and where the price of alcohol is considerably less than in the United States. On January 1, 1999, Juárez, Mexico, implemented a 2 AM (instead of 5 AM) bar-closing policy. The number of crossers and their blood alcohol concentration levels on return were reduced in the year following this policy change. The present study's objective was to determine the long-term (7-year) effect of the earlier-closing bar policy on cross-border drinking in Mexico.

METHOD

Analyzed data (1998 to August 2005) were from quarterly breath-test surveys at the El Paso (Texas)/Juárez (Mexico) border, bar observations in Juárez, and trauma data in El Paso.

RESULTS

Bar surveys in Juárez show that the 2 AM closing policy, initiated 7 years ago, continues to be enforced, as has the reduction (89%) in youthful crossers returning after 3 AM. The number of underage youths returning earlier in the evening (before 3 AM), however, unchanged for 2 years after the policy change, has doubled recently.

CONCLUSIONS

The early closing of bars in Juárez has a continuing positive impact on the reduction of the number of those returning after 3 AM. Although initially there appeared to be no displacement of the late returnees into the early hours (before 3 AM), the number of bar visitors crossing and returning earlier has been steadily increasing. Suggestions for reducing cross-border heavy episodic drinking are described.

Drug and alcohol-impaired driving among electronic music dance event attendees

BACKGROUND

Drug-impaired driving has received increased attention resulting from development of rapid drug-screening procedures used by police and state laws establishing per se limits for drug levels in drivers. Venues that host electronic music dance events (EMDEs) provide a unique opportunity to assess drug-impaired driving among a high proportion of young adult drug users. EMDEs are late-night dance parties marked by a substantial number of young adult attendees and elevated drug involvement. No studies to date have examined drug-impaired driving in a natural environment with active drug and alcohol users.

METHODS

Six EMDEs were sampled in San Diego, California, and Baltimore, Maryland. A random sample of approximately 40 attendees per event were administered surveys about alcohol and other drug (AOD) use and driving status, given breath tests for alcohol, and asked to provide oral fluid samples to test for illicit drug use upon entering and exiting the events.

RESULTS

Driving status reduced the level of alcohol use (including abstaining) but the impact on drug-taking was not significant. However, 62% of individuals who reported their intention to drive away from the events were positive for drugs or alcohol upon leaving. This suggests that these events and settings are appropriate ones for developing interventions for reducing risks for young adults.