HEALTH CARE/Joan Retsinas

Preventing Roadside Carnage

Every year more than one-half million Americans crowd into hospital emergency rooms. The cause is not a germ, a virus or a syndrome. Most victims were unlucky: they came into the path of a drunk driver, one who may have chatted coherently, maybe even walked a more-or-less straight line. Other victims — just as unlucky — were the drivers themselves. One in three Americans is statistically fated to be a victim.

The prognosis is grim. Some victims (13,000 in 2007) die. Some recover, after months of rehabilitation. But many survivors live compromised lives.

The obvious solution is prevention, and the nation has embraced a slew of preventive measures.

Teenagers, for instance, are prime offenders. Armed with a new license, and high on more than a few beers, teenagers regularly pile into cars for joyrides that segue into dirges. School systems stage horrific lectures, complete with empty coffins, on the consequences of driving drunk. At mandatory assemblies, police officers warn students that they could end up in those coffins. Parents host post-prom parties, to keep drinkers off the road.

Bars often cut drinkers off, with early “last calls” for people at the cusp of inebriation (a difficult cusp to gauge). Billboards plead: “friends don’t let friends drive home drunk.” Movies will show a heavy drinker giving a friend the car keys.

Governments too have been active. Some states use roadblocks to nab drivers who are patently weaving in and out. But the roadblocks are not everywhere. (One estimate holds that a “first-time offender” has driven drunk 87 times previously.) Besides, roadblocks don’t capture the person whom nobody would call drunk — his or her reflexes are just a tad too slow to avoid an accident. States legislate minimum ages for buying alcohol.

Finally, each year the police arrest roughly 1.4 million people for “driving under the influence.” Courts fine them, jail them, take away their licenses. But since drivers depend on cars to get them to work, many people drive without licenses. And many people, even after fines, drive drunk.

These safeguards have decreased the carnage. Mothers Against Drunk Driving (admittedly, an interest group with a strong bias against the people who killed and maimed their children) credits stringent crackdowns with reducing the toll. The federal government tabulates that more than 19,000 lives were saved last year because of a series of safe-driving measures, including seat belts. But the one-in-three statistic merits concern.

To pare that figure, the automobile manufacturers association has proposed its own remedy: a passive alcohol-detection system. (New York Times, May 19, “Support Grows for Alcohol Interlocks on Cars” by Matthew L. Wald). We already have interlocks, where a would-be driver breathes into a tube. If the tube detects too much alcohol, the car won’t start. The interlocks don’t rely on the acuity of a host, bartender, or drinker to judge sobriety. Of one million convictions each year, courts have mandated 145,000 interlocks for drivers.

This is not a surefire solution: some ingenious drivers enlist “designated breathers” to start their cars. But in New Mexico, where one conviction saddles a driver with an interlock, officials report a 30% decrease in alcohol-fueled accidents.

Passive interlocks — where the car “senses” the level of alcohol in the driver — promise to reduce the carnage even more. The auto industry proposes spending $30 million to develop such a system.

The hospitality industry is screaming “foul.” In this brave new world, fewer restaurant-goers would drink wine — at least that third glass — with their meals. Fewer dinner party hosts would serve after-dinner cordials. In bars, darts games would end early, as drinkers called it quits. The hospitality industry would lose money.

Maybe so. But the nation would save on medical bills, the courts would free up their dockets, and millions of families would be spared lifetimes of grief.

Joan Retsinas is a sociologist who writes about health care in Providence, R.I. Email

From The Progressive Populist, August 15, 2009

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