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.08

“This .08 standard is the biggest step to toughen drunk driving laws and reduce alcohol related crashes since a national minimum drinking age was established a generation ago.  It is estimated by the experts that have studied it that it will save at least 500 lives every year.” – President William Clinton, October 2000

Blood alcohol concentration is a measure of how much alcohol is in someone's blood. It is the most accurate and measurable gauge of alcohol impairment. Virtually everyone is significantly impaired at a .08 BAC, so it is a logic place to draw the line for defining what is drunk driving. At .08, a person is 11 times more likely to be involved in a fatal crash than someone who has had nothing to drink. (Zador, 2000) (Keall et al, 2004)

It isn’t a small amount of alcohol either -- to reach a .08 BAC level, a 170-pound man would have to drink approximately four drinks in one hour on an empty stomach or a 137-pound woman would have to drink approximately three drinks in one hour on an empty stomach.

And it is lifesaving legislation.  In 2001, the Centers for Disease Control (CDC) reviewed all of the studies and concluded that .08 BAC laws reduce alcohol-related traffic fatalities by an average of seven percent. (CDC Community Guide, 2001)  Other studies show its effectiveness as well among all levels of BAC. (Voas, Tippetts, & Taylor, 2001 and many others below).  These laws have also been shown to save much more money than they cost, as well as lives. (NHTSA, 1991) (NHTSA, 2001) (Miller, 2001)

In short, this is a lifesaving piece of legislation that every state should have and every state does.

Resources

  • Official Position Statement
  • Studies
    • MADD's Impaired Driving Summit Report (PDF) 
    • Aplser, Robert and Terry Klein. "The Effects of 0.08 BAC Laws." Washington DC: National Highway Traffic Safety Administration, March 1999. (Click here)
    • CDC Community Guide. "Effectiveness of 0.08 Percent Blood Alcohol Concentration (BAC) Laws," 2001. (Click here)
    • Hingson, Ralph, Timothy Heeren, and Michael Winter. "Lowering State Legal Blood Alcohol Limits to 0.08 Percent: The Effect on Fatal Motor Vehicle Crashes." American Journal of Public Health 86 (1996), 1297-1299. (not yet available online)
    • Hingson, Ralph, Timothy Heeren, and Michael Winter. "Effects of Recent 0.08 Percent Legal Blood Limits on Fatal Crash Involvement." Injury Prevention 6 (2000):109-114. (not yet available online)
    • Keall, Michael, William Frith, and Tui Patterson.  "The Influence of Alcohol, Age and Number of Passengers on the Night-Time Risk of Driver Fatal Injury in New Zealand." Accident Analysis and Prevention 36 (2004): 49-61.  (Click here)
    • Miller, Ted R.  "The Effectiveness Review Trials of Hercules and Some Economic Estimates for the Stables." American Journal of Preventive Medicine 21 (4S) (2001): 9-12. (Click here)
    • Moskowitz, H., et al. "Driver Characteristics and Impairment at Various BACs." DOT HS 809 075. Washington DC: National Highway Traffic Safety Administration, August 2000. (Click here)
    • National Highway Traffic Safety Administration. "The Effects Following the Implementation of an .08 BAC Limit and an Administrative Pre Se Law in California." DOT HS 807 777. Washington DC: National Highway Traffic Safety Administration, 1991. (not yet available online)
    • National Highway Traffic Safety Administration. "Impaired Driving in the United States: Cost Fact Sheets." Washington DC: National Highway Traffic Safety Administration, 2001. (Click here)
    • National Highway Traffic Safety Administration. "A Review of the Literature on the Effects of Alcohol at BACs of .08 and Lower." Washington DC: National Highway Traffic Safety Administration, 2001. (Click here)
    • Shults, Ruth, et al. "Reviews of Evidence Regarding Interventions to Reduce Alcohol-Impaired Driving." American Journal of Preventive Medicine 21(4S) (2001): 66-88. (Click here)
    • Voas, Robert A., et al. "Effectiveness of the Illinois .08 Law." Washington DC: National Highway Traffic Safety Administration, September 2000. (Click here)
    • Voas, Robert, A. Scott Tippetts, and Eileen Taylor. "Effectiveness of the Illinois .08 Law: An Update with 1999 FARS Data", DOT HS 809 382. Washington DC: National Highway Traffic Safety Administration, December 2001. (not yet available online)
    • Voas, Robert and A. Scott Tippetts, 1999. "The Relationship of Alcohol Safety Laws to Drinking Drivers in Fatal Crashes." Washington DC: National Highway Traffic Safety Administration, August 1999. (Click here)
    • Zador, Paul, Sheila Krawchuk, and Robert Voas. "Relative Risk of Fatal Crash Involvement by BAC, Age, and Gender," DOT HS 809 050. Washington, DC: National Highway Traffic Safety Administration, 2000. (Click here)

21 Minimum Drinking Age Effectiveness

In July 1984, Congress and President Ronald Reagan enacted legislation that set the national minimum legal drinking age to 21. MADD applauds the work of Senators Frank R. Lautenberg (D-NJ), Elizabeth Dole (R-NC), as well as Congressman Michael D. Barnes (D-MD) and the late Representative James J. Howard (D-NJ), in passing the lifesaving 21 Minimum Legal Drinking Age (MLDA), which has helped show significant declines in fatalities on and off the road.


Read MADD's press release on the anniversary of the 21 MLDA.   

  • An estimated 25,000 lives have been saved by the 21 Minimum Legal Drinking Age (MLDA).
  • The National Highway Traffic Safety Administration (NHTSA) estimates the 21 MLDA has reduced traffic fatalities involving drivers 18 to 20 years old by 13 percent and has saved an estimated 25,509 lives since 1975.
  • In 2006, an estimated 890 lives were saved by minimum drinking age laws.

President Ronald Reagan is surrounded by Congressional leaders and dignitaries as he signs the 21 Minimum Drinking Age Act It is interesting that so many people labor to discredit the 21 minimum drinking age law – one of the most studied and most proven public health measure ever taken. 

In 2003, the Centers for Disease Control looked at 49 high-quality peer-reviewed studies of the effects of changing the minimum drinking age lawAlmost every study found that increasing the minimum drinking age to 21 saved lives (an average decrease of 16 percent) and that lowering the minimum drinking age to 18 or 19 caused an average increase in crashes of eight to 10 percent.

Sign the pledge in support of the 21 minimum legal drinking age. The US General Accounting Office looked at similar data in 1987 of the states that passed 21 MLDA laws and found “raising the drinking age has a direct effect on reducing alcohol-related traffic accidents among youths affected by the laws, on average, across the states" and that "raising the drinking age also results in a decline in alcohol consumption and in driving after drinking for the age group affected by the law." (GAO 1987) These studies use different measures of crashes, fatalities and alcohol – some look at single-vehicle nighttime crashes as a strong proxy for drunk driving crashes, but all came up with the same conclusion – the 21 MLDA law saves lives.

The 21 minimum drinking age also helps those not directly effected by the law. 
NHTSA found that between 1982 and 1998, there were 61 percent fewer drinking drivers involved in fatal crashes under age 21 and a 56 percent decrease among 21-24 year olds. This is against a backdrop of a decrease of only 24 percent among 25-55 year olds. There were a number of safety improvements  during this time – better roads, better laws, safer cars, etc. – but because the people most directly affected by the law had the greatest decreases, NHTSA concluded “unequivocally that MLDA 21 laws reduce youth drinking and driving, as measured by traffic crash involvements.”

National Institute on Alcohol Abuse and Alcoholism data shows a decrease in fatalities among 16-20 year olds with the 21 minimum drinking age.

The 21 Minimum Legal Drinking Age saves lives.
Clearly, the 21 minimum drinking age law is having the intended effect of saving lives on the road way. NHTSA estimates about 900 lives are saved by the law per year. The next time someone argues otherwise, ask them what data they are looking at, because the 21 MLDA law is one of the most studied and most effective laws in public safety.

Youth drinking rates decline. 
Moreover, youth drinking rates have also declined since the 21 age law went into effect. The 2006 Monitoring the Future study shows declining alcohol consumption among American youth, although, alcohol consumption continues to be widespread among today's youth. A look at all of the research on the minimum drinking age from 1960 to 2000 found that the bulk of the evidence shows that 21 minimum drinking age laws decrease underage consumption of alcohol. (Wagenaar and Toomey, 2002) Even over the last 15 years, after the passage of the 21 minimum drinking age laws, the percentage of 8th, 10th and 12th graders who drank alcohol in the past year decreased 38 percent, 23 percent and 14 percent. (Monitoring the Future, 1991-2006)

Thus, we need to fix the law when it is weak and enforce it when it is not being enforced to increase its effectiveness, not undercut it.

Studies

  • Arnold R. Effect of raising the legal drinking age on driver involvement in fatal crashes: the experience of thirteen states. Washington, DC: U.S. Department of Transportation, National Highway Traffic Safety Administration, 1985. DOT HS 806 902.
  • Asch P, Levy DT. Does the minimum drinking age affect traffic fatalities? J Policy Anal Manage 1987;6:180–92.
  • Asch P, Levy DT. Young driver fatalities: the roles of drinking age and drinking experience. South Econ J 1990;57:512–20.
  • Bako G, Mackenzie WC, Smith ESO. The effect of legislated lowering of the drinking age on total highway accidents among young drivers in Alberta, 1970–1972. Can J Public Health 1976;67:161–3.
  • Brown DB, Maghsoodloo SA. A study of alcohol involvement in young driver accidents with the lowering of the legal age of drinking in Alabama. Accid Anal Prev 1981;13:319–22.
  • Chaloupka FJ, Saffer H, Grossman M. Alcohol control policies and motor vehicle fatalities. J Legal Stud 1993;22:161–86.
  • Colon I, Cutter HSG. The relationship of beer consumption and state alcohol and motor vehicle policies to fatal accidents. J Safety Res 1983;14: 84–9.
  • Colon I. The alcohol beverage purchase age and single-vehicle highway fatalities. J Safety Res 1984;15:159–62.
  • Cook PJ, Tauchen G. The effect of minimum drinking age legislation on youthful auto fatalities. J Legal Stud 1984;13:169–90.
  • Decker MD, Graitcer PL, Schaffner W. Reduction in motor vehicle fatalities associated with an increase in the minimum drinking age. JAMA 1988;260: 3604–10.
  • Dee TS. State alcohol policies, teen drinking and traffic fatalities. J Public Econ 1999;72:289–315.
  • DuMouchel W, Williams AF, Zador P. Raising the alcohol purchase age: its effects on fatal motor vehicle crashes in twenty-six states. J Legal Stud 1987;16:249–66.
  • Durant R, Legge JS. Policy design, social regulation and theory building: lessons from the traffic safety policy arena. Political Res Q 1993;46:641–56.
  • Ferreira J, Sickerman A. The impact of Massachusetts reduced drinking age on auto accidents. Accid Anal Prev 1976;8:229–39.
  • Figlio DN. Effect of drinking age laws and alcohol-related crashes: timeseries evidence from Wisconsin. J Policy Anal Manage 1995;14:555–66.
  • Hedlund, JH, R.G. Ulmer and D.F. Preusser. “Determine Why There are Fewer Young Alcohol-Impaired Drivers.” National Highway Traffic Safety Administration, 2001. http://www.nhtsa.dot.gov/people/injury/research/FewerYoungDrivers/iii__what_happened.htm
  • Hingson R, Scotch N, Mangione T, et al. Impact of legislation raising the legal drinking age in Massachusetts from 18 to 20. Am J Public Health 1983;73:163–9.
  • Hoskin AF, Yalung Mathews D, Carraro BA. Effect of raising the legal minimum drinking age on fatal crashes in 10 states. J Safety Res 1986;17:117–21.
  • Houston DJ, Richardson LE, Neeley GW. Legislating traffic safety: a pooled time series analysis. Soc Sci Q 1995;76:328–45.
  • Houston DJ, Richardson LE, Neeley GW. Mandatory seat belt laws in the states: a study of fatal and severe occupant injuries. Eval Rev 1996;20:146–59.
  • Legge J Jr. Reforming highway safety in New York State: an evaluation of alternative policy interventions. Soc Sci Q 1990;71:373–82.
  • Legge JS Jr, Park J. Policies to reduce alcohol-impaired driving: evaluating elements of deterrence. Soc Sci Q 1994;75:594–606.
  • Lillis R, Williams T, Williford W. The impact of the 19-year-old drinking age in New York. Advances in Substance Abuse 1987;Suppl 1, Control Issues in Alcohol Abuse Prevention: Strategies for States and Communities:133–46.
  • Males M. Minimum purchase age for alcohol and young-driver fatal crashes: a long-term view. J Legal Stud 1986;15:181–211.
  • MacKinnon DP, Woodward JA. The impact of raising the minimum drinking age on driver fatalities. Int J Addict 1986;21:1331–8.
  • Naor EM, Nashold RD. Teenage driver fatalities following reduction in the legal drinking age. J Safety Res 1975;7:74–9.
  • O’Malley PM, Wagenaar AC. Effects of minimum drinking age laws on alcohol use, related behaviors and traffic crash involvement among American youth: 1976–1987. J Stud Alcohol 1991;52:478–91.
  • Robertson LS. Blood alcohol in fatally injured drivers and the minimum legal drinking age. J Health Polit Policy Law 1989;14:817–25.
  • Ruhm CJ. Alcohol policies and highway vehicle fatalities. J Health Econ 1996;15:435–54.
  • Saffer H, Chaloupka F. Breath testing and highway fatality rates. Appl Econ 1989;21:901–12.
  • Saffer H, Grossman M. Drinking age laws and highway mortality rates: cause and effect. Econ Inquiry 1987;25:403–17.
  • Saffer H, Grossman M. Beer taxes, the legal drinking age, and youth motor vehicle fatalities. J Legal Stud 1987;16:351–74.
  • Smith DI, Burvill PW. Effect on traffic safety of lowering the drinking age in three Australian states. J Drug Issues 1986;16:183–98.
  • Smith RA, Hingson RW, Morelock S, et al. Legislation raising the legal drinking age in Massachusetts from 18 to 20: effect on 16 and 17 year olds. J Stud Alcohol 1984;45:534–9.
  • United States General Accounting Office (1987). Drinking-Age Laws: An Evaluation Synthesis of Their Impact on Highway Safety. GAO/PEMD-87-10. Washington, DC: USGAO. 
  • Vingilis E, Smart RG. Effects of raising the legal drinking age in Ontario. Br J Addict 1981;76:415–25.
  • Wagenaar AC. Effects of an increase in the legal minimum drinking age. Public Health Policy 1981;2:206–24.
  • Wagenaar AC. Effects of the raised legal drinking age on motor vehicle accidents in Michigan. HSRI Res Rev 1981;11:1–8.
  • Wagenaar AC. Preventing highway crashes by raising the legal minimum age for drinking: the Michigan experience 6 years later. J Safety Res 1986;17:101–9.
  • Wagenaar AC. Raising the legal drinking age in Maine: impact on traffic accidents among young drivers. Int J Addict 1983;18:365–77.
  • Wagenaar AC, Maybee R. Legal minimum drinking age in Texas: effects of an increase from 18 to 19. J Safety Res 1986;17:165–78.
  • Wagenaar, A.C., Toomey, T.L. Effects of minimum drinking age laws: Review and analyses of the literature from 1960-2000. Journal of Studies on Alcohol, Supp l14:206-225. 2002
  • Whitehead PC, Craig J, Langford N, MacArthur C, Stanton B, Ferrence RG. Collision behavior of young drivers: impact of the change in the age of majority. J Stud Alcohol 1975;36:1208–23.
  • Wilkinson JT. Reducing drunken driving: Which policies are most effective? South Econ J 1987;54:322–34.
  • Williams AF, Rich RF, Zador PL. The legal minimum drinking age and fatal motor vehicle crashes. J Legal Stud 1975;4:219–39.
  • Williams AF, Zador PL, Harris SS, Karpf RS. The effect of raising the legal minimum drinking age on involvement in fatal crashes. J Legal Stud 1983;12:169–79.
  • Womble K. Impact of minimum drinking age laws on fatal crash involvements: an update of the NHTSA analysis. J Traffic Safety Educ 1989;37:4–5.
  • Zylman R. Fatal crashes among Michigan youth following reduction of legal drinking age. Q J Stud Alcohol 1974;35:283–6.

Administrative License Revocation

“Based upon the extensive experience of the jurisdictions that have adopted administrative license revocation, it works.  It specifically deters those drivers who are caught drinking and driving from doing it again.  And, it generally deters those who have not been caught, because they are afraid of losing their driving privileges.” --Deborah A.P. Hersman, Member, National Transportation Safety Board, April 2006

In order to deter drunk drivers, sanctions must be swift, meaningful, and certain.  Administrative license revocation (ALR) is the removal of a DUI/DWI offender's driver's license at the time of an arrest upon the failure or refusal of a chemical test.  Just like your Department of Motor Vehicles can suspend your license for excessive points or violations, ALR allows them to do it for drunk driving.  As a result, these sanctions are swift, meaning, and certain – a model deterrent.

As a result, they save lives.  When states pass ALR laws, their fatal late-night crashes decrease by an average of nine percent.  (Voas, Tippets, and Fell, 2000) Even though 50 to 75 percent of those whose licenses are suspended or revoked drive any way (which is why ignition interlock devices are needed, (Nichols and Ross, 1990) ALR deters people from ever driving under the influence of alcohol and thus prevents crashes.  (Voas, Tippets, and Taylor, 1998) It also saves significant costs for the state as a result. (Lacey, 1991)

Some worry that this will hurt offenders’ jobs, but studies show license revocations do not lead to losses of job or income (Knoebel and Ross, 1996); also, it is fears like these that give ALR its deterrent effect.  All in all, ALR is effective and it makes sense. Driving is a privilege, not a right, and those who abuse the privilege should have it removed.


Take Action!


Nine states still do not have administrative license revocation: Kentucky, Michigan, Montana, New Jersey, New York, Pennsylvania, Rhode Island, South Dakota, and Tennessee.  If you are from one of these states, please click here to tell your representatives you would like to see them adopt ALR .

Resources

  • Official Position Statement
  • Studies
    • MADD's Impaired Driving Summit Report (PDF)
    • Beirness, Douglas, et al. "The Impact of Administrative License Suspension and Vehicle Impoundment for DWI in Manitoba.” In C. Mercier-Guyon (Ed.) Proceedings of the 14th International Conference on Alcohol, Drugs and Traffic Safety. Annecy, France: Centre d'Etudes et de Recherches en Medecine du Trafic, 1997: 919-925. (not yet online)
    • Fell, Jim. "Repeat DWI Offenders in the United States.” Washington, DC: National Department of Transportation, National Highway Traffic Safety Administration Traffic Tech No. 85, February 1995. (Click here)
    • Jones, Ralph and John Lacey. "State of Knowledge of Alcohol-Impaired Driving: Research on Repeat DWI Offenders.” Washington, DC: National Department of Transportation, National Highway Traffic Safety Administration, February 2000. (Click here)
    • Knoebel, Kathleen and H. Lawrence Ross. "Effects of Administrative License Revocation on Employment.”DOT HS 808 462. Washington DC: National Highway Traffic Safety Administration, May 1996. (not yet online)
    • Lacey, John, et al. Cost Benefit Analysis of Administrative License Suspension. MidAmerica Research, DOT HS 807 689. Washington DC: National Highway Traffic Safety Administration, January 1991. (not yet online)
    • Nichols, James, and H. Lawrence Ross. "The Effectiveness of Legal Sanctions in Dealing with Drinking Drivers.” Alcohol, Drugs and Driving 6(2) (1990): 33-55. (Click here)
    • Peck, R.C., R. J. Wilson, and L. Sutton. "Driver License Strategies for Controlling the Persistent DUI Offender,” Strategies for Dealing with the Persistent Drinking Driver. Transportation Research Board, Transportation Research Circular No. 437. Washington, DC: National Research Council (1995): 48-49. (not yet online)
    • Voas, Robert and A. Scott Tippetts. "The Relationship of Alcohol Safety Laws to Drinking Drivers in Fatal Crashes.” Washington, DC: National Department of Transportation, National Highway Traffic Safety Administration, 1999. (Click here)
    • Voas, Robert, A. Scott Tippetts, and Jim Fell. "The Relationship of Alcohol Safety Laws to Drinking Drivers in Fatal Crashes.” Accident Analysis and Prevention 32 (2000): 483-492. (not yet online)
    • Voas, Robert, A. Scott Tippetts, and Eileen Taylor. "Impact of Ohio Administrative License Suspension.” In: 42nd Annual Proceedings: Association for the Advancement of Automotive Medicine. AAAM, 1998. (not yet online)
    • Voas, Robert, et al. "Effectiveness of the Ohio Vehicle Action and Administrative License Suspension Laws.” Washington, DC: National Department of Transportation, National Highway Traffic Safety Administration, January 2000. (Click here)

 


BAC Testing

A vehicle crash scene is chaotic. Determining whether the crash was alcohol-related is secondary to saving the lives of those involved, but determining if alcohol was involved in the crash is vital.  Nationally, in crashes that caused death or serious injury in 2005, less than a quarter of surviving drivers and less than two-thirds of killed drivers had their blood alcohol concentration (BAC) tested and available. (NHTSA, 2006)

Knowing whether a crash was alcohol-related is important for a number of reasons.  More testing means a greater chance of detecting drunk drivers. More than 80 percent of drunk drivers with a illegal BAC who were involved in motor vehicle crashes and admitted to ERs were not held responsible for their crimes because hospital personnel did not report their BAC level to authorities. (McNamee, 2001)

More testing helps to gauge the effects of policies and programs that combat drunk driving and help law enforcement professionals allocate their resources to the areas most in need of enforcement.  Lack of testing makes the problem hard to quantify and hard to combat.

Finally, testing helps help offenders get treatment for underlying problems with alcohol. People who come into the emergency department are one and a half to three times more likely to have alcohol abuse issues than primary care patients. (Cherpitel, 1999) Studies show that emergency room-based interventions can decrease future drinking and driving, traffic violations, alcohol-related injuries, and trauma re-admissions.  (Gentilello, 1999) (Monti, 1999) Treating offenders’ problems with alcohol makes us all safer.

  • Cherpitel, Cheryl J. "Drinking Patterns and Problems: A Comparison of Primary Care with the Emergency Room." Substance Abuse 20 (1999):85-95. (not yet online)
  • Gentilello, Laurence M, et al. "Alcohol Interventions in a Trauma Center as a Means of Reducing the Risk of Injury Recurrence." Annals of Surgery 230 vol. 4 (1999): 473-483. (Click here)
  • McNamee, Carol. "Slipping Through the Cracks: The Need for Mandatory BAC Testing for All Crashes." DRIVEN magazine. Irving, TX: Mothers Against Drunk Driving, Spring 2001. (Click here)
  • Monti, Peter M., et al. "Brief Intervention for Harm Reduction with Alcohol-Positive Older Adolescents in a Hospital Emergency Department." Journal of Consulting and Clinical Psychology 67 vol. 6 (1999):989-994. (not yet online)
  • National Highway Traffic Safety Administration. "Alcohol Screening and Brief Intervention in the Medical Setting." DOT HS 809 467. Washington, DC: National Highway Traffic Safety Administration, July 2002. (Click here)
  • National Highway Traffic Safety Administration. “Traffic Safety Facts 2005: State Alcohol Estimates.” DOT 810 627. Washington DC: National Highway Traffic Safety Administration, 2006. http://www-nrd.nhtsa.dot.gov/pdf/nrd-30/NCSA/TSF2005/StateAlcoholEstTSF05.pdf
  • Soderstrom, Carl, JT Dailey, and TJ Kerns. "Alcohol and Other Drugs: An Assessment of Testing and Clinical Practices in U.S. Trauma Centers." Journal of Trauma 36 vol. 1 (Jan 1994): 68-73. (not yet online)

 


Child Endangerment

Child abuse or neglect: When a child’s parent or custodian, by reason of cruelty, mental capacity, immorality or depravity, is unfit to properly care for him or her, neglects or refuses to provide necessary physical, affectional, medical, surgical or institutional care for him or her or is under such improper care or control as to endanger his or her morals or health.” – Black's Law Dictionary

In 2005, 414 children under the age of 15 years old were killed in alcohol-related crashes.  Of these, over half percent were riding with the drinking driver. (NHTSA, 2006)  Between 1997 and 2001, 1,985 child passengers died and an estimated 87,226 were injured in alcohol-related crashes.  Over this five-year period, 68 percent of the deaths and 38 percent of the injuries occurred among children who were riding with a drinking driver. (CDC, 2004)

A child in a vehicle with a drinking driver is not only at risk from the impaired driver, but also from the lack of safety restraint use (like a seat belt or child safety seat), as drinking drivers are much less likely to make sure a child is properly restrained. (Margolis, 2000) (Quinlan, 2000)

MADD believes that driving under the influence of alcohol or other drugs is criminal and irresponsible.  Additional sanctions should be placed on those who drive under the influence with a child in the vehicle – regular sanctions and treatment are not enough.

Studies

  • Centers for Disease Control.  “Child passenger deaths involving drinking drivers--United States, 1997-2002.”  Morbidity and Mortal Weekly Report. 53(4) (2004 Feb 6): 77-9. (Click here)
  • MADD.  "Every Child Deserves a Designated Driver."  2004.  (Click here)
  • Margolis, Lewis, Robert Foss, and William Tolbert. “Alcohol and Motor Vehicle-Related Deaths of Children as Passengers, Pedestrians, & Bicyclists.” Journal of the American Medical Association 283 (17) (2000). (Click here)
  • National Highway Traffic Safety Administration. “Traffic Safety Facts 2005: Alcohol.” DOT 810 606. Washington DC: National Highway Traffic Safety Administration, 2006. http://www-nrd.nhtsa.dot.gov/pdf/nrd-30/NCSA/TSF2005/AlcoholTSF05.pdf
  • Quinlan, Kyran, et al.  “Characteristics of Child Passenger Deaths and Injuries Involving Drinking Drivers.”  Journal of the American Medical Association 283 (17) (2000): 2249-52. (Click here)

 


DWS

Between 50 and 75 percent of those whose licenses are suspended as the result of drunk driving continue to drive illegally without their license. (Nichols and Ross, 1990) (Voas and Tippetts, 1994)  Over 60 percent of third-time DUI offenders who have their license suspended or revoked commit some manner of traffic violation during their suspension/revocation period (NHTSA, 2003). Unlicensed drivers are involved in 20 percent of all traffic crashes (Scopatz, 2003) and are 3.7 times more likely to be involved in a fatal crash than validly licensed drivers (DeYoung, 1997). Clearly, something else must be done to deter those whose licenses are suspended or revoked from driving while suspended (DWS).

MADD's recommendations for dealing with these higher-risk offenders have been scientifically shown to work. They are (link to each one):
  • Administrative license revocation
  • Ignition interlock
  • Vehicle sanctions
  • Assessment and treatment

Studies 

  • DeYoung, David, Raymond Peck, and Clifford Helander. "Estimating the Exposure and Fatal Crash Rates of Suspended/Revoked and Unlicensed Drivers in California". Accident Analysis and Prevention 29(1) (1997): 17-23. (not yet online)
  • National Highway Traffic Safety Administration. "Traffic Safety Facts: Laws: Vehicle and License Plate Sanctions." Washington DC: National Highway Traffic Safety Administration, May 2003. (Click here)
  • Nichols, James, and H. Lawrence Ross. "The Effectiveness of Legal Sanctions in Dealing with Drinking Drivers." Alcohol, Drugs and Driving 6(2) (1990): 33-55. (Click here)
  • Rodgers, Alan. "Effect of Minnesota's License Plate Impoundment Law on Recidivism of Multiple DWI Violators." Alcohol, Drugs, and Driving, 10(2) (1994). (not yet online)
  • Scopatz, Robert, et al. "Unlicensed to Kill: The Sequel." Washington, DC: AAA Foundation for Traffic Safety, January 2003. (Click here)
  • Voas, Robert, and A. Scott Tippetts. "Unlicensed Driving by DUIs – A Major Safety Problem?" TRB ID No. CR077. Paper presented at the 73rd Annual Meeting, Transportation Research Board, Landover, MD, January 9-13, 1994. (not yet online)
  • Voas, Robert, and A. Scott Tippetts. "Evaluation of Washington and Oregon License Plate Sticker Laws." In 39th Annual Proceedings of the Association for the Advancement of Automotive Medicine (AAAM). Des Plaines, IL, 1995, pp. 29-44. (not yet online)
  • Voas, Robert, A. Scott Tippetts, and Eileen Taylor. "Impact of Ohio Administrative License Suspension." In: 42nd Annual Proceedings: Association for the Advancement of Automotive Medicine. AAAM, 1998. (not yet online)

 


First Offenders

There is a common misconception that most people who are convicted of their first drunk driving offense are social drinkers who made one mistake and learn from their conviction, never to drink and drive again. The truth is much more worrisome. Many first-time offenders are not really “first offenders.” Studies of enforcement patterns find that one arrest is generally made for every 88 instances of driving over the illegal limit. (Zador, et al, 1997) Thus, the average first offender will have driven drunk 87 times before being caught – some less, some more.

A first offender is also at a high risk of recommitting a drunk driving offense. Research has found that first offenders’ patterns of recidivism are generally similar to a drunk driving repeat offender. (Rauch, et al, 2002) Their BACs at time of arrest are almost as high as the BACs of repeat offenders. (Jones and Lacey, 2000) In places where interlocks are used for first offenders, as MADD recommends (link to interlock research page), they prevent driving after drinking every month on average. (Quaye and Boase, 2004) Thus, first offenders’ behavior tends toward recommitting the crime of drunk driving.

This is partly because those who are convicted of even their first drunk driving offense tend to have problems with alcohol. Over a three-year period, one judge sentenced all first offenders to clinical evaluation. Over eighty percent were assessed as problem drinkers or alcoholics. (Rauch, 2005) Other treatment studies confirm this (link to treatment)

For these offenders, MADD recommends (each of these should link to the individual research page for that topic):

  • Ignition interlock devices
  • Administrative license revocation
  • Assessment and treatment
  • And, of course, strong enforcement to deter and apprehend

Studies

  • Jones, Ralph and John Lacey. “State of Knowledge of Alcohol Impaired Driving: Research on Repeat DWI Offenders.” DOT HS 809 027. Washington, DC: National Highway Traffic Safety Administration, 2000. <http://www.nhtsa.dot.gov/people/injury/research/pub/Alcohol-ImpairedDriving.html>
  • Quaye, Kwei and Paul Boase. “First Time Drinking and Driving Offenders – Unraveling the Myth with Ignition Interlock and Short-Term Suspensions Data.” 17th Meeting of the International Council on Alcohol, Drugs and Traffic Safety. Glasgow, Scotland: August 8-13, 2004. http://www.icadts.org/t2004/pdfs/O115.pdf
  • Rauch, William et al. “A Longitudinal Survival Analysis of Drivers with Multiple Alcohol-Related Traffic Offenses: Fifth Year Follow-Up of a Randomized Ignition Interlock License Restriction Trial in Maryland.” Proceedings of Alcohol, Drugs and Traffic Safety - T 2002: 16th International Conference on Alcohol, Drugs and Traffic Safety, August 4-9, 2002. Ed. D. R. Mayhew and C. Dussault, (Vol. 1, pp. 139- 144). Montreal, Canada: Société de l’assurance automobile du Québec, 2002.
  • Rauch, William. “Does Alcohol-Impaired Driving Recidivism among First Offenders More Closely Resemble that of Multiple Offenders?” 6th International Symposium on Alcohol Ignition Interlock Programs, Annecy, France: September 25-27, 2005. http://www.trafficinjuryresearch.com/whatNew/newsItemPDFs/Bill_Rauch.pdf
  • Zador, Paul, Sheila Krawchuk, and B. Moore. (1997) “Drinking and Driving Trips, Stops by Police, and Arrests: Analysis of the 1995 National Survey of Drinking and Driving Attitudes and Behavior,” Rockville, MD: Estat, Inc, 1997.

 


High BAC

Drivers with a high BAC, 0.15 percent or greater, require strong intervention similar to that ordinarily prescribed for repeat offenders. Those who reach this high BAC level have consumed large amounts of alcohol, much more than is considered to be social or responsible drinking. Research has found that drivers with a high BAC are at a substantially greater risk of being involved in a fatal crash. The Insurance Institute for Highway Safety (IIHS) has estimated that the relative fatality risk for drivers in single-vehicle crashes with a high BAC is 385 times that of a zero-BAC driver and for male drivers the risk is 607 times that of a sober driver.” – Richard Healing, Member, National Transportation Safety Board, February 2004

.08 BAC is the point at which everyone is significantly impaired. .15 BAC is nearly twice the illegal limit and despite these drivers clearly being far too drunk to drive, they are responsible for over half of all alcohol-related crash fatalities (even though even at the worst times, they are only one percent of the drivers on the road).. (Foss et al, 1993).  This is not social drinking – it is callous disregard for human life. 

High-BAC offenders require additional sanctions and treatment that "normal" drunk driving sanctions cannot provide, including hard license revocations and ignition interlock devices for longer than a normal offender. They also need treatment for underlying alcohol use and abuse issues.

These sanctions work.  Enhanced sanctions in Minnesota caused high-BAC offenders to have lower rates of recidivism than those who had slightly lower BACs and thus did not receive enhanced sanctions. (McCartt and Northrup, 2004) Clearly, every state needs to increase penalties for drivers who are far beyond the illegal limit to drive.

Resources

Studies

  • MADD's Impaired Driving Summit Report (PDF)
  • Foss, Robert, Robert Voas, and Douglas Beirness. "Using a Passive Alcohol Sensor to Detect Legally Intoxicated Drivers."  American Journal of Public Health, 83, no.4 (1993): 556-560. (Click here)
  • McCartt, Anne and Veronika Northrup.  "Effects of Enhanced Sanctions for High-BAC DWI Offenders on Case Dispositions and Rates of Recidivism."  Traffic Injury Prevention 5 (3) (2004): 270-277. (Click here)
  • Zador, Paul, Sheila Krawchuk, and Robert Voas. "Relative Risk of Fatal Crash Involvement by BAC, Age, and Gender."  DOT HS 809 050. Washington, DC: U.S. Department of Transportation, National Highway Traffic Safety Administration, 2000. (Click here)

 


Higher-Risk Offender

“While higher-risk drivers are a small portion of the population, they pose a significant threat to innocent motorists. On a typical weekend night, only one percent of drivers have a BAC of .15 or higher, but high BAC drivers were involved in over one-half of all alcohol-related traffic deaths ... And, about one-third of all drivers arrested or convicted of DUI are repeat offenders.” – Wendy Hamilton, former MADD president, May 2003

MADD looks at three groups as “higher-risk drivers” – drivers who are the bulk of the drunk driving problem and are even more dangerous than a traditional offender:

  • High-BAC offenders (link to high-BAC research section): Those people who drive at a .15 BAC or higher. This is nearly twice the illegal limit and despite these drivers clearly being far too drunk to drive, they are responsible for over half of all alcohol-related crash fatalities. Click here to learn more.
  • Repeat offenders (link to repeat offender research section): Those people who have previous drunk driving convictions. They represent about one-third of all drunk driving arrests, crashes, and fatalities. Click here to learn more.
  • Those who drive while their license is suspended or revoked for drunk driving (link to DWS research section): About 50 to 75 percent of those who have their license suspended for drunk driving continue to drive anyway. Click here to learn more.

These offenders need greater sanctions to help deter them from driving drunk again and to treat any underlying issues they may have with alcohol.


Ignition Interlock

"Unfortunately, existing technology--the ignition interlock--has gotten little use in Illinois and most other states. Of the 1.4 million people arrested each year for DUI, only 100,000 end up with interlock devices. … They are the most promising available tool for curbing a fatal scourge that still claims lives every day. The pertinent question is not "should we require them?" but "what are we waiting for?" – Chicago Tribune editorial, November 2006

Administrative license sanctions (link to ALR) are effective at deterring people from committing drunk driving. Unfortunately, they aren't effective at preventing people who don't have a license from driving (link to DWS); 50 to 75 percent of those whose licenses are suspended or revoked drive anyway. (Nichols and Ross, 1990)

That's why we need ignition interlocks for all DUI offenders, even first time offenders, who are about as likely to reoffend as repeat offenders (link to first offenders). Interlocks have been shown in a number of studies to reduce recidivism. The research is clear that interlocks reduce repeat offenders by 60-90 percent:

Jurisdiction
Date
Author(s)
Recidivism Reduction
North Carolina
1993
Popkin et al
62 percent over restricted;
72 percent over suspended
West Virginia
1997
Tippets & Voas
75 percent
Maryland
1999
Beck et al
64 percent
Alberta
1999
Voas et al
89 percent over reinstated;
95 percent over ineligible
Colorado
2000
Marine et al
73 percent
Illinois
2002
Frank et al
81 percent
Quebec
2002
Vezina
66 percent

The devices have also proven very effective when applied to first-time offenders:

  • New Mexico found a decrease in recidivism by over a half among first offenders who installed interlock devices. (Voas et al, 2005)
  • West Virginia found a 77 percent decrease in recidivism among interlocked first offenders. (Tippetts and Voas, 1998)
  • Cincinnati found a 65 percent decrease in recidivism. (Elliott and Morse, 2002)
  • Alberta found over a 95 percent reduction in recidivism among interlocked first offenders. (Voas et al, 1999)
  • Quebec found a 80 percent reduction in recidivism among first offenders (Vezina, 2002)
  • A Swedish evaluation among interlocks for first and multiple offenders found recidivism dropped to nearly zero. (Bjerre, 2003)

Mandatory laws are necessary, since only 10 percent or less of offenders will install the devices if given the option. (Voas et al, 1999) MADD has a number of recommendations for laws that get interlocks installed on as many offenders as possible – read our ignition interlock white paper for details.

 

Studies:

  • Beck, Kenneth H. et al. “Effects of Ignition Interlock License Restrictions on Drivers With Multiple Alcohol Offenses: A Randomized Trial in Maryland.” American Journal of Public Health 89 (1999): 1696­1700.
  • Bjerre, B. “An Evaluation of the Swedish Interlock Program.” Traffic Injury Prevention, 4(2) (2003), 98-104.
  • Coben, Jeffrey and Gregory Larkin. “Effectiveness of Ignition Interlock Devices in Reducing Drunk Driving Recidivism.” American Journal of Preventive Medicine 16 (1S) (1999): 81-87.
  • Elliott, DS and BJ Morse. Hamilton County Drinking and Driving Study. Interlock Evaluation: Two-Year Findings. Boulder, CO: University of Colorado Institute of Behavioral Science, 1992.
  • Frank, JF et al. “Illinois Ignition Interlock Evaluation.” Alcohol Drugs and Traffic Safety – T2002. Proceedings of the 16th International Conference on Alcohol, Drugs and Traffic Safety. Ed. DR Mayhew and C. Dussault, 2002.
  • Marine, W., et al. “Results of Colorado’s Voluntary Alcohol Ignition Interlock Pilot Program: Evaluation and Recommendations for Change.” Denver, CO: University of Colorado Health Science Center, 2000.
  • Nichols, James, and H. Lawrence Ross. "The Effectiveness of Legal Sanctions in Dealing with Drinking Drivers.” Alcohol, Drugs and Driving 6(2) (1990): 33-55. (Click here)
  • Popkin, CL et al. “An Evaluation of the Effectiveness of Interlock Systems in Preventing DWI Recidivism among Second-Time DWI Offenders.” Alcohol, Drugs and Traffic Safety – T-92: Proceedings of the 12th Interlock Conference on Alcohol Drugs and Traffic Safety. Ed. H-D Utzelmann, G Berghaus, G Kroj, 1992.
  • Tashima, H.N.and C.J. Helander. 1999 Annual Report of the California DUI Management Information System. Sacramento, CA: California Department of Motor Vehicles Research and Development Section, 1999.
  • Tippetts, A. Scott and Robert Voas. “The Effectiveness of the West Virginia Interlock Program.” Journal of Traffic Medicine 26 (1-2) (1998): 19-24.
  • Vezina. “The Quebec Alcohol-Ignition Interlock Program: Impact on Recidivism and Crashes.” Alcohol Drugs and Traffic Safety – T2002. Proceedings of the 16th International Conference on Alcohol, Drugs and Traffic Safety. Ed. DR Mayhew and C. Dussault, 2002. <http://www.saaq.gouv.qc.ca/t2002/actes/pdf/(08a).pdf>
  • Voas, Robert, et al. “The Alberta Interlock Program: The Evaluation of a Province-Wise Program on DUI Recidivism.” Addiction 94 (12) (1999): 1849-1859.
  • Voas, Robert, Paul Marques, and Richard Roth. "Evidence that Interlocks Are Effective with First Offenders." 6th Annual Ignition Interlock Symposium, 2005. <http://www.tirf.ca/whatNew/newsItemPDFs/Bob_Voas.pdf>
  • Weinrath, Michael.“Ignition Interlock Program for Drunk Drivers: A Multivariate Test.” Crime and Delinquency 43 (1) (1997): 42-59.
  • Willis, C., Lybrand, S., & Bellamy, N. “Alcohol Ignition Interlock Programmes for Reducing Drink Driving Recidivism.” Cochran Database of Systematic Reviews (2005).

 


Open Container

An open container law bans an open container of alcohol in the passenger compartment of a vehicle. Since our goal is to stop people from drinking and driving, it almost goes without saying that we should stop people from drinking while driving.

An open container law can help law enforcement enforce no drinking while driving. Having a ban on only consumption while driving or an open container law that applies only to the driver makes it too easy for the driver to pass the alcohol to a friend or put it in the back seat when pulled over.

Common-sense legislation like this can save lives. Studies have shown that open container laws deter both moderate and heavy drinkers from driving under the influence. (Stout, 2000) This translates to a 5.1% decrease in fatal crashes rates after states pass an open container law. (Eisenberg, 2001)  States also have significantly fewer hit-and-run crashes after they pass an open container law. (Stuster, 2002)

It's time to take a stand – we will never be able to stop drinking and driving if we don't stop drinking while driving.

Studies

  • Eisenberg, Daniel. "Evaluating the Effectiveness of a 0.08 Percent BAC Limit and Other Policies Related to Drunk Driving." Stanford Institute for Economic Policy Research Discussion Paper No. 00-23. Stanford, CA: Stanford Institute for Economic Policy Research, January 2001. (Click here)
  • Stout, Emily, et al. "Reducing Harmful Alcohol-Related Behaviors: Effective Regulatory Methods." Journal of Studies on Alcohol 61 vol. 3 (May 2000): 402-12. (not yet online)
  • Stuster, Jack, Marcelline Burns, and Dary Fiorentino. "Open Container Laws and Alcohol Involved Crashes: Some Preliminary Data." DOT HS 809 426. Washington, DC: National Department of Transportation, National Highway Traffic Safety Administration, April 2002. (Click here)

 


Primary Seat Belt

“The surest way for a State to increase safety belt usage is through the passage of a primary safety belt law.” – Secretary of Transportation Norman Mineta

Seat belts save lives. Every state but New Hampshire requires its citizens to wear seat belts. Unfortunately, half of US states have secondary enforcement laws, meaning that a law enforcement officer has to pull someone over for a different violation and only then is able to write an additional citation for a seat belt violation. This means that officers can't pull someone over for failing to use the most important piece of safety equipment in the car – the seat belt.

Studies have found that states that pass a primary seat belt law increase average seat belt usage by nine to 14 percentage points. (Dinh-Zarr, 2001)  This, in turn, decreases crash fatalities by an average of eight percent (Dinh-Zarr, 2001)  and decreases the severity of injuries in crashes. (Houston, 1996)  The increase is especially pronounced among teen drivers, who are the most likely to be involved in crashes and the least likely to wear seat belts. (McCartt and Northrup, 2004)

Some argue that they should be able to choose not to wear a seat belt. However, seat belt use is the law already. Additionally, the decision to wear a seat belt affects those too young to make a conscious choice. Adults who do not buckle up are sending a message to children that it is all right not to use seat belts—the probability of a fatally injured child being unrestrained is more than twice as likely when the adult driving was unrestrained. (Starnes, 2003)

Also, 85 percent of the costs of crashes are borne by society, not by the individuals in the crash. (NHTSA, 2003)  Considering that a crash costs 55 percent more when a crash victim is unbelted, we have a financial imperative to enact primary seat belt laws, in addition to the moral and ethical imperatives.

  • CDC Community Guide. "Effectiveness of Primary versus Secondary Safety Belt Use Laws," 2001. (Click here)
  • Dinh-Zarr, Bella, et al. "Reviews of Evidence Regarding Interventions to Increase the Use of Safety Belts." American Journal of Preventive Medicine 21 vol. 4S (2001): 48-65. (Click here)
  • Glassbrenner, Donna. "Safety Belt and Helmet Use in 2002 – Overall Results." DOT HS 809 500. Washington DC: National Highway Traffic Safety Administration, September 2002. (Click here)
  • Houston, David, Lilliard Richardson, and Grant Neeley. "Legislating Traffic Safety: A Pooled Time Series Analysis." Social Science Quarterly 76 (1995): 328-45. (not yet online)
  • Houston, David, Lilliard Richardson, and Grant Neeley. "Mandatory Seat Belt Laws in the States: A Study of Fatal and Severe Occupant Injuries." Evaluation Review 20 (1996): 146-59. (not yet online)
  • Lange, JE, and Robert Voas. "Nighttime Observations of Safety Belt Use: An Evaluation of California's Primary Law." American Journal of Public Health 88 (1998): 1718-20. (not yet online)
  • McCartt, Anne and Veronika Northrup.  "Factors Related to Seat Belt Use among Fatally Injured Teenage Drivers."  Journal of Safety Research 35 (2004). 29-38. (not yet online)
  • National Highway Traffic Safety Administration. "Process and Outcome Evaluation of the Buckle Up America Initiatives." DOT HS 809 272. Washington DC: National Highway Traffic Safety Administration, May 2001. (not yet online)
  • National Highway Traffic Safety Administration. “Traffic Safety Facts 2005: Occupant Protection”. DOT 810 621. Washington DC: National Highway Traffic Safety Administration, 2006. http://www-nrd.nhtsa.dot.gov/pdf/nrd-30/NCSA/TSF2005/OccupantProtectionTSF05.pdf
  • Preusser DF and CW Preusser. "Evaluation of Louisiana's Safety Belt Law Change to Primary Enforcement." DOT HS 808 620. Washington DC: National Highway Traffic Safety Administration, 1997. (not yet online)
  • Solomon, Mark and William Nissen. "Evaluation of Maryland, Oklahoma, and the District of Columbia's Seat Belt Law Change to Primary Enforcement." DOT HS 808 324. Washington DC: National Highway Traffic Safety Administration, 2000. (not yet online)
  • Starnes, Marc. "The Relationship Between Driver and Child Passenger Restraint Use Among Fatally Injured Child Passengers Age 0 – 15." NCSA Research Note. DOT HS 809 558. Washington DC: National Highway Traffic Safety Administration, March 2003. (not yet online)
  • Ulmer RG, et al. "Evaluation of California's Safety Belt Law Change from Secondary to Primary Enforcement." Journal of Safety Research 26 (1995): 213-20. (not yet online)
  • Winnicki, John. "Safety Belt Use Laws: Evaluation of Primary Enforcement and Other Provisions." DOT HS 808 324. Washington DC: National Highway Traffic Safety Administration, 1995. (not yet online)

 


Repeat Offender

Repeat offenders are a significant portion of the drunk driving problem – about one-third of all DUI arrests are of people who have been previously convicted of drunk driving. (Fell, 1995)  These are offenders who have been given the opportunity to mend their ways, but have not.  They require additional sanctions and treatment that "normal" DUI sanctions cannot provide.

The sanctions that every repeat offender should get are:
  • Administrative license revocation (link to ALR research). ALR significantly reduces DUI offenses and other moving violations among people with drunk driving convictions. (Voas et al, 1998)  This in turn decreases fatal crashes. (Zador et al, 1988; Voas et al, 2000) Learn more about ALR here.
  • Ignition interlock devices (link to interlock research). All offenders need interlocks, but repeat offenders especially so. Half to 75 percent of offenders drive on their suspended licenses – interlocks can reduce recidivism by 60-90 percent. . Learn more about interlocks here.
  • Treatment (link to treatment research). Every offender with alcohol problems should have to get treatment. Repeat offenders are even more likely to need treatment – even over half those who have serious crash injuries say they continue to drive drunk. Treatment can reduce recidivism by nine percent. (Wells-Parker, et al, 1995) Learn more about treatment here.

 

Resources

  • Fell, Jim. "Repeat DWI Offenders in the United States." Washington, DC: National Department of Transportation, National Highway Traffic Safety Administration Traffic Tech No. 85, February 1995. (Click here)
  • Jones, Ralph and John Lacey.  "State of Knowledge of Alcohol-Impaired Driving: Research on Repeat DWI Offenders." Washington, DC: National Department of Transportation, National Highway Traffic Safety Administration, February 2000.  (Click here)
  • Lacey, John, et al.Cost Benefit Analysis of Administrative License Suspension.DOT HS 807 689. Washington DC: National Highway Traffic Safety Administration, January 1991. (not yet online)
  • Larkin, E., E. Vingilis, G. Stoduto, and A. Parkinson-Heyes. “Psychosocial Sequelae Following a Serious Injury Producing Crash.” In Utzelmann, H.-D., G. Berghaus, and G. Kroj (Eds.). Alcohol, Drugs and Traffic Safety – T92 (Vol. 2, pp. 945-949). Cologne, Germany: Verlage T<V Rheinland.
  • National Highway Traffic Safety Administration.  "Repeat DWI Offenders Are an Elusive Target."   Washington, DC: National Department of Transportation, National Highway Traffic Safety Administration Traffic Tech No. 217, March 2000.  (Click here)
  • Nichols, James, and H. Lawrence Ross. "The Effectiveness of Legal Sanctions in Dealing with Drinking Drivers." Alcohol, Drugs and Driving 6(2) (1990): 33-55. (Click here)
  • Peck, R.C., R. J. Wilson, and L. Sutton. "Driver License Strategies for Controlling the Persistent DUI Offender," Strategies for Dealing with the Persistent Drinking Driver. Transportation Research Board, Transportation Research Circular No. 437. Washington, DC: National Research Council (1995): 48-49. (not yet online)
  • Voas, Robert and A. Scott Tippetts.  "The Relationship of Alcohol Safety Laws to Drinking Drivers in Fatal Crashes." Washington, DC: National Department of Transportation, National Highway Traffic Safety Administration, 1999. (Click here)
  • Voas, Robert, A. Scott Tippetts, and Jim Fell. "The Relationship of Alcohol Safety Laws to Drinking Drivers in Fatal Crashes." Accident Analysis and Prevention 32 (2000): 483-492. (not yet online)
  • Voas, Robert, A. Scott Tippetts, and Eileen Taylor. "Impact of Ohio Administrative License Suspension." In: 42nd Annual Proceedings: Association for the Advancement of Automotive Medicine. AAAM, 1998. (not yet online)
  • Voas, Robert, et al.  "Effectiveness of the Ohio Vehicle Action and Administrative License Suspension Laws." Washington, DC: National Department of Transportation, National Highway Traffic Safety Administration, January 2000. (Click here)
  • Wells-Parker, Elisabeth, et al. "Final Results From a Meta-Analysis of Remedial Interventions with DUI Offenders." Addiction 90 (1995): 907-926.
  • Zador, Paul,et al. “Fatal Crash Involvement and Laws Against Alcohol-Impaired Driving.” Arlington, VA: Insurance Institute for Highway Safety, 1988.

Sobriety Checkpoint

"More than two decades of research have demonstrated that sobriety checkpoints and other law enforcement efforts make a difference.  They are vitally effective techniques to get impaired drivers off of our roads.” -- Chief Joseph Carter, President of the International Association of Chiefs of Police, November 2006

Sobriety checkpoints are used to detect impaired drivers.  Vehicles are stopped in a specific sequence (e.g., every other vehicle or every fourth vehicle).  This is designed not only to apprehend drunk drivers, but also to deter them from driving drunk.  Right now, only one arrest is made for every 88 episodes of driving over the illegal limit (Zador, 1997), so apprehension can not be the only goal.

These checkpoints have been shown several high quality studies and the Centers for Disease Control to reduce alcohol-related crashes and fatalities by 20 percent.  (CDC, 2001) This may create a minor inconvenience for drivers, but the Supreme Court ruled (in Michigan v. Sitz) that sobriety checkpoints are constitutional because this small inconvenience was overwhelmed by a compelling state interest in saving lives. Not only do they save lives, but they’ve been shown to be a cost-effective means of enforcement. (Mercer, et al, 1996; Miller et al, 1998; Stuster and Blowers, 1995)

Checkpoints are an integral and necessary part of anti-drunk driving enforcement and deserve our support.  Unfortunately, even though the US Supreme Court said sobriety checkpoints are constitutional, there are still ten states that do not allow them:  Idaho, Iowa, Michigan, Minnesota, Oregon, Rhode Island, Texas, Washington, Wisconsin, and Wyoming.  If you are from one of these states, click here to email your state legislators and tell them you want them to authorize and conduct sobriety checkpoints in your state.

  • Castle SP, et al. “Early Evaluation of a Statewide Sobriety Checkpoint Program. 39th Annual Proceedings, Association for the Advancement of Automotive Medicine.” Chicago, IL; October 16–18, 1995: 65–78.
  • CDC Community Guide.  "Effectiveness of Sobriety Checkpoints for Preventing Alcohol-Involved Crashes," 2001.  (Click here)
  • Elder, Randy, et al. "Effectiveness of Sobriety Checkpoints for Reducing Alcohol-Involved Crashes." Traffic Injury Prevention (2002): 266-274. (not yet online)
  • Lacey, John, Ralph Jones, and RG Smith. “Evaluation of Checkpoint Tennessee: Tennessee’s Statewide Sobriety Checkpoint Program.” Washington, DC: U.S. Department of Transportation, National Highway Traffic Safety Administration, 1999.
  • Lacey, John et al. “Enforcement and Public Information Strategies for DWI (driving-while-intoxicated) General Deterrence: ARREST DRUNK DRIVING—the Clearwater and Largo, Florida Experience.” Chapel Hill, NC: University of North Carolina Highway Safety Research Center, 1986.
  • Levy, David, P Asch P, and D Shea. “An Assessment of County Programs to Reduce Driving While Intoxicated.” Health Education Research 5 (1990): 247–56.
  • Mercer GW. “The Relationships among Driving While Impaired Charges, Police Drinking-Driving Roadcheck Activity, Media Coverage and Alcohol-Related Casualty Traffic Accidents.” Accident Analysis and Prevention 17 (1985): 467–74.
  • Mercer, G.W., P.K. Cooper, L. A. Kristiansen. “A Cost/Benefit Analysis of a 5-Month Intensive Alcohol-Impaired Driving Road Check Campaign.” Proc. 40th Annual AAAM (1996): 283-292.
  • Miller, Ted, M.S. Galbraith and B.A. Lawrence. "Costs and Benefits of a Community Sobriety Checkpoint Program." Journal of Studies on Alcohol 59 (1998): 462–468.  (not yet online) 
  • Shults, Ruth, et al.  "Reviews of Evidence Regarding Interventions to Reduce Alcohol-Impaired Driving."  American Journal of Preventive Medicine 21(4S) (2001): 66-88. (Click here
  • Stuster, Jack and Paul Blowers. "Experimental Evaluation of Sobriety Checkpoint Programs." DOT HS 808 287.  Washington, DC: U.S. Department of Transportation, National Highway Safety Traffic Administration, 1995. (not yet online)
  • Voas, Robert, HD Holder, and PJ Gruenewald. “The Effect of Drinking and Driving Interventions on Alcohol-Involved Traffic Crashes within a Comprehensive Community Trial.” Addiction 92 (1997): S221–S236.
  • Voas, Robert, E Rhodenzer, and Lynn. “Evaluation of Charlottesville Checkpoint Operation: Final Report, December 30, 1983 to December 31, 1984.” Washington, DC: U.S. Department of Transportation, National Highway Traffic Safety Administration, 1985.
  • Wells JK, David Preusser, and Allan Williams. “Enforcing Alcohol-Impaired Driving and Seat Belt Use Laws, Binghamton, NY.” Journal of Safety Research 23 (1992): 63–71. 
  • Zador, Paul, Sheila Krawchuk, and B. Moore, "Drinking and Driving Trips, Stops by Police, and Arrests: Analysis of the 1995 National Survey of Drinking and Driving Attitudes and Behavior," Rockville, MD: Estat, Inc, 1997. (not yet online)

Treatment

Often, drunk driving is a symptom of a person's alcohol abuse or alcoholism. Over a three-year period, one judge sentenced all first offenders to clinical evaluation. Over eighty percent were assessed as problem drinkers or alcoholics. (Rauch, 2005) Other studies have shown that by clinical criteria, over 70 percent of all DUI offenders have alcohol abuse problems and 10 to 50 percent are alcohol dependent. (Wieczorek, 1992) Even those who have had serious injuries from drunk driving said one year after their crash that they had driven impaired at least once. (Larkin, 1993) Clearly, part of the solution to drunk driving is to solve an underlying substance abuse problem.

Mandatory assessment and treatment of DUI offenders address substance abuse problems. A comprehensive treatment program and some form of follow-up has been shown to decrease repeat offenses by seven to nine percent when done with other sanctions like administrative license sanctions (link to ALR). (Wells-Parker, 1995)  Treatment has shown results across gender and racial lines. (Woodall, et al, 2004)

Assessment and treatment need to be mandatory components of all DUI sentences to make sure that offenders get treatment when necessary. If a DUI offender has a problem with alcohol, that person is less like to endanger themselves and others again if the problem with alcohol is treated.

  • Larkin, E., E. Vingilis, G. Stoduto, and A. Parkinson-Heyes. "Psychosocial Sequelae Following a Serious Injury Producing Crash." In Utzelmann, H.-D., G. Berghaus, & G. Kroj (Eds.). Alcohol, Drugs and Traffic Safety – T92 (Vol. 2, pp. 945-949). Cologne, Germany: Verlage T<V Rheinland. (not yet online)
  • National Highway Traffic Safety Administration. "Repeat DWI Offenders Are an Elusive Target." Washington, DC: National Department of Transportation, National Highway Traffic Safety Administration Traffic Tech No. 217, March 2000. (Click here)
  • Rauch, William et al. “A Longitudinal Survival Analysis of Drivers with Multiple Alcohol-Related Traffic Offenses: Fifth Year Follow-Up of a Randomized Ignition Interlock License Restriction Trial in Maryland.” Proceedings of Alcohol, Drugs and Traffic Safety - T 2002: 16th International Conference on Alcohol, Drugs and Traffic Safety, August 4-9, 2002. Ed. D. R. Mayhew and C. Dussault, (Vol. 1, pp. 139- 144). Montreal, Canada: Société de l’assurance automobile du Québec, 2002.
  • Wells-Parker, Elisabeth, et al. "Final Results From a Meta-Analysis of Remedial Interventions with DUI Offenders" Addiction 90 (1995): 907-926. (not yet online)
  • Wieczorek, William, Brenda Miller, and Thomas Nochajski. "Multiple and Single Location Drinking Among DWI Offenders Referred for Alcoholism Evaluation." American Journal of Drug and Alcohol Abuse, 18, no. 1 (1992):103-116. (not yet online)
  • Woodall, Gill, et al.  "The Prevention Paradox, Traffic Safety, and Driving-While-Intoxicated Treatment."  American Journal of Preventive Medicine, 27, no. 2 (2004): 106-111.

 


Underage Drinking

Alcohol is the No. 1 youth drug problem in America and more young people die from alcohol-related causes than from all other illicit drugs combined. National Research Council, Reducing Underage Drinking: A Collective Responsibility

Underage drinking is a serious problem. The total cost attributable to the consequences of underage drinking was almost $62 billion per year in 2001 dollars. (Miller, et al, 2006) 

Drinking before the age of 21 is associated with:

  • Damage to growing brains (White, 2001; Kuhn et al, 1998; Giedd, 1999)
  • Alcohol dependence (Grant and Dawson, 1997; Grant, 1998; Hingson et al, 2003)
  • Violence (Hingson, et al, Fall 2001; Hingson and Kenkel, 2003)
  • Dropping out of school (NIDA, 1998)
  • Drinking and driving (Hingson, et al, Jan. 2001; Hingson et al, 2003)
  • Riding with drinking drivers (Hingson, et al, Jan. 2001)
  • Unplanned and unsafe sex (Cooper, 2002)
  • Fatalities and injuries from drownings, burns, falls, (Levy, July 1999) homicides, suicides, (Institute of Medicine, 2003) and crashes (Levy, July 1999; Hingson and Kenkel, 2003; Hingson et al, 2003).

Sign MADD's pledge in support of the 21 minimum drinking age lawThe 21 minimum drinking age law alone has helped reduce the incidence and harms of underage drinking. NHTSA estimates that these laws have saved an estimated 25,000 lives since 1975 (through 2006). In 2006, an estimated 890 lives were saved by minimum drinking age laws.

Underage drinking: not just a youth problem
Many underage people still have easy access to alcohol. Adults continue to allow those under the legal drinking age to drink – illegally – by selling alcohol to those under 21, providing or purchasing alcohol, looking the other way when teens openly talk about their drinking exploits and refusing to hold other adults and youth accountable for breaking the law. 

A nationwide report by the Substance Abuse and Mental Health Administration (SAMHSA) released in June 2008 estimates that 40 percent of underage drinkers received free alcohol from adults over 21. MADD believes adults should be held accountable for providing alcohol to those under 21 for the very reasons mentioned in this report. Parents and adult caregivers are the key to preventing underage drinking. Read MADD's statement on the SAMHSA report.

Over 94 percent of twelfth graders and almost 68 percent of eighth graders report that alcohol is "very easy" or "fairly easy" to get. (Johnson, et al, 2003)  This is due in part to loopholes in the 21 minimum drinking age law.  Fifteen states do not prohibit the consumption of alcohol by those under 21. This forces law enforcement to prove that the underage person possessed the alcohol before drinking, which makes enforcement more difficult. Additionally, 15 states do not prohibit attempts to purchase alcohol by those under 21. In these states, underage potential drinkers can attempt to purchase alcohol at any number of stores with no legal sanction as long as they do not use fake identification.

While the 21 minimum drinking age law has significant effect because of the illegality (Tyler and Huo, 2002), enforcement is very important and these loopholes make the minimum drinking age harder to enforce.

Take action!
Join the fight against underage drinking in your state by contacting your governor, senators and representatives and urging them to support science-based legislation to combat underage drinking.

Contact your representatives and urge them to preserve the 21 minimum drinking age law.

Sign MADD's pledge in support of the 21 minimum drinking age. 

 

Studies

  • Cooper, M.L. "Alcohol Use and Risky Sexual Behavior Among College Students: Evaluating the Experience." Journal of Studies on Alcohol Supp. 14 (March 2002): 101-117. (Click here)
  • Giedd, Jay N. et al. " Brain Development During Childhood and Adolescence: A Longitudinal MRI Study." Nature Neuroscience 2, no. 10, October 1999. 
  • Grant, Bridget, "The Impact of a Family History of Alcoholism on the Relationship Between Age at Onset of Alcohol Use and DSM-IV Alcohol Dependence: Results from the National Longitudinal Alcohol Epidemiologic Survey." Alcohol Health and Research World no. 22, 1998. 
  • Grant, Bridgett and Deborah Dawson. "Age at Onset of Alcohol Use and Its Association with DSM-IV Alcohol Abuse and Dependence." Results from the National Longitudinal Alcohol Epidemiologic Survey.  Journal of Substance Abuse 9 (1997): 103-110.
  • Hingson, Ralph, et al.  "Age of Drinking Onset, Driving After Drinking, and Involvement in Alcohol-Related Motor Vehicle Crashes."  DOT HS 809 188.  Washington, DC: National Highway Traffic Safety Administration, January 2001.
  • Hingson, Ralph, et al.  "Age of First Intoxication, Heavy Drinking, Driving after Drinking and Risk of Unintentional Injury among US College Students."  Journal of Studies on Alcohol 64 no 1 (2003), 23+.  (Click here)
  • Hingson, Ralph, Timothy Heeren, and Rhonda Zakocs. "Age of Drinking Onset and Involvement in Physical Fights after Drinking." Pediatrics 108(4) (2001): 872-7.
  • Hingson, Ralph and D. Kenkel.  "Social and Health Consequences of Underage Drinking."  In press.  As quoted in Institute of Medicine National Research Council of the National Academies.  Bonnie, Richard J. and Mary Ellen O’Connell, eds.  Reducing Underage Drinking: A Collective Responsibility.  Washington, DC: The National Academies Press, 2003.
  • Institute of Medicine National Research Council of the National Academies.  Bonnie, Richard J. and Mary Ellen O'Connell, eds.  Reducing Underage Drinking: A Collective Responsibility.  Washington, DC: The National Academies Press, 2003. 
  • Johnston, L.D., P.M. O'Malley, and J.G. Bachman.  "Monitoring the Future National Results on Adolescent Drug Use: Overview of Key Findings, 2002."  NIH Publication No. 03-5374.  Bethesda, MD: National Institute on Drug Abuse, 2003.
  • Kuhn, Cynthia, Scott Swartzwelder, and Wilkie Wilson.  Buzzed: The Straight Facts about the Most Used and Abused Drugs from Alcohol to Ecstasy.  New York, NY: W.W. Norton, 1998.
  • Levy, David T., et al. "Costs of Underage Drinking." Pacific Institute for Research & Evaluation. The Underage Drinking Enforcement Training Center. U.S. Department of Justice, Office of Justice Programs, Office of Juvenile Justice and Delinquency Prevention (OJJDP). Updated Edition, June 1999.  (Click here)
  • Levy, David T., et al. "Underage Drinking: Immediate Consequences and Their Costs." Pacific Institute for Research & Evaluation, working paper, unpublished (July 1999).
  • Miller, Ted R. et al.  “Societal Costs of Underage Drinking.” Journal of Studies on Alcohol. 2006 Jul; 67(4):519-28. (Click here)
  • National Institute on Drug Abuse.  "Volume 1: Secondary School Students", National Survey Results on Drug Use from The Monitoring the Future Study, 1975-1997. Rockville, MD: Department of Health and Human Services, 1998.
  • Tyler, TR and YJ Huo.  Trust in the Law: Encouraging Public Cooperation with the Police and Courts.  New York, NY: Russell Sage Foundation, 2002.
  • White, Aaron M. "Substance Use and Adolescent Brain Development: An Overview of Recent Findings with a Focus on Alcohol." Durham, NC: Duke University Medical Center, 2001.

Underage Drinking - Dependence

From the Surgeon General's Call to Action on Underage Drinking, 2007
 
Alcohol is the drug of choice for youth. It is also the drug to abuse of choice for young people. Eighteen to 21 year olds are most at risk for alcohol abuse and/or dependence of any age group in the United States – over twelve percent are alcohol dependent. (Grant, et al, 2004) This abuse happens even younger -- the 2005 National Survey on Drug Use and Health (NSDUH), indicates that 5.5 percent of youth ages 12–17 meet the diagnostic criteria for alcohol abuse or dependence. (SAMHSA, 2006)
 
Some say the appropriate response to this is to teach people how to drink alcohol safely. This is a tempting approach, but its failure has been manifest in European countries. Research clearly shows that most European countries not only have higher levels of consumption (an expected consequence of the lower drinking age), but also higher levels of problematic drinking (e.g., intoxication) among youth. (Grube, 2001) Similarly, U.S. adolescents are less likely than those from a majority of European countries to report becoming intoxicated in the past year. (Hibell, et al, 2000; Johnston, et al, 2002)
 
Also, the earlier people start drinking, the more likely they are to become dependent on alcohol. More than 40 percent of individuals who start drinking before the age of 13 will develop alcohol abuse or alcohol dependence at some point in their lives. (Grant and Dawson, 1997). About 95 percent of those who are classified as alcohol dependent began drinking before age 2001. People reporting first use of alcohol before age 15 were more than five times more likely to have past year alcohol dependence or abuse compared with people who first used alcohol at age 21 or older. (SAMHSA, 2004) Drinking before it is legal to do so is significantly more likely to lead to problems with alcohol down the road.

 

Studies

  • Grant, Bridgett and Deborah Dawson. "Age at Onset of Alcohol Use and Its Association with DSM-IV Alcohol Abuse and Dependence." Results from the National Longitudinal Alcohol Epidemiologic Survey.  Journal of Substance Abuse 9 (1997): 103-110. (not yet online)
  • Grant, B.F, et al. "The 12-month prevalence and trends in DSMIV alcohol abuse and dependence: United States, 1991-1992 and 2001-2002." Drug and Alcohol Dependence74 (2004):223–234.
  • Grube, J.W. Comparison of drinking rates and problems: European countries and the United States. Calverton, MD: Pacific Institute for Research and Evaluation, Office of Juvenile Justice Enforcing the Underage Drinking Laws Program, 2001.
  • Hibell, B., et al. The 1999 ESPAD report: Alcohol and other drug use among students in 30 European countries. Stockholm: Swedish Council for Information on Alcohol and Other Drugs. 2000.
  • Hingson, Ralph, et al.  "Age of First Intoxication, Heavy Drinking, Driving after Drinking and Risk of Unintentional Injury among US College Students."  Journal of Studies on Alcohol 64 no 1 (2003), 23+.  (Click here)
  • Johnston, L.D., O’Malley, P.M., and Bachman, J.G. Monitoring the Future national results on adolescent drug use: Overview of key findings, 2001. (NIH Publication No. 02-5105). Bethesda, MD: National Institute on Drug Abuse, 2002.
  • Substance Abuse and Mental Health Services Administration (SAMHSA). Results From the 2005 National Survey on Drug Use and Health: National Findings. NSDUH Series H–30, DHHS Pub. No. SMA 06–4194. Rockville, MD: SAMHSA, Office of Applied Studies, 2006.
  • Substance Abuse and Mental Health Services Administration. “Alcohol Dependence or Abuse and Age at First Use.” Washington, DC: Department of Health and Human Services, Office of Applied Studies, October 22, 2004. http://www.oas.samhsa.gov/2k4/ageDepedence/ageDependence.htm
 

Underage Drinking - Drinking and Driving

We know that drinking plus driving spell death and disaster. We know that people in the 18-to-20 age group are more likely to be in alcohol-related accidents than those in any other age group. We know that America has a clear stake in making certain that her sons and daughters, so full of vitality and promise, will not be crippled or killed. And I know there's one -- we all know that there is one simple measure that will save thousands of young lives that are in the drinking age -- if we, or if we raise the drinking age, I should say, to 21."  – President Ronald Reagan, 1984

In 2005, 23 percent of underage drivers who were killed in crashes not only had alcohol in their system, but were at a .08 (which is illegally drunk even if they were of age). (NHTSA, 2006) Of the people 15-20 killed in traffic crashes, one-third were killed in alcohol-related crashes. (NHTSA, 2006)

Clearly, one of the problems associated with underage drinking is underage drunk driving. And it's all too common. In 2002 and 2003, 4.2 million underage people reported committing DUI. And each drink impairs underage drinkers more than their of-age counterparts (Hingson and Winter, 2003). Drinking also is related to young people riding with a drinking driver. (Hingson and Kenkel, 2003)

But the impacts of underage drinking on drunk driving are not just felt while a person is underage. Probably because those who drink underage are more likely to become alcohol dependent (link to UD – dependence research brief), drinking early increases the risk of someone becoming a drunk driver. Those who begin drinking before age 14 are:

  • Three times more likely to report driving after drinking
  • Four times more likely to report driving after drinking in the past year
  • Seven times more likely to be in a motor vehicle crash because of their drinking than someone who began drinking when it was legal (i.e., 21) (Hingson, et al, 2001)
In essence, by allowing underage drinking, we are training the drinking drivers of tomorrow and in some cases today.

 

Studies

  • Hingson, Ralph and M. Winter. "Epidemiology and consequences of drinking and driving." Alcohol Research & Health27(1) (2003): 63–78.
  • Hingson, Ralph, et al. “Age of Drinking Onset, Driving After Drinking, and Involvement in Alcohol-Related Motor Vehicle Crashes.” DOT HS 809 188. Washington, DC: National Highway Traffic Safety Administration, January 2001. 
  • Hingson, Ralph and D. Kenkel. “Social and Health Consequences of Underage Drinking.” In press. As quoted in Institute of Medicine National Research Council of the National Academies. Bonnie, Richard J. and Mary Ellen O’Connell, eds. Reducing Underage Drinking: A Collective Responsibility. Washington, DC: The National Academies Press, 2003.
  • National Highway Traffic Safety Administration. “Traffic Safety Facts 2005: Young Drivers”. DOT 810 630. Washington DC: National Highway Traffic Safety Administration, 2006. http://www-nrd.nhtsa.dot.gov/pdf/nrd-30/NCSA/TSF2005/YoungDriversTSF05.pdf

 


Underage Drinking - Education

[T]he most fundamental problem facing colleges and universities throughout America today is the challenge of developing character, conscience, citizenship, and social responsibility in a society that sometimes gives the impression that such virtues are optional. In my view, no aspect of this challenge is greater for our young adults today than the excessive consumption of alcohol and the behaviors that surround it."  – Penn State President, Graham Spanier, Ph.D.

The impacts of underage drinking show up in various ways, one of which is a decrease in school performance. This is likely because of a decreased desire to do well in school. High school students who use alcohol or other substances are five times more likely than other students to drop out of school or to believe that earning good grades is not important. (NIDA, 1998)

As Dr. Spanier mentioned, many college students come to college as experienced drinkers – binge drinking in high school, as you might guess, is a strong predictor of whether someone will binge drink in college. (Weschler, et al, 2002) And drinking in college also decreases college students' education. Each drink someone has on average at a setting is related to fifteen minutes less studying, an increase in the probability someone will miss a class by eight percent and an increase in the probability that they will get behind in school by five percent. (Williams, et al, 2002) Logically, binge drinking generally lowers a person's GPD by a half a grade. (Williams, et al, 2002) There's more information about college drinking here. (link to college research)

This may be a blinding flash of the obvious – that a depressant can make someone more apathetic about school and that an intoxicant can disrupt someone's learning. However, adults and young people both behave too often as this isn't the case. Facilitating alcohol, even in "safe" atmospheres makes it about twice as likely that a young person will engage in binge drinking. Youth who reported that a parent or a friend’s parent had provided alcohol at a party within the past year reported drinking more on their last drinking occasion and were twice as likely to have consumed alcohol within the past 30 days and to have engaged in binge drinking. (Foley, et al, 2004)

 

Studies

  • Foley, Kristie, et al. "Adults’ Approval and Adolescents’ Alcohol Use." Journal of Adolescent Health. 35, No. 4, (2004).
  • National Institute on Drug Abuse.  "Volume 1: Secondary School Students", National Survey Results on Drug Use from The Monitoring the Future Study, 1975-1997. Rockville, MD: Department of Health and Human Services, 1998. (not yet online)
  • Wechsler, Henry, et al. “Trends in College Binge Drinking During a Period of Increased Prevention Efforts.” Journal of American College Health. 50, No. 5, (2002).
  • Williams, Jenny, Lisa Powell, and Henry Wechsler. “Does Alcohol Consumption Reduce Human Capital Accumulation? Evidence from the College Alcohol Study.” Research Paper Series, No. 18. Chicago, IL: University of Chicago, February 2002. http://www.impacteen.org/generalarea_PDFs/capitalaccumulationfeb2002_final.pdf

 


Underage Drinking - Impacts

"We can no longer ignore what alcohol is doing to our children. The adverse consequences of underage drinking are wide-ranging, and include academic failure, risky sexual behavior, injuries, and even death." – Surgeon General Kenneth P. Moritsugu, M.D., M.P.H.

Underage drinking is a serious problem and, unfortunately, all too common (link to epidemiology).  It kills more underage people than all other drugs combined (Gruenbaum, et al, 2002) (Young, et al, 2002) -- approximately 5000 underage people per year (Hingson and Kenkel, 2003).  The total cost attributable to the consequences of underage drinking was almost $62 billion per year in 2001 dollars. (Miller, et al, 2006)  Drinking before the age of 21 is associated with:

Click on any of the impacts above to learn more.

 

Studies

  • Cooper, M.L. "Alcohol Use and Risky Sexual Behavior Among College Students: Evaluating the Experience." Journal of Studies on Alcohol Supp. 14 (March 2002): 101-117. (Click here)
  • Giedd, Jay N. et al. " Brain Development During Childhood and Adolescence: A Longitudinal MRI Study." Nature Neuroscience 2, no. 10, October 1999.  (Click here)
  • Giedd, Jay N. “Structural Magnetic Resonance Imaging of the Adolescent Brain.” Annals of N.Y. Academy of Sciences 1021 (2004): 77–85. http://www.annalsnyas.org/cgi/content/abstract/1021/1/77
  • Grant, Bridget, "The Impact of a Family History of Alcoholism on the Relationship Between Age at Onset of Alcohol Use and DSM-IV Alcohol Dependence: Results from the National Longitudinal Alcohol Epidemiologic Survey." Alcohol Health and Research World no. 22, 1998.  (Click here)
  • Grant, Bridgett and Deborah Dawson. "Age at Onset of Alcohol Use and Its Association with DSM-IV Alcohol Abuse and Dependence." Results from the National Longitudinal Alcohol Epidemiologic Survey.  Journal of Substance Abuse 9 (1997): 103-110. (not yet online)
  • Grunbaum, J.A., et al. "Youth risk behavior surveillance: United States, 2001." MMWR: Morbidity and Mortality Weekly Report51(SS0 4):1–62, 2002.
  • Hingson, Ralph, et al.  "Age of Drinking Onset, Driving After Drinking, and Involvement in Alcohol-Related Motor Vehicle Crashes."  DOT HS 809 188.  Washington, DC: National Highway Traffic Safety Administration, January 2001. (not yet online)
  • Hingson, Ralph, et al.  "Age of First Intoxication, Heavy Drinking, Driving after Drinking and Risk of Unintentional Injury among US College Students."  Journal of Studies on Alcohol 64 no 1 (2003), 23+.  (Click here)
  • Hingson, Ralph, Timothy Heeren, and Rhonda Zakocs. "Age of Drinking Onset and Involvement in Physical Fights after Drinking." Pediatrics 108(4) (2001): 872-7. (Click here)
  • Hingson, Ralph and D. Kenkel.  "Social and Health Consequences of Underage Drinking."  In press.  As quoted in Institute of Medicine National Research Council of the National Academies.  Bonnie, Richard J. and Mary Ellen O’Connell, eds.  Reducing Underage Drinking: A Collective Responsibility.  Washington, DC: The National Academies Press, 2003. (not yet online)
  • Institute of Medicine National Research Council of the National Academies.  Bonnie, Richard J. and Mary Ellen O'Connell, eds.  Reducing Underage Drinking: A Collective Responsibility.  Washington, DC: The National Academies Press, 2003.  (Click here)
  • Johnston, L.D., P.M. O'Malley, and J.G. Bachman.  "Monitoring the Future National Results on Adolescent Drug Use: Overview of Key Findings, 2002."  NIH Publication No. 03-5374.  Bethesda, MD: National Institute on Drug Abuse, 2003. (not yet online)
  • Kuhn, Cynthia, Scott Swartzwelder, and Wilkie Wilson.  Buzzed: The Straight Facts about the Most Used and Abused Drugs from Alcohol to Ecstasy.  New York, NY: W.W. Norton, 1998. (not yet online)
  • Levy, David T., et al. "Costs of Underage Drinking." Pacific Institute for Research & Evaluation. The Underage Drinking Enforcement Training Center. U.S. Department of Justice, Office of Justice Programs, Office of Juvenile Justice and Delinquency Prevention (OJJDP). Updated Edition, June 1999.  (Click here)
  • Levy, David T., et al. "Underage Drinking: Immediate Consequences and Their Costs." Pacific Institute for Research & Evaluation, working paper, unpublished (July 1999).
  • Miller, Ted R. et al.  “Societal Costs of Underage Drinking.” Journal of Studies on Alcohol. 2006 Jul; 67(4):519-28. (click here)
  • National Institute on Drug Abuse.  "Volume 1: Secondary School Students", National Survey Results on Drug Use from The Monitoring the Future Study, 1975-1997. Rockville, MD: Department of Health and Human Services, 1998. (not yet online)
  • Tyler, TR and YJ Huo.  Trust in the Law: Encouraging Public Cooperation with the Police and Courts.  New York, NY: Russell Sage Foundation, 2002. (not yet online)
  • White, Aaron M. "Substance Use and Adolescent Brain Development: An Overview of Recent Findings with a Focus on Alcohol." Durham, NC: Duke University Medical Center, 2001. (Click here)
  • Young, S.E., et al. "Substance Use, Abuse and Dependence in Adolescence: Prevalence, Symptom Profiles and Correlates". Drug and Alcohol Dependence68(3):309–322, 2002.

 


Underage Drinking - Sexual

"At school second semester, I assemble a steady team of drinking buddies from the girls I see every night at the campus bars. We are the sorriest girls I know. I am one of the lucky ones – among the girls I slug vodka with on the steps of the school chapter are several victims of rape and abuse and girls who have abusive boyfriends…" – Koren Zailckas, Smashed: Story of a Drunken Girlhood, 2005

Some of the reasons sometimes given for drinking by underage people are "to loosen up" or "to lose my inhibitions." Unfortunately, alcohol can cause too many inhibitions to be lost, resulting in unplanned and/or unsafe sex. In one year, 41 percent of frequent underaged binge drinkers reported reported having unplanned sex and 21 percent reported having unsafe sex as a result of their drinking.

Like many other aspects of underage drinking, the earlier it happens, the worse it is. Among drinkers, those who had their first drink before the age of 13 were twice as likely to have unplanned sex and more than twice as likely to have unprotected sex. (Hingson and Kenkel, 2003)

This doesn't just apply to consensual sex, unfortunately. Every year, drinking by college students contributes to 90,000 sexual assaults. (Hingson, et al, 2005) Forty percent of people convicted of violent victimizations, including sexual assault and 25 percent of victims had been drinking at the time of the event. (BJS, 1998) It is clearly inexcusable that too often, drunkenness by a victim is feloniously considered to be consent.

 

Studies

  • Bureau of Justice Statistics (BJS). “Alcohol and Crime: An Analysis of National Data on the Prevalence of Alcohol Involvement in Crime.” Washington, DC: U.S. Department of Justice, 1998 http://www.ojp.usdoj.gov/bjs/pub/pdf/ac.pdf
  • Cooper, M.L. “Alcohol Use and Risky Sexual Behavior Among College Students: Evaluating the Experience.” Journal of Studies on Alcohol Supp. 14 (March 2002): 101-117.
  • Hingson, Ralph, et al., “Magnitude of Alcohol-Related Mortality and Morbidity among U.S. College Students Ages 18-24: Changes from 1998 to 2001.” Annual Review of Public Health 26 (2005): 259-279.
  • Hingson, Ralph and D. Kenkel. “Social and Health Consequences of Underage Drinking.” In press. As quoted in Institute of Medicine National Research Council of the National Academies. Bonnie, Richard J. and Mary Ellen O’Connell, eds. Reducing Underage Drinking: A Collective Responsibility. Washington, DC: The National Academies Press, 2003.

 


Underage Drinking and Its Effect on the Brain

"Recent research shows that the brain continues to develop well beyond childhood — and throughout adolescence. This research raises concerns that underage drinking may affect short-term and long-term cognitive functioning, and may change the brain in ways that can lead to future alcohol dependence." – Former Acting Surgeon General Kenneth P. Moritsugu, M.D., M.P.H.


The brain is still developing in to the early 20s and alcohol use impedes that important progress, possibly irreparably. 
We must work to make sure that alcohol can not get into the hands of
youth.

Adolescent brain development
Research has shown that the brain continues to develop into the early twenties. (Kuhn, Swartzwelder, and Wilson, 1998; White, 2001; Giedd, et al, 1999; Giedd, 2004) The pre-frontal cortex, the part that controls reasoning and cognitive ability takes the longest to mature. This is why drinking, especially heavy drinking, before the brain finishes development affects memory and damages this pre-frontal cortex regions (Crews et al. 2000; Spear and Varlinskaya 2005; White and Swartzwelder 2005). Since this region is responsible for ability to learn complex tasks, control impulses and organizing, this is a significant loss. And, while the research on this is still in its early phases, there are some studies that indicate that this damage may be permanent. (Brown and Tapert, 2004)

While many of these studies are done on animals, the impacts are seen in adolescent humans as well. The hippocampus, which is responsible for forming new memories, was noticeably smaller in youth who abuse alcohol than in their nondrinking peers (De Bellis et al., 2000). Additionally, studies show that alcohol use in adolescence decreased ability in planning and executive functioning, memory, spatial operations and attention – all of which are important to academic performance and future functioning (Giancola and Mezzich, 2000; Brown et al., 2000; Tapert and Brown, 1999; Tapert et al., 2001).

Teen alcohol use and the brain 
Teen alcohol use only exacerbates the problem because of the effect it has on the developing brain. While alcohol acts as a sedative to adults, teens show more sensitivity to the stimulating effects of alcohol (White et al. 2003). Therefore, teens are more likely to drink past the points where adults would end up passing out and end up engaging in activities such as driving even though they are too impaired to do so (Hingson and Winter, 2003).


Studies

  • Brown, S.A., and SF Tapert. "Health consequences of adolescent alcohol involvement." In National Research Council and Institute of Medicine, Reducing underage drinking: A collective responsibility, background papers. [CD-ROM]. Committee on Developing a Strategy to Reduce and Prevent Underage Drinking, Division of Behavioral and Social Sciences and Education. Washington, DC: The National Academies Press, 2004.
  • Brown, S.A., et al. "Neurocognitive functioning of adolescents: Effects of protracted alcohol use." Alcoholism: Clinical and Experimental Research 24 (2) (2000): 164-71.
  • Crews, F.T.; et al. "Binge ethanol consumption causes differential brain damage in young adolescent rats compared with adult rats." Alcoholism: Clinical and Experimental Research24 (2000): 1712–1723.
  • De Bellis, M.D., et al. "Hippocampal volume in adolescent-onset alcohol use disorders." American Journal of Psychiatry 157(17) (2000): 737-744.
  • Giedd, Jay N. et al. " Brain Development During Childhood and Adolescence: A Longitudinal MRI Study." Nature Neuroscience 2, no. 10, October 1999. 
  • Giedd, Jay N. “Structural Magnetic Resonance Imaging of the Adolescent Brain.” Annals of N.Y. Academy of Sciences 1021 (2004): 77–85. http://www.annalsnyas.org/cgi/content/abstract/1021/1/77
  • Giancola, P.R., and AC Mezzich. "Neuropsychological deficits in female adolescents with a substance use disorder: Better accounted for by conduct disorder?" Journal of Studies on Alcohol 61(6) (2000): 809-817.
  • Hingson, Ralph and M. Winter. "Epidemiology and consequences of drinking and driving." Alcohol Research & Health27(1) (2003): 63–78.
  • Kuhn, Cynthia, Scott Swartzwelder, and Wilkie Wilson.  Buzzed: The Straight Facts about the Most Used and Abused Drugs from Alcohol to Ecstasy.  New York, NY: W.W. Norton, 1998. (not yet online)
  • Spear, L.P., and Varlinskaya, E.I. "Adolescence: Alcohol sensitivity, tolerance, and intake". In: Galanter, M., ed. Recent Developments in Alcoholism, Vol. 17: Alcohol Problems in Adolescents and Young Adults: Epidemiology, Neurobiology, Prevention, Treatment. New York: Springer, 2005: 143–159.
  • Tapert, S.F. and SA Brown. "Neuropsychological correlates of adolescent substance abuse: Four-year outcomes." Journal of the International Neuropsychological Society5 (1999): 481-493.
  • Tapert, S.F., et al. "MRI measurement of brain function in alcohol use disordered adolescents." Alcoholism: Clinical and Experimental Research,25 (2001): 80A.
  • White, Aaron M. "Substance Use and Adolescent Brain Development: An Overview of Recent Findings with a Focus on Alcohol." Durham, NC: Duke University Medical Center, 2001. 
  • White, Aaron M. “Substance Use and Adolescent Brain Development: An Overview of Recent Findings with a Focus on Alcohol.” Youth Studies Australia, 22 (2003), 39-45.
  • White, Aaron M., and Scott Swartzwelder. "Age-related effects of alcohol on memory and memory-related brain function in adolescents and adults." In: Galanter, M., ed. Recent Developments Alcoholism, Vol. 17: Alcohol Problems in Adolescents and Young Adults: Epidemiology, Neurobiology, Prevention, Treatment. New York: Springer (2005): 161–176.

 


Vehicle Sanctions

One of the more common sanctions for DUIs is administrative license revocation, where an offender's license is taken away. However, 50 to 75 percent of offenders continue to drive without a license during their suspension/revocation period. (Nichols and Ross, 1990). Learn more about the driving while suspended problem here (link to DWS).

It makes sense to separate the offender from the vehicle, the means of their offense. Vehicle impoundment has been consistently effective in reducing DWI offenses among convicted drinking drivers. (Beirness, 1997) (DeYoung, 1997) (Voas, Tippetts and Taylor, 1997) (Voas, Tippetts and Taylor, 1998)  In Ohio, even two years after the sanction period, those drivers who had had their vehicles impounded still had at least 35 percent fewer DUIs compared with those who had not. (Voas, Tippetts and Taylor, 1998)  This means that vehicle impoundment helps keep convicted drunk drivers from reoffending even once their sanction has been completed. This, in turn, reduces alcohol-related crashes. In California, first-time offenders who had their vehicles impounded had 25 percent fewer crashes than those who did not; repeat offenders who had their vehicles impounded had 38 percent fewer crashes that those who did not. (DeYoung, 1997)

  • Beirness, Douglas, et al. "The Impact of Administrative License Suspension and Vehicle Impoundment for DWI in Manitoba." In C. Mercier-Guyon (Ed.) Proceedings of the 14th International Conference on Alcohol, Drugs and Traffic Safety. Annecy, France: Centre d'Etudes et de Recherches en Medecine du Trafic, 1997: 919-925. (not yet online)
  • DeYoung, David, Raymond Peck, and Clifford Helander. "Estimating the Exposure and Fatal Crash Rates of Suspended/Revoked and Unlicensed Drivers in California". Accident Analysis and Prevention 29(1) (1997): 17-23. (not yet online)
  • Jones, Ralph and John Lacey. "State of Knowledge of Alcohol-Impaired Driving: Research on Repeat DWI Offenders." Washington, DC: National Department of Transportation, National Highway Traffic Safety Administration, February 2000. (Click here)
  • National Highway Traffic Safety Administration. "Traffic Safety Facts: Laws: Vehicle and License Plate Sanctions." Washington, DC: National Department of Transportation, National Highway Traffic Safety Administration, May 2003. (Click here)
  • Nichols, James, and H. Lawrence Ross. "The Effectiveness of Legal Sanctions in Dealing with Drinking Drivers." Alcohol, Drugs and Driving 6(2) (1990): 33-55. (Click here
  • Peck, R.C., R. J. Wilson, and L. Sutton. "Driver License Strategies for Controlling the Persistent DUI Offender," Strategies for Dealing with the Persistent Drinking Driver. Transportation Research Board, Transportation Research Circular No. 437. Washington, DC: National Research Council (1995): 48-49. (not yet online)
  • Scopatz, Robert, et al. "Unlicensed to Kill: The Sequel." Washington, DC: AAA Foundation for Traffic Safety, January 2003. (Click here)
  • Voas, Robert, A. Scott Tippetts, and Eileen Taylor. "Temporary Vehicle Immobilization: Evaluation of a Program in Ohio". Accident Analysis and Prevention, 29 vol. 5 (1997): 635-642. (not yet online)
  • Voas, Robert, A. Scott Tippetts, and Eileen Taylor. "Temporary Vehicle Impoundment in Ohio: A Replication and Confirmation." Accident Analysis and Prevention, 30 vol. 5 (1998): 651-655. (not yet online)