Don’t drink and drive. It's a deceptively simple rule, but one that is all too often ignored. And while efforts to eliminate drunk driving have been around as long as automobiles, every movement to ...keep drunks from driving has hit some alarming bumps in the road.
Barron H. Lerner narrates the two strong—and vocal—sides to this debate in the United States: those who argue vehemently against drunk driving, and those who believe the problem is exaggerated and overregulated. A public health professor and historian of medicine, Lerner asks why these opposing views exist, examining drunk driving in the context of American beliefs about alcoholism, driving, individualism, and civil liberties.
Angry and bereaved activist leaders and advocacy groups like Mothers Against Drunk Driving campaign passionately for education and legislation, but even as people continue to be killed, many Americans remain unwilling to take stronger steps to address the problem. Lerner attributes this attitude to Americans’ love of drinking and love of driving, an inadequate public transportation system, the strength of the alcohol lobby, and the enduring backlash against Prohibition of the 1920s. The stories of people killed and maimed by drunk drivers are heartrending, and the country’s routine rejection of reasonable strategies for ending drunk driving is frustratingly inexplicible.
This book is a fascinating study of the culture of drunk driving, grassroots and professional efforts to stop it, and a public that has consistently challenged and tested the limits of individual freedom. Why, despite decades and decades of warnings, do people still choose to drive while intoxicated? One for the Road provides crucial historical lessons for understanding the old epidemic of drunk driving and the new epidemic of distracted driving.
Praise for Barron H. Lerner’s award-winning When Illness Goes Public: Celebrity Patients and How We Look at Medicine
Lerner has done a beautiful job of tracing the degree to which celebrity patients have reflected and shaped the modern American understanding of doctors, patients, and illness.—New England Journal of Medicine
Lerner has created a powerful prism through his thoughtful exploration of celebrity illness, highlighting societal and cultural forces that widely affect public and private health care decisions.—Journal of the American Medical Association
We can learn quite a bit about our society, culture, and values from the way celebrities' illnesses are publicly portrayed . . . Lerner is at his best when he uses his considerable narrative skills to place these stories into their broader historical, cultural, and ethical contexts.—American Journal of Bioethics
In Lerner's capable hands, these dozen stories in their retelling are both colorfully dramatic narratives, ripped from the headlines (as the saying now goes) and also probing samples of historically specific contingencies and shifting attitudes.—Bulletin of the History of Medicine
Research has shown that an effective way to reduce impaired driving is to increase the perceived risk of being stopped and arrested by law enforcement if driving while impaired. One of the most ...successful strategies for doing this is the coupling of intense and highly visible enforcement with publicity about the enforcement campaign. The term "high-visibility enforcement" (HVE) is used to describe law enforcement efforts aimed at deterring unsafe driving behavior by increasing the publics perception of being caught, arrested, and prosecuted. Two common enforcement strategies of HVE operations are sobriety checkpoints and saturation patrols. Checkpoints concentrate law enforcement officers at the roadside to identify impaired drivers passing through. Saturation patrols involve an increased number of officers patrolling a limited area where impaired driving is prevalent. Both use highly visible elements (such as a concentration of law enforcement officers, bright lights, signs, and marked patrol cars) to heighten their visual impact. Enforcement efforts must be supported by an equal amount of publicity and communications. Publicity regarding the operations also raises awareness, and the perception of increased likelihood of detection of impaired driving. Research has indicated that HVE operations that are well-publicized, conducted frequently, and have high visibility deter impaired driving. This book presents case studies of HVE programs currently operating in the United States and includes discussion of the HVE programs history, enforcement strategies, visibility elements, operation, resources, use of media, educational components, funding, support from political leaders and the community, barriers encountered, and strengths of the program. This book is intended to provide information on impaired driving HVE programs for regional, state and
local agencies considering incorporating HVE strategies into their efforts to curb impaired driving or to modify existing HVE programs.
Background and aims
Cannabis and alcohol are frequently detected in fatal and injury motor vehicle crashes. While epidemiological meta‐analyses of cannabis and alcohol have found associations with an ...increase in crash risk, convergent evidence from driving performance measures is insufficiently quantitatively characterized. Our objectives were to quantify the magnitude of the effect of cannabis and alcohol—alone and in combination—on driving performance and behaviour.
Methods
Systematic review and meta‐analysis. We systematically searched Academic Search Complete, CINAHL, Embase, Scopus, Google Scholar, MEDLINE, PsycINFO, SPORTDiscus and TRID. Of the 616 studies that underwent full‐text review, this meta‐analysis represents 57 studies and 1725 participants. We extracted data for hazard response time, lateral position variability, lane deviations or excursions, time out of lane, driving speed, driving speed variability, speed violations, time speeding, headway, headway variability and crashes from experimental driving studies (i.e. driving simulator, closed‐course, on‐road) involving cannabis and/or alcohol administration. We reported meta‐analyses of effect sizes using Hedges’ g and r.
Results
Cannabis alone was associated with impaired lateral control e.g. g = 0.331, 95% confidence interval (CI) = 0.212–0.451 for lateral position variability; g = 0.198, 95% CI = 0.001–0.395 for lane excursions) and decreased driving speed (g = –0.176, 95% CI = –0.298 to –0.053. The combination of cannabis and alcohol was associated with greater driving performance decrements than either drug in isolation e.g. g = 0.480, 95% CI = 0.096–0.865 for lateral position variability (combination versus alcohol); g = 0.525, 95% CI = 0.049–1.002 for time out of lane (versus alcohol); g = 0.336, 95% CI = 0.036–0.636 for lateral position variability (combination versus cannabis; g = 0.475, 95% CI = 0.002–0.949 for time out of lane (combination versus cannabis). Subgroup analyses indicated that the effects of cannabis on driving performance measures were similar to low blood alcohol concentrations. A scarcity of data and study heterogeneity limited the interpretation of some measures.
Conclusions
This meta‐analysis indicates that cannabis, like alcohol, impairs driving, and the combination of the two drugs is more detrimental to driving performance than either in isolation.
•We examined 3 measures of driving under the influence of cannabis (DUIC).•Adults with chronic pain were seeking medical cannabis certification.•Past 6-month DUIC rates were: 56% within 2 h, 51% a ...little high, 21% very high.•Prevalence of DUIC was high and interventions should be developed for prevention.
Driving under the influence of cannabis (DUIC) is a public health concern among those using medical cannabis. Understanding behaviors contributing to DUIC can inform prevention efforts. We evaluated three past 6-month DUIC behaviors among medical cannabis users with chronic pain.
Adults (N = 790) seeking medical cannabis certification or recertification for moderate/severe pain were recruited from February 2014 through June 2015 at Michigan medical cannabis clinics. About half of participants were male (52%) and 81% were White; their Mean age was 45.8 years. Participants completed survey measures of DUIC (driving within 2 h of use, driving while “a little high,” and driving while “very high”) and background factors (demographics, alcohol use, etc.). Unadjusted and adjusted logistic regressions were used to examine correlates of DUIC.
For the past 6 months, DUIC within 2 h of use was reported by 56.4% of the sample, DUIC while a “little high” was reported by 50.5%, and “very high” was reported by 21.1%. Greater cannabis quantity consumed and binge drinking were generally associated with DUIC behaviors. Higher pain was associated with lower likelihood of DUIC. Findings vary somewhat across DUIC measures.
The prevalence of DUIC is concerning, with more research needed on how to best measure DUIC. Prevention messaging for DUIC may be enhanced by addressing alcohol co-consumption.
The National Transportation Safety Board (NTSB) has long been concerned about alcohol-impaired driving, which accounts for approximately one-third of all U.S. highway fatalities. In the past several ...decades, awareness of the dangers of alcohol-impaired driving has increased. Public and private entities focusing on this safety issue have changed social perceptions concerning alcohol-impaired driving; they have also achieved important legislative actions to help reduce it. Due to these efforts, the number of lives lost annually in alcohol-impaired-driver-related crashes declined 53 percent, from 21,113 in 1982 to 9,878 in 2011; and the percentage of highway fatalities resulting from alcohol-involved crashes is down from 48 percent in 1982 to about 31 percent today. In recent years, however, U.S. success in addressing this safety issue has plateaued. This book describes the scope of the impaired driving problem; summarizes the efforts of advocacy groups, researchers, law enforcement agencies, traffic safety groups, public health organizations, legislators, and motor vehicle agencies, as well as federal, state, and local governments, to reduce the number of crashes, injuries, and fatalities; examines the effect of alcohol consumption on an individuals ability to operate a motor vehicle and on the risk of being involved in a crash; and evaluates the effectiveness of current and emerging alcohol-impaired driving countermeasures and identifies new approaches and actions needed to reduce and ultimately eliminate alcohol-impaired driving.
Driver driving style plays an important role in vehicle energy management as well as driving safety. Furthermore, it is key for advance driver assistance systems development, toward increasing levels ...of vehicle automation. This fact has motivated numerous research and development efforts on driving style identification and classification. This paper provides a survey on driving style characterization and recognition revising a variety of algorithms, with particular emphasis on machine learning approaches based on current and future trends. Applications of driving style recognition to intelligent vehicle controls are also briefly discussed, including experts' predictions of the future development.
•Almost half of fatally injured drivers tested positive to alcohol or illegal drugs.•Alcohol was the most commonly detected substance, followed by Δ9-tetrahydrocannabinol and methylamphetamine.•Poly ...substance detection was common.•While alcohol related fatalities decreased across the time period, both Δ9-tetrahydrocannabinol and methylamphetamine related crashes increased.•Younger and less experienced drivers were not over-represented in the sample.
The problem of impaired driving is well documented in the literature but is heavily dependent upon self-report studies and/or databases that do not include in-depth information about the contributing origins of fatalities.
This study aimed to conduct an in-depth analysis of Coroner’s findings for all fatally injured drivers in the state of Queensland in order to explore the prevalence of alcohol and different types of illicit substances (including drug combinations) in fatal crash reports.
A total of 701 Coroner’s reports related to drivers or controllers of vehicles involved in traffic related fatalities for the period of 2011–2015 were analysed, revealing 306 controllers (43.6%) were detected with either alcohol or illegal drugs (e.g., methylamphetamine, Δ9-tetrahydrocannabinol, cocaine or MDMA)
Alcohol was the most commonly detected substance identified with 223 cases (72.9% of the drug and alcohol sample). Illicit drug detections totalled 147 cases (48% of the drug and alcohol sample) with Δ9-tetrahydrocannabinol the most commonly detected illicit substance (109 cases; 35.6% of the drug and alcohol sample) followed by methylamphetamine (total of 63 cases; 20.6% of the drug and alcohol sample). An important theme to emerge was the prevalence of polysubstance use among fatally injured drivers, not just for alcohol and one drug type, but also multiple drug combinations. Fatality trends revealed a decrease in both non-substance and alcohol-related fatalities across the study period. However, road fatalities where an illicit substance was detected increased by approximately 57%. Males were overrepresented as a proportion of total fatalities (82.4%) and there were no significant sex or age differences regarding illicit substance related deaths. Drivers of passenger vehicles were most commonly identified in the data (66.2%), but motorcycle operators were disproportionately represented (28.1% of the total controller sample compared to 4% of vehicle registrations in Queensland)
This case study analysis of fatal crashes not only confirms the ongoing problem of alcohol and driving, but also illuminates the emerging (and escalating) issue of illicit substances detected in fatally injured drivers.
•219 publications were reveiewed within this systematic review.•Drug drivers are more likely to be single, young males who often drive after using cannabis and who score high on sensation-seeking and ...impulsivity scales.•Peer influence is the most important social factor that would either induce or inhibit drug driving.•The effectiveness of current enforcement approaches to drug driving appears to be different between jurisdictions around the world.
Drug driving is a serious problem worldwide that can increase the risk of road crashes. This systematic review seeks to identify factors associated with drug driving (i.e., driving after consuming drugs other than alcohol) to highlight gaps in existing knowledge and inform the design of more effective countermeasures. A search of the literature was conducted for the period January 1, 2005 to July 31, 2021 using six different databases. The search protocol followed PRISMA guidelines and was registered in PROSPERO (#CRD42021234616). Studies that met inclusion criteria compared drug drivers with either non-drug drivers, alcohol-only drivers or drug drivers from an earlier time period, to identify factors specifically associated with drug driving, rather than common to all drivers. Two hundred and nineteen publications met the inclusion criteria and were included within the review. Based on the findings, a logic model was developed that presents the factors associated with drug driving. Various sociodemographic, psychosocial and legal factors emerged as the main factors associated with illegal drug driving. At the sociodemographic and psychological levels, drug drivers were more likely to be single, young males who often drive after using cannabis and who score high on sensation-seeking and impulsivity scales. The key social factor found to be associated with drug driving was peer acceptance/disapproval of the behaviour. At the legal level, the review suggested that the effectiveness of current enforcement approaches to drug driving vary among jurisdictions around the world due to differences in the level of perceived certainty of apprehension and the chances of punishment avoidance. Future research into the anticipated and actual rewards for drug driving is needed to inform the development of more effective countermeasures.
Automated driving has the potential to improve the safety and efficiency of future traffic and to extend elderly peoples' driving life, provided it is perceived as comfortable and joyful and is ...accepted by drivers. Driving comfort could be enhanced by familiar automated driving styles based on drivers' manual driving styles. In a two-stage driving simulator study, effects of driving automation and driving style familiarity on driving comfort, enjoyment and system acceptance were examined. Twenty younger and 20 older drivers performed a manual and four automated drives of different driving style familiarity. Acceptance, comfort and enjoyment were assessed after driving with standardised questionnaires, discomfort during driving via handset control. Automation increased both age groups' comfort, but decreased younger drivers' enjoyment. Younger drivers showed higher comfort, enjoyment and acceptance with familiar automated driving styles, whereas older drivers preferred unfamiliar, automated driving styles tending to be faster than their age-affected manual driving styles.
Practitioner Summary: Automated driving needs to be comfortable and enjoyable to be accepted by drivers, which could be enhanced by driving style individualisation. This approach was evaluated in a two-stage driving simulator study for different age groups. Younger drivers preferred familiar driving styles, whereas older drivers preferred driving styles unaffected by age.
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