Safety Report on Eliminating Impaired Driving
Source: National Transportation Safety Board
On May 14, 2013, the 25th anniversary of our nation’s deadliest drunk-driving crash, which killed 24 children and three adults in Carrollton, Ky., the NTSB’s five-member board voted unanimously to issue bold recommendations to help the United States reach zero and eliminate alcohol-impaired driving.
Bold steps are needed: On average, every hour, one person dies in a crash involving a drunk driver and 20 more people are injured, including three with debilitating injuries. That adds up quickly to yearly totals of nearly 10,000 deaths, 27,000 lives forever altered and another 146,000 injured.
The safety report and recommendations culminate a year-long effort by the NTSB to thoroughly examine this problem and develop a set of targeted interventions. The recommendations include:
- Reduce state BAC limits from 0.08 to 0.05 or lower
- Increase use of high-visibility enforcement
- Develop and deploy in-vehicle detection technology
- Require ignition interlocks for all offenders
- Improve use of administrative license actions
- Target and address repeat offenders
- Reinforce use and effectiveness of DWI courts
Source: RAND Corporation
Wealthier individuals engage in healthier behavior. This paper seeks to explain this phenomenon by developing a theory of health behavior, and exploiting both lottery winnings and inheritances to test the theory. It distinguishes between the direct monetary cost and the indirect health cost (value of health lost) of unhealthy consumption. The health cost increases with wealth and the degree of unhealthiness, leading wealthier individuals to consume more healthy and moderately unhealthy, but fewer severely unhealthy goods. The empirical evidence presented suggests that differences in health costs may indeed provide an explanation for behavioral differences, and ultimately health outcomes, between wealth groups.
Source: National Institute on Alcohol Abuse and Alcoholism
Celebrating at parties, cheering a favorite sports team, and simply enjoying a break from work are common activities throughout the year. For some people, these occasions also may include drinking—even drinking to excess. And the results can be deadly.
Although many people enjoy moderate drinking, defined as 1 drink per day for women or 2 for men, drinking too much can lead to an overdose. An overdose of alcohol occurs when a person has a blood alcohol content (or BAC) sufficient to produce impairments that increase the risk of harm. Overdoses can range in severity, from problems with balance and slurred speech to coma or even death. What tips the balance from drinking that has pleasant effects to drinking that can cause harm varies among individuals. Age, drinking experience, gender, the amount of food eaten, even ethnicity all can influence how much is too much.
Underage drinkers may be at particular risk for alcohol overdose. Research shows that people under age 20 typically drink about 5 drinks at one time. Drinking such a large quantity of alcohol can overwhelm the body’s ability to break down and clear alcohol from the bloodstream. This leads to rapid increases in BAC and significantly impairs brain function.
As BAC increases, so do alcohol’s effects—as well as the risk for harm. Even small increases in BAC can decrease coordination, make a person feel sick, and cloud judgment. This can lead to injury from falls or car crashes, leave one vulnerable to sexual assault or other acts of violence, and increase the risk for unprotected or unintended sex. When BACs go even higher amnesia (or blackouts) can occur.
Alcohol and energy drinks: a pilot study exploring patterns of consumption, social contexts, benefits and harm
Source: BMC Research Notes
Young people around the world are increasingly combining alcohol with energy drinks (AEDs). However, as yet, limited research has been conducted examining this issue, particularly in terms of exploring patterns of consumption, social practices and the cultural contexts of AED consumption. We sought to understand how AEDs are used and socially constructed among young people.
We conducted 25 hours of observation in a variety of pubs, bars and nightclubs, as well as in-depth interviews with ten young people who regularly consumed AEDs during a session of alcohol use.
In this pilot study, participants were highly organised in their AED consumption practices and reported rarely altering this routine. Some young people consumed upwards of eight AEDs on a typical night, and others limited their use to between three and five AEDs to avoid unpleasant consequences, such as sleep disturbances, severe hangovers, heart palpitations and agitation. Wakefulness and increased energy were identified as the primary benefits of AEDs, with taste, reduced and increased intoxication, and sociability reported as additional benefits. Young AED users were brand sensitive and responded strongly to Red Bull imagery, as well as discounted AEDs. Finally, some young people reported substituting illicit stimulants with energy drinks.
Combining energy drinks with alcohol is now a normalised phenomenon and an integral and ingrained feature of the night-time economy. Despite this, many young people are unaware of recommended daily limits or related harms. While some young people consume AEDs to feel less drunk (consistent with motivations for combining alcohol with illicit stimulants), others report using AEDs to facilitate intoxication. While preliminary, our findings have relevance for potential policy and regulatory approaches, as well as directions for future research.
Source: Centers for Disease Control and Prevention
Binge drinking is a dangerous behavior but is not widely recognized as a women’s health problem. Drinking too much – including binge drinking* – results in about 23,000 deaths in women and girls each year. Binge drinking increases the chances of breast cancer, heart disease, sexually transmitted diseases, unintended pregnancy, and many other health problems. Drinking during pregnancy can lead to sudden infant death syndrome and fetal alcohol spectrum disorders.
About 1 in 8 women aged 18 years and older and 1 in 5 high school girls binge drink. Women who binge drink do so frequently – about 3 times a month – and have about 6 drinks per binge. There are effective actions communities can take to prevent binge drinking among women and girls.
Source: Substance Abuse and Mental Health Services Administration
- Combined 2008 to 2010 data indicate that 26.6 percent of persons aged 12 to 20 drank alcohol in the past month
- Rates of underage past month alcohol use were among the lowest in Utah (14.3 percent) and among the highest in Vermont (37.0 percent)
- Approximately 8.7 percent of past month drinkers aged 12 to 20 purchased their own alcohol the last time they drank
- The rates of past month drinkers aged 12 to 20 buying their own alcohol were among the lowest in New Mexico (2.5 percent), Idaho (2.6 percent), and Oregon (2.6 percent), and among the highest in New York (15.0 percent)
Calories Consumed From Alcoholic Beverages by U.S. Adults, 2007–2010
Source: National Center for Health Statistics
- The U.S. adult population consumes an average of almost 100 calories per day from alcoholic beverages.
- Men consume more calories from alcoholic beverages than women.
- Younger adults consume more calories from alcoholic beverages than older adults.
- Men consume more beer than other types of alcohol.
- Average calories consumed from alcoholic beverages do not differ by race and ethnicity.
Source: Office of Juvenile Justice and Delinquency Prevention
In this bulletin, the authors provide a theoretical overview upon which to base policies, procedures, and practices that will help professionals—and their cor responding agencies—effectively supervise underage drinkers in the community.
They also discuss the legal issues that professionals may encounter when working with these youth.
Some of the authors’ recommendations include the following:
• An effective community supervision program should emphasize four goals: community protection, youth accountability, competency develop ment, and individual assessment.
• Conditions of community supervision must be clearly stated to the youth, must be constitutional and fair, and must help rehabilitate the youth.
• Community corrections and diversion professionals must acknowledge the diverse cultural backgrounds of youth and tailor interventions and services accordingly.
• Justice system professionals must remember that youth under supervision maintain certain basic constitutional rights. Violation of these rights, intentional misconduct, or negligence can result in legal liability.
Source: Morbidity and Mortality Weekly Report (CDC)
Foodborne botulism is a rare, potentially fatal paralytic illness caused by eating food contaminated by Clostridium botulinum toxin. It occurs most often as a single case not linked to others by a common food source. As a result of improvements in food canning, when outbreaks do occur, they typically involve fewer than five persons. During October 2–4 2011, eight maximum security inmates at the Utah State Prison in Salt Lake County were diagnosed with foodborne botulism. An investigation by Salt Lake Valley Heath Department, Utah Department of Health, and CDC identified pruno, an illicit alcoholic brew, as the vehicle. The principal ingredients in pruno are fruit, sugar, and water. Many additional ingredients, including root vegetables, are sometimes added, depending on the availability of foods in prison. A baked potato saved from a meal served weeks earlier and added to the pruno was the suspected source of C. botulinum spores. Many of the affected inmates suffered severe morbidity, and some required prolonged hospitalizations. Knowing the link between pruno and botulism might help public health and correctional authorities prevent future outbreaks, respond quickly with appropriate health-care to inmates with acute descending paralysis and/or other symptoms, and reduce associated treatment costs to states.
Source: Centers for Disease Control and Prevention
The percentage of teens in high school (aged 16 and older) who drove when they had been drinking alcohol decreased by 54 percent between 1991 and 2011, according to a Vital Signs study released today by the Centers for Disease Control and Prevention. Nine out of 10 high school teens (aged 16 and older) did not drink and drive during 2011.
“We are moving in the right direction. Rates of teen drinking and driving have been cut in half in 20 years,” said CDC Director Thomas R. Frieden, M.D., M.P.H. “But we must keep up the momentum — one in 10 high school teens, aged 16 and older, drinks and drives each month, endangering themselves and others.”
For the study, CDC analyzed data from the 1991-2011 national Youth Risk Behavior Surveys (YRBS). These national surveys asked high school students if they had driven a vehicle when they had been drinking alcohol one or more times during the 30 days before the survey; CDC researchers focused their analysis on students aged 16 and older.
The study also found that:
- Teens were responsible for approximately 2.4 million episodes of drinking and driving a month in 2011; some engaged in the dangerous behavior more than once a month.
- High school boys ages 18 and older were most likely to drink and drive (18 percent), while 16-year-old high school girls were least likely (6 percent).
- Eighty-five percent of teens in high school who reported drinking and driving in the past month also reported binge drinking. For YRBS, binge drinking means five or more drinks during a short period of time.
Source: Substance Abuse and Mental Health Services Administration
The number of people aged 18 to 25 who used prescription drugs for non-medical purposes in the past month declined 14 percent — from 2.0 million in 2010 to 1.7 million in 2011 — the U.S. Substance Abuse and Mental Health Services Administration (SAMHSA) announced today, during the 23rd annual national observance of National Recovery Month. Non-medical use of prescription drugs among children aged 12 to 17 and adults aged 26 or older remained unchanged.
In addition, the 2011 National Survey on Drug Use and Health (NSDUH), a survey conducted annually by SAMHSA, showed that the rates of past month drinking, binge drinking and heavy drinking among underage people continued a decline from 2002. Past month alcohol use among 12 to 20 year olds declined from 28.8 percent in 2002 to 25.1 percent in 2011, while binge drinking (consuming 5 or more drinks on a single occasion on at least 1 day in the past 30 days) declined from 19.3 percent in 2002 to 15.8 percent in 2011, and heavy drinking declined from 6.2 percent in 2002 to 4.4 percent in 2011.
Overall, the use of illicit drugs among Americans aged 12 and older remained stable since the last survey in 2010. The NSDUH shows that 22.5 million Americans aged 12 or older were current (past month) illicit drug users — (8.7 percent of the population 12 and older in 2011 versus 8.9 percent in 2010).
Marijuana continues to be the most commonly used illicit drug. In 2011, 7.0 percent of Americans were current users of marijuana — up from 5.8 percent in 2007. Among youths aged 12 to 17, the rate of current marijuana use remained about the same from 2009 (7.4 percent) to 2011 (7.9 percent). Increases in the rate of current marijuana use occurred from 2007 to 2011 among adolescents (ages 12-17), young adults (ages 18 to 25), and adults (ages 26 or older). Additionally, the number of people aged 12 and older who used heroin in the past year rose from 373,000 in 2007 to 621,000 in 2010 and 620,000 in 2011.
Source: Preventing Chronic Disease (CDC)
Many policy measures to control the obesity epidemic assume that people consciously and rationally choose what and how much they eat and therefore focus on providing information and more access to healthier foods. In contrast, many regulations that do not assume people make rational choices have been successfully applied to control alcohol, a substance – like food – of which immoderate consumption leads to serious health problems. Alcohol-use control policies restrict where, when, and by whom alcohol can be purchased and used. Access, salience, and impulsive drinking behaviors are addressed with regulations including alcohol outlet density limits, constraints on retail displays of alcoholic beverages, and restrictions on drink "specials." We discuss 5 regulations that are effective in reducing drinking and why they may be promising if applied to the obesity epidemic.
People often arrive in substance abuse treatment programs with multiple problems—including dependency on or addiction to both alcohol and drugs. National data from the Treatment Episode Data Set (TEDS) for 2009 show that 730,228 substance abuse treatment admissions (37.2 percent) reported abuse of alcohol and at least one other drug; 23.1 percent of all admissions reported the abuse of alcohol and one other drug, and 14.1 percent reported the abuse of alcohol and two other drugs.When alcohol is used with other drugs, it tends to be ingested in greater quantities than when used in their absence.2 Combining alcohol with other drugs is dangerous. For example, taking benzodiazepines concomitantly with alcohol increases the chances of benzodiazepine-involved death. It is important for treatment providers to identify patients who use alcohol with other drugs since that is an especially dangerous usage pattern.
Source: PLoS ONE
High levels of alcohol consumption and increases in heavy episodic drinking (binge drinking) are a growing public concern, due to their association with increased risk of personal and societal harm. Alcohol consumption has been shown to be sensitive to factors such as price and availability. The aim of this study was to explore the influence of glass shape on the rate of consumption of alcoholic and non-alcoholic beverages.
This was an experimental design with beverage (lager, soft drink), glass (straight, curved) and quantity (6 fl oz, 12 fl oz) as between-subjects factors. Social male and female alcohol consumers (n = 159) attended two experimental sessions, and were randomised to drink either lager or a soft drink from either a curved or straight-sided glass, and complete a computerised task identifying perceived midpoint of the two glasses (order counterbalanced). Ethical approval was granted by the Faculty of Science Research Ethics Committee at the University of Bristol. The primary outcome measures were total drinking time of an alcoholic or non-alcoholic beverage, and perceptual judgement of the half-way point of a straight and curved glass.
Participants were 60% slower to consume an alcoholic beverage from a straight glass compared to a curved glass. This effect was only observed for a full glass and not a half-full glass, and was not observed for a non-alcoholic beverage. Participants also misjudged the half-way point of a curved glass to a greater degree than that of a straight glass, and there was a trend towards a positive association between the degree of error and total drinking time.
Glass shape appears to influence the rate of drinking of alcoholic beverages. This may represent a modifiable target for public health interventions.
See: Stein, Tankard, Pint, Boot: Different beer glasses affect drinking speed (EveryONE blog)
Alcohol Use and Binge Drinking Among Women of Childbearing Age — United States, 2006–2010
Source: Morbidity and Mortality Weekly Report (CDC)
Alcohol use during pregnancy is a leading preventable cause of birth defects and developmental disabilities. Alcohol-exposed pregnancies (AEPs) can lead to fetal alcohol syndrome and other fetal alcohol spectrum disorders (FASDs), which result in neurodevelopmental deficits and lifelong disability (1). In 2005, the Surgeon General issued an advisory urging women who are pregnant or who might become pregnant to abstain from alcohol use (2). Healthy People 2020 set specific targets for abstinence from alcohol use (MICH-11.1) and binge drinking (MICH-11.2) for pregnant women (3). To estimate the prevalence of any alcohol use and binge drinking in the past 30 days among women aged 18–44 years, CDC analyzed 2006–2010 Behavioral Risk Factor Surveillance System (BRFSS) data. Based on their self-reports, an estimated 51.5% of nonpregnant women used alcohol, as did 7.6% of pregnant women. The prevalence of binge drinking was 15.0% among nonpregnant women and 1.4% among pregnant women. Among pregnant women, the highest prevalence estimates of reported alcohol use were among those who were aged 35–44 years (14.3%), white (8.3%), college graduates (10.0%), or employed (9.6%). Among binge drinkers, the average frequency and intensity of binge episodes were similar, approximately three times per month and six drinks on an occasion, among those who were pregnant and those who were not. Clinical practices that advise women about the dangers associated with drinking while pregnant, coupled with community-level interventions that reduce alcohol-related harms, are necessary to mitigate AEP risk among women of childbearing age and to achieve the Healthy People 2020 objectives.