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Drugs and Human Activities
(Topics: Society & Culture » Recreational Drugs | Back to Home)
People use drugs for exactly one reason: they have an impact on their bodies. Sometimes the drug is prescribed by a health professional and it makes life possible; sometimes it's acquired at a drugstore and makes allergy season bearable. Some drugs people take because they make them feel good. Bottom line: if it didn't do something we wanted it to do, then we wouldn't use that drug.
But drugs also have something called side-effects. They can lead to physiological or psychological changes, sometimes permanent, that weren't necessarily desired by the person who took the drug.
And it turns out that in modern life we really need our physical and mental acuity to be top notch, especially when we're doing a job.
It makes sense: you can't be drunk or high at work. You can't be a teacher or a plumber or a lawyer while under the influence. You shouldn't work in a factory or land a plane or put on a uniform. Most jobs have explicit rules against using or being affected by drugs while you're there.
And perhaps even more profoundly, there are the jobs that we aren't paid to do and lots of us do all the time but can have a devastating impact if we do them while on drugs: operating a vehicle and raising a child.
This is where we need to talk about culture and policy.
Drinking* and Driving**
First: the alliteration of drinking and driving is far more appealing than being under the influence of substances while operating tools or machinery which require concenration and dexterity. It's not just about booze and cars. It's about pills and private planes [1]. It's about weed and trains and cocaine and backhoes [2]. It's about having too much to drink while working in your own home kitchen [3]. When we use drugs and we do other things, we are often not as good at doing those things.
But drinking and driving is the big one. In the United States, about one third of all traffic fatalities involve a driver that was over the legal limit [4]. That's about 40 people a day. And these are the situations where we have the data. Lots of people drive drunk and manage to not kill anyone which only serves to reinforce the idea that they “are fine and can handle it.” Not true.
Today the policy in the United States is as follows:
- Specify a blood alcohol content (BAC) threshold, such as 0.08
- Stop people who drive suspiciously
- Test their sobriety in the field, sometimes using technical equipment
- Arrest and prosceute them accordingly with a combination of fines, imprisonment, and license suspension
In one sense, this seems to be working. It's a lot safer to be in a car today than ever before. If we look at deaths per vehicle mile traveled (VMT), the annual deaths are going way down while our total amount of distance being covered is going way up. This is the result of a lot of factors: cars are safer, roads are better, and drivers have more training and experience.
But the question isn't “are we less likely to die in a car accident if we get on the road?” The question is: “are we less likely to die in a car accident that could have been prevented if the driver wasn't intoxicated?”
And the answer to that question is: no, not really. Because for the last twenty years at least, about 12 out of every 100,000 fatalities in the US were motor vehicle deaths.
And again, about a third of those involved alcohol. And while there's some debate on the number, roughly 1/3 of all drunk-driving accidents were caused by people who were previously arrested for driving under the influence. [5]
The single largest source of people dying in car accidents is when a driver is drunk. And if we look at the trends, we aren't making much progress. The numbers are still grim, despite all of the work being done all over the country by advocates and policy makers.
Options for Policies
Focusing on repeat offenders is the most straightforward way to have a large impact on the problem. One idea is the ignition interlock device that is installed in the vehicle and requires that the driver demonstrate they are sober before starting the car [6]. All fifty states, including Indiana, have laws that allow these to be mandated.
And if they were required in the cars of every single person convicted of a DUI, studies estimate we could save 800 lives per year [7]. That's about 6%.
Another idea is reducing the legal limit. It already went from 0.10 to 0.08 in a lot of places [8] and from 0.08 to 0.05 in others [9]. We could even make the law have zero tolerace: you can only drive legally with a 0.0 BAC. But even if that was politically viable, there's not much evidence it would work. A study of three cities in Brazil showed no effect after passing a zero-tolerance law. [10]
And we could make penalties harsher for perpetrators. That could maybe help.
But there is one place in the world where being killed by a drunk driver almost never happens. And yes, it's a place with lots of roads and lots of drivers and lots of alcohol.
That mythical land is Sweden [11].
The Challenge is Culture
Here's what I believe: most Americans would say “Sure, drinking can be dangerous, but I have my own drinking under control.” Whereas I bet Swedes would say “Drinking can be dangerous, and it's wrong to take risks like driving when you've had anything to drink.” [12]
Of course, there's nothing particularly svenska about that second statement. It's one that could become the norm for Americans. Because like smoking cigarettes (which is no longer cool) and littering in public places (which is no longer cool) and bullying (which is no longer cool) there is power in moral consensus.
We have to make saying “I'm fine to drive” no longer cool. We have to change our culture.
Postscript: Self-Driving Cars and Self-Reflection
Being killed by a drunk driver today is sort of like being killed by smallpox in the 1940s. It's horrible but we know it's not going to be an issue soon. Autonomous vehicles are well on the way and algorithms do not hit the sauce. Eventually technology will solve the problem of drinking and driving but not in a particularly satisfying way.
Because being a human is about getting better. We need to learn how to respect drugs and their impact on our minds and bodies. We need to be smarter about booze and other substances and admit their power. We need to make better choices.
And finally, no discussion of the countless drug-based incidents which have maimed or killed people should fail to mention the human toll. The lives and limbs that have been lost are irreplacable. The funerals and the hospital bills are an endless sea of tragedy. Even one person killed by a drunk driver is one person too many.
After all of this, I can only make one final plea. The next time you have even one drink consider calling a ride or staying the night.
You probably don't think doing so could save a life. But those who did drive drunk and shatter families asunder would have said the same.
Your choice—all of our choices—matter.
Don't drink and drive.
[1] https://apps.dtic.mil/sti/pdfs/ADA542726.pdf
[3] https://www.bmj.com/rapid-response/2011/11/02/association-between-alcohol-misuse-and-hand-trauma
[4] https://www.nhtsa.gov/risky-driving/drunk-driving
[5] https://www.nhtsa.gov/sites/nhtsa.gov/files/811991-dwi_recidivism_in_usa-tsf-rn.pdf but also https://www.nhtsa.gov/risky-driving/drunk-driving
[6] https://en.wikipedia.org/wiki/Ignition_interlock_device. Which could be installed in all cars, or maybe as cars could detect erratic driving and shut themselves down. But that's a lot of regulatory oversight.
[7] https://www.nhtsa.gov/sites/nhtsa.gov/files/documents/812445-interlock-data-utilization.pdf
[8] Old studies are fun. From 1994, PDF link.
[9] It's less clear that this is working. We have meta-analyses that say it should and whole books and lab studies but only really one state has done it but it does looks promising.
[10] After five years of zero-tolerance there was no measurable impact on alcohol-fatalities but even though it doesn't seem to be working, it is now the law nationwide.
[11] Yes, Svenska. Because the culture there is that it's not cool to drink and drive.
[12] Here's one study but it's not of Americans and not comprehensive, and I've only been to Sweden once so I don't really know.