DRINKING AND DRIVING IN CALIFORNIA AND THE UNITED

DRINKING AND DRIVING IN
CALIFORNIA AND THE UNITED STATES
by J. FORT*
40,000 road traffic deaths are d riv in g .9 T h ere are a pp r o x i ma t e l y
occurring each year in the United States as 75.000.000 Americans who drink alcoholic
compared to 8,000 murders and 14,000 beverages, one-half of them drinking at
rapes in the same period, which received least once a week. Of this number, some
far more public attention. It is estimated 6.000.000 are alcoholics, with California
that 30% of these highway deaths are due having 10% or 600,000 of these alcoholics,
to drunken driving, with the percentage the highest incidence in the United States.
rising to more than 50% in some metro­ The taxes paid to the federal government
politan areas and on holiday weekends.1 for spirits, beer and wine consumed in
Automobile accidents represent 40% of California alone in 1961 amounted to
$450,000,000.
all accidents in the United States, are one
It is now recognized that 85% of people
of the ten leading causes of death in every
age group from 1 to 85 years, and result in are “ drunk” at a blood alcohol level of
1,500,000 years of life being lost prema­ 0-1%, and 100% are drunk at a level of
turely each year.22 California, which this 0-15%.8’ 20’ 24>26>30 Many authorities feel
year becomes America’s largest state in that any amount of drinking reduces the
population, has 9,000,000, or one-tenth of ability to drive by impairing co-ordination,
all the cars registered in the United States, judgment, vision and psychological stabil­
but only 4% of the highways. California ity. One study has shown a 2 \ times
has an average of 61 vehicles per mile of greater chance of road accidents with a
highway as compared to a figure of 17 for blood alcohol level between 0-1% and
the entire U.S., and 8 for the world. Last 0-15%, and a 10 times greater chance if the
year in California 3,839 were killed and level is above 0-15%.21 The now classic
163,945 injured from road accidents. At study by Goldberg and Bjerver showed a
least 1,100, or 3 deaths per day, from these 25-30% deterioration of performance in
accidents involved drunken driving. The skilled drivers after the consumption of
economic loss from known traffic accidents alcohol, with the threshold of impairment
amounted to $1,500,000 daily. There were being around 0-04%.3 There was a deteri­
42,899 individuals arrested for drunken oration of overall performance, and sup­
driving in California in 1961. However, in pression of normal practice effects, an
one recent year, of 1,147 drivers who increase in the usual effects of fatigue and
accidentally killed someone while driving those with the poorest original performance
under the influence of alcohol, only 270 were most affected. In single vehicle fatal
were convicted of the felony of drunken accidents Haddon and Bradess found that
driving, and only 47 were sent to jail or 49% of the drivers had blood alcohol
levels of 0 -15% or above, with an additional
prison.24
Recent studies of drinking behaviour in 20% having 0-05% to 0-15%. Alcohol thus
California show that most drinking takes appeared to be a causal factor in half or
place after dark and on weekends, usually more of the deaths.18 The average blood
in the company of a friend or relative. At alcohol level of 6,000 drivers apprehended
least half do their drinking away from by various police agencies was 0-22%.1
Cisin has distinguished three kinds of
home and must use their automobile or
other form of transportation after drinking. drunken drivers: the alcoholic who drives,
One-third of the people interviewed the psychopathic driver who drinks, and
believed a person can have 3 or more “the normal drinker” who is “a normal
drinks at a two-hour party and still drive
.D., Director, Centre for Treatment and Education on
normally. Only 1 out of 10 felt that there ♦M
Alcoholism, Oakland, Calif.; Lecturer, School o f
Criminology, University o f California.
was anything bad or stupid about drunken
nearly
339
340
COMPARATIVE
driver” .9 He also reports a study in
Belgium which found that those arrested
for drunken driving were people of inter­
mittently high alcohol consumption at
comparatively short intervals, and onefifth of them had a previous record of
criminal conviction. The California Vehicle
Code does not refer to drunken driving as
such, but declares it unlawful for a person
to drive while under the influence of intoxi­
cating beverages. Such a person is guilty
of a misdemeanour and, if injury to another
results, he is guilty of a felony. California
has no law requiring participation in a
chemical test or establishing a blood
alcohol level for defining “under the
influence” .
Thirty-six states have laws similar to the
provisions of the Uniform Vehicle Code
suggested in 1944.8 This Code provides
that the amount of alcohol in the defen­
dant’s blood as shown by chemical analysis
of blood, urine and breath, will be presump­
tive of not being under the influence of an
intoxicating liquor if 0-05% or less; not
presumptive of the defendant being or not
being under the influence but to be con­
sidered with other competent evidence if
between 0-05% and 0-15%; presumptive of
being under the influence if 0-15% or more.
Six additional states have supplemented
these provisions by authorizing the revoca­
tion of a driver’s licence when an individual
is reasonably suspected of driving under
the influence of intoxicating liquor and
refuses to submit to a chemical test (the
so-called “implied consent” laws). Accord­
ing to the World Health Organization,
chemical tests for intoxication are now used
in Australia, Belgium, Canada, Czecho­
slovakia, Denmark, Finland, France, West
Germany, Greece, Iceland, Japan, Holland,
Norway, Sweden, Peru and Switzerland, as
well as the United States. The blood
alcohol concentration accepted as evidence
of intoxication ranges from 0-05% to
0-15%, and the maximum penalties range
from 14 days’ imprisonment with 6 months’
loss of licence up to 5 years’ imprisonment.
In November, 1960, the American
Medical Association adopted the policy
statement that a blood alcohol level of
0-1% be accepted as prima facie evidence
of alcoholic intoxication, although recog­
nizing that many individuals are under the
influence in the 0-05% to 0-1% range.
Implied consent laws requiring submission
to chemical testing or loss of licence have
also been recommended by the American
Medical Association, the American Bar
ASPECTS
(3)
Association, the National Safety Council
and the National Conference of Com­
missioners on Uniform State Laws. The
British Medical Association Committee
on Alcohol and Road Accidents has stated
that the number of road accidents caused
by alcohol has been considerably under­
estimated, and that 0-05% is the highest
blood alcohol level compatible with road
safety.26
Discussion and Recommendations
McFarland,22 in stressing the importance
of an epidemiological approach to motor
vehicle accidents, has ably pointed out the
shortcomings of much of the research on
highway accidents: inadequate time sam­
pling and criteria of accidents; studies of
single variables out of context; poor
sampling techniques, particularly a lack of
control groups; lack of appropriate statisti­
cal procedures; and conclusions based on
intuition rather than empirical information.
Study after study in country after country
leaves no doubt that alcohol is a major
factor in causing road accidents, especially
fatal ones. We have yet to determine,
however, the full extent of this causal
relationship and its complex interaction
with other factors within the driver, the
vehicle, and the social and physical
environment in which driving behaviour
occurs.5-7’ 10,17*28, 29 Certainly the prob­
lem of alcohol and road traffic cannot be
understood apart from the total context
of drinking in general and the society in
which it occurs. Some have suggested a
significant overlapping of drunken driving
and alcoholism25 but, while it is undoubt­
edly true that some drunken drivers are
alcoholics in terms of the W.H.O. defini­
tion, much more thorough evaluations of
individual drivers will be necessary to
accurately assess the role of alcoholism
in this problem. This group, whatever its
size, would be less likely to be deterred by
the threat of punishment than would less
compulsive drinkers. We also need to
develop techniques for singling out the
psychopathic drivers and the medically
unfit by requiring examination of all
drivers, as has been done in the state of
Pennsylvania since 1960. We should then
attempt to reach the remaining segment of
“normal” drinking drivers, presumably
the majority, with skilfully planned massive
public health educational and advertising
campaigns, both to stress the dangers of
consuming even small amounts of alcohol
before driving and to counteract the
FORT
existing strong pressures to conform and
gain status through drinking, and drinking
heavily. Around $200,000,000 per year is
being spent by the wine, beer and liquor
industries to advertise their products.
Stricter governmental controls and taxes
on advertising seem necessary to reduce
the public’s over-exposure and to control
the frequent deception and misrepresenta­
tion. We must communicate to the public,
including legislators, that the drinking
driver represents one of our greatest social
and criminal problems. Hosts, partygoers and bartenders require education on
safe amounts of alcohol to drink and serve,
and safe intervals of time before driving.
One related suggestion which has merit is
to establish “party pools” , where one
person will have the responsibility of
driving the others home and will not drink
on that occasion.
To solve the enormous and complex
problem of the drinking driver, we will
need the combined efforts of medicine,
psychology, pharmacology, public health
and law enforcement. The automobile
must be recognized as a potentially deadly
weapon, and society must be protected
from the drinking driver. We need uniform
state and national laws, providing for
routine chemical testing for alcohol content
of the body, if a police officer has reason­
able grounds for requesting it; and we need
similar uniform legislation, making a blood
alcohol level of 0-1% or more presumptive
evidence of intoxication, and blood alcohol
levels between 0-05% and 01% presump­
tive evidence that driving ability is im­
paired. Strengthened law enforcement
procedures are essential, including more
highway patrolmen, the use of radar,
roadside breath analysis and careful
preparation of evidence for trials. A
minimum penalty of six months’ suspen­
sion of licence should be instituted with
provision in cases of extreme hardship to
drive only between 7 a.m. and 7 p.m. on
weekdays. The licence-suspension on an
individual basis would range up to
“indefinite” , and this penalty should be
combined with large fines, with mandatory
jail sentences for driving with a suspended
or revoked licence and with retraining and
re-licensing programmes. Facilities should
also be established and legalized for the
routine medical and psychiatric evaluation
of individuals apprehended for driving
violations where alcohol has been con­
sumed. Such a programme is being
jointly carried out by our Centre on
341
Alcoholism and the Department of Motor
Vehicles in California.
Additional helps in our effort to solve
the problem of alcohol and road traffic
would include: rapid transit installations;
construction of freeways when further
roads are necessary, since these have been
found to be three times safer; improved
automobile design and an increase in
protective features such as seat belts;
uniform and consistent reporting proce­
dures so that we have an accurate tabula­
tion of accidents and arrests and specific
notation of whether drinking was involved;
and finally, intensive research on all aspects
of this problem, ranging from the develop­
ment of chemical measures to increase the
rate of metabolism of alcohol in the body,
to study of the socio-psychological bases
for attitude change and the development of
programmes of preventive education.
R
eferences
1 N ational Safety Council (1962). Accident Facts,
Chicago.
2 Birrell, J. H. W. (1960). Med. J. Aust., 1, 714.
3 Bjerver, K. and Goldberg, L. (1950). Quart. J.
Stud. Alcohol, 11, 1.
4 Block, M. A. (1960). J. Amer. med. Ass., 170,
18.
5 Borkenstein, R. F. (1961). Alcohol and Road
Traffic—Enforcement and Prosecution P rob­
lems. U.S. Public Health Service, National
Conference on Alcohol and Traffic Safety.
6 C ahalan, D. (1961). M otivational and Educa­
tional Aspects o f D rinking-Driving. Ibid.
1 Carpenter, J. A. (1961). Psychological Effects
o f the Ingestion o f Alcohol. Ibid.
8 American M edical Association (1959). Chemi­
cal Tests fo r Intoxication. Chicago.
9 Cison, L. H. (1961). Driver Intoxication as a
Social-Psychological Problem. U.S. Public
Health Service National Conference on Alcohol
and Traffic Safety.
10 Conger, J. J., et al. (1959). J. Amer. med. Ass.,
169, 121.
11 Control o f the Negligent Driver. Part I.
Characteristics o f Negligent Drivers. State of
California D ept, o f M otor Vehicles, Feb. 1961.
12 Drew, G. C. (1961). Alcohol and Road Safety.
13 U.S. D ept, o f H ealth, Education and Welfare
(1962). Drugs and Driving.
14 Dubowski, K . M. (1961). Alcohol D eterm ina­
tion—Some Physiological and M etabolic
Considerations. U.S. Public Health Service
National Conference on Alcohol and Traffic
Safety.
15 Eysenck, H. J. (1960). New Scientist, p. 18.
16 Freem an, S. (1960). Brit. med. J., 2, 1513.
17 G oddard, L. (1959). J. Amer. med. Ass., 169,
119.
18 H addon, W. J., and Bradess, V. A. (1959).
Ibid., 167, 1587.
19 Influence o f Alcohol on Traffic Safety. Accident
Prevention Dept., Association o f Casualty and
Surety Companies, New Y ork, 1961.
20 Loomis, T. A., and West, T. C. (1958). Quart.
J. Stud. Alcohol, 19, 30.
21 Lucas, G. H. W. et al. (1955). Proc. 2nd
International Conf. Alcohol and Road Traffic,
T oronto.
22 M cFarland, R. A. (1962). / . Amer. med. Ass.,
180, 289.
23 Miller, S. E., and Brandaleone, H. (1959).
Ibid., 169, 118.
344
C O M P A R A T I V E A S PE CT S ( 3 )
diese sind in dem vergossenen Blut, den
Toten und den Schaden zu suchen, die
alljahrlich und in zunehmendem MaBe
Verletzungen in die Statistik aufgenommen,
weil die entsprechenden Protokollangaben
sofort weitergeleitet werden miissen, so daB
T a b e l l e III
IT A L IE N
Zahl der Einwohner pro Automobil:
1915
1.664,5
1920
1925
1930
1935
1939
1946
1950
1955
1960
1.197,7
464,5
223,5
173,5
150,7
304,7
138,2
57,1
26
unser Land der Motorisierung als Tribut
zahlt. Seit einigen Jahren sind zum
Beispiel die Verkehrsunfalle in Italien
sozusagen zur wichtigsten “Infektionskrankheit” geworden.
In der Tat
iibersteigt die jahrliche Anzahl der Verletzten die Gesamtzahl der meldepflichtigen
Infektionskrankheiten, Tuberkulose inbegrifFen, wahrend die Anzahl der Toten
hoher liegt, als die durch alle Infektions­
krankheiten zusammem bewirkten Todes­
falle, ausgenommen die todlich verlaufenden Formen der Tuberkulose.
Die Tabelle IV gibt einen sprechenden
Beweis dafiir.
Ein Vergleich der noch unvollkommenen
Angaben fiir 1961 mit den entsprechenden
Erhebungen von 1960 beweist, daB die
Ziffem noch im Anstieg begriffen sind,
obwohl von seiten der Regierung, der
Polizei und der besonderen Organisationen
sehr viel unternommen worden ist, um
in dieser Lage Abhilfe zu schaffen und um
vor allem die rechtswidrigen Handlungen
im StraBenverkehr zu unterdriicken. Von
Januar bis Mai 1960 ereigneten sich 98.215
Verkehrsunfalle, wahrend im Laufe der
es nicht moglich ist, den weiteren Verlauf
einer Verletzung zu verfolgen, die oftmals
todlich endet. Aus demselben Grund sind
auch die amtlichen Angaben iiber die
alkoholbedingten Verkehrsunfalle und die
GeldbuBen fiir Trunkenheit des Fahrers
sehr niedrig, wobei noch hinzukommt, daB
die Alkoholbestimmung im Blut aus
gewissen, spater zu erlautemden Griinden
nicht systematisch durchgefiihrt werden
kann.
Die amtlichen Angaben sind folgende:
T a b e lle V
IT A L IE N
D urch “Betrunkenheit
verursachte
Verkehrsunfalle”
“ sichere oder vermutliche Ursache”
1956
1957
1958
1959
671
785
684
765
(0,4%) (0,4%) (0,3%) (0,3%)
T a b e l l e VI
Geldbussen fiir Trunkenheit
des Fahrers (nur von der
Strassenpolizei)
1960
1961
252
229
T a b e l l e IV
IT A L IE N
1956
Verkehrsunfalle
Verungluckte Personen
Todesfalle
Verletzte
167.574
143.346
6.746
136.660
gleichen M onate des darauffolgenden
Jahres 119.062 zu verzeichnen waren; das
entspricht einem Anstieg von 21,2%.
Immer auf die gleichen Monate von 1960
und 1961 bezogen, kamen 2.736 beziehungsweise 3.145 Todesfalle (=14,9%) vor,
wahrend die Anzahl der Verletzten von
68.324 auf 80.199 (=17,4%) stieg.
Hinsichtlich der Anzahl der Todesfalle
ist noch hervorzuheben, daB die amtlichen
Ziffem nicht der Wirklichkeit entsprechen,
da sie sich nur auf die sofort todlichen
Unfalle beziehen. Die verspateten Todes­
falle werden nicht als solche, sondern als
1957
1958
1959
1960
1961
188.854
153.357
6.936
148.421
201.236
160.847
7.137
153.710
225.116
174.958
7.160
167.798
275.993
209.478
8.197
201.285
301.889
227.944
8.986
218.958
Die fiir die Statistik notwendigen
Angaben werden von Polizeibeamten
gemacht und erfolgen vorwiegend auf
G rund von Zeugenaussagen, wahrend die
wirkliche Ermittlung der Trunkenheit der
Justizbehorde vorbehalten bleibt; wird die
Blutalkoholbestimmung angefordert, so
kann der Gerichtsmediziner, als Sachverstandiger des Richters, nur diesem allein
die Ergebnisse seiner Untersuchung mitteilen. Damit soil nicht gesagt sein, daB in
Italien das Problem der Trunkenheit am
Steuer solche AusmaBe erreicht hat wie
zum Beispiel in anderen Staaten, sondern