Psychosocial characteristics of alcohol-involved and nonalcohol-involved seriously injured drivers.

This study compared two groups of alcohol-positive and alcohol-negative, seriously injured, crash-involved drivers on demographics, personality characteristics, driving-related attitudes, prior driving history, lifestyle, substance use, and antecedent driver condition. The study sample was drawn from motor vehicle accident admissions to the Sunnybrook Health Science Centre Regional Trauma Unit. One hundred and six interviews were completed between August 1986 and November 1989, with blood alcohol concentration (BAC) data available for 96 drivers. These data suggest no driving-related attitude differences between the two groups. Self-reported driving histories indicated significantly fewer graduates of driving schools and more licence suspensions for the BAC-positive group. The only consistently significant differences were found for the drinking-related variables, with a greater percentage of the BAC-positive group reporting: lower age of first intoxication; a greater self-perceived drinking problem; a greater frequency of intoxication in the month before the accident; and greater self-reported drinking-driving in the month before the accident. Principal-components factor analysis revealed a four-factor solution labelled: Alcohol Use, Deviant/Illicit Drug Use, Aggression, and Neuroticism. Alcohol Use was the only factor found to contribute substantially to the discriminant function, together with the job-related stress item. These data suggest that seriously injured, alcohol-positive and alcohol-negative crashed drivers are similar except that the alcohol-positive drivers show more signs of an alcohol problem.

Alcohol and drug use among motor vehicle collision victims admitted to a regional trauma unit: demographic, injury, and crash characteristics.

This study examined the incidence of alcohol and drugs in a sample of seriously injured motor vehicle collision victims, and differences related to pre-crash use of alcohol and/or other drugs on demographic variables, injury severity measures, and crash variables. The sample selected were all motor vehicle collision admissions to the Regional Trauma Unit at the Sunnybrook Health Science Centre in Toronto, Ontario, over a 37-month period (N = 854). Prospective demographic and injury-related information were collected from hospital charts, and crash data were collected from motor vehicle collision police reports. Blood samples were routinely collected on admission and tested for blood alcohol concentration (BAC). We found 32.0% of the BAC-tested motor vehicle collision admissions and 35.5% of drivers tested positive for blood alcohol. The drivers' mean BAC on admission was found to be 145.2 mg/100 ml, and the mean estimated BAC at crash time was 181 mg/100 ml. Drug screens were performed on a two-year subsample (n = 474), of whom 339 were drivers. Drug screens revealed that 41.3% of drivers tested positive for other drugs in body fluids, and 16.5% were positive for alcohol in combination with other drugs. Other than alcohol, the drugs most frequently detected in the drivers were cannabinoids (13.9%), benzodiazepines (12.4%), and cocaine (5.3%). Investigation of differences on demographic, injury, and crash characteristics related to precrash use of alcohol and/or drugs yielded significant findings. In the drug screened sample we found sex, admission type, and occupant status were related to precrash alcohol use. Also, use of drugs was found to interact with admission type and mean BAC on admission. Elapsed time was found to be significantly different for BAC by other drug use, with a greater length of elapsed time found for the subjects testing other drug positive but BAC negative. We found that BAC-positive drug-screened drivers were significantly more likely to be male, involved in a single-vehicle collision, not wearing a seat belt, ejected from the vehicle, and travelling at higher speeds than BAC negative drivers. No significant differences were found between BAC and/or other drug use on injury severity measures.

Introducing beer sales at a Canadian ball park: the effect on motor vehicle accidents.

The impact of introducing the legal sale of beer in a Toronto stadium on drinking-driving accidents is investigated. The results suggest that a greater proportion of accidents in the postgame time are alcohol-related when compared to pregame times and to control times. No significant effect was found, however, for the introduction of legal beer sales, suggesting that drinking was common before the public sales policy.

Blood alcohol testing of motor vehicle crash admissions at a regional trauma unit.

Motor vehicle crashes remain a leading cause of death and injury in the industrialized world. Alcohol consumption is implicated as a major factor in fatal motor vehicle crashes (MVCs), but only poor estimates of blood alcohol concentrations among nonfatally injured crash victims are available. A 3-year study was undertaken at a Regional Trauma Unit to determine the demographics, injury severity, and alcohol positivity of motor vehicle crash victims. Between August 1, 1986 and July 31, 1989, 825 motor vehicle crash victims were available for study; 368 drivers were admitted to the unit within a period of 4 hours. Of 715 patients tested for alcohol, 31.0% were positive. A total of 333 drivers were tested for blood alcohol; 128 (38.4%) were positive. The mean blood alcohol concentration (BAC) at admission for the drivers was 145.6 mg/100 ml; the estimated mean BAC at crash was 180.9 mg/100 ml. The mean age of BAC positive drivers was 31.4 years, compared to a mean age in the BAC negative drivers of 35.2 years (p less than 0.02). Male patients represented 76.6% of the drivers, yet represented 83.6% of the BAC positive drivers (p less than 0.05). There was a marked seasonal variation in BAC positivity, with 46.1% of drivers positive during the summer months. Alcohol appears to be a significant factor in nonfatal MVCs.

The Canadian drinking-driving countermeasure experience.

An overview of countermeasures implemented and evaluated in Canada to reduce impaired driving and alcohol-related accidents and fatalities are presented. Intervention strategies to detect and/or deter impaired drivers included legal measures, public information and education campaigns, rehabilitative programmes for convicted impaired drivers and technological aids to the prevention and detection of impairment. In general, the impact on drinking and driving of most countermeasures has been limited and short-term. The full effect of many countermeasure efforts was impeded by methodological shortcomings of the evaluations. Overall, the findings suggest that there is a need to take a comprehensive approach, tackling both drinking habits and driving habits. In order to effect behavioural change, a systems-oriented strategy would focus on motivational factors and alternative actions to drinking and driving.

Alcohol consumption as estimated by the informant method; a household survey and sales data.

The informant method of estimating alcohol use yielded higher rates of drinking and of heavy drinking in the general population than did the standard household survey method. The informant method provided estimates of per capita consumption closer to those based on alcoholic beverage sales. Overall, the informant method appears to obtain higher estimates of heavy and problem alcohol use, is cheaper than survey methods and may overcome some selective reporting problems typical of standard surveys.

Drinking and drug use among Ontario Indian students.

From the sample of Ontario students in grades 7 through 13 surveyed during 1979, 64 students of Native Indian parentage were successfully matched with 64 non-Indian students on five demographic variables. A comparison of alcohol and drug use among the two groups suggested that Indian students use alcohol and drugs in a manner similar to that of their peers in the same geographical locale and socio-economic background.

Cannabis use and alcohol problems among adults and students.

Earlier studies have indicated that cannabis use and alcohol problems should be related. This paper reports a test of this hypothesis using multivariable analyses with two separate samples--one adult and one student. In both analyses alcohol problems were the best predictors of cannabis use. The results indicate the need to consider cannabis use to be often part of a larger set of problems around drugs.

A follow-up study of male halfway-house residents and matched nonresident controls.

Men in a halfway-house sample had more detoxication readmissions but fewer drunkenness arrests in a 3-month follow-up period than did their matched controls; the total number of documented drunkenness episodes did not differ in the two groups.