Communities Attack Extreme Drinking From All Sides -- and Win
Nov. 8, 2000 -- It takes a village to reduce the excessive drinking that often leads to car accidents and assaults, a new study suggests.
When combined, several community-based efforts aimed at reducing such drinking do indeed reduce alcohol-related car accidents and assaults, California researchers report in Wednesday's issue of the Journal of the American Medical Association.
While they are not as effective on their own, the combination of the following programs can curb these dangerous drivers and violent drinkers:
- media campaigns
- changes in alcohol serving practices in bars and restaurants
- increased enforcement of drinking and driving laws with sobriety checks
- limiting access to underage people
- reducing the concentration of stores that sell alcohol
From 1992 to 1996, study authors compared three communities in northern California, southern California, and South Carolina with a matched community in each state where none of the community-based interventions were implemented. Each month, researchers conducted telephone interviews, looked at traffic accident records, and surveyed hospital emergency departments to see if the interventions trickled down to affect drinking behavior in the communities.
As a result of the combined interventions, people reported drinking an average of 6% less at any one sitting. In addition, times when people reported "having had too much to drink" declined by almost 50% over each six-month period. And reports of driving while "over the legal limit" dropped by more than 50% each six-month study period.
Also, the rate of nighttime crashes declined by 10% and assault injuries dropped by 43% in the intervention communities where emergency departments were surveyed.
One of the study authors, Andrew J. Treno, PhD, a research scientist at the Pacific Institute for Research and Evaluation in Berkeley, Calif., tells WebMD that he was impressed with the findings. "It is an extremely intense effort," he says. But "presumably, one could put together a similar program if there was an interested community."
The approach involved a "structuring or restructuring of the alcohol environment in a community or neighborhood. We had reason to believe that each of these interventions work on their own so the real question is what would happen if you put it all together," he says. And indeed, the new study suggests that they do work better when used in combination.
The approach used in the study is "reasonable, but the nationwide implementation would be more difficult and expensive," says Gilbert Ross, MD, medical director of the American Council on Science and Health in New York City.
"It's a worthwhile effort to control a potentially dangerous activity. ... Certainly, the problem of particularly excessive drinking before driving is an issue that needs to be more intensively addressed in this country," Ross tells WebMD.
The National Highway Traffic Safety Administration reports that in 1999, almost 40% of auto accidents were alcohol-related, which caused almost 16,000 deaths.
Young people are an important part of the equation when it comes to educating the public about the dangers of excessive drinking, says Franklin, Tennessee's Millie Webb, the national president of Mothers Against Drunk Driving. "We've got to continue to educate, legislate and rehabilitate," she says.
Since the minimum drinking age was raised to 21 in 1984, 1,000 teenage lives have been spared each year, she says. But "we still have a lot to do -- the problem of drinking and driving is everyone's problem," Webb says.
"Drinking and driving is still the number one killer of our teenagers," she says. "Alcohol is a drug and it is killing more of teenagers than all other drugs combined."