Indication for the Assessment of Driver Fitness after Problematic Alcohol Consumption

2014 ◽  
Vol 60 (3) ◽  
pp. 139-147
Author(s):  
Caroline Reimann ◽  
Wolfgang Schubert ◽  
Michael Berg ◽  
Elke van der Meer
Keyword(s):  
Alcohol Consumption ◽  
Psychological Assessment ◽  
Blood Alcohol Concentration ◽  
Drunk Driving ◽  
Experimental Manipulation ◽  
Alcohol Concentration ◽  
Fitness To Drive ◽  
Legal Limit ◽  
Research Findings ◽  
Practice Methods

Objectives: The present review of literature examines the relationship of alcohol consumption and fitness to drive. The legal limit (1,6 ‰) for establishing fitness to drive by means of a medical-psychological assessment (MPA) in Germany is analyzed on the background of published empirical research to present recommendations for the improvement of the current legal situation and administrative practice. Methods: 103 published articles have been analysed (inclusion criteria: completeness, comprehensibility, and experimental manipulation of the blood alcohol concentration [BAC]). The number of alcohol-induced impairments is to be shown in a quantitative analysis. The qualitative analyses of the studies will reveal the impaired areas of psychological and medical functioning. Results: It appears that 97 % of the documented impairments occur at a maximum BAC of 1,1 ‰. Numerous skills are impaired by low doses of alcohol (e. g. attention, memory, perception). Conclusion: Alcohol-induced impairments arise at a BAC far below 1.6 ‰, which marks the legal limit for a medical-psychological assessment (MPA) after drunk driving in Germany. The BAC limit in the current ordinance for assigning a medical-psychological fitness assessment cannot be confirmed on the basis of research findings. A reduction of this BAC limit to 1,1 ‰ is proposed.

4. Are a Blood Alcohol Concentration of 256mg/dl and Minimal Signs of Impairment Reliable Indications of Alcohol Dependence?

1994 ◽  
Vol 34 (3) ◽  
pp. 265-270 ◽  
Author(s):  
A W Jones
Keyword(s):  
Expert Witness ◽  
Blood Alcohol Concentration ◽  
Drunk Driving ◽  
Alcohol Concentration ◽  
Driving Under The Influence ◽  
Blood Alcohol ◽  
Lower Court ◽  
Dna Profile ◽  
Court Of Appeals ◽  
Driving Scenario

This article describes a drink-driving scenario where a woman was apprehended for driving under the influence (DUI) with a blood alcohol concentration (BAC) of 256mg/dl1 The correctness of this result was vigorously challenged by a medical expert witness for the defence, who was actually a specialist in alcohol diseases. Despite reanalysis to confirm the BAC as well as a DNA profile to prove the identity of the blood specimen, the woman was acquitted of the charge of drunk driving by the lower court. However, she was subsequently found guilty in the High Court of Appeals with a unanimous decision and sentenced to four weeks imprisonment. This case report illustrates some of the problems surrounding the use of expert medical evidence by the defence to challenge the validity of the prosecution evidence based solely on a suspect's BAC. In situations such as these, an expert witness should be called by the prosecution to clarify and, if necessary, rebut medical and/or scientific opinions that might mislead the court and influence the outcome of the trial.

scholarly journals Impact of legislation to reduce the drink-drive limit on road traffic accidents and alcohol consumption in Scotland: a natural experiment study

2019 ◽  
Vol 7 (12) ◽  
pp. 1-46 ◽  
Author(s):  
Jim Lewsey ◽  
Houra Haghpanahan ◽  
Daniel Mackay ◽  
Emma McIntosh ◽  
Jill Pell ◽  
...  
Keyword(s):  
Alcohol Consumption ◽  
Health Research ◽  
Traffic Accidents ◽  
Road Traffic ◽  
Blood Alcohol Concentration ◽  
Public Health Research ◽  
Alcohol Concentration ◽  
Control Group ◽  
England And Wales ◽  
Per Capita

Background It is widely recognised that drink driving is a leading cause of road traffic accidents (RTAs). There is evidence that changing the drink-drive limit from a blood alcohol concentration of 0.08 to 0.05 g/dl is effective in reducing RTAs. Scotland changed the blood alcohol concentration limit to 0.05 g/dl on 5 December 2014. Aims To assess whether or not the numbers and rates of RTAs and per capita alcohol consumption in Scotland were reduced because of the 2014 drink-drive legislation. To assess whether or not the 2014 change in legislation provided good value for money. Design A natural experimental, quantitative study. The control group was England and Wales, that is, the other countries in Great Britain, where the drink-drive legislation remained unchanged. Setting Great Britain. Participants The entire population of Scotland, England and Wales for the period of January 2013–December 2016. Intervention The change to drink-drive legislation in Scotland. Outcome measures The counts and rates of RTAs; and per capita alcohol consumption. Methods For the numbers and rates of RTAs (both traffic flow and population denominators were used), and separately for the intervention and control trial groups, negative binomial regression models were fitted to panel data sets to test for a change in outcome level after the new 2014 legislation was in place. To obtain a ‘difference-in-differences’ (DiD)-type measure of effect, an interaction term between the intervention group indicator and the binary covariate for indicating pre and post change in legislation (‘pseudo’-change for the control group) was assessed. For off- and on-trade per capita alcohol sales, and separately for the intervention and control trial group, seasonal autoregressive integrated moving average error models were fitted to the relevant time series. Results The change to drink-drive legislation was associated with a 2% relative decrease in RTAs in Scotland [relative risk (RR) 0.98, 95% CI 0.91 to 1.04; p = 0.53]. However, the pseudo-change in legislation was associated with a 5% decrease in RTAs in England and Wales (RR 0.95, 95% CI 0.90 to 1.00; p = 0.05). For RTA rates, with traffic flow as the denominator, the DiD-type estimate indicated a 7% increase in rates for Scotland relative to England and Wales (unadjusted RR 1.07, 95% CI 0.98 to 1.17; p = 0.1). The change to drink-drive legislation was associated with a 0.3% relative decrease in per capita off-trade sales (–0.3%, 95% CI –1.7% to 1.1%; p = 0.71) and a 0.7% decrease in per capita on-trade sales (–0.7%, 95% CI –0.8% to –0.5%; p < 0.001). Conclusion The change to drink-drive legislation in Scotland in December 2014 did not have the expected effect of reducing RTAs in the country, and nor did it change alcohol drinking levels in Scotland. This main finding for RTAs was unexpected and the research has shown that a lack of enforcement is the most likely reason for legislation failure. Future work Investigations into how the public interpret and act on changes in drink-drive legislation would be welcome, as would research into whether or not previous change in drink-drive legislation effects on RTAs in other jurisdictions are associated with the level of enforcement that took place. Trial registration Current Controlled Trials ISRCTN38602189. Funding This project was funded by the National Institute for Health Research (NIHR) Public Health Research programme and will be published in full in Public Health Research; Vol. 7, No. 12. See the NIHR Journals Library website for further project information.

Epidemiology of alcohol-related accidental death in Tokyo Metropolitan area (2015)

2019 ◽  
Vol 60 (1) ◽  
pp. 4-10
Author(s):  
Hideto Suzuki ◽  
Takanobu Tanifuji ◽  
Satoko Kimura ◽  
Tatsushige Fukunaga
Keyword(s):  
Alcohol Consumption ◽  
Blood Alcohol Concentration ◽  
Incidence Rates ◽  
Alcohol Concentration ◽  
Blood Alcohol ◽  
Alcohol Group ◽  
Tokyo Metropolitan Area ◽  
Significant Difference ◽  
Primary Type ◽  
At Home

Background Alcohol consumption may be a risk factor for accidental deaths; however, characteristics of alcohol-related deaths are unclear. We investigated characteristics of alcohol-related accidental deaths to facilitate target strategies. Methods In this article, 1060 cases of accidental deaths examined by the Tokyo Medical Examiner’s Office (2015) were divided into two groups: deceased individuals who drank alcohol (alcohol; n = 212) and those who did not (control; n = 848). Age, sex, alcohol consumption patterns, and manners/causes of deaths were compared. Places where individuals in the alcohol group met with an accident, and their blood alcohol concentration was assessed. Results Lower mean age (60.5 vs. 73.7 years) and a higher male ratio (75.9% vs. 58.5%) were observed in the alcohol group. Daily alcohol consumption was more common in the alcohol group (70.8% vs. 13.4%). Falling was the leading cause of death in the alcohol group, but without a significant difference (alcohol: 31.6%, control: 30.4%). Incidence rates of drowning (22.2% vs. 7.9%) and poisoning (11.3% vs. 2.0%) were significantly higher in the alcohol group. The mean blood alcohol concentration was 1.6 mg/mL. Of the total alcohol-related accidents, 60.8% occurred at home. Falling down the stairs was the primary type of falling, and majority of drownings occurred in a bathtub. Conclusion Male habitual drinkers (middle-aged to older adults) should be targeted to prevent alcohol-related accidental deaths. More than 50% of deaths occurred at home and care should be taken when performing daily activities, including using stairs and while bathing.

“Nurse, I Only Had a Couple of Beers”: Validity of Self-reported Drinking Before Serious Vehicular Injury

2002 ◽  
Vol 11 (2) ◽  
pp. 106-114 ◽  
Author(s):  
Marilyn Sawyer Sommers ◽  
Janice M. Dyehouse ◽  
Steven R. Howe ◽  
Kathryn Wekselman ◽  
Michael Fleming
Keyword(s):  
Alcohol Consumption ◽  
Motor Vehicle ◽  
Blood Alcohol Concentration ◽  
Alcohol Concentration ◽  
Alcohol Intervention ◽  
Blood Alcohol ◽  
Traffic Crashes ◽  
The Mean ◽  
Reported Data ◽  
Vehicular Crashes

• Background Of the more than 40 000 Americans killed each year in vehicular crashes, 40% are involved in alcohol-related collisions. Although self-reported alcohol use has become an anchor for alcohol intervention after traffic crashes, clinicians are often skeptical about the truthfulness of self-reporting. • Objective To determine the validity of self-reported alcohol consumption of vehicular occupants hospitalized for a serious, alcohol-related injury. • Methods Non-alcohol–dependent subjects 18 years and older who were injured in motor vehicle crashes were interviewed. The self-reported number of standard drinks, time that drinking commenced, sex, and weight were used to calculate estimated blood alcohol concentration. This value was compared with the blood alcohol concentration measured at admission. • Results Of the 181 subjects, 60% provided sufficient data to calculate the estimated concentration. Seven men with admission concentrations of 10 mg/dL or more denied drinking. Among the 113 subjects with estimated concentrations who acknowledged drinking (excluding the 7 who denied drinking), the mean concentration at admission was 158.67 mg/dL, and mean estimated concentration was 83.81 mg/dL. According to multiple regression analyses, weight and number of drinks accounted for 3% of the variance in alcohol concentration at admission for women (R =0.174, F2,40 = 0.623, P = .54) and for 29% of the variance in men (R=0.543, F2,128 =26.71, P&lt; .001). • Conclusions Most persons who drink before vehicular injury acknowledge drinking. Self-reported data from men generally reflect the overall trend of alcohol consumption but with systematic underreporting. Reports from women are less predictable.

The Tracometer as an Intoxication Warning Device

1987 ◽  
Vol 31 (7) ◽  
pp. 751-755 ◽  
Author(s):  
Y. Ian Noy
Keyword(s):  
Alcohol Intoxication ◽  
Blood Alcohol Concentration ◽  
Drunk Driving ◽  
Alcohol Concentration ◽  
Tracking Task ◽  
Alcoholic Beverages ◽  
Subsequent Test ◽  
Pursuit Tracking ◽  
Wide Range ◽  
Male Subjects

An experiment was conducted to investigate the feasibility of developing an in-vehicle skill-based drunk driver detection and deterrence system. The experiment compared two well-developed psychomotor test devices, the Tracometer and the Critical Tracking Task (CTT), for their ability to detect alcohol intoxication. The Tracometer employed a pursuit tracking task whereas the CTT employed a compensatory tracking task. Twenty male subjects, aged 19 − 30 were trained on the Tracometer and the CTT over a three day period. On two subsequent test days, they were treated with either placebo or alcoholic beverages designed to bring their peak Blood Alcohol Concentration (BAC) to 1.2% (1200 mg/L). On each day, the subjects were tested once before treatment and six times after treatment at hourly intervals as their BAC levels declined. The results indicate that the Tracometer was more sensitive than the CTT to the the effects of alcohol over a wide range of BAC levels. At a BAC level of .08%, performance on the Tracometer deteriorated by 16% whereas performance on the CTT deteriorated by only 7%. Using optimized pass/fail protocols, the Tracometer failed 60% of subjects with BAC in the range .08–1.0%, whereas the CTT failed 34%. At BAC levels above 1.0%, the Tracometer failed about 85% whereas the CTT failed 40%. These results clearly illustrate the potential of the Tracometer as a test of alcohol intoxication. Although the impetus behind the study was the development of drunk-driving countermeasures, the technology can be easily extended to include other applications.

scholarly journals Effects of varenicline on alcohol self-administration and craving in drinkers with depressive symptoms

2017 ◽  
Vol 31 (7) ◽  
pp. 906-914 ◽  
Author(s):  
Walter Roberts ◽  
Terril L Verplaetse ◽  
Kelly Moore ◽  
Lindsay Oberleitner ◽  
Marina R Picciotto ◽  
...  
Keyword(s):  
Depressive Symptoms ◽  
Alcohol Consumption ◽  
Alcohol Use ◽  
Blood Alcohol Concentration ◽  
Alcohol Concentration ◽  
Depression Symptoms ◽  
Self Administration ◽  
Alcohol Craving ◽  
Ad Libitum ◽  
Alcohol Users

Varenicline (VAR) is approved to aid in smoking cessation and has been shown to be effective for reducing alcohol consumption in heavy drinkers. Little is known, however, about treatment moderators that may influence efficacy. The current study reanalyzed data from a human laboratory study (Verplaetse et al., 2016) to determine whether VAR was more effective at reducing alcohol use among drinkers reporting symptoms of depression. Participants were 60 adults meeting DSM-IV criteria for alcohol use disorders ( n = 60) who were randomly assigned to receive VAR (1 mg/day, 2 mg/day) or placebo. Following 7 days of medication pretreatment, participants attended a laboratory testing session. They provided self-reported ratings of alcohol craving and performed an ad libitum alcohol consumption task after receiving a priming dose of alcohol (target blood alcohol concentration = 0.030 g/dL). Higher blood VAR plasma levels were associated with less alcohol craving and less drinking among participants with more depressive symptoms. Among participants with fewer depressive symptoms, VAR was associated with more drinking during the ad libitum drinking task. These findings show that depression symptoms may be a moderator of VAR efficacy in alcohol users and provides evidence for the role of nAChRs in depression and alcohol use.

scholarly journals Factors Affecting Recidivism of Drunk Driving for Car and Motorbike Users

2021 ◽  
Vol 2021 ◽  
pp. 1-16
Author(s):  
Rong-Chang Jou ◽  
Yi-Hao Lu
Keyword(s):  
Life Cycle ◽  
Alcohol Consumption ◽  
Family Life ◽  
Drunk Driving ◽  
Alcohol Concentration ◽  
Family Life Cycle ◽  
Recidivism Rate ◽  
Factors Affecting ◽  
Breath Alcohol ◽  
Drunk Drivers

This study explored the important factors affecting the recidivism rate of drunk driving for car and motorbike users. The respondents were students of Taiwan’s road safety training course, which was required for all drunk drivers who were suspended from driving due to the violation of regulations. The characteristics of the drunk car and motorbike drivers, such as socioeconomic variables, alcohol consumption changes, family life cycle, and changes in the number of trips, were investigated. This study estimated the models affecting the recidivism rate of drunk driving for car and motorbike users with the logistic regression model. The main variables included drivers with a university degree or above who tend not to be recidivists compared to the drivers without one. Such respondents are more willing to avoid the risk of becoming drunk driving recidivists. Moreover, the variables of alcohol use disorders’ identification test (AUDIT), breath alcohol concentration, and frequency of drunk driving all significantly affect the possibility of recidivism. In terms of family life cycle, married respondents with children aged between 1 and 5 are less likely to become drunk driving recidivists. Those who take motorbikes as an alternative vehicle after being suspended from driving cars are more likely to become drunk driving recidivists. This study suggests the measures of suspending or withdrawing car and motorbike driver’s licenses at the same time, using alcolocks to restrict the right to drive, and increasing the frequency of drunk driving crackdowns. In addition, in terms of alcohol consumption behaviors, drinkers with high risks and drunk drivers with high breath alcohol concentrations should be regarded as the key targets for future tracking in order to avoid drunk driving recidivism.

scholarly journals Alcohol unleashes homo economicus by inhibiting cooperation

PLoS ONE ◽  
2021 ◽  
Vol 16 (6) ◽  
pp. e0253296
Author(s):  
Paul J. Zak ◽  
Kylene Hayes ◽  
Elizabeth Paulson ◽  
Edward Stringham
Keyword(s):  
Alcohol Consumption ◽  
Blood Alcohol Concentration ◽  
Alcohol Concentration ◽  
Public Goods Game ◽  
Homo Economicus ◽  
The Public ◽  
Self Interest ◽  
Standard Task ◽  
Socially Motivated ◽  
The Brain

Human behavior lies somewhere between purely self-interested homo economicus and socially-motivated homo reciprocans. The factors that cause people to choose self-interest over costly cooperation can provide insights into human nature and are essential when designing institutions and policies that are meant to influence behavior. Alcohol consumption can shed light on the inflection point between selfish and selfless because it is commonly consumed and has global effects on the brain. The present study administered alcohol or placebo (N = 128), titrated to sex and weight, to examine its effect on cooperation in a standard task in experimental economics, the public goods game (PGG). Alcohol, compared to placebo, doubled the number of free-riders who contributed nothing to the public good and reduced average PGG contributions by 32% (p = .005). This generated 64% higher average profits in the PGG for those who consumed alcohol. The degree of intoxication, measured by blood alcohol concentration, linearly reduced PGG contributions (r = -0.18, p = .05). The reduction in cooperation was traced to a deterioration in mood and an increase in physiologic stress as measured by adrenocorticotropic hormone. Our findings indicate that moderate alcohol consumption inhibits the motivation to cooperate and that homo economicus is stressed and unhappy.

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