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Addiction, Health Policy, In the News

The frightening rise of drugged driving

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As if the thought of drivers who are drunk or texting isn’t enough to make you anxiously tighten your grip on the steering wheel, two just-released government studies show that Americans are increasingly driving under the influence of drugs.

The National Highway Traffic Safety Administration recently reported that 18% of drivers who died in car accidents in 2009 tested positive for legal or illegal drugs. And that figure is actually quite conservative, because it assumes no drug use by the drivers in the more than one-third of fatal crashes in which no drug tests was conducted.

Resonating with these disturbing results, a national survey by the Substance Abuse and Mental Health Services Administration showed that 10 million Americans admitted to driving under the influence of illegal drugs in 2009. Again, this is a conservative estimate because many people who drug and drive are not going to admit it in a government survey.

Because the amount of drugs Americans use (both by prescription and illegally) and the amount of miles they drive both rose from 2008 to 2009, the increase in driving under the influence of drugs is perhaps to be expected. But that, of course, doesn’t make it safe. Certainly, some people with legal or illegal drugs in their system crash for other reasons, but no reasonable person would dispute that 10 million (or more) drug-intoxicated drivers on the roads poses a grave risk to public health and public safety.

How can we respond to this problem? With drunk driving, public policies that increased the drinking age, punished convicted offenders more consistently and promoted safe-server training in bars and restaurants all helped reduce the problem. But fundamentally, there are simply too many cars and too many drinking opportunities in a nation of 300 million people for public policy to be the sole or even primary source of our success at reducing drunk driving: Government simply can’t be everywhere. What mattered the most was a transformation in widely shared cultural norms, knowledge and values.

In the Mad Men episode Red in the Face, Don and Betty Draper make sure their heavily drunken friend Roger Sterling has one more for the road, and stand at the doorway and laugh as he tries to get into the wrong car and then drives off in darkness with the headlights off. That is an accurate reflection of attitudes about drunk driving that are mercifully behind us. Today, Don and Betty would cut Roger off, or drive him home, or call a cab, or cajole him into sleeping on their couch.

We need to expand such cultural norms, knowledge and attitudes to include driving under the influence of drugs. Health professionals can aid this process by more consistently letting patients know that a number of prescribed drugs can impair driving ability, particularly if they are abused or combined with alcohol. If we don’t start taking drugged driving as seriously as we do drunk driving, the former may someday outstrip the latter as a risk to our collective safety.

Addiction expert Keith Humphreys, PhD, is a professor of psychiatry and behavioral sciences at Stanford and a career research scientist at the Palo Alto VA.

Photo by rocknjosie

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