Why Are DUIs Down When Addiction Is Up?

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This article was originally published by The Fix.

Many efforts went into reducing drunk driving. This success may have something vital to teach us about controlling addiction. Someone should figure out what it is.

Is drunk driving going out of style? In the last 20 years, alcohol-related traffic deaths have been cut in half. Between 1982 and 2001, according to the National Institutes of Health, reductions in driving after drinking saved more than 150,000 lives—more than the total saved by increases in the use of seat-belts, airbags and helmets. This is almost unprecedented progress in a field where statistics—for instance, only 10% of people who need treatment get it—are often grim.

Although many different programs have been aimed at reducing DUIs, no one really knows what works. In the 1980s, the national drinking age was raised to 21. More recently, almost every state has made a blood alcohol level of .08 the cutoff for illegal driving. A combination of increased legal penalties, police education, and advances in technology—more portable breathalyzers and car ignitions linked to breathalyzers—are all certainly part of the picture. In 2006, Congress passed the STOP Act (Sober Truth in Preventing Underage Drinking), and although 3,700 deaths a year are still caused by underage drinking and driving, federal interventions such as STOP have also made a difference in the plummeting DUI numbers.

At the same time, the nonprofit Ad Council’s public service ads have made the role of designated driver seem cool, and Mothers Against Drunk Drivers (MADD) have pressed their campaigns, including one that succeeded in New York State in passing Leandra’s Law—mandating 15 years in prison for an adult who kills a child while driving drunk. Passed in the wake of the horrific 2009 Taconic Crash, in which four children were killed in a car driven by their mother under the influence of alcohol, the law is named for 11-year-old Leandra Rosado, who was also killed in a car driven by a drunk driver.

Some states are going further to crack down on drunk driving. Last month, a law sailed through the New Mexico legislature that would stop anyone who has been sentenced to using an ignition interlock device, which tests the driver’s blood alcohol level before the car can start, from buying liquor. State Rep. Brian Egolf was inspired to write the legislation when he noticed a man buying whiskey miniatures and a Coke. Then the man blew into the interlock device, started the car, poured the whiskey into his Coke, put it in the cup holder and drove away.

Other addictive behaviors are also becoming less common as a result of public health measures. Since the 1990s, smoking cigarettes has diminished nationwide in the wake of a raft of regulations that make lighting up increasingly inconvenient, expensive and unattractive.

If an addictive behavior is made expensive, inconvenient and socially unattractive, it seems to diminish.

In the past decade, obesity has been declared an epidemic. First Lady Michelle Obama has made it her no. 1 cause, and federal health officials and many states have backed menu labeling and other public education measures. In New York City, Mayor Bloomberg has launched one of the nation’s most controversial crusades, including requiring chain restaurants to post the calories of each food item and instituting a band on giant-size sugary soda. The courts overturned both measures after suits by the restaurant lobby, but the calorie counting ultimately succeeded. The courts have temporarily halted the soda ban, which was wildly unpopular with many New Yorkers. For his efforts, the mayor has been mocked for trying to turn the city into a “Nanny State.”

When the government attempts to control public health problems through what most experts view as common-sense restrictions on behavior, many Americans often howl that their personal liberty and freedom of choice are under attack. Nevertheless, it is clear that the clever application of laws and education can reduce the incidence of harmful behavior. And as the DUI and smoking issues show, over time most Americans come to accept the restrictions as rational and cost-effective.

Is it just a matter of time until we become a nation that eschews unhealthy habits and embraces moderation in all things?

That certainly isn’t the lesson of history. Although Prohibition cut down on American drinking, it also had dreadful side effects, ranging from the marketing of poisonous replacements for booze to the development of organized crime. The war on drugs has also been a disaster, failing to limit drug addiction while swelling the nation’s incarceration rate to the highest in the world. (Imprisonment for drug offenses has increased 12-fold over the last three decades to nearly 500,000 by 2010, accounting for two-thirds of the rise in the federal inmate population since 1985.)

Perhaps the secret to improving the lives of all of us is to take a combination of measures to limit addictive substances but not to outlaw them. That seems to have worked with DUIs (although legal penalties were increased). Raising prices on cigarettes has been effective, and many studies have shown that upping the cost of alcohol has reduces the amount consumed. If an addictive behavior is made expensive, inconvenient and socially unattractive, it seems to diminish.

But anyone who has struggled to get sober has to wonder whether a true-blue addict or alcoholic can really be deterred by the barrier of…inconvenience? Perhaps the DUI crackdown has changed the behavior only of everyone who is not an alcoholic. Perhaps no rational measure can keep the 10% of the population who are alcoholics from getting behind the wheel when they are drunk. (Their drinking has many other destructive effects on themselves and others.)

Whatever the answer, thousands of lives have been saved by legal and social campaigns against drunk driving. That may be the best we can do for now.

Susan Cheever, a regular columnist for The Fix, is the author of many books, including the memoirs Home Before Dark and Note Found in a Bottle, and the biography My Name Is Bill: Bill Wilson—His Life and the Creation of Alcoholics Anonymous.

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