This past Friday I was honored to be a presenter at the 2015 Oregon DUII Multi-Disciplinary Impaired Driving Training Conference. Unfortunately, due to a nasty cold, I was only able to muster the energy for one session instead of my planned two, which was a bummer. The talk, despite my low energy, was important to me because every year about 100 people die in alcohol-related driving accidents.
For those who attended my presentation, thank you! And for those who missed it, hopefully I can return to give it again. In the meantime, my Reducing the Risk of Drinking and Driving presentation is available. A few key takeaways from my talk:
- A significant number of fatalities involve males, aged 21 to 30, who drink chronically and often have multiple DUIIs. As a population, we need to engage this group in longer term treatment (years not months) that includes a focus on treating underlying trauma.
- Oregon has a significant problem with prescription drug abuse, despite the trend of pharmaceutical companies introducing tamper-resistant formulations into the market. The unintended consequence of this action, has been a significant rise in abuse of heroin. The FDAs primary antidote has been REMS, which I had no time to discuss in my talk. If you’d like to learn about REMS, read my article,”REMS Rethinking the Public Response to Drug Overdose Death” on the blog “A” is for Addiction.
- I am no expert on public policy specific to marijuana, but what I do know is that the research is clear it is not good for young, developing brains! As Oregon leads the way in decriminalizing pot, we must keep our eye on how best to protect our children. About seven percent of high school students smoke pot daily, and many more have used it in the past 30 days. Better access and treatment for adolescents is critical.
- I am a huge fan of CRAFT, which stands for the Community Reinforcement and Family Training Approach, and encouraged all in attendance at my talk to learn more about it. It’s a wonderful, evidence-based intervention for family members of addicts that I believe every treatment provider should offer as a service.
- For those who struggle with addiction, shame is at the heart of the individual consequences. It fuels continued drinking if treatment does nothing to resolve it. Unfortunately, very often interventions to reduce DUII increase shame, deepening the internal voice that “I am a piece of crap.” As a group wanting to reduce the risk of DUII in our communities, we need to discuss how to implement interventions in the least shaming way.
- One of the most important leverage points I spoke about was the need for treatment to implement developmentally-based psychotherapies. So often those who struggle work hard in treatment to get abstinent, only to relapse shortly after discharge because emotionally they remain a child, stuck at the developmental age of when they first experienced trauma. It’s very challenging holding a job, being in an intimate relationship, and raising children if you remain a child yourself. A big key in doing this work is engaging in emotion beyond talk therapy.
- As a system, we tend to see the worst in those who drink and drive. We pathologize our clients, seeing them through the lens of their diagnoses and DUIIs. I have long believed that everyone has innate talents and a contribution they can make to society if they are awakened to their purpose. We must balance our efforts at intervening on problems, with time spent helping our clients create the life they really want. Our interventions can still be evidence-based, coming straight from the field of positive psychology!
To wrap this up, my hat’s off to the collaborative group of dedicated folks who come together every year to engage in ways to make our streets safer from intoxicated drivers. It’s not an easy task bringing together law enforcement, prosecutors, prevention and treatment experts, the OLCC, and many others – so those who make it happen I applaud you!
I personally thought there were more than 105 fatalities each year due to drunk driving. I thought it was a lot higher than that. This post about DUI’s really interested me because there are a lot of people in my family who drink. A member in my family drinks every single day. I have never seen him not drinking a beer. He would even drive with a beer. And it wasn’t just one or two a day, it’s like a 12 pack a day. He was always the fun one taking the kids to the river or up to the snow. He would allow his kids friends to come and still he was drinking and driving. I find it crazy to say he has never had a DUI. Even when he was pulled over they couldn’t tell he had been drinking. To be honest I was always scared to go in the car with him but nothing bad ever happened. The bad thing about this is it reinforced the people (mostly kids) who were there to see him drink and drive and nothing bad happen for them to do the same. I would never do this but I hope everyone else feels the same. And I pray nothing bad happens to this family member of mine. And I pray he doesn’t harm another.
Katie, thanks for the comment. It’s true that many who drink have a high tolerance that only well-trained experts can detect. And that people can go for a long time drinking and driving without problems. But all it takes is one death to change life forever… hope he changes his ways and gets the help he needs sooner rather than later.
J
Dr. Fitzgerald,
This post has been a recent topic of discussion in my Drug Education course at PSU. I would like to note on your first bullet point, if people have multiple DUII’s they might have an addiction. Addiction can be a lifelong process for many individuals. For some people years may still not be enough time for them. About your section on marijuana, I agree with you that it is not good, in my opinion for anyone. But when marijuana becomes legal in Oregon, it can only be sold to those 21 and over and these individuals are not so young. Addiction is something that hits home with me, I have family members who have and some that still are dealing with addiction. I recently read the book TWEAK, which taught me a lot about addiction. One important thing is that support from a community can help a huge deal. In the DUII communities, this could also help, there is less of a feeling, “I am a piece of crap” since people there have/are going through the same. I also think that each individuals feelings should be kept in mind when receiving treatment for addiction or seeing help for anything.
-Elizabeth Garcia
Let me start off by saying this was a great article with good information. One question I had was, I’ve heard before and you mentioned it again in the article, that people with alcohol problems need more then months in treatment, in fact need years of treatment. My question is, how do we fund someone going through rehab for years? I think there are rehab centers those are nonprofit and free for use, how would they fund for a patient to stay in rehab for years? Even for people who pay for there rehab, people want to leave right when they feel they are cured, how would anyone convince them to stay in the rehab for years?
I found this blog post very interesting. Being 21 years old, I know plenty of people in my age group that drink and drive. I know someone who got a DUI in 2013, years later that person still doesn’t have their license. She got in a car accident and the car was totaled. She was told she was lucky that she lived. Since her near death experience, she has been in a lengthy program to assist with getting her license back. But to this day, she still drinks and drive. I believe that she should’ve been in a program that helps her with her alcohol problem rather than a program that is just going to help her receive her license back.
I really liked that you wrapped up the article describing how people tend to see the worst in those who drink and drive. I know several great human beings, that I have found out after how awesome I thought they were, about a previous DUI. Every time it shocks me that someone that I look up to, or truly admire has had a DUI. But this goes along with how everyone has a contribution to society, and people really do make mistakes. We just have to make sure that we don’t define people by their mistakes made in the past, and people really do change.
I found this blog to be interesting because it covered a topic that I personally did not know a lot about. Just as Katie stated in the first comment I would have guessed there to be way more deaths per year due drinking and driving then 105. Although that still is significantly high number, also this blog was a gate way to more information regarding drinking and driving. But I also had question, what do you feel about the drinking age and would you change to 18 if you had the power to? This was one of the topics of discussion in my drug education class and I would like to know your perspective on the matter
“We” don’t fund it, it gets paid by the person who has received the multiple DUIIs. One model of this is drug courts where people often are in treatment at least one year and working full time to pay for “outpatient” treatment – not expensive residential treatment. Hope this clarifies.
J
Shayna, well said! Thanks for the comment.
J
Darien, research suggests that “age of first use” is a more notable metric than legal drinking age. The earlier someone starts the more likely they are to struggle with alcohol problems later in life. So I might put more emphasis on discussing how to prevent early drinking, but that is really another way of saying I don’t know the answer to your question :)
J
Dr. Fitzgerald,
When I first clicked on this blog entry, I fully expected you to be bashing those who drove drunk. I expected you to pull at my heart strings, as so many have done before, telling me a story about a person who had lost a loved one due to a drunk driver. But that is not what this article is about. And I’m so glad.
As a student who is going into the health profession, this article has made me rethink my own approach to reducing the risk of drinking and driving. You words on the importance of not shaming those who drove drunk really stood out to me. How many times do we do this? Does this fix the problem at all? Of course not. But what does? You presented suggestions of what we can do as a society to eliminate drunk driving: targeting the population that is most at risk, implementing a long -term program, and getting communities involved. Together we can reduce deaths by drunk driving. This gives me hope and encouragement to see a new approach to this issue and I hope I will be able to put some of this perspective into my own practice.
Thank you,
Shelly-Anne
Thanks for the nice feedback! And thanks for taking the comments and moving them forward in a productive and actionable way, your efforts will make a difference.
J
Drinking and driving is a real sore spot for me. Last year my mom was hit head on by a drunk driver at 12:30 in the afternoon! My mom was taken by Lifeflight to the local trauma hospital and spend 5 days there. She is still plagued by the injuries she received. The woman who hit her had a total of “5” DUI’S with one of those being just 6 days before she hit my mom. Clearly this is an individual story and it did not occur here in the state of Oregon, however it was a very traumatic time for us.
Clearly this woman had an alcohol problem and could not/ would not shake it. I am curious as to how we can hold people more accountable when they are repeat offenders with out adding to our already overcrowded correction facilities. I would be nice if we can rehabilitate individuals before they seriously injure or kill someone.
Thank you for your input in here. As a resident of Oregon I am always curious how we compare and where our weaknesses are. I feel that this is a good resource to find that information.
Meghan, thanks for your comment. Understand why this topic brings up pain for you, as it does for anyone who has been a victim of drinking and driving. There are no simple answers. Even when someone is not supposed to drive legally, has their car impounded, and faces serious consequences for drinking and driving, once drunk, reason goes out the window and people do get behind a wheel, even when the car is not their own. The only way to ultimately prevent such behavior is to intervene at the level of the individual struggling with alcohol, and do a better job of treatment – which is the purpose of my website. Just because someone has 5 DUIs does not mean they have ever received good treatment. In your case, the woman who hit your mom likely suffers from underlying untreated trauma (and likely other co-occurring disorders), and continues to drink because she has no other way of regulating her internal emotional world. This is not an excuse for her behavior and what she did to your mom, but we must find constructive ways to move forward in society with this problem, and improving treatment seems like an important leverage point.
J
I absolutely agree that there needs to be longer treatment sentences for young males that receive DUI’s. I feel that they should have to speak with victims and families effected by drunk drivers so to further drive home how serious the charge is. It’s obvious that penalties for them the first time around aren’t discouraging them from doing it again and this needs to be addressed. If they’re not already, I also suggest educating young men after they receive a DUI that their demographic is most likely to be involved in fatalities. Hopefully some form of additional treatment can help reduce the number of these incidents.
One thing I greatly appreciate about this blog post is that there is a different light shone on drinking and driving and those who make the decisions to do so. If a person’s mentality is not matured then they are stuck at an immature state without the capabilities as a matured brain. Those who have multiple DUII’s should be looked at as someone who needs help from those who care about them. People who have suffered multiple consequences as a result of alcohol intoxication should seek help before it is too late. Someone very close to me recently passed from alcoholism and because he had multiple consequences occur to him due to consuming alcohol it did not stop him. What he needed was help and support from those close to him to try to stop the addiction and get him healthy again. With statistics such as 6,699 DUII in Oregon in 2013 and 105 alcohol-impaired driving fatalities there is something else that must be done. I believe that education is the greatest way to inform our citizens.
I love this post and feel it moving. I would love to get involved in my community to help young adults find helpful resources for their alcohol problem. I found it interesting that there is only 100 deaths year in Oregon from drunk driving. The media helps make that number seem like much more. I do really want to give an applaud to those that are digging deeper to discover the under lying problem of those that have committed multiple offenses. I also think that all people have a “innate talent”, and some need to experience trust within someone else, helping them shine through the rough roads of the past. I do see this being one of the most beneficial ideas that I have heard in a long time, combined with all other services. Thank you!
I too assumed that there would be many more than 105 alcohol related deaths while driving. As a volunteer firefighter I have seen many wrecks, some with alcohol and others with drivers obviously high on something. It’s shocking that this number is this low. The point on marijuana is also of interest with the new laws in oregon being passed allowing for residents to legally smoke. This will more than likely have some affect on the number of people who are driving impaired, I’m curious to see how this will affect the number of wrecks and or deaths associated with this drug.
I don’t have much experience with alcohol. In fact, I’ve only tasted it once. So, my credibility may be lacking, but I have seen the effects that it has on the individual through repeated occurrences of binge-drinking from my friends at parties and other social gatherings. A great friend of mine struggled with the gripping effects of alcohol and made awful choices that caused her dearly. From making choices that would scar relationships to endangering her own life, a lot was had in the scope of trying to overcome the noxious, alcoholic beast. But you make a really good point in your article that sums up her battle; shame is at the heart of the individual consequences. She needed encouragement from us, from those who stood on the outskirts of those pointless parties, not the shame that comes from a bruised self-perspective. People would sneer, she would cry. People would talk, she would stay silent. There is no way out of the trap that is alcohol unless there is a loving and unconditional support from those who are willing to sacrifice their time and effort. She needed accountability, and she eventually got it. Over time, with the help from friends and family and all their encouragement, she ascended beyond the pits and reached new heights in life. Her conquest to drop alcohol was successful, and still today she is living a strong and healthy life. The point of this comment is just to acknowledge and agree with the fact that self-worth is so important to overcoming alcohol abuse, and we all ought to join the struggle of overcoming it together.
Hello Dr. Fitzgerald I do agree with you on the treatment for DUI’s, because if you look at it many of the offenders do have multiple offenses for driving while intoxicated. Pretty much their first time going before a judge is a slap on the wrist unless someone was injured or killed. But I think that they should have their treatment like probation for at least a year because with the probation they have to go in and see their probation officer or counselor. And also I think that they should add a tracking device on their Id or driver’s license so if they tried to buy Alcohol the computer would let the seller know not to sell to that individual. This would also bring in more jobs for counselors and treatment providers in turn lowering the state’s unemployment rate. To me it’s like killing two birds with one stone, getting help for the DUI and also providing jobs for the state’s unemployment to drop.
I find it really interesting about the number of deaths that related to alcohol. So far this year as a witness I’ve seen more than 10 people that know me or i know them through friends have died because of drinking heavily. I was born in Asian family and as you know, asian people drink crazy. My dad, he’s been drinking for almost 25 years consistently; however, I really am happy and respect because he’s really responsible about what he does. If he has EVEN 1 drink, he would never drive and of course either he sleeps at his friends house or he ask someone to drive him home. Based on my personal experience, I think drinking is fun and relax but people need to understand how to act responsible after drinking. I really like your blog because its really informative, you states your opinion right away at the beginning of the blog.
Dr. Fitzgerald,
While most DUI articles that I have read, address the problem with drinking and driving, they leave out the importance of addressing the problem from the root. When one is convicted of drinking and driving they are punished. They attend a series of classes where the main goal is to get back privileges; a license to drive. If there were more long term treatment options for those that partook in drinking and driving, that focused on the individual I believe that we would have less re-offenders.
Hello Dr. Fitzgerald,
This article really hits home for me because I have actually had two DUII’s. My first one was when I was 22 and all I got was a slap on the hand and didn’t even lose my license. My second one, on the other hand, was another story. It cost me over $11,000, lost my license for two years, went to jail for five days, and was in treatment for a year. It was absolutely humiliating but I actually don’t regret it and here’s why- I stopped drinking. I feel as though I am the luckiest person alive to not have killed someone else or myself while drinking and driving. For some reason I got another chance and it was time for me to do something about it. I really like what you said about shaming people who drink and drive. It took a long time for me to not feel like “a piece of crap,” but through treatment, I was able to let that go and make the necessary changes in order to feel good about myself again.
Thanks for the comment Brandon, and for recognizing the importance of rooting out shame and moving on with life despite past mistakes.
J
Thank you Dr. Fitzgerald for giving our society this important information. I have used this and many other drinking articles to try and help my children’s father to stop drinking. He is 27 and has been drinking on and off since he was 18. Both, from his mother’s side and father’s side of the family have heavy drinkers. I only fear that he is going down the same path. He used to drink wine coolers, like Mikes hard lemonade and then went hardcore wine for a month, a bottle a day and then stopped. After a while he went to Mikes again and just recently i have found Hennessy bottles in the fridge. I asked why he is drinking dark hard liquor and he just says because he wants to. I was told by a store clerk that alcoholics tend to switch up from one drink to the next and i never realized he did that until I talked to the clerk and now I feel it is a big issue and only going to get bigger.
He has never had a ticket or gotten in any trouble what so ever so my question is, should I be concerned? If so do you think this long term treatment, years of therapy, would be a benefit to him? I feel that he should go head on with the issue of drinking until it gets worse and he is head on with another vehicle.
Thank you for all your posts and information you share.
Yes, given what you have said, he would benefit from treatment. His answer about just wanting to drink is only partially correct. Part of him wants to keep drinking because drinking works to numb life, but other parts of him know he is doing damage to himself and others. But if he is not motivated to enter treatment, then finding a way to increase his motivation is key. Read helping a love one for more information on how to get him to seek treatment. Best of luck.
J
I agree with you that marijuana is not good for young, developing brains, but it’s really hard to control youths also young adults as well, since it is legal to buy at any stores. I just wonder how can we educate young people while they know that is no good for them, and the bad effects of it. I think each of us is a part of how to convince and help people out of trouble even though they have their own ways to escape the problems. If I can, you can, then we can!
I agree with everything mentioned, however I do think that another reason behind people not admitting they have an addiction is denial. Many assume that what they are doing is normal because they are functioning addicts. For example, an alcoholic who drinks day to night but is doing well at work and hasn’t gotten a DUI (yet) may think that they don’t have a problem. I think it’s essential for people to recognize what qualifies as an addiction.
I somewhat disagree with the second to last point you had mentioned in regards to people remaining emotionally as a children. I believe that there may be some individuals who fall into this category, and I do believe that there is always an underlying issue when it comes to any addiction but I’m not too sure what would qualify somebody into being “emotionally like a child”.
And lastly, the points you mentioned are great but the next step is to actually implement them through programs in schools, rehab, and perhaps harsher DUI laws.
Thanks for the comment. It may be denial, but in my experience it is more ambivalence. When push comes to shove, most I have worked with are not in denial, they will admit that drinking and driving is not good. At the same time, they also admit they can’t stop, but would like to live life differently if they could. When I say “emotionally like a child” it is a way for people to understand developmental constriction. If the image of an emotional child does not work for you, no worries, then you must delve a bit more into understanding what early adverse childhood experiences do to stunt emotional development. And as to your last point, implementation as you say is key, but not so easy to do.
J
I really enjoyed reading about your more wholistic view of addiction. While I don’t personally know anyone with an addiction, the CRAFT model you described sounds incredibly powerful. From what I do know about addiction and abuse, I can gather that the families of those struggling are often deeply affected. Addiction and abuse are lifelong battles and it seems critical that people’s families have the tools to help them throughout their lives.
Your first bullet point was also incredibly interesting. I had no idea that a significant number of fatalities involve males, aged 21 to 30. I find that pretty concerning considering that it also sounds like people in that group generally have multiple DUIIs. Clearly the treatment that we’re using at present isn’t very effective, otherwise this wouldn’t be the case. I’d love to know how you think we could engage this group in a more effective manner. Males between those ages don’t tend to be the most engaged with any type of drug or alcohol education and it’s been hard to think through how engagement could be increased with that group. Is there anything you’ve seen work well?
Thanks!
Yes! The Five Actions approach :) Here is a summary: http://addictionmanagement.org/5-actions/
J