When it Comes to Driving Drunk, the Rest of the World Must Think We’re Nuts

It seems like we here in the United States are reluctant to learn anything from foreign countries. That indeed is the case where healthcare is concerned. For example, the cost of such care runs to nearly twice that of other countries regarding GDP and the results are the most dismal of nearly all of the industrialized nations of the world.

The underlying issue with drunk driving is alcohol use, period. The scientific literature bears this out. The widely respected British journal The Lancet, which is among the world’s oldest, most prestigious, and best known general medical journals in the world, just published a study this year about the risks of alcohol use. The Lancet declares flat-out that in 2016, alcohol use led to 2.8 million worldwide deaths and was the leading risk factor for premature death and disability among people aged 15–49 years and that their results show that the safest level of drinking is none. Traffic crashes are a part of the mix for this stunning set of findings.

But specifically, this is a blog about drinking and driving. So, since drinking is an a priori condition of drunk driving, what is the experience of other countries with respect to alcohol consumption and then getting behind the wheel? Interestingly, the European countries, (Spain, England, France, Germany, Belgium, the Netherlands, along with Russia, China, and Australia drink more than us in terms of overall per capita consumption. In the communist-led countries, the opiate of the people turns out not to be religion but rather booze! Persons who are citizens of the Muslim diaspora broadly speaking are those who drink the least. But when it comes to drinking and then getting behind the wheel, Americans are among the worst violators in the world. It turns out that drinking and driving is about normative behavior—a sort of cultural okee-dokee that says that drunk driving behavior ought to be tolerated somehow and that the risk in doing so is acceptable in this freedom-loving country.

The residents of many other countries do not drink and then drive anywhere. Last year a friend of mine, born in the UK but now a naturalized U.S. citizen, spent some time in Ireland. He is known to frequent a pub or two while in that region and had occasion to observe the behavior of the local patrons there. What he came away with are two things: first, that drinking during the week was uncommon on the part of most, and; that if one were drunk or even impaired, there was no social stigma in calling a cab or finding another way home. In fact, that norm was the rule and not the exception.

Sweden has had a ≤ .02 g/dl legal limit since 1990 compared to that of the U.S. legal limit of ≤ .08 in all 50 states. Among 19 European countries, Sweden has the lowest self-reported percentage (at 2%) of drivers who state that they may have been over the legal limit for drinking and driving at least once over the last month while Cyprus and Italy have the highest at nearly 35%! But in no case, is the legal limit in those 19 countries over .05.

And there’s more. Of all automobile crashes where alcohol is a factor, the United States ranks third in the world at 31% of all crashes resulting in death, followed by Canada at 34% and South Africa at 58%! Following the they-don’t-drink-and-drive-in-Europe thesis above, France follows in fourth at 29%, Italy at 25%, the UK at 16% (includes Ireland), Germany at 9%, Russia at 9% and throw in China at 4%.
All of this is to say that foreign countries do a better job of holding down drunk driving crashes that result in death (and by extension, injury as well). How do they do it? The Swedes led the way in 1990 by lowering the legal limit to .02, improving road design, limiting sales or access, and heightening drunk driving penalties and law enforcement. To be fair, the U.S. has adopted a few of these strategies in its national Toward Zero Death’s (TZD) campaign. But after years of working with this campaign and even road improvements over time, the data doesn’t lie: we still lead the categories cited above.

America, can the rest of the world still teach us something about preventing and ameliorating drunk-driving? Europe, China and the rest, do you have something to teach us? It isn’t hard to teach; it’s just hard for us to learn.

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