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Preventing Impaired Driving During the Holidays

Sometimes it seems as if holiday celebrations and booze are inexorably intertwined, that seasonal parties and alcohol go together like milk and cookies and Santa and his sleigh.
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Family gatherings with hot toddies, office parties with spiked punch, Christmas Day with brandied eggnog, New Year's Eve champagne galas, football and beer on New Year's Day.... The list is literally endless. Sometimes it seems as if holiday celebrations and booze are inexorably intertwined, that seasonal parties and alcohol go together like milk and cookies and Santa and his sleigh.

This is the season for over-imbibing, a joyful time when guzzling booze is socially acceptable and sometimes even expected. (Who among us hasn't been to a holiday celebration where drinks were literally shoved into our hands and we and others were admonished for not immediately downing them?) The holidays are a time when people who rarely drink suddenly partake, people who drink regularly but not heavily consume more than their usual, and people with an ongoing problem feel free to run amok. After all, if the teetotalers are getting tipsy, why shouldn't the drinkers get hammered? Unfortunately, when the party ends, people like to go home. And a lot of those people are in no condition to drive.

The simple facts are a 12-ounce beer, a five-ounce glass of wine, and a shot of hard liquor all contain approximately the same amount of alcohol, and the average adult can process that amount of alcohol in about an hour. Therefore, someone who attends a three-hour dinner party and drinks a martini before dinner, two glasses of wine with dinner, and an Irish coffee with dessert is impaired at evening's end, perhaps rather seriously depending on how large the martini and how strong the Irish coffee. At the very least, that person has consumed four drinks in a three-hour period -- one drink beyond the amount a human body typically processes in that time. Whether this is enough to push someone's blood alcohol content (BAC) past the legal limit will also depend on factors such as the drinker's weight, sex, age, and body composition, but it's more than enough to cloud their judgment and slow their reflexes. And do you really want that person behind the wheel of a car, battling holiday traffic in what may be less-than-ideal road conditions (particularly if you live in a cold-weather state)?

The common term for the person described above is "buzzed driver." He or she may not be noticeably (or legally) drunk, but as a motorist his or her skills are still diminished. He or she is without doubt an "alcohol-impaired" driver. And while alcohol-impaired drivers are not as dangerous as drunk drivers, they are much more dangerous than drivers who've not been drinking. In fact, studies consistently show that the probability of a fatal crash increases steadily with increasing driver BAC -- starting with the very first drink.

So how do we keep people who've consumed alcohol off the roads during the holiday season? If it's not you who's had a drink or two, it's a loved one, a friend, or a coworker. Maybe the person is noticeably inebriated. If so, intervening is usually pretty easy. You simply take away the individual's car keys and say something along the lines of, "Hey, buddy, you're drunk. Why don't you call a cab or ask someone who's not drinking take you home?"

The situation can be more difficult when the individual who's been drinking is not noticeably impaired. A "buzzed" person is much less likely to voluntarily relinquish his or her keys. He or she may say, "I'm fine. It's no problem." Sometimes buzzed people -- foolishly and mistakenly -- argue that they're better drivers after a couple of drinks because "they're on their toes, paying attention because they don't want to get pulled over." The fact that they can make that argument with a straight face is a pretty good indication of how clouded their judgment actually is! One useful trick is to remind these folks that local law enforcement agencies nearly always step up their drunken driving patrols during the holidays. You can even outright lie if you need to, saying something like, "My pal the police officer told me on the sly that they've set up roadblocks tonight." The fear of arrest will cause most people, even buzzed people, to exercise caution.

Happily, there are numerous other steps you can take to protect buzzed and/or drunk individuals from their own bad judgment. Most of these steps involve setting ground rules for the party in advance. For instance, if you're throwing an office party that includes booze, make it a rule that to get your first drink you must relinquish your car keys, and make sure everyone knows the company will pay cab fare or otherwise provide rides so drinkers can get home safely after the party. At family gatherings and neighborhood parties, make sure everyone knows up-front that anyone who drinks, even a little, will not be allowed to drive home. Ask around before the party to find out who doesn't drink -- there will be more people than you think -- and enlist them as designated drivers. If you have teenagers with driver's licenses, hire them as a taxi service. You'd be surprised how much fun they'll have babysitting the "sloppy" grown-ups! Plus, it's a great way to subtly teach "monkey see, monkey do" kids a lesson in responsible drinking.

Of course, even with precautions, someone will get behind the wheel of a car having had one drink too many. Hopefully the worst that will happen is he or she ends up in jail for drunk driving. If this person has an obvious problem with alcohol, this is an excellent time to leverage their predicament by refusing to bail them out until they agree to go straight into a treatment center, or at least to a certain number of AA meetings. You might consider planning an intervention when the rest of the family is in town. Most alcoholics need to hit a "bottom" before they become willing to face their problem, and for many the humiliation (and expense) associated with an arrest can serve as the needed catalyst. If you truly care about this person, now is the time for action.

David Sack, M.D., is board certified in addiction psychiatry and addiction medicine. As CEO of Elements Behavioral Health he oversees a network of addiction treatment centers that include Malibu drug rehab Promises, The Ranch outside Nashville, The Recovery Place in Florida, and the Right Step and Spirit Lodge in Texas.

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