Alcohol-Related Laws and Avoidable Burden and Its Costs Due to Motor Vehicle Collisions in Canada
Popova, Svetlana, Patra, Jayadeep, Sarnocinska-Hart, Anna, Gnam, William, Mann, Robert E., Rehm, Jürgen, Contemporary Drug Problems
Despite the important decreases in the past two decades in the levels of impaired driving and alcohol-attributable motor vehicle collisions (MVCs) in Canada, drunk driving remains a serious problem, especially among young drivers (Traffic Injury Research Foundation of Canada, 2009). According to the Canadian Addiction Survey, approximately 21% of those aged 15-24 reported driving under the influence of alcohol and about 33% having been a passenger in a vehicle driven by someone under the influence of alcohol in the previous 12 months (Flight, 2007). MVCs were the largest cause of death among 15-24 year old Canadians, accounting for 31% of their deaths in 2003 (Mothers Against Drunk Driving, 2006). The largest age group seriously injured or killed in alcohol-attributable MVCs was those aged 19 (MADD, 2006). Among drivers killed in 2006, 38.2% of 16-19 year olds and 45.4% of 20-25 year olds had been drinking. Approximately 33% of the 16-19 year old and 38% of the 20-25 year old fatally injured drivers had BACs greater than 0.08% (TIRF, 2009).
It was estimated that acute care hospitalizations due to alcohol-attributable MVCs accounted for $26.1 million (1.8%) of the total alcohol-attributable costs for acute care hospitalizations in Canada in 2002 (Rehm et al., 2006; 2007). In 2006, alcohol and/or drugs were involved in 1,278 traffic fatalities, 75,374 injuries, and 163,893 property-damage-only crashes in Canada (Mercer, 2009). The total financial and social costs of these losses were estimated to be as high as $12.8 billion (Mercer, 2009).
The purpose of this study was to estimate the avoidable burden and cost of alcohol-attributable MVCs that could be achieved with the implementation of effective populationbased interventions to reduce alcohol-impaired driving in Canada.
This study is part of a recent study on the avoidable cost of alcohol abuse in Canada (Rehm, Gnam, Popova, Patra, & Sarnocinksa-Hart, 2008), which is one of the first attempts to systematically estimate the avoidable costs of alcohol abuse with implementation of effective public policies aimed at reducing alcohol-attributable harm (the only similar study was recently conducted by Collins and Lapsley for Australia (2008)). This study also pioneers the application of the methodology from the first International Guidelines for the Estimation of the Avoidable Costs of Substance Abuse developed by world experts in the field (Collins et al., 2006). A brief description of the methodology will follow; however, a detailed report with study methodology is available at the Centre for Addiction and Mental Health website: http://www.camh .net/News_events/News_releases_and_media_advisories_and _backgrounders/Avoidable_costs_study.html.
To estimate the avoidable alcohol-attributable burden and costs of health care, criminality problems, and indirect costs of lost productivity due to disability or premature death attributable to alcohol-attributable MVCs, we used one of the approaches recommended by the first International Guidelines (Collins et al., 2006), which is based on the outcome of proven-effective major interventions. Based on this approach, we modeled the hypothetical impact of the following three effective and cost-effective alcohol policy interventions relative to baseline (aggregate) costs obtained from the Second Canadian Cost Study (Rehm et al., 2006; 2007): (a) lowering the blood alcohol concentration (BAC) legal limit from 0.08% to 0.05% (a measure supported by the Canadian Medical Association (Canadian Medical Association, 2002); (b) introducing a zero BAC restriction for all drivers under the age of 21 (i.e., up to the day before their 21st birthday); and (c) increasing the minimum legal drinking age (MLDA) from 19 to 21 years. The effect of lowering the BAC level was modeled for the Canadian population older than 15 years of age, and the zero BAC restriction and raising the MLDA were modeled for those individuals in the 19-21 age group (in Alberta, Manitoba and Quebec from 18 years of age). …