Nursing Consideration for Driving During Drinking

Drinking and Driving Among Adolescents

    Drinking
and driving is rooted in the central role that alcohol plays in American life
and culture. Alcohol is commonly found at celebrations, parties, and leisure
activities. In addition, advertisements on television, magazines, and
billboards present messages that shine a positive light on drinking. 

    Given this
situation and despite drinking laws, adolescents drink and drive, and
adolescents who have been drinking are involved in fatal crashes at twice the
rate of adult drivers (National Highway Traffic Safety Administration, 2002). 

    Thirty percent of youth aged 15 to 20 who were killed in automobile accidents
had been drinking (National Center on Addiction and Substance Abuse at Columbia
University, 2002).

Drinking and  Driving and Nursing Care

    Six
articles on drinking/driving were published in the nursing literature from 1995
to 2001. No nursing publications were uncovered on drinking/driving for 2002
and 2003. Only two of the six focused on drinking/driving among adolescents
(Kuthy, Grap, Penn, & Henderson, 1995; Shreve, 1998). 

    Kuthy and colleagues
evaluated a 20-minute program showing pictures of automobile accidents to
determine if there was a change in drinking/driving behavior after the program. 

    One month after the program a telephone interview indicated that the 274 high
school driver’s education students showed a significant change in
drinking/driving behavior. Shreve evaluated a student drinking/driving
prevention program with 39 students. 

    Following the program, 40% of the students
indicated they would change their behavior. It can be concluded that little has
been published in the nursing literature on drinking/driving and there are no
studies focusing on intervening in drinking/driving situations. 

    However, health
promotion is a major goal of nursing, and investigating intervening as a passenger
in drinking/driving situations may offer approaches to change behavior that may
prevent the injurious consequences associated with drinking/driving among
adolescents. 

    In a national study of 10,277 drunken driving fatalities, Isaacs,
Kennedy, and Graham (1995) found that in 5% to 10% of these cases there were
superior passengers who could have intervened. Furthermore, helped of the
fatalities in persons 16 to 19 years of age had at least one sober passenger in
the car who could have intervened. 

    In a study of adolescents in grades 9-12
conducted in 199 schools in 34 states, 30% reported that in the previous 30
days they had ridden with a driver who had been drinking alcohol and 13% had
driven a car or other vehicle after drinking alcohol (Grunbaum et al., 2002).

 Interventions in Drinking/Driving

    Shore
and Compton (2000) describe successful interventions in drinking/driving as
forceful statements, clear demands, and concrete actions. These are more
effective than requests, pleas, or suggestions. 

    Thus, more assertive
interventions tend to be more successful than less assertive interventions.
Threatening the drinking driver’s competence is less likely to be effective in
stopping the drinker from driving (Shore & Compton, 1998). Smart and
Stoduto (1997) found that people tend to intervene more with friends than with
strangers. 

    Having some familiarity with the intoxicated individual seems to be
more conductive to intervening. Smith and colleagues (2004) in a qualitative
study on intervening as a passenger in drinking/driving queried 52 youths about
drinking/driving situations and interventions. 

    Findings of the study included
the following drinking/driving situations where the participants were:
entangled with a drinking driver who was determined to drive, end edangered
while riding in a car with a drinking driver, and stranded because they did not
get in the car with a drinking driver and had no one to turn to for a ride. 

    Interventions described by the participants were: to persuade, to interfere, to
plan ahead, and to threaten. It can be concluded that if youth passengers
intervene and break the link between drinking and driving there is potential
for reducing drinking/driving fatalities.