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Road Crashes and Alcohol Abusage in Kabardino-BalkariaA. ElgarovKabardino-Balkarian University, 42 Shogenchukova Str, Ap. 92, Nalchik 360051, Russia ABSTRACTThe decreasing tendency of the total number of the roadside crashes (RC) and the injured has become noticeable (from 1141 to 879 and 1335 to 1052, respectively) in Kabardino-Balkaria. Alongside, the number of the killed does not change (281), while that of fatal RC is growing. Drivers' errors cause 76.0% of total RC. Main risks of RC: bad driving, high speed (19.3%), against traffic on both ways, wrong overtaking (19.2%), drunken driving (13.4%), wrong driving at crossways (8.3%). More than 48% of the total RC are observed from May to September, 47% happened between 6 and 11pm (51.9% killed and 54.1% injured). Top of RC on weekdays: Wednesday, Thursday and Saturday (30.6% RC: 35.7% killed and 30.6% injured). Pedestrians' drunken behaviour led to 29.7% of total RC. The number of the drunken drivers has increased in Kabardino-Balkaria, as well as in Russia, that causes 25% of RC, involving primarily private vehicle owners (more than 70% of RC). On the whole, RC with drunken drivers have an increasing tendency (1.5 - 2 times). For the last 5 years the local police have been reporting drunken driving 2 - 3 times as often. The same data is observed in medical statements: from 36.6% in 1991 to 70% for the first half of 1994. An educational programme has been worked out to help the drivers, on the one hand, and, on the other, the population (adults and children) have a clear-cut comprehension of the effect of alcohol abusage on psychophysiology and the incompatibility of drinking and driving. A co-operative research with IAATM is being planned to study alcohol levels in drivers and work out adequate preventive measures. INTRODUCTIONIn Kabardino-Balkaria, South Russia, the indices of safe driving (SD) continue their decreasing trend. The rates of road crashes (RC) still remain high, and still numerous are the injuries and fatalities. The analisis of the situation on the roadside causes our anxiety. It should be noted that in the population mortality structure accidents and poisoning come out second after cardiovascular diseases, replacing malignant tumours. In fact, the whole population, both adults and children, and about 80% of vehicle drivers (VD) jeopardize themselves, and eventually are hurt, injured or even killed, so tense has become the situation on the roadside. For the period from 1991 to 1994, however, the absolute number of crashes has somewhat decreased (from 1107 to 755 cases) with the injuries decreasing from 1232 to 910. Besides this, there is practically no growth in fatalities and fatal RC, being especially notable in 5 out 9 local areas. The major reason for the unfavorable situation is the drivers' and pedestrians' behaviour causing conflicts on road which frequently end in RC. For instance, the faults of VD led to 83,2 - 89,4% of the total RC where there were 71,3 - 94,0% fatalities, and 86,2 - 92,9% injuries of the total corresponding indices. In these two thirds of cases were caused by the faultes of the private vehicle drivers: 73,6 - 78,3% of the total (69,8 - 74,9% fatalities and 73,5 - 82,1% injuries). It should be addedthat pedestrians' faults led to 13 - 18% of total RC, which makes it urgent that a set of preventive measures be taken both in VD and the population. The major causes of RC leading to RC are: speeding (19,3%), wrong overtaking (19,2%), drunken driving (13,4%), bad driving at the crosses (8,3%). According to our data, the state of drivers' health causes faults and crashes (hypertension, coronary heart disease, cardiac arrhythmia, diabetes, neuroses, epilepsy, visual disorders), with some medicines taken because of these diseases, and because of fatigue and sleeplessness (6 - 10,5%), overstrain - about 3%. The pedestrians break the traffic rules when they cross the road or street in the wrong place (34%), unexpectedly show up from behind the vehicle (about 28 %), and walk around drunken (up to 28%). MATERIAL AND DISCUSSIONThe official statistics given by Roadside Inspection Police, shows no essential growth in the fatalities and injuries that occurred through drunken driving. As it becomes apparent from Table 1, first, the propotion of drunken driving in keeping the situation tense on the roadside remains having no obvious fluctuations; secondly, private vehicle drivers are far ahead of the commercial drivers in all main parameters of SD - RC, fatalities and injuries. This circumstance should be taken into consideration when some appropriate measures are taken to cut down alcohol consumption, primarily, in private vehicle drivers. Table 1
Unfortunately, the number of drinking VD has risen in the area. Breaking of the traffic regulations (luckily not all of them actually lead to catastrophes), one way or the other,are connected with alcohol abusage in 30-40% of cases. Drunken driving has become 2-3 times as frequent for the recent 5 years. This is confirmed by the statistics available at the Drug Control Board. In 1991, of 5124 cases of arrests, alcohol intoxication was confirmed in 33,6%, in 1992 - of 4555 - 51,0%, in 1993 - of 7301-67,9%, in 1994 - of 8642 - 71%. It is noteable, that 65% of the VD total number came to be the drivers of private vehicles. According to the reports, rule breaking rates in highly qualified drivers are five times (4,8%) as low as those with mean qualification status (23,8). Among the latter drunken drivers are reliably more often reported by the police. The Forensic Board statistics estimate allows to assert considerable growth of the alcohol factor as a cause for RC in 1990-1994. Up till now, it was not officially acknowledged that there were drivers suffering from dipsomania. Nalchik Narcology Center reports that in 1992 they had records of 423, where 121 VD did their jobs in the town of Nalchik in 1993, correspondingly 597 and 101, and 1994 - 428 and 73. Simaltenuously, there were also drug addicts (34 totally in 1992, in 1993 - 28;22; in 1994 22 and 14. It may certainly be supposed, that these figures do not seen real, they are put too low. Taking into account the destructive role of alcohol on the roads of North Caucasus, we have defined a clearly cut set of measures in "Safe Driving" regional programme. Police officers undertake usual measures to prevent drunken driving daily random choice alcohol control, road-safety months, a constant strict control of traffic regulations; mass media highlight the road-safety months, their results, the risks for crashes and prevention ways. At large vehicle enterprises police offcers, narcologists and physicians make clarification talks on the consequences of careless and even cynical behaviour of both VD and pedestrians, emphasizing the problem of dipsomania. A special educational programme has been launched and is being carried out by the Traffic Medicine Laboratory at the University of Nalchik. Adapted sanitary education methods are used at nursery and high schools, and at higher institutions, as well- business and situational games, roadside conflict modelling, road-crash projector films are shown, a wide use of training grounds with a set of specially design devices and appliances are resorted to. Together with narcologists, we attempt to define the methods of bringing out the susceptibility to alcohol abuse and addiction in VD; a specially designed psychophysiological testing is performed (and an all-round clinical check-up, as well if necessary) to medically approve or disapprove the drivers' licensing. The applicants who take driving tests are liable to pass their medical psychological check-ups, along with VD involved in RC, traffic violators and VD captured for drunken driving. Psychophysiological checkup aims at the definition of the drivers' state of health and their behaviour, their abilities to respond to outer factors of the roadside. The data being now accumulated, will, as we believe, contribute a lot into the carried out composite reseaches to eventually bring about the suseptibility of the certain groups of drivers (their age, sex, length of service, personal features, presence of some diseases, consumption of alcohol, legal or illegal drugs) to be involved in RC. Personnel have been given a training course to further carry out the scheduled prevention programme with the aid of a number of methods, alcometer calibration, for instance, to clarify the real situation with alcohol in the area, together with the National Public Health Institute, Helsinki (professor J.Pikkarainen, President of IAATM). The major field for further research lies, as we think, in the elimination or in the restriction of the man factor, that is, selection, licensing, discipline and behaviour of the traffic participants, unawareness of VD about the correlation of safe driving and the state of health, alcohol and drug abusage.
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