Drink and drug driving law

Memorandum from the Royal College of Physicians (RCP) (DDD 25)

The Royal College of Physicians (RCP) plays a leading role in the delivery of high quality patient care by setting standards of medical practice and promoting clinical excellence. We provide physicians in the United Kingdom and overseas with education, training and support throughout their careers. As an independent body representing over 25.000 Fellows and Members worldwide, we advise and work with government, the public, patients and other professions to improve health and healthcare.

1. Should the permitted blood alcohol limit be reduced as proposed?

The RCP has consistently called for the blood alcohol limit to be reduced to 50mg/dl. The data confirming BAC of 50mg/dl as a suitable level for legislation has been accepted by all EU countries with the exception of the UK. Ireland has recently passed a Bill reducing the level to 50mg/dl. There is clear evidence that a reduction in the drink drive limit will reduce the number of deaths and serious injury caused by drink driving. Reaction times and motoring skills of drivers begin to deteriorate after even a small amount of alcohol, with the effects becoming more marked with increasing alcohol consumption.

With blood alcohol levels (BAC) between 50mg/dl and 80mg/dl the risk of accident increases by 400%, this data is quoted by the Dept of Transport in a previous consultation document [1] . When blood alcohol levels were reduced from 80 to 50mg/dl in New South Wales, fatal accidents reduced by 8% and single vehicle night time crashes by 11% [2] . When Denmark reduced BAC from 80mg% to 50mg% in 1998, overall accidents were reduced although there was no significant change in fatal accidents [3] . Furthermore introduction of BAC of 20mg/dl for inexperienced drivers led to reduction in fatal crashes of between 9% and 24% in California [4] .

If there is to be a BAC prescribed limit, we believe that 50mg limit is the simplest message for drinkers to understand. The current level is complex and difficult for people to calculate what they are likely to be able to drink. This is dependent on body size, gender, age and whether food is consumed. One pub measure of alcohol (a 175ml glass of standard-strength wine or half a pint of strong beer) is all that would be allowed; compliance would increase as it would be easier to understand.

A survey by the Automobile Association in conjunction with Populus in 2008 found that two thirds of the Association’s members were in support of a reduction in the drink driving limit. Almost a third of respondents felt that a ‘zero tolerance’ approach would be preferable. [5] Clearly there is strong public support for action on drink driving. Responses to the Government’s consultation, ‘Combating Drink Driving’, published in 2000, revealed a clear majority in favour of a lower limit, including 79% of the local authorities which responded. [6]

2. How severe is the problem of drug driving and what should be done to address it?

The RCP believes that there are good grounds for believing that driving under the influence of drugs, both recreational and prescription may be a factor in traffic fatalities and injuries, and we regret the paucity of good data that would enable policy in this area to be evidence based. In view of the lack of good data we strongly support the proposal that the routine assessment of alcohol levels in fatal accidents is extended to the presence of both prescription and recreational drugs. All fatal or near fatal traffic accidents should be fully investigated with samples taken for the assay of alcohol and levels of recreational and prescription drugs.

3. What are the wider costs and benefits that are likely to result from changes to the drink and drug driving law?

Between 50mg and 80 mg drivers are 2 – 2.5 times more likely to be involved in an accident than drivers with no alcohol, and up to 6 times more likely to be involved in a fatal crash [7] . In 2000, the Government’s Road Safety Strategy estimated that reducing the limit to 50mg could save 50 lives, and prevents 250 serious injuries and 1,200 slight injuries each year. A more recent examination of the figures suggests that reducing the legal limit could save 65 lives each year and prevents 230 serious injuries. [8] Given an average cost of over £1.6m per fatality; the economic benefits would be very significant. Changes to drink driving laws, and the public attention that is likely to accompany such changes, may contribute to the wider public health debate about sensible drinking.

August 2010