Panel F

Law Enforcement

 

Chair: Maury Hannigan
Background Paper: John Lacy, Ph.D.
Robert Voas, Ph.D.
Recorder: LTJG Dorothy Stephens
Panel Members: Peter O’Rourke
Dean Gerstein
Ralph Hingson, Sc.D.
Johnny Mack Brown
John Moulaen
Howard P. Patinkin
James P. Donovan

Driving Under the Influence (DUI) enforcement is a short-term control
over a much more fundamental problem — public attitudes toward alcohol
abuse. This public health problem must be addressed in the long range by
effective education programs beginning in our primary schools and
extending to adult programs, mass media, advertising, and regulation. This
will require a concerted and cooperative effort among agencies concerned
with health, education, transportation, commerce, and the administration
of justice. Enforcement can contribute to this longer range process through
well-publicized programs enforcing community standards regarding
drinking and driving.

We recommend six high-priority measures that would make DUI
enforcement more efficient and effective in the apprehension of DUI
offenders. The goal of enforcement is deterrence. The recommended
measures are likely to increase the volume of DUI arrestees and thus affect
other components of the DUI control system — notably the courts,
corrections, and licensing agencies.

The Law Enforcement Panel of the U.S. Surgeon General’s Workshop
on Drunk Driving makes the following recommendations.

51
52

RECOMMENDATIONS

F-1 Develop a comprehensive DUI training program for chief executives
of law enforcement agencies. The graduates of the program should —

Understand the specific nature and extent of the DUI
problem;

Understand state-of-the-art strategies and technologies of
DUI enforcement;

Be able to implement and use DUI data systems in their

jurisdiction; and

Be able to identify and effectively draw on relevant
organizations and resources at the local, State, and national
level.

Strategy

An executive training program should be developed by NHTSA, in
conjunction with the International Association of Chiefs of Police
(IACP) and the National Sheriffs Association (NSA). This training
program should be disseminated nationwide to ail chief law
enforcement executives through the auspices of [ACP and NSA.

@ Timeframe: development of program in 1989

@ Timeframe: implementation of program in 1990 and beyond

F-2 Apply innovative techniques of DUI enforcement such as passive
sensors, preliminary breath testing (PBT) devices, BATmobiles (mobile
breath alcohol testing units), drug recognition experts, and horizontal gaze
nystagmus. Adopt appropriate enabling legislation where needed and train
field officers and court personnel in appropriate evidentiary use and
interpretation of these techniques.

Strategy:

A program should be established by NHTSA in conjunction with the
National Bureau of Standards and the IACP to certify passive breath
sensors for DUI enforcement.

Such a program shall include minimum standards for these devices,
a quantification test, the development of a certified products list
(CPL), and a quality-control sampling procedure. This program
Should be established in consultation with the NSA.

@ Timeframe: develop standards and CPL by January 1990.

@ Timeframe: establish quality-control procedures by January 1991
LAW ENFORCEMENT 53

NHTSA, LACP, and NSA should educate law enforcement
personnel in the use of devices (passive sensors, PBTs) and
techniques (drug recognition experts, horizontal gaze nystagmus) and
encourage their application and wide utilization.

e@ Timeframe: begin implementation by calendar year 1989 and
beyond as necessary

NHTSA should also continue to evaluate devices and techniques
through appropriate research.

@ Timeframe: ongoing

F-3 Implement DUI checkpoints in those jurisdictions currently not using
this technique, and expand their use in jurisdictions currently using them.
To enhance the efficiency and effectiveness of checkpoints, we advocate
the use of BATmobiles, passive sensors, and/or PBT devices and the
adoption of legislation to permit sobriety checkpoints where necessary.
These techniques should be used in accordance with the standards set
forth by the United States Supreme Court and/or respective State Courts.
Also, research data on the effectiveness of checkpoints should be broadly
disseminated.

Strategy

The IACP and NSA should conduct leadership workshops on the
conduct of single and multiple agency checkpoints during their 1989
annual conferences, to be followed by a series of workshops across
the country to disseminate this information to line supervisors, with
the assistance of each State’s Governor's Highway Safety
representative.

e Timeframe: Calendar year 1989 and continue thereafter

Where checkpoints are currently not being used, consult with the
attomey general of that State for the purpose of meeting the
constitutional requirements of that State, relative to the application
of checkpoints or drafting necessary constitutional/legislative
amendments to allow their application.

e@ Timeframe: immediate
F-4 Make blood alcohol concentration testing mandatory for all drivers

involved in fatal and serious injury traffic collisions, both for data
collection and prosecution, as appropriate.
54

RECOMMENDATIONS

Strategy

NHTSA should develop and disseminate model legislation for
application by the states.

@ Timeframe: during calendar year 1989

F-5 Adopt administrative license suspension and revocation procedures
for DUI that are designed to keep to a minimum the time required for field
officers to carry out their testifying functions.

Strategy

The Surgeon General should wnite a letter to the governors of those
States that currently have no administrative license suspension
legislation (administration per se) to encourage such legislation.

e Timeframe: immediate

F-6 Maximize public perception of the risk of arrest and punishment for
driving under the influence through law enforcement public information
and education efforts. These efforts are essential to the deterrent
effectiveness of DUI enforcement.

Strategy

To deter drunk driving through enforcement, public information and
education (PI&E) efforts must be tailored to the specific activities of
the enforcement agency and thus must be developed at the local
level. NHTSA should develop and disseminate basic PIKE
resources and materials for training in their adaptation and use at
the local level. NHTSA should work with the Governor’s Highway
Safety Representatives (NAGHSA), IACP, and NSA to conduct
training to foster the use of these materials at training sessions
sponsored by these organizations.

@ Timeframe: no later than 1989, annual LACP, NSA, and
NAGHSR conferences, and ongoing
Panel G

Transportation and Alcohol Service

 

Policies
Chair: Joseph Gusfield, Ph.D.
Background Paper: Robert Saltz, Ph.D.
Robert Apsler, Ph.D.
Recorder: Michael Impellizzeri
Panel Members: William Scott
Perla Niguidula
James Peters
Terry Pence

The Transportation and Alcohol Service Policies Panel was charged with
reviewing the role of alternative forms of transportation, such as taxis and
designated driver programs, and their ability to reduce the problem of
drinking-driving. The panelists were further charged with reviewing and
recommending policies that might also have a direct bearing on the
drinking-driving event, such as drinking establishment patterns, server
education, and employee assistance programs.

The panel focused its attention on the environment of transportation
opportunities and on social and commercial practices for serving alcohol.
One element common to both concerns was the aim of disengaging
prevention of the driving act from the drinking act. We recognize that
policies to affect transportation and server practices have received scant
attention in public health circles. Among alternative forms of
transportation, the support of and information about designated driver,
safe ride, and employee assistance programs are important adjuncts to
public transportation and private commercial transportation.

No less important are the practices of beverage service establishments
in the prevention of drinking-driving. Training servers and other beverage
service personnel to monitor and recognize patrons at risk should be a
significant aspect of beverage service enterprises. The panel further

55
56 RECOMMENDATIONS

recognized that commercial beverage serving establishments have an
obligation to be concerned about safe transportation for patrons whose
drinking creates a risk to themselves, passengers, and/or pedestrians. The
role of such enterprises, as well as social hosts, is vital to a successful
program to curb drinking-driving.

The panel was also convinced that the cogency and feasibility of such
service programs and alternative transportation forms depend on
particular local conditions of servicing agencies and transportation
facilities. They also require the cooperation and support of community
agencies and groups. The need for implementing programs at the local and
communal level was stressed. The purpose of the special community task
force recommended below is to create community standards for serving
practices by social hosts and commercial establishments so as to prevent
drinking-driving and ensure compliance with existing local rules and
regulations. In addition, the task force would examine and encourage
improvements in alternate systems of transportation. Such task groups are
important since, in the past, transportation and server practices have been
overlooked in public health prevention efforts.

The panel recognizes the possible danger that programs to provide safe
transportation for drinkers may encourage drinking and risk exacerbating
other alcohol problems. Servers and others should be aware of these risks
and not view the recommendations here as encouraging any lessening of
other actions to prevent problems related to the use of alcohol.

Community Focus

G-1 Each community should form or expand a task group to review and
implement, in a systematic way, interacting policies and priorities as to
alcohol service and alternative transportation. Such groups should include,
but not be limited to, representatives of public transportation, taxi
associations, alcohol and drug abuse authorities, traffic safety
professionals, hospitality industry associations, zoning authorities, licensing
agencies, citizen support groups, insurance companies, alcohol beverage
authorities, educational institutions, and other public and private sector
groups.

The agenda for this community effort includes the recommendations in
the three broad areas of transportation, server practices, and
implementation strategies.

Transportation

Alternative transportation plans enable impaired drinkers to reach their
destinations without risking harm to themselves or others.
TRANSPORTATION AND ALCOHOL SERVICE POLICIES 57

G-2 The designated driver program should be a community-wide
approach addressing all types of drinking situations at all hours and
involving drinkers, commercial establishments, social hosts, transportation
alternatives, and special events, including sports events. Servers and social
hosts must not allow guests or patrons to become intoxicated and thus
become a danger to themselves and others, not only through
drinking-driving but in other dangerous situations as well. Designated
driver programs should incorporate these features:

— The designated driver does not drink any alcoholic beverages.

— Establishments or social hosts provide easy availability of and
promote food and alcohol-free beverages.

G-3 Information describing the relationship among alcohol consumption,
blood alcohol level, and risk of injury or death should be provided to all
individuals obtaining a new or renewal license for operating any type of
motor vehicle.

G-4 The hours of drinking establishments should be consistent with the
hours of alternative transportation.

G-5 Improving the effectiveness of taxi cabs and other similar forms of
transportation as alternatives to drinking and driving should be explored
with representatives of the taxi and other pertinent industries.

G-6 The automotive industry and the National Highway Traffic Safety
Administration should continue to explore the viability of ignition
interlocks and their incorporation in future vehicle design.

G-7 As acondition of obtaining a license to serve alcohol, including “one
day” or special permits, an organization must develop and implement a
specific plan to provide transportation for individuals who are impaired.
Social hosts should do the same.

G-8 Programs to promote safe or alternative transportation (designated
driver, safe rides, etc.) should keep in mind that problems related to
impairment are not limited to driving automobiles, but also include
operating motorcycles, bicycles, boats, snowmobiles, and airplanes;
horseback riding; skiing; and even being an impaired pedestrian.

Beverage Service Policies and Practices

Alcohol service training and intervention refer to a broad set of strategies
58 RECOMMENDATIONS

that address environmental reforms at two basic levels: the legal
environment and the specific environment of the licensed establishment.
The following policy considerations are recommended in order to achieve
a consistent and effective prevention plan.

G-9 Crowd management: Licensees must maintain an adequate ratio of
staff to patrons in order to monitor beverage sales, consumption, and
patron behavior.

G-10 Promotions: Licensees should not encourage drinking as a focus of
activity through promotions such as free drinks, drinking contests,
discounted drinks, or multiple drink purchases (e.g., happy hours).

G-11 Training: Training appropriate to the type of facility should be
made available to all managers and servers of alcoholic beverages,
consonant with policies recommended here.

G-12 Written policies: Written policies must be posted and made
available to all employees. These should be included and made a part of
alcohol service training.

G-13 Food options: Food should be offered and available during all hours
of operation.

G-14 Alcohol-free beverages: Alcohol-free beverages of all types should
be promoted, offered, and made available where alcoholic beverages are
sold.

G-15 Alternative transportation: Alternative transportation options must
be made available wherever and whenever alcoholic beverages are served.

G-16 Serving sizes: All alcoholic beverage drinks should be served in
single- serving standard sizes (e.g., 12 oz beer, 5 oz wine, or 1 Ys OZ
80-proof liquor).

G-17 Drinking on the job: Managers and staff are required to be
alcohol-free while on duty.

G-18 Age identification: All patrons must produce a valid identification
when a server is in doubt as to legal drinking age. Two forms of
identification, one with a photo such as government identification or
drivers license, are recommended.
TRANSPORTATION AND ALCOHOL SERVICE POLICIES 59
G-19 Intoxicated patrons: Service to intoxicated patrons is prohibited.

G-20 Employee assistance programs: All alcohol service employees must
have access to an employee assistance program.

Implementation and Incentives

It is recognized that responsible beverage service policies will be followed
only in a legal, economic, and social environment that encourages them.
The following specific recommendations serve to foster that environment.

G-21 Server practices require vigilant enforcement by regulatory
agencies. Those agencies must be adequately funded to carry out that task.
In addition, State regulatory agencies (Alcohol Beverage Control boards)
should be reviewed to determine current practices, conflicts of interests,
scope of authority, and enforcement of existing statutes. State legislatures
should review the structure of their Alcohol Beverage Control agencies to
emphasize their place in the promotion of public health.

G-22 State licensing regulations should be adopted to provide incentives,
such as adjustment of licensing fees, for compliance with responsible server
practices as recommended.

G-23 State legislatures should review and reform their dram shop (liquor)
liability laws to maximize their preventive impact and to encourage
business to adopt responsible serving practices. (The 1985 Dram Shop Act,
Western State Law Review 12:417-517, 1985, can serve as a reference.)

G-24 States should review and certify server and manager training
programs to assure that they accomplish prevention goals, and that the
implementation of monitoring and certification of trainees is consistent
with other vocational and educational programs in the State.

G-25 State insurance commissioners should review the rate-setting
practices of liability insurance companies to ensure incentives for
implementing risk management practices that minimize drinking-driving.

G-26 Adequate records of the site of the last drink should be kept in all
cases of all officially reported alcohol-related incidents.

G-27 A representative from each of the 11 panels from this workshop
60 RECOMMENDATIONS

should be selected to serve on the advisory board of the governmental
interagency implementation group.

G-28 The final report of this workshop should be widely disseminated to a
broad range of agencies and enterprises in public and private sectors,
including regulatory agencies, insurance companies, trade associations,
and local workshops and conferences such as Responsible Service Forums
and Life Savers. Dissemination might include representatives from the
implementing groups or from the workshop panels.
Panel H

Injury Control

 

Chair: John M. Templeton, Jr., M.D.
Background Paper: Julian Waller, M.D.
Recorder: CDR Richard J. Smith IIf
Panel Members: Martin R. Eichelberger, M.D.
George L. Reagle
Lawrence Schneider
Clark Watts, M.D.
Stephen Teret, J.D.
Katherine McCarter
Susan McLoughlin, M.S.N., R.N.
Chief Ricky Davidson

Injury control in drunk driving crashes requires examination of all
components covering precrash, crash, and postcrash phases. These phases
are not isolated but are intimately linked and interrelated. Injury
prevention, injury control, and rehabilitation are inseparable parts of the
treatment of alcohol abuse as a disease.

Specific concrete recommendations concerning injury control require
direct and indirect approaches. Direct approaches concern prevention
and treatment programs directed at the drinking driver as a perpetrator of
injury. Indirect approaches concern programs directed at generic injury
control, such as improved environment and behavior modification. Specific
agencies and groups should be designated to help in the implementation of
these approaches.

Injury Control in the Precrash Phase

H-1 Establish a program to integrate at the national, State, and local level

61
62 RECOMMENDATIONS

highway safety personnel, highway engineers, maintenance personnel, and
Federal and State Departments of Transportation. The program should —
— Stress injury prevention; and
— Foster technology transfer and implementation.

H-2 State governors: Develop a State-sponsored injury control coalition
in each State comprising components from public health, education, traffic
safety, judiciary, alcohol beverage control, communications, alcohol and
drug abuse, and others, including balanced representation from grassroots
citizen groups. The goals of the coalition should be to—
— Develop scientifically based education in injury prevention;
— Evaluate the program to measure the impact of education;
— Develop expertise in the correlation of injury severity scores
on crash analyses;
- Identify high-risk roadway and environmental conditions, and
to implement programs to correct these hazards; and
— Propose legislative initiatives designed to implement injury
control.

H-3 State governors: Establish a Fatal Crash Review Panel in each State
to include broad government and lay community representation. Its goals
would be to—
— Produce better epidemiological reporting of the crash event
by police and other authorities;
— Analyze causation, including multiple components of
causation; and
- Recommend changes in action programs and environmental
improvements such as signs, guard rails, etc.

H-4 Federal Department of Transportation: Establish a national safety
' feature checklist to be displayed on all new cars, highlighting objective
scores concerning rollover potential, front end yielding, intrusion
protection, fields of vision, etc. Mandated standards should include —
— Adefined numerical range for each feature;
— The vehicle’s specific score for each feature; and
- Consumer education programs for the public.

H-5 FCC and Congress: Develop and implement national policies and
programs to lessen the use of alcohol seen in TV programs and feature
movies.
INJURY CONTROL 63

H-6 FCC and Congress: Develop and implement national policies and
programs for television that encourage positive lifestyle decisions such as
routine buckling up, refusing to drive after drinking, and refusing to ride
with a driver under the influence.

H-7 FCC and Congress: Establish national policies requiring equal time
on television for public service announcements to advise the public of the
hazards of alcohol.

H-8 NHTSA and State and local authorities: Develop demonstration
programs to study the use of an interlock mechanism for the vehicle of
anyone convicted of a DUI offense, and encourage the use of interlock
mechanisms where proven effective.

Injury Control in the Crash Phase

H-9 Federal DOT: Promote enactment in every State of effective
mandatory seatbelt laws to include “primary” enforcement with an
adequate fine.

H-10 Federal DOT: Promote enactment of laws requiring airbags for
drivers and front seat passengers as standard equipment.

H-11 Federal DOT: Promote the proper use of seatbelts and child safety
seats in both cars and trucks. Stress —

— 3-point harness devices and improved technology for the
protection of young children and low birth weight infants;

— Use of seatbelts even in vehicles with airbags; and

- Use of seatbelts in front and back seat.

H-12 Federal DOT, HHS, and Justice: Promote Federal policies that
foster passage and maintenance of laws regarding mandatory helmet usage
for all motorcycle riders.

H-13 NHTSA: Encourage industry and consumer programs to retrofit
used vehicles with appropriate standard restraint devices and air bags.

H-14 Federal DOT, HHS, and Justice: Foster policies for mandatory
fitting of large trucks with devices to prevent “underride.”
64 RECOMMENDATIONS

Injury Control in the Postcrash Phase

H-15 Regionalize emergency medical service systems for the care of
injured patients throughout the Nation.
~ Establish guidelines for the care of injured patients in the
prehospital, inhospital, and rehabilitation phases of care.
— Define regionalization guidelines for urban and rural areas.

— Develop “self-sufficiency” funding mechanisms such as a
surcharge on DUI and other traffic violations.

~ Develop new approaches to the financing of inhospital and
rehabilitation care of indigent patients.

— Encourage public education in the structure and function of
emergency medical systems.

H-16 DHHS and medical care professional groups: Develop and
implement comprehensive rehabilitation programs for —

— Physical rehabilitation;

— Psychosocial intervention for the drinking driver; and

— Psychosocial rehabilitation of the victims and the family of the
victim.

H-17 DHHS: Require BAC testing of all age-appropriate trauma victims
of traffic-related injuries as a component of their medical care and
management.

H-18 DHHS interacting with professional education organizations:
Encourage the teaching of alcohol abuse and injury control as a public
health issue in the curricula for health care providers.

H-19 States: Establish State trauma registries as an important part of a
system to provide epidemiological data on death, disabilities, and costs to
government and private resources.

Strategy

1. The Surgeon General should speak to the National Governor’s
Conference on what each governor can do to be a catalyst for
administrative and legislative action on drinking and driving within
each State.
- Stress that injury is a preventible disease that
requires a comprehensive approach to reduce
INJURY CONTROL 65

the human and financial cost of alcohol
abuse and traffic-related injuries.

Provide specific recommendations regarding
improved vehicle safety, environmental safety,
and injury prevention behavior.

Support regionalization of injury care systems.

The Surgeon General and his office should also address the
issue of drinking and driving through —

TV programs to educate the public (as done
with AIDS);

A speech to the National Governor's
Conference; and

A formal congressional hearing on the issue of
drinking and driving.

The expertise and assistance of the following specific agencies
and groups, as listed with the individual recommendations
made by the injury control panel, should be enlisted:

Department of Transportation (NHTSA)
Federal Communications Commission
Department of Justice

Department of Health and Human Services
(CDC)

U.S. Congress

State Departments of Transportation
State governors

State legal authorities

National Association of State Emergency
Medical Services Directors

Medical care professional groups
Professional education organizations
Panel |

Youth and Other Special Populations

 

Chair: Galen Davis
Background Paper: Michael Klitzner, Ph.D.
Philip May, Ph.D.
Elsie Taylor
Recorder: CDR Phillip Smith, M.D.
Panel Members: Allan F. Williams, Ph.D.
Anthony J. Heckemeyer
Judy Zundel
Raul Caetano, M.D., Ph.D.

The several recommendations coming out of this Surgeon General’s
workshop may be effective in the general population. However, their
effectiveness in ethnic minority groups will depend on the extent to which
those interventions are tailored to the social and cultural identity of the
specific ethnic group. Educational efforts, for instance, need to take into
account the best media for dissemination of information as well as sensitive
use of meaningful cultural symbols and images.

Drunk driving as a major public health problem affects youth and ethnic
minority groups disproportionately. Specifically targeted interventions are
needed. However, drinking and driving occur in the context of social
norms, and cultural and regional trends are influenced by a multitude of
other factors.

Drinking and driving among youth are frequently determined by their
adult role models. Action at the school level should include more than just
classroom prevention programs; a restructuring of the schools to improve
student commitment to education and other social values is also needed.
Concerted efforts should be aimed at improving self-concept, coping skills,
and psychological adjustment.

The panel finds it difficult to provide specific recommendations for the
special populations as distinct entities given the lack of data on the extent

66
YOUTH AND OTHER SPECIAL POPULATIONS 67

and correlates of the problems within each group. Therefore, the panel
addresses those issues which the various ethnic groups have in common
while highlighting the specific needs of certain ethnic groups. The
following recommendations are based on this premise.

Relative to drinking and driving, we recommend the following
programs, policies, and countermeasures.

I-1 Increase local, State,and Federal taxation on alcoholic beverages.
I-2 Increase justice system training.

I-3 Increase health care system training (i.c., cross-train disciplines where
possible).

I-4 Increase the precision and consistency of present data collection
systems (i.e., the Fatal Accident Reporting System (FARS), Multiple
Cause of Death (MCD) file, death certificates) to collect and record data
on drinking and driving among youth and at-risk minority groups.

Strategy

Research funds should be allocated from NIAAA, probably the
epidemiology branch. The request for proposals (RFP)
announcement should include provisions for evaluation of data
collection measures. Results should be realized within 2 years of
implementation.

© Timeframe: 3 months for RFP

9 months to go through review and award system

I-5 Renew governmental regulatory guidelines on motor vehicle design
and road safety.

I-6 Support community involvement through proven strategies and
programs.

1-7 Restrict Federal highway funds if States do not institute administrative
drivers license revocation for DUI.

1-8 Ensure swift and sure sanctions including making the sanctions reflect
the magnitude of the problem.
68 RECOMMENDATIONS

I-9 Support enactment and enforcement of the 1987 National Commission
Against Drunk Driving (NCADD) checklist of countermeasures.

Strategy

The National Highway Traffic Safety Administration should include
the 19 countermeasures of the 1987 NCADD Checklist of
Countermeasures in their 408 or 410 DWI countermeasure incentive
programs. States must attain 80 percent of the countermeasures to be
eligible for the incentive grant funds in the first year and 90 percent to
be eligible for the second and subsequent years. Special grant
incentives should be set up for 100- percent attainment.

e@ This program should be implemented during the 1990 Federal
fiscal year.

I-10 Encourage comprehensive school-based K-12 alcohol and other drug
abuse education and educator training programs of proven efficacy.

Strategy

By the end of 1990, NIAAA in conjunction with NHTSA should
award a series of 5-year contracts to evaluate existing and/or
innovative educational strategies and teacher-training efforts in terms
of student behavioral outcomes, including age of first use, drinking
patterns, DWI/RWID, and other alcohol-related problems.

Teacher training should be evaluated in terms of increased teacher
awareness and knowledge, increased comfort with addressing
alcohol-related issues, increased skill in implementing aicohol
education, and increased skill in action planning of prevention for
the school and community.

These contracts should be restricted to individuals and institutions
who have not participated in the development of the programs and
who have no financial interest in the dissemination of the programs.

I-14 Add funds for States to develop and evaluate innovative programs to
prevent and reduce drinking and driving.

1-12 Encourage civil liability for intentionally providing, directly or
indirectly, alcohol to minors.
YOUTH AND OTHER SPECIAL POPULATIONS 69

1-13 Institute night driving curfews for beginning drivers under 18 years of
age.

Strategy

e NHTSA and the Office of Juvenile Justice and Delinquency
Prevention (OJJDP) should develop model curfew and 0.02
legislation by the end of 1990.

@ States failing to adopt legislation conforming to these models by
the end of 1992 should forfeit 10 percent of their Federal
highway funds.

@ By the end of 1992, NHTSA and OJJDP should have developed
a training curriculum for local law enforcement officers in
methods for identifying youth driving with low BACs.

e By the end of 1992, training of trainers conferences of the above
curriculum should be held in all NHTSA program regions.

e By the end of 1992, NHTSA should award a 3-year contract to
study the implementation of curfew and 0.02 legislation in all
States.

I-14 Increase the effectiveness of minimum alcohol purchase age laws.

I-15 Support mandatory seatbelt and motorcycle helmet laws and tie them
to Federal highway funds.

1-16 Endorse the following recommendations of the National Commission
on Drunk Driving report on youth:

- Administrative per se license suspensions should be
statutorily permitted.
— Open container laws should be promulgated.

— Strict sanctions should exist for the sale or transfer of
alcoholic beverages to youths under the legal drinking age.

Appropriate State agencies and State legislatures should consider
legislation in the following areas.

I-17 Make classroom instruction on alcohol use, other drug use, and
impaired driving mandatory for grades K-12; develop curriculum
guidelines for each grade level.
70 RECOMMENDATIONS

Strategy

By the end of 1990, based on current knowledge, NIAAA in
conjunction with NHTSA and Department of Education should
develop guidelines for the selection and development of curricula
and teacher-training methods by local school districts. This effort
should be overseen by a national panel of experts who do not have a
financial interest in any such programs.

NOTE: The Department of Education recently did this for drug
education (including alcohol and tobacco), but there is little (if any)
traffic safety thrust in their materials.

I-18 Encourage insurance rebates for drivers who take an approved
driving risk-reduction course and have a clean driving record.

I-19 Include a mandatory component on alcohol use and impaired driving
in driver education courses.

1-20 Discourage and/or limit beverage advertising and promotion that is
directed at youth and minorities.

Strategy

Implementation should follow guidelines set up by the Advertising
and Marketing Panel.

I-21 Endorse 0.08 BAC for DWI for ail the population 21 years of age and
older.

I-22 Endorse additional penalties over and above standard liquor law
violations for those under age 21 with an 0.02 BAC or above.

I-23 Increase the enforcement of DUI laws relative to youth.

!-24 Increase professional and public information and education with
regard to youth and other special populations. Proven strategies for
prevention and remediation should be utilized. Emphasis should be placed
on providing education to:

— Criminal justice personnel
- Health care professionals
— Educators
YOUTH AND OTHER SPECIAL POPULATIONS 71

~ Media professionals

— Other policymakers

— Other community leaders
— General public

Prevention media communications should take into account the
appropriate culture and ethnic values when delivering their message.

1-25 Provide broad-based education of Indian tribal leaders and tribal

.

members on policy options pertaining to alcohol.

Strategy

Require the Federal Agencies, in consultation with tribal
communities, to develop strategies and plans for providing training
on tribal specific and appropriate alcohol policy, ¢.g., to include
personnel plans and policies, law and order codes and ordinances,
school criteria and guidelines for education, diagnosis and treatment
protocols in clinics and hospitals, and quality assurance plans for ail
treatment and rehabilitation programs.

The lead Agencies should be the Bureau of Indian Affairs (BIA), the
Indian Health Service ( IHS), NIAAA, NHTSA, etc.

@ Timeframe: By December 1990
1-26 Increase Indian tribal law enforcement resources.
|-27 Expand traffic safety initiatives among Indian tribes.

|-28 Better utilize all sources of funding for education, recreation, and
economic development. In particular, improve the socioeconomic status of
the American Indian.

1-29 Support Federal/tribal/State cooperation for the establishment of
detention and treatment centers for American Indians.

I-30 Improve social and cultural relevance in all programming and
countermeasures.

I-31 For American Indians and Alaska Natives, seek support of tribal
governments in the development of tribal resolutions for establishing policy
actions on alcohol and operation of motor vehicles while under the
influence of alcohol or other drugs.
72

RECOMMENDATIONS

Strategy

Amend P.L. 99-570, the Anti-Drug Abuse Act of 1986, to include
incentives for tribal governments to formulate, execute, and enforce
tribal-specific drinking-driving policies. Lead agencies: Bureau of
Indian Affairs, Indian Health Service

@ Timeframe: December 1989 for amended legislation

1-32 Develop and implement educational efforts to increase Hispanics’
awareness of the risks associated with drinking and driving and to minimize
drinking practices that lead to the consumption of higher volumes of
alcohol per occasion. The target groups should be youth and males aged
21-39 years.

Strategy

A campaign should be developed nationwide with sponsorship from
the Office for Substance Abuse Prevention (OSAP). Proposals
Should include carefully laid out pians for evaluations of campaign
effectiveness.
@ Timeframe: 3 months to request proposals

4 months to proposal deadline

2 months for review

3 months for funding

I-33 Encourage special training of law enforcement officers to ensure
nondiscriminatory DUI law enforcement.

I-34 Increase community recreational resources for black (and American
Indian and Hispanic) youth.

Strategy

Funds may be allocated from State block grants or from OSAP for
demonstration projects to set up neighborhood afterschool programs
(e.g., music, drama programs; physical rehabilitation programs;
occupational therapy programs; RAP and counseling programs).

@ Timeframe: 1 year for implementation of program
1 year for evaluation of success of programs
look for results in 1992
YOUTH AND OTHER SPECIAL POPULATIONS 73

1-35 Increase education of religious and other black community leaders
about alcohol abuse and drunk driving.

Strategy

Include an appeal to religious leaders in their religious training
programs.

Institute training curricula in ministerial schools.

Encourage black community leaders to set up neighborhood RAP
sessions and programs.

Funds may be allocated from the Office for Substance Abuse
Prevention or the National Highway Traffic Safety Administration.

@ Timeframe: One year setup time to implement programs, one
additional year to see how or if the program works and produces
results.

1-36 Increase religious and community programs on alcohol and other
drug abuse for blacks.

Research

In the area of research, the panel recognizes the extreme lack of data on
specific minority populations with regard to drinking and driving.
Descriptive data are needed on the following topics.

1-37 Describe effective alcohol and other drug abuse assessment tools for
youth.

1-38 Identify effective support groups for youth and ethnic minorities
returning from treatment.

I-39 Develop more precise and consistent measures to collect and record
data on drinking and driving among youth and ethnic minority groups.

1-40 Determine the extent of drinking and driving among ethnic groups
and the major demographic characteristics of individual members of the
group who engage in such behavior.

I-41 Study the relationships among drinking patterns such as volume
consumption per occasion and drinking and driving.
74 RECOMMENDATIONS

I-42 Investigate the attitudes toward drinking and driving among blacks/
Hispanics/American Indians and how deviance is defined in the specific

group.

I-43 Track arrest patterns to assess the question of the validity of high
prevalence of DUI arrest among Hispanics as it relates to law enforcement
practices.

I-44 Assess the effectiveness of first and multiple offender rehabilitation
programs for youth and ethnic minorities.

1-45 Assess the effectiveness of driver’s license sanctions associated with
DUI convictions.

I-46 Assess the effectiveness of State laws that apply special license
sanctions to youth for alcohol-related violations.

1-47 Evaluate the effect of liquor advertisements on the use of alcohol by
minors.

1-48 The panel endorses the research questions listed in Dr. Perrine’s
background paper for the Epidemiology Panel as they relate to the
different age groups in the minority population. (See background papers in
separate volume.)

In specifically addressing the recognized research priority needs among
American Indians, the panel makes the following additional
recommendations.

I-49 In the area of epidemiology, research is needed on the following
issues relevant to American Indians:

- Motor vehicle accidents based on geographic location, i.e.,
reservation/off-reservation, urban or rural sites

— Adult prevalence studies
— Survey of tribal alcohol policies

— Prevalence and level of impairment due to drinking and
driving related motor vehicle accidents

I-50 In the area of social-psychological research, the following topics are
of major importance to American Indians:

- Social-psychological studies of accident victims
YOUTH AND OTHER SPECIAL POPULATIONS 715

— Attitudinal values and trends on drinking and driving

Strategy

Sponsorship for this research should come from the National
Institute on Alcohol Abuse and Alcoholism. The mechanism for
funding would be the basic ROJ grant funding of the extramural
research program.
e Timeframe: February 1, 1989 Receive proposals

June 1989 Initial review

October 1989 Council review

December 1989 Funding awarded

1-51 Organize Federal coordination efforts to provide technical assistance
to tribes regarding legislation implementation.

Strategy

Lead agencies: Bureau of Indian Affairs, Indian Health Service,
NHTSA, NIAAA, ete.

e@ Timeframe: December 1990

|-52 Evaluate the effectiveness of policy execution by:

— Process evaluation — the stages of passing and implementing
new policy; and

~ Outcome measures — maintain accident (e.g., pregnancy,
morbidity and mortality) data and alcohol (e.g,,
alcohol-related problems) data on a longitudinal database.

Strategy

Lead agencies: Indian Health Service, NIAAA, and private sector
agencies.

1-53 Identify potential State, Federal, tribal, and private funding resources
to implement tribal policy.

Strategy

Lead agencies: IHS, BIA, NIAAA

e Timeframe: ongoing