Alcoholism: Seven Roads to Wrecks

Up to 650 Americans will die and 30,000 will be injured on the nation's highways this weekend. More than half these accidents will involve drivers who have been drinking, even though drinking drivers will constitute no more than 5% of the motorists on the road at any given time.

Medical men recognized, as far back as 1904, the close link between drinking and traffic mishaps; yet no effective technique for reducing the carnage has been devised. One reason, suggests Dr. R. F. Borkenstein, chairman of Indiana University's Department of Police Administration, is that there are vastly different types of drinking drivers. While the threat of punishment may be a deterrent for some, others may need medical and psychiatric treatment.

Impaired Skill. During a recent seminar in Manhattan on traffic and accident medicine, Borkenstein listed seven specific types: 1) the drinking driver to whom neither drinking nor driving is a problem and whose blood alcohol concentration never goes over the .10% or .15% threshold accepted by most states; 2) the skillful driver who usually imbibes moderately, but on occasion overindulges to the point where his skill is impaired; 3) the man whose skill behind the wheel has deteriorated because of age or illness and who may consequently feel the effects of alcohol more acutely; 4) the inexperienced driver, whose lack of skill may be magnified by even minute amounts of alcohol; 5) the normal driver who is unusually sensitive to alcohol; 6) the motorist who is prone to "aggressive, sociopathic driving," and who may become even wilder with a few drinks in him; 7) the driver whose basic problem is "chronic, compulsive, sociopathic drinking."

Because they cannot control their deep-rooted impulses, those in the last two categories are the most dangerous of all. The threat of punishment is usually effective with social drinkers, Borkenstein notes, and those who are unusually sensitive to alcohol can learn to allow for it. But psychotherapy—as well as strict enforcement by the highway patrol—may be the answer for the sociopathic driver, whose chief problem is immoderate behavior behind the wheel rather than at the bar. For alcoholics, Borkenstein cautiously proposes suspending their driving privileges until, through medical and psychiatric help, they have their problem under control. Alcoholism is hard to define and detect, and to penalize a man for such a vaguely defined condition is not consistent with the American concept of civil liberty. As a result, Borkenstein advises against suspending licenses except in cases of frequent alcohol-related violations of law.