College Students are Still Driving Impaired and We Need to Do Something About It

students walking on campus
Dr. Jim Lange is Executive Director of the Higher Education Center for Alcohol and Drug Misuse Prevention and Recovery
College Students are Still Driving Impaired and We Need to Do Something About It

     - Jim Lange, Ph.D.

When people think of college students’ alcohol and drug use, a lot of stereotypical behaviors come to mind: binge drinking, loud and rowdy parties, and concerns such as hazing, overdose, falls, and violence. Such issues are worthy of concerted prevention efforts; but impaired driving is often missing from campus discussions. We can only speculate why that omission occurs. For some, it could be that crashes and/or arrests can happen far from the campus property, and therefore not always reported to the campus administration. For others, it may be a misperception that college students tend not to drive because they live on campus. Or perhaps for others, it stems from a belief that somehow rideshare services have solved the impaired driving problem.

However, the reality is college students remain more likely to drive impaired than their same-age, noncollege cohort[1]. And while in the recent past (i.e., during the rideshare era) the rate of impaired driving has decreased, as the NIAAA’s College AIM makes clear, “Alcohol-impaired driving accounts for the majority of alcohol-related deaths among college students nationwide”[2]. Add in drug-impaired driving, and risks both to our students and community members sharing the roads are substantial.

COVID-19 has likely made this worse. We know that within the general population, rates of impaired driving have gone dramatically higher during 2020 and 2021[3]. There is no reason to think this upward trend isn’t also occurring within college students. So, urgency to address this issue stems not merely from a long-standing neglect, but from an emergent trend of substantial increases in deaths and injuries.

So, what can we do about this? First, I’d suggest recognizing the prevalence and impact of impaired driving. Many campuses use the American College Health Association’s National Collegiate Health Assessment to gather information about the health of their students. Within that survey, there are a few items that are impaired driving-related. For instance, the Spring 2021 NCHA Reference Group[4] reports that for students who had both driven a car and consumed alcohol, 13.1% drove after drinking in the past 30 days. For cannabis users, it was even higher, with 29.6% of recent cannabis users saying they had driven within 6 hours of using it. And as for the impact of alcohol-impaired driving, in their most recent update, Hingson and colleagues estimate that almost 1,000 college students die in alcohol-related crashes a year.[1]

Acknowledging the substantial problem should evoke urgency to do something about it. But unfortunately, the guidance for campuses is mixed. Some approaches rest on the belief that preventing alcohol and drug misuse will naturally prevent impaired driving. While this belief is logical, and indeed encouraged in such documents as the College AIM[2], evidence supporting this belief is mixed. There are examples of alcohol-consumption interventions—especially individual-focused interventions—that effectively reduced alcohol use but failed to demonstrate prevention of impaired driving[5–7]. Also note that drug use prevention efforts are almost uniformly silent on drug-impaired driving outcomes.

That said, effectiveness is not assured just because a prevention program is intentionally impaired driving focused. The research on efforts to educate about the risks and/or create opportunities to illicit fear of either crashes or an expensive DUI arrest is thin. Indeed, such scare tactics have at times been shown to elicit resistance in the most at risk within the audience. It may even yield a boomerang effect.[8] So there is justification for the often-heard advice to avoid an “awareness day” event that brings a crashed car and “beer goggles” to campus. These will not lower the prevalence of impaired driving and may harden the opinions of those who think the risk is exaggerated or that their skills are such that they are impervious to crashes[9].

Other recent studies have called into question approaches centered on providing rideshare coupons[10]. While designated drivers have shown to be a protective factor within drinking friend-groups[11], rideshare coupons are less promising. Rideshares have the added problem: researchers have observed increase in consumption within drinking groups when they are used. So, the easiest and most attractive interventions (e.g., risk-awareness events and rideshare coupons) appear to either be ineffective or perhaps even counterproductive.

So instead, we must accept that the much harder approach needs to be considered: working at the community level to create an environment that supports prevention. That means supporting barriers for underage and illegal use of alcohol and other drugs; consistent implementation of administrative driver license suspension and other related sanctions; creating widespread belief of enforcement certainty; and assuring there are cues for protective behaviors, such as rideshare and designated drivers. Cues that activate responsible decisions prior to consumption, placed proximal to the time and place of consumption, has an impact[11]. All these approaches require campus professionals to work together with community stakeholders to create environmental change. This may be hard work, but it has been shown to be effective.[12]

And here again I’ll repeat the need for data and an understanding of the prevalence. To mobilize community-level action, there needs to be a sense of urgency. Perhaps a recent SADD report[13]can serve that role. But for the community, it’s probably more persuasive to use data that your local campus may have. As described above, the National Reference Report of the ACHA-NCHA gives a hint to the national statistics, but if the campus you care about uses the NCHA, rates of impaired driving should be relatively easy to find. Even if the campus is below the reference group, it almost assuredly is above zero. Each impaired driving instance is a risk to the student and the community, and it represents a failed opportunity to reduce the impact of alcohol and other drugs. So, improvement should be sought regardless of the current comparative statics.

And finally, a caveat about the risk-awareness discussion above: cannabis needs special attention. Data from various sources, including the NCHA data mentioned above, keep demonstrating that a higher proportion of cannabis users are willing to drive while impaired than the proportion of alcohol consumers. Indeed, studies have shown that many cannabis users believe they are unaffected—or perhaps even better drivers—when using. That belief is demonstrably wrong[14]. Given the changing use patterns that state-level legalization has evoked, it’s clear that consumer education is necessary to correct these erroneous views. With alcohol, such education comes from a variety of sources; but for cannabis, there are far fewer voices reaching young people. Campuses need to take cannabis education seriously, even if guidance usually suggests that education alone is not the path to prevention.

References

  1. R. Hingson, W. Zha, D. Smyth, Magnitude and Trends in Heavy Episodic Drinking, Alcohol-Impaired Driving, and Alcohol-Related Mortality and Overdose Hospitalizations Among Emerging Adults of College Ages 18–24 in the United States, 1998–2014, J. Stud. Alcohol Drugs. 78 (2017) 540–548. https://doi.org/10.15288/jsad.2017.78.540.
     
  2. CollegeAIM NIAAA’s Alcohol Intervention Matrix, (n.d.). https://www.collegedrinkingprevention.gov/CollegeAIM/Default.aspx (accessed April 26, 2022).
     
  3. Update to Special Reports on Traffic Safety During the COVID-19 Public Health Emergency: Third Quarter Data, (n.d.) 10.
     
  4. NCHA-III_SPRING-2021_REFERENCE_GROUP_DATA_REPORT.pdf, (n.d.). https://www.acha.org/documents/ncha/NCHA-III_SPRING-2021_REFERENCE_GROUP_DATA_REPORT.pdf (accessed April 26, 2022).
     
  5. M.J. Paschall, T. Antin, C.L. Ringwalt, R.F. Saltz, Effects of AlcoholEdu for College on alcohol-related problems among freshmen. A randomized multicampus trial, J. Stud. Alcohol Drugs. 72 (2011) 642–650.
     
  6. M.E. Larimer, J.M. Cronce, Identification, prevention, and treatment revisited: Individual-focused college drinking prevention strategies 1999-2006., Addict. Behav. 32 (2007) 2439–2468.
     
  7. J.F. Schaus, M.L. Sole, T.P. McCoy, N. Mullett, M.C. O’Brien, Alcohol Screening and Brief Intervention in a College Student Health Center: A Randomized Controlled Trial - Journal of Studies on Alcohol and Drugs, J. Stud. Alcohol Drugs. (2009). http://www.jsad.com/jsad/article/Alcohol_Screening_and_Brief_Intervention_in_a_College_Student_Health_Center/4367.html (accessed December 14, 2009).
     
  8. D.E. Logan, J.R. Kilmer, K.M. King, M.E. Larimer, Alcohol Interventions for Mandated Students: Behavioral Outcomes From a Randomized Controlled Pilot Study, J. Stud. Alcohol Drugs. 76 (2015) 31–37. https://doi.org/10.15288/jsad.2015.76.31.
     
  9. J. Jewell, S.D.A. Hupp, Examining the effects of fatal vision goggles on changing attitudes and behaviors related to drinking and driving, J. Prim. Prev. 26 (2005) 553–565.
     
  10. T.R. Miller, M. Courser, S.R. Shamblen, J.E. Lange, A.S. Tippetts, C. Ringwalt, Efficacy and cost-effectiveness of subsidized ridesharing as a drunk driving intervention in Columbus, OH, Accid. Anal. Prev. 146 (2020) 105740. https://doi.org/10.1016/j.aap.2020.105740.
     
  11. J.E. Lange, M.B. Reed, M.B. Johnson, R.B. Voas, The efficacy of experimental interventions designed to reduce drinking among designated drivers, J. Stud. Alcohol. 67 (2006) 261–268.
     
  12. J.D. Clapp, M. Johnson, R.B. Voas, J.E. Lange, A. Shillington, C. Russell, Reducing DUI among US college students: Results of an environmental prevention trial, Addiction. 100 (2005) 327–334.
     
  13. SADD, The Status of College Impaired Driving, SADD, 2020. https://www.sadd.org/NHTSAPrograms (accessed January 27, 2021).
     
  14. T.D. Marcotte, A. Umlauf, D.J. Grelotti, E.G. Sones, P.M. Sobolesky, B.E. Smith, M.A. Hoffman, J.A. Hubbard, J. Severson, M.A. Huestis, I. Grant, R.L. Fitzgerald, Driving Performance and Cannabis Users’ Perception of Safety: A Randomized Clinical Trial, JAMA Psychiatry. (2022). https://doi.org/10.1001/jamapsychiatry.2021.4037.

Dr. Jim Lange is Executive Director of the Higher Education Center for Alcohol and Drug Misuse Prevention and Recovery, an academic center of The Ohio State University. But he lives in San Diego where he is San Diego State University’s Coordinator of Alcohol and Other Drug Initiatives. His expertise in campus prevention efforts is based upon over 20 years at SDSU, and over 25 years of prolific, funded research in the field of AOD prevention. He is credited with over 70 peer-reviewed and scholarly publications, and over 180 conference and invited guest presentations. Dr. Lange also has spearheaded statewide and local coalitions, and other major prevention initiatives. He has served in leadership roles within the collegiate prevention field, including as executive committee co-chair of The Network Addressing Collegiate Alcohol Other Drug Issues, and continues to serve on SAMHSA’s Prevention Technology Transfer Center Network’s Advisory Board.