August 17, 2016
Area(s) of Interest: Advocacy Physician Leadership 


By Nicky Herrick and Daniel Spinosa, third-year medical students at the University of California, San Diego

Each year, more than 20,000 Californians are injured in drunk driving accidents and more than a thousand additional victims don’t survive long enough to make it to the hospital. Perhaps most troubling is that two out of three Americans will be involved in a drunk driving crash in their lifetime.

There’s not a clinician in California who hasn’t seen the heartbreaking consequences of drunk driving, and we only see the victims who are fortunate enough to need medical care. As much as clinical experiences motivate physicians to eliminate drunk driving, we don’t carry this emotional burden alone. Police officers, firefighters, and EMTs see these accidents daily in their rawest forms.

Drunk driving is a prime example of a preventable medical emergency for which education and legislation are substantially more productive than pins to reset bones after the victims arrive at the hospital.

As medical students with little experience in policy and politics, we saw a problem and chose not to look away. Working with friends, family, colleagues and policymakers, we helped craft sensible legislation that has the power to save lives — the Responsible Food and Beverage Training Program Act, AB 2121. This bill, authored by Assemblywoman Lorena Gonzalez, harnesses the power of both education and legislation to save lives by empowering bartenders and servers to prevent drunk driving.

In the moments before an intoxicated person gets behind the wheel, they’ve already forgotten (or chosen to ignore) the public awareness campaigns they’ve heard since childhood. The sentencing guidelines designed to deter drunk driving and whatever good-angel usually sits on their shoulder have flown the coop. AB 2121 gives servers and bartenders the training and tools needed to meet their legal requirements and potentially prevent a tragedy.

Just as we practice evidence-based medicine, so too should we practice evidence-based legislation, and AB 2121’s efficacy is rooted in the very nature of binge drinking, bystander education campaigns and beverage service training.

Binge drinking — defined as four or more drinks for women and five or more drinks for men — is strongly associated with drunk driving. 50 percent of binge drinking occurs at licensed liquor-serving establishments, and a whopping 10 percent of binge drinkers drive within two hours of their last drink.

Bystander education also has a long and successful history, most notably with Cardiopulmonary Resuscitation (CPR) training. After decades of training doctors, nurses, lifeguards, paramedics, teachers and interested citizens, the American Heart Association estimates that CPR and automated external defibrillators (AED) save 92,000 people each year.

And our neighbors in Oregon illustrate the power of responsible beverage service training. Similar legislation decreased the incidence of late night alcohol-involved accidents by 23 percent — any medication that reduced mortality by that amount would be hailed as a medical breakthrough!

A physician’s job is to save and improve lives. Classically, we picture that work taking place in a medical setting, but those aren’t the only tools and locales at a clinician’s disposal. The process of crafting this legislation has reinforced our belief that the medical community has a responsibility to engage in legislative advocacy that can save lives.

We’re energized by the opportunity to be a part of helping to save thousands of lives even before earning our license to practice medicine.

18 other states have already enacted similar legislation, and the California Senate overwhelmingly passed AB 2121 with a 36–2 vote today. The California Medical Association (CMA), Mothers Against Drunk Drivers (MADD), California Police Chiefs Association and others proudly support this legislation because AB 2121 is common-sense legislation that California needs to prevent communities from having to mourn the senseless loss of loved ones to drunk drivers.

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