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Driving down road deaths

By Mindo - 01st Mar 2018

<p class=”p1″>This is an era of significant <span class=”s1″>change for the Medical Bu</span>reau of Road Safety. With new drink driving legisla<span class=”s1″>tion moving through the Oireach</span><span class=”s2″>tas, the recent introduction of drug </span><span class=”s1″>driving regulations, the slow pas</span><span class=”s2″>sage of the Public Health (Alcohol) </span>Bill, and rapid developments in technology there is much to keep Director Prof Denis Cusack and <span class=”s1″>the Bureau staff busy.</span>

<p class=”p1″>Prof Cusack, who has been Di<span class=”s1″>rector of the Bureau since 1997, re</span>gards its work as vital at the most <span class=”s1″>basic level.</span>

<p class=”p1″><span class=”s1″>“The work is important because </span>it’s about saving lives and it is also about cutting down on serious injuries. It is that human cost of <span class=”s1″>course. But also the economic cost </span>of losing that person to work, or the cost of looking after that person or rehabilitating them; it’s <span class=”s1″>huge,” Prof Cusack told the <strong><em>Med</em></strong></span><strong><em>ical Independent </em></strong>(<strong><em>MI</em></strong>) in his office on the University College <span class=”s1″>Dublin (UCD) Belfield Campus.</span>

<p class=”p1″>“We can’t be complacent, but if <span class=”s1″>you go back to the 1970s, we had a </span>smaller population, less cars and <span class=”s1″>more than 600 people were dying each year in road traffic accidents.</span>

<p class=”p1″>“We are down now to 150-160 [road deaths per year on average]. That’s still unacceptable and our aim for 2020 is to get it down into the 120s. But we are making huge <span class=”s1″>progress; this [the Bureau] is part of it, a lot of other people are contributing to it as well.”</span>

<h3 class=”p2″>Alcohol</h3> <p class=”p1″>Prof Cusack regards the high profile, but slow moving, Public <span class=”s1″>Health (Alcohol) Bill as vital to the Bureau’s work.</span>

<p class=”p3″>“I liaise fairly closely with my colleague and [ex-] classmate of <span class=”s1″>mine Prof Frank Murray [Chair of </span><span class=”s2″>the RCPI Policy Group on Alcohol] </span><span class=”s1″>because we have a common inter</span>est in how alcohol affects driving <span class=”s2″>and indeed in my other role as cor</span>oner [for County Kildare], sadly a <span class=”s2″>lot of deaths have alcohol associated with them,” he said.</span>

<p class=”p2″>“There was a perception that drink driving was a thing of the past. But our figures from the last few years shows that it is still a very big problem. In fact, the big<span class=”s2″>gest drugs-driving problem is alcohol, because alcohol is a drug, a so</span>cial drug that is licensed and per<span class=”s2″>mitted.</span>

<p class=”p2″><span class=”s2″>“We haven’t completely tackled </span>that. We have brought in a huge number of measures. It has im<span class=”s2″>proved over the years.”</span>

<p class=”p2″><span class=”s2″>With his experience as a coroner, </span>Prof Cusack predicts the country <span class=”s2″>faces serious long-term health challenges because of binge drinking.</span>

<p class=”p2″>“This is a health crisis that we <span class=”s2″>are going to face. Because the pat</span>tern of excessive drinking and binge drinking is going to lead to <span class=”s2″>liver damage,” he warned.</span>

<p class=”p2″>“We are going to see more and <span class=”s2″>more people in their 30s and their </span>early 40s, with liver impairment and liver failure, something that 30 or 40 years ago you wouldn’t have seen in the same people un<span class=”s2″>til maybe they were into their 50s or 60s.</span>

<p class=”p2″><span class=”s2″>“That’s going to be a problem. </span><span class=”s3″>One of the causes is the availability </span><span class=”s2″>of alcohol at a very low price. The minimum pricing is a very good part of this [Public Health Alcohol Bill].”</span>

<h3 class=”p2″>Drug driving</h3> <p class=”p1″><span class=”s2″>But while drink driving has been </span><span class=”s1″>on the agenda of the Bureau for the last half century, other drugs, often illegal, are now also a major focus of its work.</span>

<p class=”p1″><span class=”s1″>“I’ve been Director of the Bureau for over 20 years and we have seen </span>huge change since 1997. Then we <span class=”s1″>had a big focus on alcohol, very lit</span>tle to do with [other] drugs,” Prof <span class=”s1″>Cusack commented.</span>

<p class=”p1″>Last April witnessed the introduction of new drug testing regu<span class=”s1″>lations for driving. The drugs test- </span>ing enable gardaí to test motorists whom they suspect of driving under the influence of drugs. The new drug testing devices involve testing a sample of a driver’s oral <span class=”s1″>fluid for the presence of cannabis, cocaine, opiates (eg, heroin, morphine) and benzodiazepines.</span>

<p class=”p1″><span class=”s2″>“Drugs have always been a problem. But we know that it is increas</span><span class=”s1″>ing. It has been reported as well with the huge increases in prescribed drugs, the Z drugs, the </span><span class=”s2″>benzodiazepines and codeine,” ex</span><span class=”s1″>plained Prof Cusack.</span>

<p class=”p1″>He acknowledged that the new drug driving regulations were “slow <span class=”s1″>to take off because the Garda [Síochá</span>na] obviously had to have time to <span class=”s1″>train enough gardaí on roadside drug testing”.</span>

<p class=”p1″>But that pedestrian pace has not continued and, according to Prof Cusack, the Bureau has now issued 308 certificates under the <span class=”s1″>new rules.</span>

<p class=”p1″>“So the answer is yes, it is a big <span class=”s1″>change, it is having an impact.”</span>

<p class=”p1″>Prof Cusack is keen to dampen the fears of patients who may be <span class=”s1″>raising concerns with their doctors about taking prescribed medicine.</span>

<p class=”p1″>”So people who are medications prescribed, or even over the counter, if they are taking it in accordance with the prescription and they themselves know not to drive if they are feel<span class=”s1″>ing drowsy or affected in any way, </span>then there should be no worry,” <span class=”s1″>said Prof Cusack.</span>

<h3 class=”p2″>Cannabis</h3> <p class=”p1″>The most recent annual report <span class=”s2″>from the Bureau published in Jan</span>uary showed that cannabis was the second most common drug (after alcohol) detected in tested <span class=”s2″>drivers.</span>

<p class=”p1″><span class=”s2″>“Road safety is not about wheth</span>er the drug is legal or illegal, it is about — does it affect your driv<span class=”s2″>ing?” said Prof Cusack.</span>

<p class=”p1″><span class=”s2″>“There is no doubt we are going </span>to face this, as the debate about medicinal cannabinoids increas<span class=”s2″>es and even the debate around decriminalisation. I think something like 30 countries in the world have </span>some form of licensing or decriminalisation of cannabis. The <span class=”s2″>Dáil and Seanad are debating this </span>whole area at the moment. That’s going to be an issue [for the Bu<span class=”s2″>reau] in the future as well.”</span>

<h3 class=”p2″>Challenges</h3> <p class=”p1″><span class=”s2″>In August 2016, the Bureau pub</span>lished a five-year plan and among the looming challenges it noted <span class=”s2″>were budgets and legal cases.</span>

<p class=”p1″>In terms of funding, Prof Cu<span class=”s2″>sack said, “like any publicly fund</span>ed body we have to be aware that <span class=”s2″>our money is not limitless”.</span>

<p class=”p1″>“So in our plans we very much respond to what the Dáil and Seanad ask us to do. Obviously we have an input on what we are capable of, in order for it to make <span class=”s2″>sense you have to have money and resources.</span>

<p class=”p1″><span class=”s2″>“Sometimes in the health sphere </span><span class=”s3″>this is probably one of the problems. Great ideas are brought into law, but </span><span class=”s2″>without the staffing or resources.</span>

<p class=”p1″><span class=”s2″>“So people who are taking their </span>medications prescribed, or even over the counter, if they are taking it in accordance with the prescription and they themselves know not to drive if they are feel<span class=”s1″>ing drowsy or affected in any way, </span>then there should be no worry,” <span class=”s1″>said Prof Cusack.</span>

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