Earlier this week Joseph Froncioni, former Chairman of Bermuda Road Safety Council wrote about the deadly physics of road crashes. Here he examines the issue of Bermuda’s drinking and driving habit.Some time ago, on a quiet Sunday afternoon, I was at the wheel of my car, stationary at a red light, when suddenly, I was rear-ended by a motorcyclist. The chap was quick to get up from the ground and fortunately had sustained no injuries. He was, however, quite drunk; the bleary eyes, slurred speech and poor coordination gave him away immediately. I called the police and while we waited for them to arrive, he readily admitted to having consumed a dozen beers watching football at his favourite pub.The police arrived and did their thing: they took statements from both of us and noted the damage to our respective vehicles. And that was it, or rather it would have been it had I not spoken up and suggested to the constable he might ask the gentleman if he had been drinking. He did and the motorcyclist admitted to the twelve beers and was promptly arrested.Not three months later, I was the first person to attend the scene of a crash. A motorcyclist had been stationary behind a taxi van at a red light when he was rear-ended, sandwiched really, by an SUV. The motorcyclist lost consciousness momentarily when his head struck the bonnet of the SUV but he recovered quickly and without any permanent damage. Once again, the driver of the SUV was drunk as a skunk displaying the same telltale signs as my friend the beer-drinking football fan.Let me make an important point here: there are telltale signs and symptoms that should lead anyone, especially trained medical personnel, first responders and, yes, even police officers, to suspect alcohol and/or drug impairment in an individual. So, I bet you can guess the rest of this story.As I stood back and observed, the police took statements and carefully documented the damage to the three vehicles and in no time at all were reminding all three drivers to contact their respective insurers ... and have a pleasant evening. That’s when I opened my big mouth. “Aren’t you going to ask her if she’s been drinking, constable, because she looks pretty drunk to me.”The constable’s threatening reply: “You are interfering with official police work and one more word out of you and you will be placed under arrest” or words to that effect. Well, I was not arrested and the constable did eventually ask and the driver replied in the affirmative and was promptly arrested. (You have to admire people’s honesty, though.)These two incidents started to bother me quite a bit. What if this kind of thing happens on a regular basis, I thought. How can we solve our drinking and driving problem if we keep brushing it under the carpet? I though about this for some time and finally got the courage up to call a former police commissioner. I described the two incidents and asked him why this was happening and was it common.He answered me honestly and explained that unfortunately, it probably happened but could not say how often. The work involved in a regular police report of a road crash, he explained, is multiplied many times if impairment is involved. Apart from the arrest and the mountain of paperwork facing the constable, usually in the middle of the night, is the stressful court appearance often required. Add to this a manpower shortage on the BPS and this goes a long way to explaining why some constables will choose to overlook impairment.To make matters worse, it has become evident to me that we are not identifying impairment in those people who sustain road injuries and present to the emergency room. The emergency room doctors frequently draw blood to determine alcohol or drug impairment but the results are only used to assess and treat the patient and cannot, by law, be used as court evidence.On the other hand, police, under the Road Traffic Amendment Act 1997, have the right to demand a sample of blood, urine or other body fluid from an individual they suspect has been driving while impaired. To do this, they need a designated person to draw the blood from the patient and that person cannot be a doctor or a nurse involved in the care of the patient. The police doctor or nurse are the logical designers. Do you think this ever happens? Hardly ever according to my colleagues in the emergency room and this in spite of the overwhelming impression as treating physicians that a very large percentage of persons with road traffic injuries are impaired.As a result of this, I now view police collision stats with a certain degree of, shall we say, scepticism. In a recent Royal Gazette article on the 2012 collision stats the following are listed as the main causes of collisions (in order of frequency): inattention, inexperience, following too close (sic), bad road surface (wet roads), overtaking improperly and entering main road carelessly.There’s an elephant in the room, two in fact, but they seem to be pretty well hidden; no mention of driving while impaired or speeding on the list, in my mind two of the most common contributors to road crashes.How are we to deal effectively with the problem of impaired driving if we only get to see the tip of the iceberg? We must get a handle on the true prevalence of impaired driving in Bermuda. To do this, we need to test absolutely everyone involved in a crash. Every time. No exceptions. Many jurisdictions have legislation in place allowing police to do a quick roadside breathalyser on every individual involved in a crash as a matter of routine.Testing all of the parties involved in a crash as part of the police crash scene routine eliminates profiling and attribution of fault. If the preliminary test is positive, a definitive breath analysis can be performed on a calibrated device at Police Headquarters. In addition, a sample of blood, urine or other body substance can be required from the individual suspected of impaired driving as already permitted in the Road Traffic Amendment Act 1997.Finally, there is an additional solution to our impaired driver problem, this one with the stated purpose not of catching impaired drivers but rather of preventing impaired driving in the first place. How do you prevent people from drinking and driving? You do that by implementing measures that function as a serious and very visible deterrent.Deterrence is by far a more cost effective measure in the long term no matter how you measure it and roadside sobriety checkpoints are the way to go. Frequent, strategically placed and well publicised roadside sobriety checkpoints are tried and tested and have lead to significant decreases in alcohol related road deaths in many countries including Ireland, Australia and all European Union countries.A study by the US based Centers for Disease Control and Prevention combining the results of 23 scientifically-sound studies from around the world and published in the journal Traffic Injury Prevention concluded that sobriety checkpoints consistently reduced alcohol-related crashes, typically by about 20 percent.We’ve started off the year in a terrible way with five road deaths in the first five weeks. Recent statistics show that we have the highest number of yearly road fatalities per capita compared to all OECD and Pan American Countries (25.5 per 100,000 in 2008). What will it take for our legislators to do the right thing. We don’t need to reinvent the wheel. This problem is not unique to Bermuda and it has been successfully addressed in other countries. It’s about time we address it here.* Dr Froncioni is a member of the CADA board however, the views and opinions expressed herein are solely those of the author and do not necessarily reflect CADA’S position.