USE OF ALCOHOL AND OTHER DRUGS ON BRAZILIAN ROADS AND OTHER STUDIES President of the Federative Republic of Brazil Luiz Inácio Lula da Silva Vice-President of the Federative Republic of Brazil José Alencar Gomes da Silva Minister of the Institutional Security Cabinet of the Office of the President and President of the National Drug Policies Council - CONAD Jorge Armando Felix Minister of Justice Luiz Paulo Telles Barreto Minister of Cities Márcio Fortes de Almeida National Secretariat for Drug Policies Paulo Roberto Yog de Miranda Uchôa Deputy National Secretary for Drug Policies and Technical Representative at Senad Paulina do Carmo Arruda Vieira Duarte U84 Use of alcohol and other drugs on brazilian roads and other studies / Flavio Pechansky, Paulina do Carmo Arruda Vieira Duarte, Raquel Brandini De Boni, org.; - translated by Ângela Maria Silveira - TraduMed – Porto Alegre: National Secretariat for Drugs Policies; 2010. 121 p. ISBN 978-85-60662-48-7 1. Alcohol drinking. 2. Substance-related disorders. 3. Psychiatry. I. Pechansky, Flávio. II Duarte, Paulina do Carmo Arruda Vieira. III De Boni, Raquel Brandini. CDU: 616.89 Cataloguing in publication: Maria Luiza Farias de Campos – CRB10/1820 Original title: Uso de bebidas alcoólicas e outras drogas nas rodovias brasileiras e outros estudos Cover Ronald Souza Publication Digitalcom Comunicação & Design Ltda Revision Ana Paula dos Santos Zacca Introduction There is much evidence of the high economic and social costs of inappropriate consumption of alcoholic beverages. These costs are a direct consequence of the damage to individual and collective health, of the high number of accidents, and of cases of violence, early disability, and, unfortunately, a large number of deaths. Other psychoactive drugs besides alcohol, consumed by drivers, are a constant concern for the government and society at large. The association between drugs and accidents impacts not only on the number of traffic accidents but, above all, in their severity. Being aware of this reality, and in accordance with the principles of the National Policy on Drugs and the National Policy on Alcohol, the Federal Government sponsored the “Study on the impact of the use of alcoholic beverages and other psychoactive substances on Brazilian traffic”. This study is unprecedented in Brazil and presents information on the extent and pattern of use of alcohol and other drugs by private and professional drivers, its impact on the number and severity of traffic accidents, besides producing an estimate of social and economic costs related to the problem. Developed by the National National Secretariat for Drug Policies (SENAD), in partnership with the National Program of Public Security with Citizenship (PRONASCI), the Federal Police Department, the Federal Highway Police Department, the National Health Surveillance Agency (ANVISA) and the National Traffic Department (DENATRAN), this study, conducted by the Federal University of Rio Grande do Sul (UFRGS) will certainly be an important asset to foster scientific knowledge on the subject, in addition to guiding and legitimizing global public policies, capable of preventing and reducing damage caused by the dangerous association between alcohol, other drugs, and traffic. JORGE ARMANDO FELIX Minister of the Institutional Security Cabinet of the Office of the President and President of the National Drug Policies Council - CONAD Foreword This book is the product of the collective effort of more than 130 professionals. From the initial contacts until its publication, approximately four years have passed. The idea was born from a common interest between the National Secretariat for Drug Policies – SENAD, and the Federal University of Rio Grande do Sul – UFGRS. After initial discussions, it was developed into a huge nucleus for the production of information and innovative research technologies in the field of traffic and alcohol in Brazil. For the implementation of the many studies described in this book, SENAD developed a specific managerial structure to follow this large project, including the allocation of professionals specially assigned to it in full time. The UFRGS created the NEPTA group – The Nucleus for the Study and Research on Traffic and Alcohol, now a formal research group of the National Council on Research (CNPq) ,which gathers professionals engaged on this area of knowledge. The NEPTA group could be created thanks to the involvement of the Hospital de Clínicas de Porto Alegre (HCPA) where the UFRGS Center for Drug and Alcohol Research (CPAD) was established five years ago. A permanent organization, NEPTA will not cease to exist when the data collection and analysis of this project ends. It will continue to develop knowledge and research methodology, gathering professionals, and establishing partnerships with other institutions, for the purpose of contributing to the advancement of science. The book presented here comprises 15 chapters divided into two main sections. Section A introduces the subject alcohol/other drugs/traffic, and has six conceptual chapters, ranging from the political and technical issues involved in implementing the project at a local and national level, to the description of the data collection scenarios, aiming at placing the reader inside the peculiar reality of obtaining research information in an atypical environment such as national highways. It also presents chapters on the history of alcohol related to traffic in Brazil, on the theory that studies the economic impact of traffic accidents, and on the delicate ethical and legal aspects of this type of study. There is also a chapter on the toxicological essays used to obtain biological samples of the drivers studied in the different projects. Section B is mostly practical. It has nine chapters that describe in detail the data data collections routine of the different studies and the main findings analyzed until the date when this book was finalized. The main focus is not a large and detailed theoretical dissertation on each of the subjects researched, but rather a minute description on the methods – what will entitle other research groups to repeat and improve data collections of this kind – as well as the main findings. For the sake of concision, all the annexes mentioned in the footnotes are available for full access to the reader in the website of the Brazilian Observatory on Drug Information – OBID (www.obid.senad.gov.br) and the CPAD website (www.cpad.org.br) The partnership between the many branches of government – especially the Presidency, Ministry of Education, Ministry of Justice, Ministry of Health and Ministry of Cities, through different organs and Departments – has proved that interdisciplinarity is an achievable goal. Different players participated in the intense articulation necessary to complete eight research projects in little over two years, in some cases encompassing all State capitals. It is impossible, in this introductory note, to thank all of those who so diligently dedicated time and effort to the appropriate implementation of the research steps anticipated for the project. A complete list of partners can be found at the end of this book. Above all, we would like to acknowledge the dozens of data collectors and support personnel – as well as the group that performed the data collections in the state capitals - for their dedication in accomplishing their task. The special effort of Fernanda Cubas and Sinara Santos in the editorial supervision of this book should also be emphasized. Certainly the quality of this material mirrors the motivation and dedication of those professionals throughout the period of the studies. Flavio Pechansky Paulina do Carmo Arruda Vieira Duarte Raquel Brandini De Boni September 2010 List of Collaborators Ana Paula Schmidt Metzger – Medical Student. Anne Sordi – M.D., collaborating with HCPA/UFRGS CPAD, Medical Resident in Psychiatry at HCPA. Bárbara Diniz – Biologist, Master’s Degree Student in Medical Sciences at the UFCSPA, Supervisor of VIVAVOZ. Bárbara Ponzi Holmer – Psychologist, Research Assistant at HCPA/UFRGS CPAD. Breno Matte – M.D., Collaborator in the Attention Deficit and Hyperactivity Disorder Program of the HCPA/UFRGS, Medical Resident in Psychiatry at HCPA. Carl Leukefeld – Social Worker, Professor of Behavioral Science in the Departments of Psychiatry and Social Assistance at the University of Kentucky, Director of the Drug and Alcohol Research Center of the University of Kentucky. Carolina Fernández Fernandes – Lawyer, Master’s Degree Student in Public Law at Unisinos/RS and researcher at the Research Laboratory on Bioethics and Ethics in Science. Cássio Machado – Psychology Student. Christian Kieling – Physician, Doctoral Degree Student in Psychiatry at UFRGS, Medical Resident in Psychiatry at the HCPA. Cláudia Maciel Szobot – Psiquiatra, Mestre e Doutora em Psiquiatria pela UFRGS, Pesquisadora do Programa Nacional de Pós-Doutorado/CAPES. Daniela Benzano – Statistics Student, Statistics Consultant for the NEPTA and HCPA/UFRGS CPAD. Daniela Goya Tochetto – Economist, Master in Economics by the UFRGS and Master in Philosophy by the London School of Economics. Daniele Zago Souza – Pharmacist, Master’s Degree Student in Pharmaceutical Science at UFRGS, Federal Forensics Expert in the Federal Police Department. Débora S. Prusch – Pharmacy Student at UFRGS. Deise Schroeter – Psychologist, Research Assistant at HCPA/UFRGS CPAD. Eliseu Weber – Agronomist, Master in Remote Sensing by UFRGS and Researcher at UFRGS. Eloisa Comiran – Pharmacist, Collaborator at the Toxicological Analysis Laboratory of HCPA/UFRGS. Esmeralda Correa – Economist, Doctoral Student in Developmental Economy at the UFRGS, Research Assistant at HCPA/UFRGS CPAD. Fernanda Cubas de Paula – Psychologist, Master in Health Psychology by the UCDB, Research Assistant at the HCPA/UFRGS CPAD. Fernanda Kreische – Medical Resident in Psychiatry at HCPA, Collaborator at HCPA/UFRGS CPAD. Fernanda dos Santos de Oliveira – Biologist, PhD Flavio Pechansky in Child and Adolescent Health – UFRGS. – Psychiatrist,.Doctor in Medicine – Clinical Medicine by UFRGS, Head of HCPA/ UFRGS CPAD, Coordinator of UFRGS NEPTA UFRGS, Associate Professor in the Department of Psychiatry at UFRGS. Francisco Inácio Bastos – Psychiatrist, PhD in Public Health, Full Researcher for the Oswaldo Cruz Foundation. Heinrich Hasenack – Geographer, Professor in the Department of Ecology of UFRGS. Helena Hubert Silva – M.D., Medical Examiner in the Office of the Medical Examiner, Coordinator of the Teaching and Research Section of the Office of the Medical Examine (DML/IGP). Helena Maria Tannhauser Barros – M.D. PhD of Neuropsychopharmacology by UNIFESP, Coordinator of VIVAVOZ. Ivomar Zancanaro – Pharmacist, Special Doctoral student, Toxicology Laboratory/LaTox/UFRGS. José Roberto Goldim – Biologist,.Doctor in Medicine by UFRGS, Responsible for the Research Laboratory in Bioethics and Ethics in Science at HCPA/UFRGS. Júlia Schneider Protas – Psychologist, Master’s Degree Student in Medical Sciences at UFRGS. Juliana Camargo – Economist, Master’s Degree Student in Applied Economy at PPGE/UFRGS. Kristiane de Cássia Mariotti – Pharmacist, Master’s Degree Student in Pharmaceutical Science at the UFRGS. Lísia Von Diemen – Psychiatrist, Doctoral Student in Psychiatry at the UFRGS, Coordinator of the Data Analysis Sector of CPAD, Researcher at NEPTA and CPAD. Luis Augusto Rohde – Psychiatrist, Doctor in Medicine by UFRGS, Director of the Attention Deficit Hyperactivity Program at HCPA, Associate Professor in the Psychiatry Department of UFRGS. Márcia Maria Martins Lopes – Psychologist, General Coordinator of Project Management of SENAD/GSI/PR. Márcia Santana Fernandes – Lawyer, Post-doctoral student in the Graduate Program of Medicine at the UFRGS Medical School., Collaborator for the Research Laboratory in Bioethics and Ethics in Science at HCPA/UFRGS. Marianne Zwilling Stampe – Economist, Doctoral Student in Economics at the UFRGS. Maristela Ferigolo – Pharmacist-biochemist, PhD in Medical Sciences by UFRGS, Coordinator of VIVAVOZ Service. Mauricio de Vasconcellos – EStatistician, PhD in Public Health at the National Public Health School of the Oswaldo Cruz Foundation, Researcher of the Evandro Chagas Institute of Clinical Research of Fiocruz. Mauro Soibelman – Physician, Masters Degree in Medicine – Clinical Medicine by the UFRGS, Assistant Professor at UFRGS, Physician of the Porto Alegre City Administration, Epidemiology Consultant for NEPTA Paula O. Boehl – Pharmacy Student at UFRGS, Collaborator of the Laboratory of Toxicological Analysis of HCPA/ UFRGS. Paulina do Carmo Arruda Vieira Duarte – Social Worker. PhD in Science by the Medical School of the University of São Paulo, Deputy National Secretary for Drug Policies - SENAD. Pedro E. Fröehlich – Pharmacist, MSc. and PhD in Pharmaceutical Sciences by UFRGS. Raquel Brandini de Boni – Psychiatrist, Doctoral Student in Psychiatry at UFRGS, Researcher at NEPTA and HCPA/ UFRGS CPAD. Renata Rocha Kieling – Physician, Collaborator of the Attention Deficit and Hyperactivity Disorder Program of HCPA/UFRGS. Renata P. Limberger – Pharmacist, PhD in Pharmaceutical Sciences by UFRGS, Assistant Professor at Roberta P. S. Coelho UFRGS. – Psicóloga, Mestranda em Cognição Humana pela PUC-RS, Pesquisadora do Programa de Déficit de Atenção e Hiperatividade do HCPA/UFRGS. Robson Robin da Silva – Lawyer, Federal Police Marshall, General Coordinator of Strategic Projects for SENAD/ GSI/PR. Sabino da Silva Porto Júnior – Economist, PhD in Economics by UFRGS, Full Professor in the Department of Economics and in the Graduate Program in Economics of UFRGS. Sibele Faller – Psychologist, Master in Psychiatry by UFRGS, Researcher for the NEPTA and the CPAD. Sinara Santos – Psychologist, Research Assistant at HCPA/UFRGS CPAD. Taís de Campos Moreira – Speech Therapist, Master in Medical Sciences by UFCSPA, Supervisor of the VIVAVOZ Service. Tanara Rosângela Vieira Sousa – Economist, PhD in Applied Economics- Graduate Program in Economics - PPGE/ UFRGS. Vivian Machado – Medical Resident in Psychiatry at HCPA, Research Assistant at HCPA/UFRGS CPAD. Vladimir de Andrade Stempliuk – Psychologist, PhD in Sciences by the Medical School of the University of São Paulo, General Coordinator of the Brazilian Observatory on Drug Information - OBID of the SENAD/GSI/PR.