alcool et drogues

La problématique de l'alcooldans la circulation routière est une des priorités  du BPA (Bureau de prévention des accidents).Mais, du fait que la présence de drogues n'est pas systématiquement détectée après les accidents, la statistiqueofficielle ne renseigne pas  assez sur cepoint. Néanmoins, 20 pour cent de tous les accidents de la circulation mortelssont liés à l'alcool. Le chiffre réel est estimé à 30 pour cent environ.  Les personnes qui causent ces  accidents sont avant tout des hommes, desjeunes et de forts buveurs. Après l'alcool, c'est  la consommation de médicaments(benzodiazépines et  barbituriques),suivie de celle de cannabis et d'opiacés qui provoque des accidents de laroute. L'association de  différentessubstances et surtout celle de l'alcool avec des  somnifères, des calmants et du cannabis sontparticulièrement dangereuses, car elle augmente les risques.

Prévention - les bons trucs pour les enseignants, pour les spécialistespour la sécurité  des entreprises (SST),pour les usagers de la route motorisés, pour les cyclistes et les piétons: lesmesures de prévention doivent se placer au niveau des causes  et des habitudes de consommation. Laprévention des accidents et celle  destoxicomanies ont des buts communs. Elles doivent donc concorder. Les solutionspeuvent être réparties de la manière suivante: éviter la conduite sous l'effetde l'alcool ou de drogues en réglementant (loi sur la circulation routière,contrôles de police, menaces de sanctions, limitation de l'offre); aidant etinformant (éducation routière, éducation à la santé, formation des conducteurs,campagnes); réduire le risque de rechute (prévention secondaire); enréglementant (sanctions, retraits de permis); aidant et informant (formationcomplémentaire, conseils, thérapie).

Les mesures juridiques les plus importantes sont le respect du tauxlimite d'alcool scientifiquement justifié (0,5 pour mille), les contrôles  d'haleine réguliers ainsi que les mesuresciblées sur les groupes à risque. En plus, il faut intégrer le thème «alcool etdrogues» aux matières enseignées à l'école et à la formation des conducteurs,faire preuve de  plus de sévérité dansles retraits de permis, ainsi qu'offrir de l'aide  aux forts consommateurs. Incorporer le thèmede l'alcool et des drogues dans la circulation routière à l'enseignement etproduire les supports pédagogiques correspondants. Dans le cadre de laprophylaxie de l'alcool et des drogues, parler de leur signification dans lacirculation routière. Thématiser la problématique de l'alcool et des droguesdans les  entretiens avec lescollaborateurs. Considérer la prévention des toxicomanies ainsi que ledépistage précoce des problèmes de dépendance comme des tâches favorables  à la prévention des accidents professionnelset non professionnels. Le risque d'accident augmente à partir de 0,5 pour mille(le 2e verre peut être de trop). Renoncer à la consommation simultanée dedifférentes substances (par ex., alcool et médicaments, alcool et cannabis). Sefaire accompagner si l'on a beaucoup bu ou consommé des drogues. Se faireramener (en taxi, par ex.). But de la mesure: principe d'influence,réglementer, restreindre, punir informer, encourager, aider. Améliorer lerespect des lois sur la circulation routière; éducation routière de la loi engénéral;  surveillance policière,éducation à la santé (prévention globale), menace de sanctions et de formation à la conduite, retrait depermis, campagnes de sécurité routière; limiter la consommation d'alcool enaugmentant les taxes. Réduire le risque de récidive, sanctions, formationcomplémentaire des conducteurs délinquants, retrait du permis (retrait -éducation routière - prévention spécifique - d'admonestation et de sécurité-  conseils - thérapie).

Alcoolémie auvolant dans le Monde - World drink driving legislation (état 2004,actualisé pour la Suisseà 2005)                           Theaim of drink-driving legislation is to reduce the number of accidents, injuriesand fatalities that result from driving while being intoxicated. In many cases,this harmminimization approach also covers legislation for boating and civilaviation, and even bicycling in some countries. Earlier general laws againstdriving while intoxicated or impaired have now been supplemented in mostcountries with much more effective laws forbidding driving while above aspecified blood alcohol concentration (BAC). The legal blood alcoholconcentration level in a country is usually based on the evidence of risk,public safety and what is perceived as publicly convenient and acceptable.Testing for the intoxication of drivers is either done randomly or only afterjustified suspicion, for example after an accident or in cases of erraticdriving. The means used for testing is either a breathalyser, blood or urinesampling, or using behavioural and psychomotor tests such as the StandardizedField Sobriety Test Battery used in the United States. The effectiveness of anydrink-driving law is primarily determined by the degree of certainty ofdetection and the quickness of punishment. A successful drink driving strategy wouldideally require highly visible, frequent and random road checks, which includebreath testing and blood sampling (Rehn, Room et Edwards, 2001).

Comprehensive drinkdriving legislation could also include provisions for areas such as the legalinterpretation of a refusal to take a test, the penalties (fine, suspension oflicence, or imprisonment) and treatment or education programmes for habitualdrink driving offenders, or offenders who have significantly exceeded the legalBAC.

In this survey, two questions were asked aboutdrink driving. The existence and legal limit of the Blood Alcohol Concentration(BAC or the amount of alcohol in the bloodstream) when driving a car (notincluding graduated licensing or lower limits for young/new or professionaldrivers that exist in some countries e.g. Austria, Italy, New Zealand, RussianFederation and Spain). Also the existence and frequency of Random BreathTesting (RBT) was asked with the intention to measure the enforcement of a BAClevel. In the literature Random Breath Testing refers to an enforcementstrategy where drivers passing a testing location are stopped at random by thepolice and asked to take a breath test, even if there is no prior suspicion oftheir drinking or involvement in any accident. The places and times forthe testing vary and a refusal to take the test amounts to the same as apositive result. Occasional roadblocks where all drivers are tested would notqualify as true RBT. Caution is warranted in interpreting the presented data,as positive responses may be describing a level of enforcement short of trueRBT. The research evidence is quite strong that highly visible, non-selectivetesting can have

a sustained andsignificant effect in reducing drink driving and the associated crashes, injuriesand deaths (Babor et al., 2003). In Australia one study found that RBT wastwice as effective as selective checkpoints (Henstridge, Homel et Mackay,1997). The detailed country data are found in Table 14. In this report the BAC is expressed in per mille (‰)and refers to the amount of ethanol in grammes in each litre of blood (0.5 permille equals 50 mg% and 0.05%).

Table 14: Maximum Blood Alcohol Concentration (BAC) levels and use ofRandom Breath Testing (RBT), by country

WHOREGION                                 COUNTRY MAXIMUM BAC LEVEL PERMILLE                 USE OF RBT

AFR

Algeria                                                                                  0.1                                                               NO

Benin                                                                                    0.5                                                              OFTEN

Cape Verde                                                                          0.8                                                         SOMETIMES

Central African Rep.                                                            0.8                                                         NO

Comoros                                                                                              NO                                                        NO

Congo                                                                                  NO                                                        NO

Equatorial Guinea                                                                0.0                                                         NO

Eritrea                                                                                   0.0                                                         OFTEN

Ethiopia                                                                                               NO                                                        NO

Gabon                                                                                  ?                                                            NO

Gambia                                                                                 0.0                                                         NO

WHOREGION                                 COUNTRY MAXIMUM BAC LEVEL PER MILLE                 USE OF RBT

Ghana                                                                                  0.8                                                         RARELY

Guinea                                                                                  0.0                                                         NO

Guinea-Bissau                                                                     0.5                                                         NO

Kenya                                                                                   0.8                                                         NO

Malawi                                                                                  0.0                                                         RARELY

Mauritius                                                                                              0.5                                                         OFTEN

Mozambique                                                                         ?                                                             ?

Namibia                                                                                0.5                                                         SOMETIMES

Niger                                                                                     0.8                                                         NO

Nigeria                                                                                  0.0                                                         NO

Seychelles                                                                           0.8                                                         RARELY

South Africa                                                                         0.5                                                         RARELY

Togo                                                                                     NO                                                        NO

Uganda                                                                                0.8                                                          NO

UR Tanzania                                                                        0.5                                                         RARELY

AFR

Zambia                                                                                  0.8                                                         NO

AMR

Argentina                                                                             0.5                                                         SOMETIMES

Belize                      &nbs