A driving under the influence (DUI) case in Kaohsiung late last month, in which one person was killed and three family members were injured, has once again put the issue at the forefront of public debate in Taiwan.
However, the debate is mostly focused on legislative amendments to increase penalties for DUI offenses, such as whether caning should be used as a punishment, increasing sentences or even publicly shaming repeat offenders, for example by releasing mugshots of recidivists.
As a medical health professional working in the fields of addiction prevention and treatment, and public health, I have some thoughts on policies the government could adopt to prevent drunk driving.
The number of fatalities from DUI incidents has fallen from a peak of 909 in 2011 to 289 in 2020, dropping by almost 70 percent in a decade.
However, in terms of DUI-related fatalities per 100,000 people, the rate is still more than double that of Japan.
Clearly, Taiwan still has a long way to go if it wants to prevent drunk driving.
The question is whether Taiwan’s drunk driving laws are sufficiently severe.
From 2007 to last year, there were four major amendments linked to DUI offenses, including increasing the penalty to life in prison for being drunk behind the wheel of a vehicle that leads to somebody’s death.
In addition, the standard for blood alcohol content at which a person is considered legally drunk has been reduced to 0.03 percent, even more stringent than the 0.08 percent in Singapore, which is regarded as a nation with strict laws.
The legislative amendments have brought down the number of deaths from DUI incidents, but simply increasing the severity of the punishment every time a tragedy occurs, without introducing any other public health measures, leads to a reduction in the marginal utility of these changes, and is unable to offer a solution to the problem of recidivism.
In March, 2020, the government announced three major measures to tackle drunk driving, including requirements that offenders seek treatment for addiction at a medical institution and installation of ignition interlock devices in vehicles, as well as collective liability for people who agree to be driven by a drunk driver, for which a passenger can be fined a maximum of NT$3,000.
Data show that 40 percent of drunk drivers in Taiwan are repeat offenders, with 70 percent of them having an addiction to alcohol.
Research in Taiwan and abroad shows that repeat offenders who undergo compulsory treatment are less likely to reoffend. The problem is that the proportion of repeat offenders in Taiwan who enter a medical program is low, and a public backlash against the requirement for repeat offenders to have ignition interlocks installed in their vehicles has meant it has only been implemented in 4 percent of cases.
Rather than amend the law every time there is a high-profile case and a wave of public anger, it is more important to properly enforce the laws that are on the books and provide enough resources.
This would be far more effective than constantly amending the rules and making it increasingly difficult to implement them.
Drunk driving is just the tip of the iceberg when it comes to the harm that alcohol abuse causes. Dealing with alcohol-related issues takes up more than 1 percent of the GDP of middle and high-income countries, and massive amounts of medical resources are expended on the harm from alcohol abuse.
The issue is also related to social costs, such as suicide and domestic violence.
According to the WHO, alcohol abuse is the No. 1 risk factor in deaths among young people aged 15 to 24 around the world.
A 2018 health behavior study conducted by the Ministry of Health and Welfare’s Health Promotion Administration found that 52.2 percent of junior-high students in Taiwan had used alcohol, with 9.4 percent reporting having been drunk.
Clearly, the stipulation within the Enforcement Rules of the Protection of Children and Youth Welfare and Rights Act (兒童及少年福利與權益保障法施行細則) that children and minors should not be provided with alcohol is not being implemented.
The government should refer to the WHO’s global strategy to reduce the harmful use of alcohol and bring the powers of the state to bear to deal with drunk driving prevention, alcohol abuse among young people, the control of the price of alcohol and the allocation of adequate resources to the medical treatment of addiction.
If it does not, not only will Taiwan continue to see more DUI incidents, but misuse of alcohol among young people will have a corrosive effect on the nation.
Chen Lian-yu is director of the Kunming Prevention and Control Center at Taipei City Hospital.
Translated by Paul Cooper
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