MADD Gone Mad: How Focusing on Alcohol Prohibition has deterred the group from Drunk Driving Prevention - Christopher Wilterdink
INTRODUCTION
Alcohol’s presence, availability, and potential for abuse make it a significant public health concern, especially when used in excess and in combination with other activities and behaviors, such as motor vehicle use and operation. In 2006, there were 13,470 fatalities in crashes involving an alcohol-impaired driver (BAC of .08 or higher) – 32 percent of total traffic fatalities for the year (1). While it is true that drunk driving deaths have decreased 35 percent since the early 1980s when MADD was formed, it continues to be an issue of significant concern (2). In fact, there were 12,998 drunk driving deaths in 2007, a figure that has remained relatively constant since the year 2000, according to the NHTSA (3). In this respect, alcohol abuse and drunk driving remain prominent public health issues that need to continue to be addressed.
MADD, or Mothers Against Drunk Driving, is a non-profit organization founded in 1980 in
ARGUMENTS
1. MADD data and reports repeatedly focus on the severity and susceptibility of individuals to the dangers of alcohol use and drunk driving accidents by using inaccurate statistics, targeting social drinkers and ignoring other related factors to drinking behavior.
MADD manipulates the Health Belief Model in their promotional and advertising materials in order to misrepresent the drunk driving and under aged drinking problems as more severe than they are in actuality, thus using fear as a vehicle for making more young people feel susceptible to alcohol-related car crashes (7). Furthermore, by approaching people as individuals rather than groups who may act in concert, the intervention fails to target the individuals who continue to violate the traffic safety regulations the group was instrumental in passing. Arguably one of MADD’s biggest victories has been lowering the legal limit from .10 to .08. However, research shows that over two-thirds of alcohol related crashes are caused by individuals whose blood alcohol level is over .14 and the average fatal accident is caused by individuals whose blood alcohol level is above .17. According to the National Institute in Alcoholism, those individuals with a blood alcohol level this high are 480 times as likely to have an accident as those individuals who have had nothing to drink (8). The majority of drunk driving accidents that continue to occur annually happen under these circumstances, with significantly impaired drivers. Furthermore, the U.S. Government Accountability Office reviewed all the statistical data and concluded "the evidence does not conclusively establish that .08 BAC laws by themselves result in reductions in the number and severity of crashes involving alcohol." (9) On a related note, MADD will not discuss the fact that using a cell phone while driving is actually more dangerous than having a blood alcohol level of .08 (10). By focusing on the blood alcohol limit, MADD fails to address to target those individuals who are most susceptible to accidents, those with BACs of nearly double the legal limit, and admit to the presence of other contributing factors to accidents and fatalities.
Other factors that MADD overlooks with respect to alcohol-related motor vehicle deaths are fatigue, drug use, inexperience in driving, road rage, speeding, poorly lit roads, and failure to use safety belts (11). By ignoring these other factors, MADD again relies on the Health Belief Model, assuming that individuals operate within a vacuum in which environmental factors play no role, which is clearly false. While some of MADD’s efforts have focused on seat belt use, these interventions assume that people who have been drinking will act rationally and decide to put on a seatbelt. However, if they have decided that driving while intoxicated is a sound decision, then their judgment can clearly not be relied on to when it comes to buckling up.
MADD’s Public Relations Department also uses misrepresented statistical evidence in order to make the drunk driving problem appear more severe than it actually is (see end of this paragraph for citation). In addition, research clearly states that by repeatedly doing a certain task after drinking, like driving home after being at one’s favorite bar, can lead to the development of a form of adaptation referred to as "learned" or tolerance. This tolerance reduces the impairment caused by the alcohol, thus enabling one to drive home safely. However, if any unexpected changes were to occur, this learned tolerance would be negated (12). When MADD reports alcohol related motor vehicle fatalities, these figures include deaths where pedestrians, passengers, or third parties could have been drinking, thus inflating the number of deaths caused by drunk drivers themselves. The Insurance Institute for Highway Safety reports that MADD exaggerates the problem, referring to it as a “growing epidemic” (13).
MADD exaggerates the severity of the effects of alcohol use among young adults in order to make alcohol less appealing to young adults (an issue also addressed by the 3rd argument in this paper). A MADD ad campaign targeted at under-aged drinkers linked alcohol use to weight-gain, rape, STDs, and drug use, behaviors that are far more influenced by group behavior, dynamics, and other circumstances than the use of alcohol. In this way, MADD also manipulates the Theory of Reasoned Action by considering the importance of social norms (14). The stigmas attached with these behaviors are far more severe than drinking. One MADD statistic states that underage drinkers are 50 times as likely to use cocaine as non-drinkers, a statement not founded in any formal research (15). Additionally, a former MADD officer Ralph Hingson produced inaccurate reports, including one where he estimated that alcohol kills 1,400 college students annually, even though there is evidence suggesting that this figure is a gross overestimation (16). This research was used by MADD without mentioning that Hingson was employed by MADD, thereby raising questions regarding its validity (17).
2. MADD’s efforts to curb drunk driving accidents are impeded by the organization’s bureaucracy, a lack of services for drunk drivers, and a lack of acknowledgment of individual community and MADD chapter needs, which are reflective of the drinking behaviors of those populations.
MADD spends nearly twice as much as the AIP recommends for fundraising, and these efforts do not go to the communities that are in greatest need, but rather to fund the agency’s bureaucracy, through higher employee salaries and increased benefits (18). In Canada, while the group reports that over 83% of its resources go into programs, actually only 19% do, because MADD counts professional fundraisers as charitable work, claiming that they make their pitch about drunk-driving to their potential donors (19). On the
Also important to consider is the way that MADD frames the issue of drunk driving and drinking in general as a law and regulation issue rather than a social behavior issue that varies from state to state. One of MADD’s more famous promotional materials is the State Progress Report, where it rates states according to the prevalence of drunk driving fatalities and comparing them to one another (21). The reasons that MADD cites as to why a particular state may or may not have done poorly is generally due to the strength / presence of interlock laws and use of sobriety checkpoints, not the social norms regarding drinking behavior in the region, resources available for repeat DUI offenders and the presence of interventions targeted at youth and high risk populations. In fact, the three states that MADD gives the worst marks to on the State Progress Report, Wisconsin, South Caroline and Montana, all average more than 30 gallons of alcohol consumed per person per year, far exceeding the national average (22). But surprisingly enough, even in a rural state like
Interlock laws require repeat DUI offenders to use ignition interlock devices when mandated to do so by a judge. These devices require the user to blow into the device before turning on their vehicle, which will not start if their BAC is above .025 (24). The interlock laws passed, in addition to other drunk-driving legislation, are the only contact that MADD has with drunk drivers outside of the courtroom. However, for victims of drunk driving accidents, they offer support services including a hotline, online chatting, and legal assistance to ensure that the drunk driving offender receives the maximum penalty. In addition to serving justice, MADD should provide support services for drunk driving offenders and work with local communities to provide transportation alternatives whenever possible.
MADD pledges local community support through the local chapters established throughout the country. However, the geographic distribution of these chapters, in addition to the lack of diversity among local MADD members does not address the segments of the population most likely to drink underage or to drive while drunk. In a survey of local MADD chapters, it was revealed that most of the chapters’ officers are white, married, educated women, often the mothers and relatives of victims of drunk driving accidents (25). Furthermore, as Dr. Weed, a sociology professor at the
What is flawed in this approach is that these women do not represent the minority populations at risk for drunk driving that do not live in their community / belong to their social class, nor can they always effectively reach out to the opposite gender. In fact, accounting for gender differences alone, a 1995 study stated, “Twenty-nine percent of male drivers involved in fatal motor vehicle crashes had BAC's of 0.01 percent or greater, compared with 15 percent of female drivers” (27). While these women may be able to reach out to the men in their community, MADD chapters are often far removed and isolated from the male populations at highest risk for alcohol abuse and thus at higher risk for drunk driving accidents, like Native American males (28). For example, in
Drinking behaviors also differ by race among adolescent and underage drinkers. According to a study by the Center for Substance Abuse Treatment, the three groups with highest prevalence of binge drinking within the past thirty days are White (46%), Hispanic (40%) and Black (19%) (32). What is so provocative about these numbers is that the underage binge drinking rate is highest in the same racial group as that of local MADD chapter officers, suggesting that MADD may not be as effective an intervention as reported and that there are other factors at work. The importance of socioeconomic status of underage drinkers, access to alcohol, social acceptance and rates of car ownership should not be overlooked as they often are by MADD (33). By approaching alcohol abuse as a population wide epidemic and ignoring the social factors at work in specific regions, ethnicities, and subgroups, MADD fails to achieve real change at a community level.
3. By arguing for prohibition of drinking for underage individuals, MADD fails to accept the reality of drinking prevalence, and fails to fully educate adolescents about alcohol use and its effects.
As MADD’s founder noted in the quote given in the introduction, the organization has become more focused on alcohol itself than on drunk driving. As a result, the group has clearly articulated that it is unacceptable to drink at all when underage (34). By linking drinking to poor achievement in school, depression, suicide, and pregnancy, MADD frames the negative consequences of drinking such that any consumption of alcohol would seem dangerous. However, according to a national survey of U.S. college and university students, “93% of students never received a lower grade for drinking too much and 90% have never damaged property or pulled a false alarm while drinking" (35). These figures are enlightening, considering the fact that almost half (48%) of all alcohol use at colleges and universities is done by underage individuals (36). What is even more illuminating about this data is that binge drinking rates are actually higher among more educated individuals (37). These findings, while striking, also point to possible statistical inaccuracies and the presence of bias and confounding in many of the studies related to alcohol use.
MADD states that adolescent drinking behavior is most highly influenced by children’s parents, thus emphasizing the need for parents to properly educate their children regarding the dangers of alcohol. A MADD pamphlet for parents states “For many parents, the riskiest thing they did in their youth was play spin the bottle. Today young people are taking much bigger risks with a bottle – a beer bottle and its no game” (38). However, the proportion of adolescents between the ages of 12 and 17 that has consumed alcohol within the last month has dropped from 50% in 1979 to 19% in 1998, according to the government’s National Household Survey on Drug Abuse (39). This data demonstrates that parents are more likely to have consumed alcohol while underage than their children, thus highlighting the need for alcohol education efforts among parents. What this data also points to is a widespread prevalence of underage drinking that has decreased significantly.
Labeling theory shows that by portraying widespread drinking and the reckless behavior associated with it as a growing epidemic, as MADD does, that it becomes a self-fulfilling prophecy, and adolescents become more likely to drink solely because they believe that so many other people are doing it (40). Abusive drinking behavior increases because of the importance of social norms, especially among teenagers and young adults (41). Research has indicated that by providing adolescents with accurate information about alcohol abuse and addressing misconception can lower alcohol abuse rates according to a study in the journal, Preventive Medicine (42). MADD reports in their underage drinking fact sheet that “In 2006, about 10.8 million young people aged 12 to 20 (28.3 percent) reported drinking alcohol in the last month” (43). According to labeling theory, these staggering statistics act more to promulgate the message of widespread underage drinking than to prevent it. In a
By stigmatizing alcohol, and associating it with and leading to the use of illegal drugs like cocaine and marijuana as MADD does, they only reinforce the negative label that alcohol has been given. Instead of stigmatizing the substance all together, MADD needs to recognize that it is the abuse of alcohol that causes the drunk driving fatalities that the group originally set out to stop. Rather than providing children with reasons not to drink, as MADD suggests parents do, the organization needs to tell parents to give their kids all of the information about alcohol, including how to drink it safely, thereby enabling them to make informed decisions armed with that knowledge. A 1996 study comparing abstinence-only alcohol education programs to those that provide moderate alcohol use as an option has shown those programs advocating for responsible use rather than no use at all are far more successful (45).
CONCLUSION
MADD’s failure to continue to address the drunk driving problem stems from their recent focus on alcohol prohibition rather than drunk driving itself. The legislation the group has helped to pass, including Interlock-ignition laws and other traffic safety laws proved to be instrumental in lowering the rates of both alcohol-influenced traffic accidents and fatalities. However, the continued high prevalence of drunk driving and high numbers of yearly deaths caused by drunk driving show that MADD’s focus on improved legislation, victim advocacy and extensive fundraising have not been enough to eliminate this very serious problem. This failure is caused by not only not considering all the factors that influence drinking behaviors, but also by not reaching out to those who continue to drive while drunk, most of them over double the legal limit. The organization’s growth has driven them away from the community level support upon which they were founded, and has deterred them from opening new chapters in areas whose populations are most affected by drunk driving incidents, and increasing the amount of resources and support given to those communities where MADD chapters already exist.
A more effective public health intervention to address underage drinking and drunk driving would not be focused on alcohol prohibition but rather on an interdisciplinary approach, relying on the social and behavioral sciences to examine all the factors that influence drinking behavior, especially among those segments of the population with highest alcohol abuse prevalence rates. By removing the stigma associated with alcohol use, treating it as a separate issue from other drugs and redefining adolescent social norms, public health can effectively address the alcohol abuse issue that leads to reckless behaviors. Focusing on an abstinence only approach is unrealistic and misleading because it deprives adolescents of information regarding how to use alcohol safely and under what circumstances. A more realistic and successful approach would be to provide people with accurate information regarding alcohol, enabling them to make the informed choice whether to abstain or not. In order to reach out to underage drinkers and of age alcohol abusers, community support must be available to provide people with transportation alternatives and to help not only drunk driving victims, but drunk drivers themselves. Renewed attention must be paid to the behavior actually in question and which directly causes the fatalities: driving while intoxicated and not alcohol as a substance, which can be consumed safely when done in moderation.
ALTERNATIVE INTERVENTION DESCRIPTION
An alternative proposal to address the drunk driving problem will need to return to MADD’s original mission, to stop drunk driving and underage drinking, and offering support to not only drunk driving victims and families as MADD has done, but to offenders as well (46). By returning to the drunk driving issue, rather than focusing on alcohol prohibition, the new intervention will specifically work at significantly reducing the 12,998 drunk driving deaths occurring in 2007 alone (47). I will demonstrate why an alternative intervention will effectively address the drunk driving issue using social behavioral science principles and theories, taking into consideration some of the most crucial factors that shape underage drinking and drunk driving behavior.
The proposed intervention, Families for Responsible Drinking Behavior (FRDB), will be a network of local organizations that strive to promote community level change, by reducing drunk driving fatalities and traffic accidents and encouraging safer drinking behaviors, especially among adolescents and underage drinkers. Social network theory argues that health behavior is determined by one’s social network, so by targeting networks of people in which binge drinking and drunk driving behavior is acceptable, the intervention will reach out to those individuals at highest risk for drunk driving fatalities (48). By acknowledging the social norms associated with drinking behavior, this intervention will not target the consumption of alcohol, but rather the setting in which it occurs and the other related behaviors that when combined with drinking, prove to be dangerous, like motor vehicle use (49). Most important is that FRDB approaches drunk driving at a group level, rather than relying on individual level factors like those of the Health Belief Model (50).
With these social behavioral principles in mind, the practical operations of the new anti-drunking driving organization are described in the following sections that delineate how FRDB addresses the flaws in MADD’s approach to the public health problem.
ARGUMENTS
1. MADD data and reports repeatedly focus on the severity and susceptibility of individuals to the dangers of alcohol use and drunk driving accidents by using inaccurate statistics, targeting social drinkers and ignoring other related factors to drinking behavior.
Families for Responsible Drinking Behavior approaches drinkers as groups of people who may act in concert, thereby targeting the individuals who continue to violate drunk driving laws and traffic regulations. Research shows that over two-thirds of alcohol related crashes are caused by individuals whose blood alcohol level is .14 and the average fatal accident is caused by individuals whose blood alcohol level is above .17 (51). With Social Network Theory in mind, FRDB will reach out to these groups of people by examining where they fit within their social circle, what group attitudes are towards binge drinking and whether there are other contributing factors like family history of alcoholism, employment status and education level (52).
FRDB members will volunteer to drive a federally subsidized free shuttle service for any patron that local bar and restaurant owners deem to have had too much to drink, and advertise when the shuttle will be running and where it is available. In addition, FRDB will work with legislators for stricter laws regarding contributing factors to alcohol-related motor vehicle accidents, like highway safety, safety belt use, and cell phone use. However, FRDB acknowledges that drunk individuals act irrationally with respect to these contributing factors as well, and will work with law enforcement to increase patrolling, which both law research has shown to be more effective than the sobriety checkpoints that MADD advocates (53). This approach will target the most dangerous drivers at highest risk for motor vehicle accidents rather than the population at large.
Through promotional materials and advertising, FRDB will accurately represent statistical evidence to show the actual severity of the drunk driving problem, doing its best to make the issue still relevant without referring to it as a “growing epidemic” (54). Furthermore, the group will target under-age drinkers by linking alcohol abuse with negative health effects, like liver, heart, and kidney disease (55). By focusing on alcohol abuse rather than just use, adolescents will be more inclined to consider how much they are drinking rather than whether or not they are at all. FRDB will take into consideration the importance of social norms, part of the Theory of Reasoned Action, by linking moderate alcohol consumption with a positive outcome, like relaxation and socialization after a tough week of papers, tests and work (56). By taking into consideration group level behaviors and dynamics, targeting repeat DUI offenders rather than social drinkers, and providing accurate alcohol related statistics and information to young drinkers, FRDB places alcohol use in its proper context while still presenting it as a significant public health concern.
2. MADD’s efforts to curb drunk driving accidents are impeded by the organization’s bureaucracy, a lack of services for drunk drivers, and a lack of acknowledgment of individual community and MADD chapter needs, which are reflective of the drinking behaviors of those populations.
Families for Responsible Drinking Behavior, while a nation-wide organization, is principally a network of local FRDB chapters that, as the name suggests, aim at providing family-like support and activism for drunk driving victims and offenders. These local chapters are allowed to keep 75% of the money they raise. The remaining 25% goes to the national office in Washington, D.C. where that money is used to fund research regarding drunk driving prevalence and accident statistics and provide additional resources for those chapters whose serve areas with the highest rates of drunk driving, like Wisconsin, South Carolina, and Montana (57). FRDB’s activities on a local and national level are monitored by a group of individuals elected by their FRDB chapter to ensure that fundraising money goes to drunk driving prevention efforts, not group members. Fundraising efforts play an integral role in the success the group is able to have, but the funds need to stay at a local level to effectively promote community-wide change.
FRDB, because it is places so much emphasis on individual chapters, frames the issue of drunk driving as a social behavior issue that is different in every state and region (58). Regions and communities cited as having high numbers of drunk driving fatalities would not only receive more funds and be targeted as areas where stricter laws and regulations should be enacted, but would also receive more resources for repeat DUI offenders, including support services like online chats, legal assistance and counseling. Rather than focusing solely on victim services, the program will reach out to drunk driving offenders by offering a hotline they can call if they need a ride home, and FRDB members could volunteer for different shifts to help get these drunk drivers out of the driver’s seat and safely home. In addition, FRDB could work with local town parks and recreation departments to sponsor board game nights, dances, potluck dinners and other activities so people who do not drink do not feel marginalized either, and all local residents have access to forms of recreation besides drinking.
In order to acknowledge that drinking behavior varies by race and gender, local FRDB chapters will have leadership teams comprised of individuals of different background, socioeconomic status, and ages, advocating adolescent participation as well. These leadership teams will be responsible for reaching to the different segments of the population, with activism efforts specifically catered for different drunk driving risk groups. With Social Marketing Theory in mind, for adolescents for example, FRDB efforts could try to sell to them the idea of success, that comes with drinking moderately, responsibly, and in a way that does not endanger their academic pursuits and future opportunities (59). By selling the idea of a happy family to middle-aged binge drinkers, it forces them to think about their family before they drink too much or get behind the wheel.
Male representation in the FRDB chapters is essential, since they are almost twice as likely as female drivers to be involved with alcohol-related fatal motor vehicle accidents (60). While white, married, educated women are pivotal in spearheading efforts for drunk driving victims, underage binge drinking rates are highest in the areas where these women live, suggesting that both men and adolescents are needed to successfully combat the issue (61). In addition, part of the national FRDB office’s efforts need to include identifying areas not served by FRDB, starting new local chapters there, especially if they are at higher risk for alcohol abuse and drunk driving fatalities. Part of the FRDB efforts in South Dakota for example could include outreach programs to the Native American Reservations, whose male populations are highly susceptible to binge drinking, and thus worthy of greater attention and efforts (62). By offering services for drunk drivers, acknowledging individual community and FRDB chapter needs, the group strives to promote local change with national support and base their interventions around the drinking behaviors of these populations. Alcohol use is not a population wide epidemic, it is a public health problem influenced by social factors that vary among states and population sub-groups.
3. By arguing for prohibition of drinking for underage individuals, MADD fails to accept the reality of drinking prevalence, and fails to fully educate adolescents about alcohol use and its effects.
FRDB recognizes that underage drinking is prevalent and occurs despite minimum age drinking laws. Therefore, FRDB adolescent interventions need to remain focused on drunk driving rather than alcohol. By describing the negative consequences of drunk driving, like losing one’s friends, wrecking you or your parents’ car, and not remembering social gatherings because you were unconscious, FRDB frames drunk driving as something negative under any circumstances by keeping in mind what matters most to underage drinkers, their friends and family (63). Some data shows that binge drinking rates are higher among more educated individuals, including under-aged college students (64). Therefore, FRDB will also have local chapters, called Students for Responsible Drinking Behavior (SRDB), similar to the MADD spin off, Students Against Destructive Decisions, formerly known as Students Against Driving Drunk. SADD, like MADD also no longer focuses primarily on drunk driving, thereby limiting their efficacy in this area (65). Local SRDB chapters will work with area colleges to provide transportation services from off-campus housing or bars back to campus, as well as working with resident assistants living in the dormitories to provide alcohol education sessions for students and support services for alcohol abusers.
Because adolescent drinking behavior is most highly influenced by children’s parents, special educational efforts need to be taken in order to promote responsible drinking among this segment of the population so that their children will not see alcohol as off-limits in all circumstances, but rather able to be enjoyed in moderation. For that reason, FRDB will work with prenatal clinics and doctors to encourage safe drinking behaviors among parents after children are born and provide support services for those parents who abuse alcohol themselves or want to educate their children about alcohol use and its effects. Parents then become an additional resource for their children, and by offering support rather than prohibiting alcohol use, they work to change social norms by encouraging moderation, with the understanding that they will also provide support and further education if their children do drink too much.
Labeling theory shows that by portraying widespread drinking and the reckless behavior associated with it as highly prevalent then adolescents become more likely to drink because they believe that so many other people are doing it (66). Research has demonstrated that by providing adolescents with accurate information about alcohol abuse and addressing misconceptions can lower alcohol abuse rates (67). Therefore, FRDB would work with researchers to publish results about people’s actual drinking behavior in both college newspapers and other magazines read by adolescents, which has been shown to result in a decrease in alcohol related injuries to others (68).
If stigma theory is to be used by FRDB, than it should be done with drunk driving and not alcohol itself (69). However, stigmatizing this behavior could result in it becoming more attractive or appealing for adolescents. Regardless, the group needs to encourage parents to provide children with information about alcohol, how to drink it safely, and enable them to make informed decisions about how they will choose to use it. Alcohol-related public health programs that have advocated for responsible use rather than taking an abstinence only approach to alcohol have been demonstrated to be far more effective (70). By presenting drinking in moderation and abstaining both as acceptable alternatives, FRDB prepares young people to make either choice, knowing that they will always have community support if they need it.
CONCLUSION
In order to effectively address the drunk driving problem, Families for Responsible Drinking Behavior challenges dogma by changing beliefs about alcohol as a substance, its consumption, and education regarding its use. By presenting alcohol as neither a positive or negative, there are no positive or negative stigmas attached to it, and it is seen as neither forbidden or encouraged. Furthermore, by tolerating consumption of alcohol, FRDB acknowledges its presence in social settings while still remaining adamantly against its abuse. Finally, with respect to alcohol education, FRDB argues that it be done both at home and in social settings like school, and while children are still young, so they see their parents’ positive example of moderate and responsible drinking (71). MADD’s recent efforts have failed make any significant strides in reducing the number of drunk driving deaths, a figure that has remained relatively constant since 2000, according to the NHTSA. (72) This is because they have invested more money time and energy on the same individual level approaches they have for the last 25 years, in addition to showing a new focus against alcohol use altogether. By taking into consideration group level factors and dynamics, social norms, accounting for irrational behavior, and utilizing behavior and social science principles, Families for Responsible Drinking Behavior can effectively address the drunk driving problem by focusing on community level change by targeting and offering support for those groups at highest risk for alcohol abuse.
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5. Ibid, 4.
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9. Ibid, 2.
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13. O’Donnell, Jayne. MADD enters 25th year with change on its mind.
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16. Hingson, R., et al. Magnitude of alcohol-related morbidity, mortality, and alcohol dependence among
17. Ibid, 16.
18. Boland, Michael.
19. Recksiedler, Dean. MADD stops fundraising over controversy.
20. MADD Money. Investigative report., K5 News,
21. http://www.madd.org/getattachment/12293f6f-4a16-4caa-8c85-2b6735f9c7ca/State-Progress-Report.aspx
22. http://www.time.com/time/2007/america_numbers/alcohol.html
23. http://www.maddwisconsin.org/localdirectory/localdirectory.htm
24. http://www.nmshtd.state.nm.us/upload/images/Traffic_Safety/Ignition_Interlock-Facts.pdf
25. Weed, Frank J. “Grass-Roots Activism and the Drunk Driving Issue: A Survey of MADD Chapters” Law & Policy. Vol.9, Issue 3. 2008
26. Ibid, 25.
27. National Highway Traffic Safety Administration (NHTSA). Traffic Safety Facts 1994: A Compilation of Motor Vehicle Crash Data from the Fatal Accident Reporting System and the General Estimates System.
28. National Institute on Alcohol Abuse and Alcoholism. Alcohol Alert: Alcohol and Minorities No. 55 January 2002.
29. http://www.madd.org/getattachment/12293f6f-4a16-4caa-8c85-2b6735f9c7ca/State-Progress-Report.aspx
30. http://www.alcoholfreechildren.org/en/states/sd.cfm?doc_id=223
31. http://www.nps.gov/history/nagpra/documents/resmap.htm
32. http://www.icpsr.umich.edu/SAMHDA/NTIES/NTIES-PDF/SHEETS/121_binge_drinking.pdf
33. A multilevel analysis of the relation of socioeconomic status to adolescent depressive symptoms: does school context matter? . The Journal of Pediatrics , Volume 143 , Issue 4 , Pages 451 - 456 E . Goodman
35. Engs, Ruth C., Hanson, David J., and Diebold, Beth A. The drinking patterns and problems of a national sample of college students, 1994. Journal of Alcohol and Drug Education, 1996, 42 (3), 13-33, and unpublished data collected by those researchers
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37. 2000
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39. Substance Abuse and Mental Health Services Administration. The 1998 National Household Survey on Drug Abuse.
40. http://www.britannica.com/EBchecked/topic/326674/labeling-theory
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43. The Substance Abuse and Mental Health Services Administration (SAMHSA). 2006 National Survey on Drug Use andHealth (2006).
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45. Hanson, David J. Alcohol Education: What We Must Do.
46. Ibid, 4.
47. Ibid, 3.
48. Freeman, Linton. 2006. The Development of Social Network Analysis.
49. DeFleur, M. L. & Ball-Rokeach, S. (1989). Theories of mass communication (5th ed.).
50. Ibid, 7.
51. Ibid, 8.
52. Ibid, 48.
53. http://www2.potsdam.edu/hansondj/DrivingIssues/1103163004.html
54. Ibid, 13.
55. http://www.healthchecksystems.com/alcohol.htm
56. Ibid, 14.
57. Ibid, 33.
58. Baars, B. (1988), A Cognitive Theory of Consciousness,
59. Kotler, P, Zaltman, G. Social marketing: an approach to planned social change. J Market. 1971;35:3-12
60. Ibid, 27.
61. Ibid, 33.
62. Ibid, 28.
63. Ibid, 58.
64. Ibid, 37.
66. Ibid, 40.
67. Ibid, 42.
68. Ibid, 44.
69. Heatherton, Kleck, Hebl & Hull, The Social Psychology of Stigma, The
70. Ibid, 45.
71. Guthrie, R. S. Abstinence and Alcohol Use Among Senior Students Enrolled in Seventh-Day Adventist Academies. Unpublished M.S. thesis,
72. Ibid, 3.
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