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Boating Under the Influence

It's not just alcohol. Waterborne "stressors" may affect seniors in unexpected ways

By John M. Malatak, U.S. Coast Guard, Office of Boating Safety Program Operations. Division Chief and Dr. Richard C. Lavy, M.D., U.S. Coast Guard Auxiliary

The go-fast party boat roars by, tossing you in its wake. A personal watercraft cuts across your bow, forcing an emergency course change. A bass boat speeds recklessly through your favorite anchorage. Drunken antics like these can ruin a relaxing day on the water, or worse, cause tragic accidents, injuries, and fatalities.

Would it shock you to know that your own behavior on the water might be just as risky? If you're like most seniors, you're climbing aboard your boat with more than just a hat and extra sunscreen. You're leaving the dock with a prescription "cocktail" in your bloodstream. According to a study cited in the Journal of the American Geriatric Society, recent estimates show that adults, 60 and older, take an average of five prescription medications daily. The side effects of drugs such as heart medications, blood thinners, insulin, diuretics, antidepressants and anti-inflammatories are well documented. Still, few understand the danger of mixing prescription medications with boating.

"The marine environment exposes people to heat or cold, motion, wind, noise and other factors that can cause fatigue in anyone." says Dr. Richard C. Lavy, M.D., U.S. Coast Guard Auxiliary (USCGA) and representative of the U.S.Coast Guard Office of Health Services. "For seniors on prescription medications, these effects may lead to diminished hearing, vision, concentration, observation and judgment. In this way, levels of medication that would have little impact on land can potentially cause a much greater degree of impairment for a boater."

That is why the U.S. Coast Guard (USCG) cautions boaters that prescription medications can also be a cause of boating under the influence (BUI) Water borne "stressors" like sun, breeze, engine noise and vibration amplify common side effects like drowsiness and dizziness. Under certain conditions they can leave a boater confused, disoriented and thoroughly incapable of driving a vessel safely. Therefore, prescription medications for the boat's operator can be nearly as dangerous as the use of alcohol or illegal drugs.

Seniors boating under the influence may overlook warning signs of their own passengers' physical stress, subtle changes in weather conditions, or indicators of potential boat problems, until they're in trouble. For example, if storm clouds are building and the wind picks up, a boat operator affected by prescription medications could fail to notice the changing conditions in time to seek safe harbor in order to protect the boat and its passengers.

The solution is not to stop boating. Recreational boating is one of life's great pleasures and many seniors gravitate to boating as a relaxing and invigorating way to spend their days. The Coast Guard wants you to enjoy your time on the water. Nor, under any circumstances, should you stop taking medications prescribed by your doctor.

The key is awareness: understand the issue and be careful not to subject yourself to conditions that would put you, your passengers or other boaters at risk. A perfect boating day (clear, hot and breezy) might not be so perfect if you take a diuretic. Individually these factors might be harmless. Together, they could cause rapid dehydration, making it quite difficult for you to control a vessel or make clear decisions.

Medications that affect balance put a boater in greater danger of falling, the leading cause of senior injury deaths and the most common cause of nonfatal injuries and hospital admissions for trauma. The risk to you, whether from a fall inside the boat that leads to serious injury, or a fall overboard, is obvious.

Heart disease, poor circulation and obesity also affect the body's ability to regulate temperature and to protect against heat-related illness, such as heat cramps, heat exhaustion and heat stroke. If you suffer from these conditions and take medicine to control them, you should be particularly careful when it's hot on the water.

The effects of stressors on a boater taking prescription medications are multiplied when alcohol is present. Drinking while boating is never a good idea. The combination with heart medication, diuretics, antidepressants and other medications can have serious consequences.

"Seniors on medications who use alcohol while boating, significantly increase the impact of many medications and the effects of fatigue," says Dr. Lavy. "Alcohol alone can hamper peripheral vision, night vision, focus and the ability to distinguish colors, particularly red and green. Combine alcohol with medications, and these adverse effects are made worst."

Today's seniors need to remember that these concerns don't just apply to power boaters or sailors. Canoeists, kayakers, personal watercraft riders, anglers and hunters are boaters too—and impaired operators are in just as much danger as those in larger and more powerful craft.

What can you do to boat safety while continuing to enjoy the life extending and life-enhancing benefits of prescription medications? The Coast Guard has a number of recommendations.

1. Evaluate your own risk. Consider your physical condition. Do you have a heart condition, poor circulation, extra weight or other factors that make you more susceptible to fatigue and medication side effects? What medicines do you take? Do these medicines have warnings about driving or operating heavy equipment? Talk with your physician about the medications and whether there is a need to alter dosages when boating.

2. Be conservative when planning your boating outings If you take prescription medications, limit your trips to avoid fatigue. Divide longer voyages into shorter segments, with plenty of time to rest in between time spent motoring, paddling or sailing. Always file a float plan, so that someone knows where you are.

3. Monitor your own condition on board. Pay attention to the way you're feeling. Are you tired, drowsy, dizzy, disoriented, momentarily confused, hot, cold, angry or giddy? Any of these sensations may indicate that you are under the influence of your medication and water-borne stressors,- Stop! Get to port, hand over your boat to another qualified operator or seek medical advice by calling the USCG or State Marine Law Enforcement on Channel 16. Realize that you may be unable to boat safely, and that you are putting yourself and others at risk.

4. Rotate Duties. The physical and mental effort connected with operating a boat is fatiguing. No one person should be at the wheel all day. Make sure that there is another qualified skipper on board. In addition, everyone on the vessel should be on the lookout for shifting weather and traffic or waterway obstructions, It's also a very good idea for all passengers to know how to administer first aid, perform CPR and use the marine radio to call for help.

5. Never drink while boating. Operating a boat while inebriated is illegal. Violators are subject to arrest and prosecution by the USCG and local law enforcement authorities. Remember that the marine environment also augments the effects of alcohol—and that the combination with prescription medication can be deadly. The USCG recommends that passengers not drink alcohol while onboard either. Drinking may lead to risky behavior, falls overboard and inability to help in an emergency.

6. Always wear a life jacket. Most people who are killed while recreational boating drown, and most people who drown are not wearing a life jacket. Accidents happen with terrifying speed on the water, and there is seldom time to reach for stowed life jackets in an emergency. The USCG recommends all boaters and passengers wear an approved life jacket while underway, unless the boater is inside a closed cabin. Today's life jackets are lighter, more compact and more comfortable than the bulky orange vests most of us are used to. New inflatable life jackets are no bigger than a heavy scarf, and many can be set to inflate automatically when the wearer is immersed.

7. Wear proper clothing. Make sure you can stay cool in the summer and warm in the winter. Temperature extremes can be a major stressor dramatically increasing fatigue and augmenting the side effects of medications.

8. Bring plenty to eat and drink. Stay hydrated! Drink plenty of cool water or other non-alcoholic beverages while boating. Bring food and snacks, which help with the proper absorption of medications and keep you alert and comfortable.

9. Take a boating safety course. Seventy percent of recreational boating accidents are caused by factors that are controlled by the boat operator; failure to pay attention, carelessness, recklessness, inexperience, excessive speed and failure to watch for hazards. No matter what your level of experience, you can benefit from a refresher on the navigation rules and important safety procedures. Today's boating safety courses are a great way to make sure your spouse or other members of your family are capable of operating your boat safely should you become impaired.

The Coast Guard recognizes America's Boating Course (ABC) – a joint partnership between two country's most prominent boating safety organizations, the USCGA and the United States Power Squadrons (USPS). ABC is available on CD-ROM, on the Internet at AmericasBoatingCourse.com.

10. Get a Vessel Safety Check every year. If you own a boat, take advantage of the free Vessel Safety Check program. You can get a bow-to-stern check of the condition and safety equipment on your boat—from canoe to a 65' yacht - from a qualified member of the USCGA or USPS. It's by far your best way to learn about safety problems or possible violations before they become a problem on the water. Visit vesselsafetycheck.org. for more details or to request a FREE Vessel Safety Check.

As a boat operator or owner, it's your responsibility to understand the factors like prescription medications that can affect your safety, or the safety of passengers or other boaters, on the water. That's why at the Coast Guard we say, "You're in Command. Boat Safety!"

Enjoy your time on the water. But never Boat Under the influence of alcohol, drugs or prescription medications. For more boating safety information and resources, visit http://www.uscgboating.org/.

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