DR Ashraf Butt first noticed the problem last summer. A large number of motorists involved in collisions arrived at Cavan General Hospital not only with alcohol in their system but also with horrific injuries that could have been avoided had they worn a seatbelt.
The lead consultant in emergency medicine in the Cavan/Monaghan Hospital Group, he says while the overall number of crashes hasn't risen in recent years, the severity of injuries has.
Not only were people dying in greater numbers – the death toll on Cavan's roads increased from five in 2011 to 10 last year – but victims were being left with long-term injuries.
"We have had concerns about this problem since 2012 when colleagues in the accident and emergency department, and in radiology, saw a cluster of patients where drink was involved in crashes, and where they weren't wearing seatbelts," he said.
"The injuries were horrendous. We were, and are still, seeing severe head injuries, spinal fractures – which leads to a risk of paralysis – and cases where the patient's chest is completely crushed because they weren't wearing a seatbelt.
"A lot of these injuries are long-term. A lot are transferred from Cavan to the Mater Hospital spinal unit or Our Lady of Lourdes in Drogheda. But in a lot of cases, not a lot can be done for these patients.
"We find the percentage of patients using alcohol is increasing. These patients don't wear their seatbelts when they have alcohol on board. Middle-aged men used to drink and drive, but now we're seeing younger patients aged 17-24 with drink on board who are not wearing their seatbelts, and who survived but need long-term care," he said.
Apart from the obvious impairment effects, including slower reaction times, alcohol in the system also relaxes the body, which means if a seatbelt isn't being worn, drivers and passengers can often be thrown out of the car.
"We do what we have to do, but they're so common now," Dr Butt says.
"There hasn't been a significant increase in road traffic collisions but the numbers presenting who aren't wearing seatbelts and with alcohol on board is higher."