What is the problem?
Alcohol impairment remains a leading cause of highway crashes.
Nearly 30 percent of the 37,000 deaths on U.S. roads in 2017 were
due to alcohol impairment, according to the National Highway Traffic
Safety Administration (NHTSA). Every day, nearly 29 people in the U.S.
die in alcohol-impaired crashes—that’s 1 person every 50 minutes.
We know that a per se 0.08 percent blood alcohol concentration
(BAC) limit is just too high. Our 2013 Reaching Zero report concluded
that BAC levels as low as 0.01 have been associated with drivingrelated
performance impairment, and levels as low as 0.05 percent
have been associated with significantly increased risk of fatal
crashes. Our report also examined other countermeasures, such as
high-visibility enforcement operations, DUI courts, and all-offender
ignition interlock laws, and determined that those are also effective
in eliminating alcohol-impaired driving.
“Driving under the influence” doesn’t just include impairment by
alcohol. Consumption of any mood- or mind-altering substance can
leave a driver impaired. Drugged driving, which includes the use of
illicit drugs, prescription, and over-the-counter medications, is on the
rise in the U.S.—at even greater rates than that of alcohol-impaired
driving. In NHTSA’s National Roadside Survey, conducted in 2013–
2014, 22 percent of drivers surveyed tested positive for some drug
or medication. NHTSA’s Fatality Analysis Reporting System (FARS)
data identified the presence of drugs in 30 percent of fatally injured
drivers with valid drug test results in 2006, in 37 percent in 2009, and
in 46 percent in 2015.
More states are moving to legalize recreational marijuana. A 2018
study by the Insurance Institute for Highway Safety showed an
increase in collision claims in some states that legalized recreational
marijuana, compared to neighboring
states that did not change their laws.
Unlike for alcohol, no standardized
drug-testing protocol exists, and there
is no established limit or threshold to
determine drug impairment. Evaluating
the impact of other drugs on drivers
is challenging because many drugs
impair individuals differently than
alcohol, and there are hundreds of
different drugs—illicit and legal—available to users. Additionally,
data on drug-impaired driving is incomplete and inconsistent.
What can be done?
Alcohol- and other drug-impaired driving is 100 percent preventable.
Stronger laws and increased enforcement are needed to prevent
alcohol-impaired driving, and standardized drug testing and
methodology are needed to prevent other drug impairment in
transportation. We cannot fully understand the scope of drug-impaired
driving without the data that would emerge from having a common
standard of practice for drug toxicology testing.
Drug impairment must be treated and handled concurrently, yet
separately, from alcohol impairment. A combination of legislation,
enforcement, and education, at all levels of government and in all
communities, is the only way to tackle this challenging problem.
To address the problem of impairment on our
roadways, the following actions should be taken:
- Establish a per se BAC limit of 0.05
percent or lower for all drivers who are
not already required to adhere to lower
BAC limits. In December 2018, Utah
became the first state to enact a per se
BAC limit of 0.05 percent. More than
100 countries have some type of 0.05
percent or lower BAC law, resulting in
lower rates of alcohol-related roadway
- Include in your impaired-driving
prevention plan or highway safety plan
provisions for conducting high-visibility
enforcement of impaired driving
laws using passive alcohol-sensing
technology during law enforcement
contacts, such as routine traffic
stops, saturation patrols, sobriety
checkpoints, and accident scene responses. Thirteen states currently
do not conduct sobriety checkpoints.
- Require the use of alcohol ignition interlock devices for all
individuals convicted of driving while intoxicated (DWI) offenses.
Currently, 31 states have all-offender ignition interlock laws.
- Develop and disseminate to appropriate state officials a common
standard of practice for drug toxicology testing, including the
circumstances under which tests should be conducted, a minimum
set of drugs for which to test, and cutoff values for reporting the
- Seek legislative authority to award incentive grants for states to
establish a per se BAC limit of 0.05 percent or lower for all drivers
who are not already required to adhere to lower BAC limits.
- Develop and disseminate to the states best practices for DWI
- Accelerate widespread implementation of Driver Alcohol Detection
System for Safety technology (a technology that can detect driver
alcohol use) by defining usability testing that will guide driver
interface design, and by implementing a communication program
that will direct driver education and promote public acceptance.
- Become informed about the effects of drugs and alcohol on
driving. Abstain from drinking or taking other drugs if you will be
driving, or designate a sober driver.
- Consider the effects of your prescription medicine on your driving.
It could be making you drowsy or otherwise reducing your decisionmaking
abilities. Ask your doctor about the impairing effects of any
medications you are prescribed.
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