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II-1 SECTION II Introduction Driving while intoxicated (DWI)1 is among the most common contributors to fatal motor vehicle crashes in the United States. In 2003, 17,013 individuals were killed in a motor vehicle crash in which the driver or other participant had a positive blood alcohol concentration (BAC), and 15,630 of those were above 0.08 percent, which is the legal limit for drivers in all 50 states and the District of Columbia. The 17,013 alcohol-related fatalities2 represent 40 percent of the 42,643 motor vehicle fatalities that occurred in 2003. Alcohol- related crashes cost the public more than $50 billion yearly. Although hundreds of millions of dollars have been spent during the past two decades on efforts to reduce driving after drinking, the problem has proved resistant to change. There were marked declines in alcoholârelated crash fatalities from the mid-1980s to the early 1990s; however, there has been little change since that time. Between 1994 and 2003, alcohol-related traffic fatalities have hovered between 16,500 and 17,500 a year (see Exhibit II-1). 1 Different terms are used in various states to describe alcohol-impaired driving. The term DWI is used to designate the legal infraction of driving in violation of a stateâs statute concerning alcohol use and driving. 2 âAlcohol-related fatalitiesâ refers to deaths occurring in crashes where at least one participant (driver, pedestrian, or bicyclist) had a BAC of 0.01 percent or higher. In 2003, about 12 percent of persons with BACs above 0.08 percent were pedestrians or bicyclists. EXHIBIT II-1 Number of Alcohol-Related Fatalities in the U.S., 1982â2003 Source: NHTSA, 2005 0 2,500 5,000 7,500 10,000 12,500 15,000 17,500 20,000 22,500 25,000 27,500 2891 3891 4891 5891 6891 7891 8891 9891 0991 1991 2991 1 399 1 499 5991 6991 7991 8991 9991 0002 1002 2002 3002
Population growth and increased driving can obscure an actual decrease in alcohol-related crash fatality rates. Hence, another useful indicator of the actual rate of progress is an exposure-adjusted crash rate. Exhibit II-2 shows the number of alcohol-related fatalities per 100 million vehicle-miles traveled from 1982 to 2003. Taking increases in population and travel into account, it is evident that substantial progress was made in reducing alcohol-related fatalities until about 1992, with another modest drop from 1996 to 1998. However, since 1999 there have been small increases and decreases, with only a slight overall downward trend. The actual number of alcohol-related fatalities has been higher in each of the past 4 years than it was from 1997 to 1999. Hence, by either measure (number and exposure-adjusted rate of alcohol-related crash fatalities), little progress has been made in recent years. Despite the slowed progress in recent years, most experts agree that further reductions in alcohol-related crashes and fatalities are possible. Several strategies, when properly implemented, have been demonstrated by careful research studies to effectively address the problem. By adopting the strategies described in this guide, or by improving the implementation of these strategies where they are already in place, states can further reduce their alcohol-related crashes and the variety of health and economic problems they cause. Although this guide is not intended to address driving while impaired by either medicinal or illicit drugs, at least some of the strategies described here may also help deter drug-impaired driving since most individuals who drive after using illicit drugs have also been drinking. SECTION IIâINTRODUCTION II-2 0.0 0.2 0.4 0.6 0.8 1.0 1.2 1.4 1.6 1.8 2891 3891 4891 1 89 5 91 86 7891 8891 9891 1 99 0 1 99 1 1 99 2 3991 4991 5991 1 99 6 1 99 7 1 99 8 91 99 0002 2 100 2 00 2 2 00 3 EXHIBIT II-2 Alcohol-Related Fatalities per 100 Million Vehicle-Miles Traveled in the U.S., 1982â2003 Source: NHTSA, 2003a
