Can progress in reducing alcohol-impaired driving fatalities be resumed? Results of a workshop sponsored by the Transportation Research Board, Alcohol, Other Drugs, and Transportation Committee (ANB50)

Abstract

Objective Despite successes in the 1980s and early 1990s, progress in reducing impaired driving fatalities in the United States has stagnated in recent years. Since 1997, the percentage of drivers involved in fatal crashes with illegal blood alcohol concentration (BAC) levels has remained at approximately 20% to 22%. Many experts believe that public complacency, competing social and public health issues, and the lack of political fortitude have all contributed to this stagnation. The number of alcohol-related crashes, injuries, and fatalities is still unacceptable, and most are preventable. The public needs to be aware that the problem presented by drinking drivers has not been solved. Political leaders need guidance on which measures will affect the problem, and stakeholders need to be motivated once again to implement effective strategies. Methods The National Academy of Sciences (NAS) Transportation Research Board (TRB) Alcohol, Other Drugs, and Transportation Committee (ANB50) sponsored a workshop held at the NAS facility in Woods Hole, MA, on August 24–25, 2015, to discuss the lack of progress in reducing impaired driving and to make recommendations for future progress. A total of 26 experts in research and policy related to alcohol-impaired driving participated in the workshop. The workshop began by examining the static situation in the rate of alcohol-impaired driving fatal crashes to determine what factors may be inhibiting further progress. The workshop then discussed eight effective strategies that have not been fully implemented in the United States. Workshop participants (16 of the 26) rated their top three strategies. Results Three strategies received the most support: Impose administrative sanctions for drivers with BACs = .05 to .08 g/dL.Require alcohol ignition interlocks for all alcohol-impaired driving offenders.Increase the frequency of sobriety checkpoints, including enacting legislation to allow them in the 11 states that currently prohibit them. Five other important strategies included the following: (a) increase alcohol taxes to raise the price and reduce alcohol consumption; (b) re-engage the public and raise the priority of impaired driving; (c) lower the illegal per se BAC limit to .05 for a criminal offense; (d) develop and implement in-vehicle alcohol detection systems; and (e) expand the use of screening and brief interventions in medical facilities. Conclusions Each of these strategies is proven to be effective, yet all are substantially underutilized. Each is used in some jurisdictions in the United States or Canada, but none is used extensively. Any one of the three strategies implemented on a widespread basis would decrease impaired driving crashes, injuries, and fatalities. Based on the research, all three together would have a substantial impact on the problem.

Toward a “Post-Legalization” Criminology for Cannabis: A Brief Review and Suggested Agenda for Research Priorities

“…These may well draw on important lessons from alcohol-impaired driving enforcement strategies. Over the past decades, the prevalence of alcohol-impaired driving, and specifically related crashes/fatalities, have consistently decreased in North America (Fell et al, 2016; Naimi et al, 2018; Teutsch et al, 2018; Yao et al, 2016). This decrease has been mainly attributed to optimized “deterrence”-based enforcement approaches (e.g., more severe penalties, improved detection or apprehension strategies, swifter consequences) combined with systematic negative social norming of “drinking-and-driving” (Babor et al, 2010; Elder et al, 2004; Hyder, 2018; Kilmer & Midgette, 2020).…”

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“…For example, the frequency of sobriety checkpoints must be increased, and alcohol ignition interlocks should be required for all alcohol-impaired driving offenders, which is one of the most supported strategies for reducing alcohol-impaired driving. 35 The enforcement with random breath testing is associated with a significant reduction in the rate of alcohol-related crashes. 36 Immediate roadside prohibitions, which aimed to increase the efficiency of police and courts for processing drinking drivers, significantly reduced fatal and injury crashes than non-alcohol-related crashes.…”

Reducing Harm Through Evidence‐Based Alcohol Policies: Challenges and Options

“…Develop and implement a multi‐component strategy that includes several complementary interventions (Clough & Bird, ; Fell et al, ; Roman, Scherer, Fell, & Taylor, ). McKee et al () identified several strategies that were used in cities that demonstrated the capacity to restrict malt liquor sales, including recruiting persistent leaders with a commitment to neighborhood issues, developing a broad coalition of community support, and shaping messages to win public acceptance.…”

“…Evidence of effectiveness does not necessarily mean that these policies are implemented, or if implemented, enforced and sustained (Thomas, Paschall, Grube, Cannon, & Treffers, ; van Hoof and van Velthoven, ). Effective policies may be underutilized (Fell et al, ; Giesbrecht et al, ), guidelines ignored (Grubesic et al, ), or policies contrary to the international evidence implemented (Gruenewald et al, ; Rossow & Buvik, ). We examine key challenges in implementing and sustaining alcohol policies and propose several strategies to counter these challenges.…”