National Academies Press: OpenBook
Suggested Citation:"Front Matter." National Academies of Sciences, Engineering, and Medicine. 2018. Getting to Zero Alcohol-Impaired Driving Fatalities: A Comprehensive Approach to a Persistent Problem. Washington, DC: The National Academies Press. doi: 10.17226/24951.
×

GETTING TO ZERO
ALCOHOL-IMPAIRED
DRIVING FATALITIES

A Comprehensive Approach
to a Persistent Problem

Steven M. Teutsch, Amy Geller, and Yamrot Negussie, Editors

Committee on Accelerating Progress to Reduce
Alcohol-Impaired Driving Fatalities

Board on Population Health and Public Health Practice

Health and Medicine Division

A Consensus Study Report of

images

THE NATIONAL ACADEMIES PRESS
Washington, DC
www.nap.edu

Suggested Citation:"Front Matter." National Academies of Sciences, Engineering, and Medicine. 2018. Getting to Zero Alcohol-Impaired Driving Fatalities: A Comprehensive Approach to a Persistent Problem. Washington, DC: The National Academies Press. doi: 10.17226/24951.
×

THE NATIONAL ACADEMIES PRESS 500 Fifth Street, NW Washington, DC 20001

This project was supported by the National Highway Traffic Safety Administration (Contract No. 10002951). Any opinions, findings, conclusions, or recommendations expressed in this publication do not necessarily reflect the views of any organization or agency that provided support for the project.

International Standard Book Number-13: 978-0-309-46826-8
International Standard Book Number-10: 0-309-46826-4
Digital Object Identifier: https://doi.org/10.17226/24951
Library of Congress Control Number: 2018932638

Additional copies of this publication are available for sale from the National Academies Press, 500 Fifth Street, NW, Keck 360, Washington, DC 20001; (800) 624-6242 or (202) 334-3313; http://www.nap.edu.

Copyright 2018 by the National Academy of Sciences. All rights reserved.

Printed in the United States of America

Suggested citation: National Academies of Sciences, Engineering, and Medicine. 2018. Getting to zero alcohol-impaired driving fatalities: A comprehensive approach to a persistent problem. Washington, DC: The National Academies Press. doi: https://doi.org/10.17226/24951.

Suggested Citation:"Front Matter." National Academies of Sciences, Engineering, and Medicine. 2018. Getting to Zero Alcohol-Impaired Driving Fatalities: A Comprehensive Approach to a Persistent Problem. Washington, DC: The National Academies Press. doi: 10.17226/24951.
×

images

The National Academy of Sciences was established in 1863 by an Act of Congress, signed by President Lincoln, as a private, nongovernmental institution to advise the nation on issues related to science and technology. Members are elected by their peers for outstanding contributions to research. Dr. Marcia McNutt is president.

The National Academy of Engineering was established in 1964 under the charter of the National Academy of Sciences to bring the practices of engineering to advising the nation. Members are elected by their peers for extraordinary contributions to engineering. Dr. C. D. Mote, Jr., is president.

The National Academy of Medicine (formerly the Institute of Medicine) was established in 1970 under the charter of the National Academy of Sciences to advise the nation on medical and health issues. Members are elected by their peers for distinguished contributions to medicine and health. Dr. Victor J. Dzau is president.

The three Academies work together as the National Academies of Sciences, Engineering, and Medicine to provide independent, objective analysis and advice to the nation and conduct other activities to solve complex problems and inform public policy decisions. The National Academies also encourage education and research, recognize outstanding contributions to knowledge, and increase public understanding in matters of science, engineering, and medicine.

Learn more about the National Academies of Sciences, Engineering, and Medicine at www.nationalacademies.org.

Suggested Citation:"Front Matter." National Academies of Sciences, Engineering, and Medicine. 2018. Getting to Zero Alcohol-Impaired Driving Fatalities: A Comprehensive Approach to a Persistent Problem. Washington, DC: The National Academies Press. doi: 10.17226/24951.
×

images

Consensus Study Reports published by the National Academies of Sciences, Engineering, and Medicine document the evidence-based consensus on the study’s statement of task by an authoring committee of experts. Reports typically include findings, conclusions, and recommendations based on information gathered by the committee and the committee’s deliberations. Each report has been subjected to a rigorous and independent peer-review process and it represents the position of the National Academies on the statement of task.

Proceedings published by the National Academies of Sciences, Engineering, and Medicine chronicle the presentations and discussions at a workshop, symposium, or other event convened by the National Academies. The statements and opinions contained in proceedings are those of the participants and are not endorsed by other participants, the planning committee, or the National Academies.

For information about other products and activities of the National Academies, please visit www.nationalacademies.org/about/whatwedo.

Suggested Citation:"Front Matter." National Academies of Sciences, Engineering, and Medicine. 2018. Getting to Zero Alcohol-Impaired Driving Fatalities: A Comprehensive Approach to a Persistent Problem. Washington, DC: The National Academies Press. doi: 10.17226/24951.
×

COMMITTEE ON ACCELERATING PROGRESS TO REDUCE ALCOHOL-IMPAIRED DRIVING FATALITIES

STEVEN M. TEUTSCH (Chair), Adjunct Professor, University of California, Los Angeles, Fielding School of Public Health; Senior Fellow, Public Health Institute; Senior Fellow, Leonard D. Schaeffer Center for Health Policy and Economics, University of Southern California

JULIE A. BALDWIN, Professor, Department of Health Sciences, Director, Center for Health Equity Research, Northern Arizona University

LINDA C. DEGUTIS, Executive Director, Defense Health Horizons, Henry M. Jackson Foundation; Adjunct Professor, Rollins School of Public Health, Emory University

MUCIO KIT DELGADO, Assistant Professor of Emergency Medicine and Epidemiology, Perelman School of Medicine, University of Pennsylvania

DAVID H. JERNIGAN, Associate Professor, Department of Health, Behavior and Society, Bloomberg School of Public Health, Johns Hopkins University

KATHERINE KEYES, Associate Professor of Epidemiology, Mailman School of Public Health, Columbia University

RICARDO MARTINEZ, Chief Medical Officer, Adeptus Health; Assistant Professor of Emergency Medicine, School of Medicine, Emory University

TIMOTHY S. NAIMI, Associate Professor of Medicine, School of Medicine, School of Public Health, Boston University; Clinician-Investigator, Section of General Internal Medicine, Boston Medical Center

JEFF NIEDERDEPPE, Associate Professor, Department of Communication, Cornell University

CHARLES P. O’BRIEN, Kenneth Appel Professor and Founding Director, Center for Studies of Addiction, University of Pennsylvania

JODY L. SINDELAR, Professor, Public Health (Policy) and Economics, School of Public Health, Yale University

JOANNE E. THOMKA, Program Counsel, National Association of Attorneys General

DOUGLAS WIEBE, Associate Professor of Epidemiology, Department of Biostatistics, Epidemiology, and Informatics, University of Pennsylvania

Suggested Citation:"Front Matter." National Academies of Sciences, Engineering, and Medicine. 2018. Getting to Zero Alcohol-Impaired Driving Fatalities: A Comprehensive Approach to a Persistent Problem. Washington, DC: The National Academies Press. doi: 10.17226/24951.
×

Study Staff

AMY GELLER, Study Director

YAMROT NEGUSSIE, Research Associate

AIMEE MEAD, Research Associate (from June 2017)

SOPHIE YANG, Research Assistant (from June 2017)

MARJORIE PICHON, Senior Program Assistant (until September 2017)

JENNIFER COHEN, Program Officer (July 2017–January 2018)

HOPE HARE, Administrative Assistant

MISRAK DABI, Financial Associate

BERNARDO KLEINER, Associate Division Director, Transportation Research Board

ROSE MARIE MARTINEZ, Senior Board Director, Board on Population Health and Public Health Practice

Suggested Citation:"Front Matter." National Academies of Sciences, Engineering, and Medicine. 2018. Getting to Zero Alcohol-Impaired Driving Fatalities: A Comprehensive Approach to a Persistent Problem. Washington, DC: The National Academies Press. doi: 10.17226/24951.
×

Reviewers

This Consensus Study Report was reviewed in draft form by individuals chosen for their diverse perspectives and technical expertise. The purpose of this independent review is to provide candid and critical comments that will assist the National Academies of Sciences, Engineering, and Medicine in making each published report as sound as possible and to ensure that it meets the institutional standards for quality, objectivity, evidence, and responsiveness to the study charge. The review comments and draft manuscript remain confidential to protect the integrity of the deliberative process.

We thank the following individuals for their review of this report:

KRISTINE M. GEBBIE, Torrens Resilience Institute, Flinders University

NORMAN GIESBRECHT, Institute for Mental Health Policy Research, Centre for Addiction and Mental Health

RALPH HINGSON, National Institute on Alcohol Abuse and Alcoholism, National Institutes of Health

ANNE McCARTT, formerly with Insurance Institute for Highway Safety

SCOTT C. RATZAN, AB InBev Foundation

EDUARDO ROMANO, Pacific Institute for Research and Evaluation

RUTH SHULTS, Centers for Disease Control and Prevention

MICHAEL D. SLATER, The Ohio State University

Page viii Cite
Suggested Citation:"Front Matter." National Academies of Sciences, Engineering, and Medicine. 2018. Getting to Zero Alcohol-Impaired Driving Fatalities: A Comprehensive Approach to a Persistent Problem. Washington, DC: The National Academies Press. doi: 10.17226/24951.
×

FRANK A. SLOAN, Duke University

GORDON SMITH, West Virginia University

SRINIVASAN SUNDARARAJAN, Ford Motor Company

STEPHEN K. TALPINS, Rumberger Kirk & Caldwell and National Partnership on Alcohol Misuse and Crime

LAWRENCE WALLACK, Portland State University

Although the reviewers listed above provided many constructive comments and suggestions, they were not asked to endorse the conclusions or recommendations of this report nor did they see the final draft before its release. The review of this report was overseen by ROBERT B. WALLACE, The University of Iowa, and RICHARD J. BONNIE, University of Virginia. They were responsible for making certain that an independent examination of this report was carried out in accordance with the standards of the National Academies and that all review comments were carefully considered. Responsibility for the final content rests entirely with the authoring committee and the National Academies.

Suggested Citation:"Front Matter." National Academies of Sciences, Engineering, and Medicine. 2018. Getting to Zero Alcohol-Impaired Driving Fatalities: A Comprehensive Approach to a Persistent Problem. Washington, DC: The National Academies Press. doi: 10.17226/24951.
×

Acknowledgments

The Committee on Accelerating Progress to Reduce Alcohol-Impaired Driving Fatalities wishes to acknowledge the many people whose contributions and support made this report possible. The committee benefited from presentations made by a number of experts. The following individuals shared their research, experience, and perspectives with the committee: Nadia Anderson, Douglas Beirness, Nancy Bill, Jessica Cicchino, Phillip Cook, James C. Fell, Debra Furr-Holden, Jacqueline Gillan, Thomas Greenfield, J. T. Griffin, Frank Harris, Ralph Hingson, Tara Kelley-Baker, Bill Kerr, Russ Martin, Jim McDonnell, Jeff Michael, Keith Nothacker, M. J. Paschall, Francesca Polletta, Rebecca Ramirez, Craig Reinarman, Lawrence Robertson, Steve Schmidt, Clint Shrum, Brooke Stringer, Steve Taylor, Anne Teigen, Nick Van Dyke, Robert Voas, Diane Wigle, and Thomas Woodward.

The following individuals were important sources of information, generously giving their time and knowledge to further the committee’s efforts: Thomas F. Babor, Charles DiMaggio, Lori Dorfman, Deborah Fisher, Adnan Hyder, Jonathan Noel, Jamie Oliver, Katherine Robaina, Robert Strassburger, Andres Vecino-Ortiz, and Katherine Wheeler-Martin.

The committee is thankful to the study staff for their support of this study: Amy Geller, Yamrot Negussie, Aimee Mead, Sophie Yang, Marjorie Pichon, Jennifer Cohen, Bernardo Kleiner, and Rose Marie Martinez. The committee also acknowledges the support of other National Academies of Sciences, Engineering, and Medicine staff, especially Daniel Bearss, Clyde Behney, Misrak Dabi, Iliana Espinal, Chelsea Frakes, Greta Gorman,

Suggested Citation:"Front Matter." National Academies of Sciences, Engineering, and Medicine. 2018. Getting to Zero Alcohol-Impaired Driving Fatalities: A Comprehensive Approach to a Persistent Problem. Washington, DC: The National Academies Press. doi: 10.17226/24951.
×

Hope Hare, Nicole Joy, Sarah Kelley, Ellen Kimmel, Dana Korsen, Rebecca Morgan, Tina Ritter, Doris Romero, Barbara Schlein, Lauren Shern, Elizabeth Tyson, and Taryn Young.

The committee also benefited from past National Academies studies relevant to this report, particularly the 2004 report Reducing Underage Drinking: A Collective Responsibility.

Finally, funding for this project was provided by the National Highway Traffic Safety Administration. The committee extends special thanks for that support.

Suggested Citation:"Front Matter." National Academies of Sciences, Engineering, and Medicine. 2018. Getting to Zero Alcohol-Impaired Driving Fatalities: A Comprehensive Approach to a Persistent Problem. Washington, DC: The National Academies Press. doi: 10.17226/24951.
×
Suggested Citation:"Front Matter." National Academies of Sciences, Engineering, and Medicine. 2018. Getting to Zero Alcohol-Impaired Driving Fatalities: A Comprehensive Approach to a Persistent Problem. Washington, DC: The National Academies Press. doi: 10.17226/24951.
×

This page intentionally left blank.

Suggested Citation:"Front Matter." National Academies of Sciences, Engineering, and Medicine. 2018. Getting to Zero Alcohol-Impaired Driving Fatalities: A Comprehensive Approach to a Persistent Problem. Washington, DC: The National Academies Press. doi: 10.17226/24951.
×

Acronyms and Abbreviations

AASHTO

American Association of State Highway and Transportation Officials

ABI

American Beverage Institute

ABV

alcohol by volume

ACEP

American College of Emergency Physicians

ACTS

Automotive Coalition for Traffic Safety

AHA

American Hospital Association

AI/AN

American Indian/Alaska Native

AIS

Abbreviated Injury Scale

ALR

administrative license revocation

ALS

administrative license suspension

AMERSA

Association for Medical Education and Research in Substance Abuse

APIS

Alcohol Policy Information System

ASSIST

American Stop Smoking Intervention Study

AUD

alcohol use disorder

BAC

blood alcohol concentration/content

BrAC

breath alcohol concentration

BRFSS

Behavioral Risk Factor Surveillance System

CADCA

Community Anti-Drug Coalitions of America

CBA

cost-benefit analysis

CBT

cognitive behavioral therapy

Suggested Citation:"Front Matter." National Academies of Sciences, Engineering, and Medicine. 2018. Getting to Zero Alcohol-Impaired Driving Fatalities: A Comprehensive Approach to a Persistent Problem. Washington, DC: The National Academies Press. doi: 10.17226/24951.
×
CDC

Centers for Disease Control and Prevention

CEA

cost-effectiveness analysis

CI

confidence interval

CIREN

Crash Injury Research and Engineering Network

CODES

Crash Outcome Data Evaluation System

CPSTF

Community Preventive Services Task Force

CVD

cardiovascular disease

DADSS

Driver Alcohol Detection System for Safety

DMV

Department of Motor Vehicles

DOT

Department of Transportation

DUI

driving under the influence

DWI

driving while impaired

ED

emergency department

EMS

emergency medical services

ESV

Enhanced Safety of Vehicles

FARS

Fatality Analysis Reporting System

FAST

Fixing America’s Surface Transportation

FBI

Federal Bureau of Investigation

FDA

Food and Drug Administration

FHWA

Federal Highway Administration

FMCSA

Federal Motor Carrier Safety Administration

FY

fiscal year

GHSA

Governors Highway Safety Association

GIS

geographic information system

HVMT

highway vehicle miles traveled

IIHS

Insurance Institute for Highway Safety

ITE

Institute of Transportation Engineers

MADD

Mothers Against Drunk Driving

MAP-21

Moving Ahead for Progress in the 21st Century Act

MLDA

minimum legal drinking age

NCSA

National Center for Statistics and Analysis

NCSL

National Conference of State Legislators

NEISS

National Electronic Injury Surveillance System

NESARC

National Epidemiologic Survey on Alcohol-Related Conditions

Page xvii Cite
Suggested Citation:"Front Matter." National Academies of Sciences, Engineering, and Medicine. 2018. Getting to Zero Alcohol-Impaired Driving Fatalities: A Comprehensive Approach to a Persistent Problem. Washington, DC: The National Academies Press. doi: 10.17226/24951.
×
NHTS

National Household Travel Survey

NHTSA

National Highway Traffic Safety Administration

NIAAA

National Institute on Alcohol Abuse and Alcoholism

NIBRS

National Incident-Based Reporting System

NRS

National Roadside Survey of Alcohol and Drug Use by Drivers

NSC

National Safety Council

NSDUH

National Survey on Drug Use and Health

NTDB

National Trauma Data Bank

NTSB

National Transportation Safety Board

NTX

Naltrexone

OECD

Organisation for Economic Co-operation and Development

OR

odds ratio

PAHO

Pan American Health Organization

PAR

police accident report

PAS

passive alcohol sensor

PBT

preliminary breath test

POLD

place of last drink

RBS

responsible beverage service

RID

Remove Intoxicated Drivers

ROADS SAFE

Research of Alcohol Detection Systems for Stopping Alcohol-Related Fatalities Everywhere

RR

relative risk

SAMHSA

Substance Abuse and Mental Health Services Administration

SBIRT

screening, brief intervention, and referral to treatment

SCC

Safe Communities Coalition

SDLP

standard deviation of lane position

SDOH

social determinants of health

SDS

State Data System

SDSP

standard deviation of speed

SES

socioeconomic status

SFST

standardized field sobriety test

SHS

secondhand smoke

SIP

sales to intoxicated persons

STRADA

Swedish Traffic Accident Data Acquisition

Page xviii Cite
Suggested Citation:"Front Matter." National Academies of Sciences, Engineering, and Medicine. 2018. Getting to Zero Alcohol-Impaired Driving Fatalities: A Comprehensive Approach to a Persistent Problem. Washington, DC: The National Academies Press. doi: 10.17226/24951.
×
TAC

transdermal alcohol content

UCR

Uniform Crime Reporting System

UPPL

Uniform Accident and Sickness Policy Provision Law

V2I

vehicle to infrastructure

V2V

vehicle to vehicle

VMT

vehicle miles traveled

WHO

World Health Organization

WISQARS

Web-based Injury Statistics Query and Reporting System

YRBSS

Youth Risk Behavior Surveillance System

Suggested Citation:"Front Matter." National Academies of Sciences, Engineering, and Medicine. 2018. Getting to Zero Alcohol-Impaired Driving Fatalities: A Comprehensive Approach to a Persistent Problem. Washington, DC: The National Academies Press. doi: 10.17226/24951.
×

Glossary

Alcohol-impaired driving crash/fatality—In all U.S. states1 drivers are considered legally impaired to drive when their blood alcohol concentration (BAC) is greater than or equal to 0.08 grams per deciliter (g/dL, often expressed as %, as in 0.08%).2 Thus, in the United States, any crash involving one or more drivers with a BAC of 0.08% or higher is typically referred to by the National Highway Traffic Safety Administration (NHTSA) as an alcohol-impaired driving crash, and fatalities stemming from those crashes are defined as being alcohol-impaired driving crash fatalities. Of note, however, is that impairment begins below 0.08%, so this is an underestimate relative to all crash fatalities in which impairment from alcohol may have contributed.3

Alcohol-related crash/fatality—A crash or a fatality from a crash that involves one or more drivers of a motor vehicle with any alcohol in their system (i.e., a BAC greater than 0.00%). This term also subsumes alcohol-impaired driving crashes. It is a useful umbrella term for all motor vehicle

___________________

1 Utah recently passed legislation to lower the BAC law to 0.05% beginning in December 2018.

2 States may have lower BAC laws for individuals under the minimum legal drinking age of 21 and for commercial drivers.

3 Of note, a crash involving a nonimpaired motor vehicle driver and an impaired pedestrian or cyclist is not counted as an alcohol-impaired motor vehicle crash by NHTSA’s Fatality Analysis Reporting System, which collects information about all motor vehicle crash fatalities occurring on U.S. public roadways.

Suggested Citation:"Front Matter." National Academies of Sciences, Engineering, and Medicine. 2018. Getting to Zero Alcohol-Impaired Driving Fatalities: A Comprehensive Approach to a Persistent Problem. Washington, DC: The National Academies Press. doi: 10.17226/24951.
×

crashes that involve any alcohol. Some have also used the term alcohol-involved to convey the same idea.

Alcohol use disorder (AUD)—The current Diagnostic and Statistical Manual of Mental Disorders (DSM-5) combines previously separate disorders (alcohol abuse and alcohol dependence) into one alcohol use disorder with a continuum of mild, moderate, and severe subclassifications. A patient is diagnosed with AUD if he or she displays 2 of the 11 symptoms during a 12-month period; the subclassifications are based on the number of symptoms the patient has (mild AUD = 2 or 3 of the symptoms, moderate AUD = 4 or 5 symptoms, and severe AUD = 6 or more symptoms).

Binge drinking—Used to connote drinking at or above levels during a drinking occasion/episode that typically results in impairment-level BAC (i.e., ≥0.08%) for most men and women drinking at typical drinking rates. This corresponds to drinking five or more drinks for men and four or more drinks for women in about 2 hours. Most public health and epidemiologic studies use five/four thresholds, and members of the general public interpret the term binge drinking to mean drinking to the point of impairment or intoxication.

Blood alcohol concentration/content (BAC)—The percentage (%) of ethanol in the blood, based on the mass of alcohol per mass of blood. For instance, a BAC of 0.10 (0.10%, or one-tenth of 1 percent) means that there are 0.10 grams of alcohol for every deciliter (100 ml) of blood. Blood alcohol concentrations can also be derived from breath tests or transcutaneous monitors. This is sometimes expressed in milligrams per deciliter, in which case a BAC of 0.1% is expressed as 100 mg/dL.

Driver—Refers to the operator of any motor vehicle, including a motorcycle or motorboat. For surveillance purposes (e.g., NHTSA), this is usually restricted to motor vehicles operating on land, meaning motor vehicles, including motorcycles and related vehicles, operating on public roadways.

Driving under the influence (DUI), driving while impaired (DWI)—These are legal terms that refer to operating a motor vehicle while one’s blood alcohol concentration is above the limit set by state law, or on the basis of field sobriety tests or observed behavior. Colloquial terms for DUI and DWI include

Drink-driving—Refers to driving or operating a motor vehicle while impaired or while one’s blood alcohol concentration is above the limit set by law (more commonly used in the United Kingdom).

Suggested Citation:"Front Matter." National Academies of Sciences, Engineering, and Medicine. 2018. Getting to Zero Alcohol-Impaired Driving Fatalities: A Comprehensive Approach to a Persistent Problem. Washington, DC: The National Academies Press. doi: 10.17226/24951.
×

Drunk driving crash/fatality—Widely used and recognized, and generally refers to driving or crashes or fatalities that are related to alcohol impairment (in most U.S. states based on BAC levels ≥ 0.08%; see footnote 1).

Impairment—Refers to the deterioration of an individual’s judgment and/or physical ability. Physiological and cognitive impairment begin at BAC levels below those that are associated with intoxication. As a legal standard, impairment and DWI laws are based on a person’s physical or mental impairment as judged on the basis of BAC level, performance in standardized field sobriety tests, or observed behavior. Although this report is focused on impairment from alcohol, impairment can result from other substance use, distracted driving, and other reasons.

Intoxication—Refers to the condition of having physical or mental control markedly diminished by the effects of alcohol or drugs. This is usually based on a subjective determination (one feels the sensation, or observes a behavior in another person). Physiological impairment begins at BAC levels below those that are associated with intoxication. Intoxication is not a legal standard.

Motor vehicle crash fatality—NHTSA defines a motor vehicle crash fatality as one that (1) involves at least one motor vehicle (e.g., car, motorcycle); (2) results in the death of a driver, passenger, cyclist, pedestrian, or occupant of a vehicle in transit within 30 days of the crash; and (3) occurs on a public U.S. roadway.

Per se laws—Per se laws in DUI or DWI cases generally establish that once an individual is shown to have a BAC at or above a certain limit (e.g., 0.08%) that person will be considered impaired by law. In such circumstances, no further evidence of intoxication or impairment need be demonstrated for the purpose of a DUI case. Currently, all states have per se DUI laws.

U.S. standard drink—In the United States, a standard drink is 14 grams or 0.6 ounces of pure ethanol (a weight-based measure). This is the amount of ethanol in 12 ounces of 5 percent alcohol-by-volume (ABV) beer, 5 ounces of 12 percent ABV wine, or 1.5 ounces of 40 percent ABV distilled spirits (40 percent ABV, or 80 proof, is the concentration in most brands of whiskey, vodka, rum, gin, etc.).

Page xxii Cite
Suggested Citation:"Front Matter." National Academies of Sciences, Engineering, and Medicine. 2018. Getting to Zero Alcohol-Impaired Driving Fatalities: A Comprehensive Approach to a Persistent Problem. Washington, DC: The National Academies Press. doi: 10.17226/24951.
×

This page intentionally left blank.

Page xxiii Cite
Suggested Citation:"Front Matter." National Academies of Sciences, Engineering, and Medicine. 2018. Getting to Zero Alcohol-Impaired Driving Fatalities: A Comprehensive Approach to a Persistent Problem. Washington, DC: The National Academies Press. doi: 10.17226/24951.
×

Preface

More than 10,000 people are killed in the United States each year from alcohol-impaired driving, and that number is on the rise. After decades of progress, the number of alcohol-impaired driving deaths first stagnated and is now actually increasing. Alcohol-impaired driving remains the greatest single cause of motor vehicle fatalities, significantly exceeding the number of deaths from distracted driving and drugged driving. Passengers, pedestrians, cyclists, and occupants of other vehicles—who make up almost 40 percent of alcohol-impaired driving fatalities1—are secondhand victims, and their fatalities are just as intolerable as those of the victims of cigarette secondhand smoke. For each death, hundreds more are injured or disabled.

Our apathy toward 29 alcohol-impaired driving deaths per day is unacceptable, particularly because these tragic events can be prevented. This report describes how this can be accomplished with the tools already at our disposal and on the near-term horizon. By marshalling real-time, comprehensive data and the collective action of all the relevant stakeholders, we can make step-by-step progress toward eliminating these needless deaths and injuries. Vision Zero—the framework for eliminating motor vehicle deaths—provides the road map. Policy makers can enact and implement evidence-based policies, the clinical care system can identify and manage those at risk, the enforcement and legal systems can

___________________

1 NCSA (National Center for Statistics and Analysis). 2016. Alcohol-impaired driving: 2015 data. DOT HS 812 350. Washington, DC: National Highway Traffic Safety Administration.

Page xxiv Cite
Suggested Citation:"Front Matter." National Academies of Sciences, Engineering, and Medicine. 2018. Getting to Zero Alcohol-Impaired Driving Fatalities: A Comprehensive Approach to a Persistent Problem. Washington, DC: The National Academies Press. doi: 10.17226/24951.
×

identify and manage offenders, the alcohol beverage industry can support and implement effective actions grounded in evidence and take steps to reduce harmful drinking, engineers and the private sector can partner to develop and incorporate effective technologies into vehicles and devices, government agencies can provide the leadership and research to enact and enforce policies to reinvigorate progress, and the public can advocate for effective actions. These collaborations can establish processes for the actions that need to be taken, determine the entities primarily responsible, assess progress toward implementation, and develop mechanisms to identify problems, investigate them, and take effective action. As some Organisation for Economic Co-operation and Development nations have demonstrated, alcohol-impaired driving deaths can be virtually eliminated. This report provides the science base to do so.

I want to extend my gratitude to the National Highway Traffic Safety Administration for stimulating and sponsoring this report. It is another step in its continued leadership in making our roadways safer. Thanks, too, to the committee, staff, and consultants for their creativity and energy in bringing this report to fruition.

Steven M. Teutsch, Chair
Committee on Accelerating Progress to Reduce
Alcohol-Impaired Driving Fatalities

Suggested Citation:"Front Matter." National Academies of Sciences, Engineering, and Medicine. 2018. Getting to Zero Alcohol-Impaired Driving Fatalities: A Comprehensive Approach to a Persistent Problem. Washington, DC: The National Academies Press. doi: 10.17226/24951.
×
Page R1
Suggested Citation:"Front Matter." National Academies of Sciences, Engineering, and Medicine. 2018. Getting to Zero Alcohol-Impaired Driving Fatalities: A Comprehensive Approach to a Persistent Problem. Washington, DC: The National Academies Press. doi: 10.17226/24951.
×
Page R2
Suggested Citation:"Front Matter." National Academies of Sciences, Engineering, and Medicine. 2018. Getting to Zero Alcohol-Impaired Driving Fatalities: A Comprehensive Approach to a Persistent Problem. Washington, DC: The National Academies Press. doi: 10.17226/24951.
×
Page R3
Suggested Citation:"Front Matter." National Academies of Sciences, Engineering, and Medicine. 2018. Getting to Zero Alcohol-Impaired Driving Fatalities: A Comprehensive Approach to a Persistent Problem. Washington, DC: The National Academies Press. doi: 10.17226/24951.
×
Page R4
Suggested Citation:"Front Matter." National Academies of Sciences, Engineering, and Medicine. 2018. Getting to Zero Alcohol-Impaired Driving Fatalities: A Comprehensive Approach to a Persistent Problem. Washington, DC: The National Academies Press. doi: 10.17226/24951.
×
Page R5
Suggested Citation:"Front Matter." National Academies of Sciences, Engineering, and Medicine. 2018. Getting to Zero Alcohol-Impaired Driving Fatalities: A Comprehensive Approach to a Persistent Problem. Washington, DC: The National Academies Press. doi: 10.17226/24951.
×
Page R6
Suggested Citation:"Front Matter." National Academies of Sciences, Engineering, and Medicine. 2018. Getting to Zero Alcohol-Impaired Driving Fatalities: A Comprehensive Approach to a Persistent Problem. Washington, DC: The National Academies Press. doi: 10.17226/24951.
×
Page R7
Page viii Cite
Suggested Citation:"Front Matter." National Academies of Sciences, Engineering, and Medicine. 2018. Getting to Zero Alcohol-Impaired Driving Fatalities: A Comprehensive Approach to a Persistent Problem. Washington, DC: The National Academies Press. doi: 10.17226/24951.
×
Page R8
Suggested Citation:"Front Matter." National Academies of Sciences, Engineering, and Medicine. 2018. Getting to Zero Alcohol-Impaired Driving Fatalities: A Comprehensive Approach to a Persistent Problem. Washington, DC: The National Academies Press. doi: 10.17226/24951.
×
Page R9
Suggested Citation:"Front Matter." National Academies of Sciences, Engineering, and Medicine. 2018. Getting to Zero Alcohol-Impaired Driving Fatalities: A Comprehensive Approach to a Persistent Problem. Washington, DC: The National Academies Press. doi: 10.17226/24951.
×
Page R10
Suggested Citation:"Front Matter." National Academies of Sciences, Engineering, and Medicine. 2018. Getting to Zero Alcohol-Impaired Driving Fatalities: A Comprehensive Approach to a Persistent Problem. Washington, DC: The National Academies Press. doi: 10.17226/24951.
×
Page R11
Suggested Citation:"Front Matter." National Academies of Sciences, Engineering, and Medicine. 2018. Getting to Zero Alcohol-Impaired Driving Fatalities: A Comprehensive Approach to a Persistent Problem. Washington, DC: The National Academies Press. doi: 10.17226/24951.
×
Page R12
Page xiii Cite
Suggested Citation:"Front Matter." National Academies of Sciences, Engineering, and Medicine. 2018. Getting to Zero Alcohol-Impaired Driving Fatalities: A Comprehensive Approach to a Persistent Problem. Washington, DC: The National Academies Press. doi: 10.17226/24951.
×
Page R13
Suggested Citation:"Front Matter." National Academies of Sciences, Engineering, and Medicine. 2018. Getting to Zero Alcohol-Impaired Driving Fatalities: A Comprehensive Approach to a Persistent Problem. Washington, DC: The National Academies Press. doi: 10.17226/24951.
×
Page R14
Suggested Citation:"Front Matter." National Academies of Sciences, Engineering, and Medicine. 2018. Getting to Zero Alcohol-Impaired Driving Fatalities: A Comprehensive Approach to a Persistent Problem. Washington, DC: The National Academies Press. doi: 10.17226/24951.
×
Page R15
Suggested Citation:"Front Matter." National Academies of Sciences, Engineering, and Medicine. 2018. Getting to Zero Alcohol-Impaired Driving Fatalities: A Comprehensive Approach to a Persistent Problem. Washington, DC: The National Academies Press. doi: 10.17226/24951.
×
Page R16
Page xvii Cite
Suggested Citation:"Front Matter." National Academies of Sciences, Engineering, and Medicine. 2018. Getting to Zero Alcohol-Impaired Driving Fatalities: A Comprehensive Approach to a Persistent Problem. Washington, DC: The National Academies Press. doi: 10.17226/24951.
×
Page R17
Page xviii Cite
Suggested Citation:"Front Matter." National Academies of Sciences, Engineering, and Medicine. 2018. Getting to Zero Alcohol-Impaired Driving Fatalities: A Comprehensive Approach to a Persistent Problem. Washington, DC: The National Academies Press. doi: 10.17226/24951.
×
Page R18
Suggested Citation:"Front Matter." National Academies of Sciences, Engineering, and Medicine. 2018. Getting to Zero Alcohol-Impaired Driving Fatalities: A Comprehensive Approach to a Persistent Problem. Washington, DC: The National Academies Press. doi: 10.17226/24951.
×
Page R19
Suggested Citation:"Front Matter." National Academies of Sciences, Engineering, and Medicine. 2018. Getting to Zero Alcohol-Impaired Driving Fatalities: A Comprehensive Approach to a Persistent Problem. Washington, DC: The National Academies Press. doi: 10.17226/24951.
×
Page R20
Suggested Citation:"Front Matter." National Academies of Sciences, Engineering, and Medicine. 2018. Getting to Zero Alcohol-Impaired Driving Fatalities: A Comprehensive Approach to a Persistent Problem. Washington, DC: The National Academies Press. doi: 10.17226/24951.
×
Page R21
Page xxii Cite
Suggested Citation:"Front Matter." National Academies of Sciences, Engineering, and Medicine. 2018. Getting to Zero Alcohol-Impaired Driving Fatalities: A Comprehensive Approach to a Persistent Problem. Washington, DC: The National Academies Press. doi: 10.17226/24951.
×
Page R22
Page xxiii Cite
Suggested Citation:"Front Matter." National Academies of Sciences, Engineering, and Medicine. 2018. Getting to Zero Alcohol-Impaired Driving Fatalities: A Comprehensive Approach to a Persistent Problem. Washington, DC: The National Academies Press. doi: 10.17226/24951.
×
Page R23
Page xxiv Cite
Suggested Citation:"Front Matter." National Academies of Sciences, Engineering, and Medicine. 2018. Getting to Zero Alcohol-Impaired Driving Fatalities: A Comprehensive Approach to a Persistent Problem. Washington, DC: The National Academies Press. doi: 10.17226/24951.
×
Page R24
Next: Summary »
Getting to Zero Alcohol-Impaired Driving Fatalities: A Comprehensive Approach to a Persistent Problem Get This Book
×
Buy Paperback | $85.00 Buy Ebook | $69.99
MyNAP members save 10% online.
Login or Register to save!
Download Free PDF

Alcohol-impaired driving is an important health and social issue as it remains a major risk to Americans’ health today, surpassing deaths per year of certain cancers, HIV/AIDS, and drownings, among others, and contributing to long-term disabilities from head and spinal injuries. Progress has been made over the past decades towards reducing these trends, but that progress has been incremental and has stagnated more recently.

Getting to Zero Alcohol-Impaired Driving Fatalities examines which interventions (programs, systems, and policies) are most promising to prevent injuries and death from alcohol-impaired driving, the barriers to action and approaches to overcome them, and which interventions need to be changed or adopted. This report makes broad-reaching recommendations that will serve as a blueprint for the nation to accelerate the progress in reducing alcohol-impaired driving fatalities.

  1. ×

    Welcome to OpenBook!

    You're looking at OpenBook, NAP.edu's online reading room since 1999. Based on feedback from you, our users, we've made some improvements that make it easier than ever to read thousands of publications on our website.

    Do you want to take a quick tour of the OpenBook's features?

    No Thanks Take a Tour »
  2. ×

    Show this book's table of contents, where you can jump to any chapter by name.

    « Back Next »
  3. ×

    ...or use these buttons to go back to the previous chapter or skip to the next one.

    « Back Next »
  4. ×

    Jump up to the previous page or down to the next one. Also, you can type in a page number and press Enter to go directly to that page in the book.

    « Back Next »
  5. ×

    Switch between the Original Pages, where you can read the report as it appeared in print, and Text Pages for the web version, where you can highlight and search the text.

    « Back Next »
  6. ×

    To search the entire text of this book, type in your search term here and press Enter.

    « Back Next »
  7. ×

    Share a link to this book page on your preferred social network or via email.

    « Back Next »
  8. ×

    View our suggested citation for this chapter.

    « Back Next »
  9. ×

    Ready to take your reading offline? Click here to buy this book in print or download it as a free PDF, if available.

    « Back Next »
Stay Connected!