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, Massachusetts, 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 8 effective strategies that have not been fully implemented in the United States. Workshop participants (16 of the 26) rated their top 3 strategies.Results: 3 strategies received the most support: Impose administrative sanctions for drivers with BACs = 0.05 to 0.08 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.5 other important strategies included the following: (1) increase alcohol taxes to raise the price and reduce alcohol consumption; (2) reengage the public and raise the priority of impaired driving; (3) lower the illegal per se BAC limit to 0.05 for a criminal offense; (4) develop and implement in-vehicle alcohol detection systems; and (5) 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 3 strategies implemented on a widespread basis would decrease impaired driving crashes, injuries, and fatalities. Based on the research, all 3 together would have a substantial impact on the problem.

The goal of the AASHTO Strategic Highway Safety Plan is to reduce annual highway fatalities to 1.0 fatality per 100 million vehicle miles of travel. This goal can be achieved through the widespread application of low-cost, proven countermeasures that reduce the number of crashes on the nation's highways. This sixteenth volume of NCHRP Report 500, Guidance for Implementation of the AASHTO Strategic Highway Safety Plan, provides strategies that can be employed to reduce crashes involving alcohol. The report will be of particular interest to safety practitioners with responsibility for implementing programs to reduce injuries and fatalities on the highway system.

Substantial progress has been made in the United States (U.S.) in reducing the impaired driving problem. Future gains will be more difficult because of certain high risk groups of drivers who are more resistant to change. Persistent drinking drivers are one of those groups: they drink and drive again and again; their behavior apparently has not been affected by information and education; and many of them have not been deterred by laws and enforcement or even by arrest and punishment. We need tit know who this driver is, what he knows and thinks, and how he acts. This paper gives a brief overview of recent data and studies on the persistent drinking driver primarily from the U.S. Programs being initiated to deal with some of these high risk drivers will be discussed.

Drinking drivers crash more frequently than sober drivers. Drinking drivers who crash, however, are similar in many ways to sober drivers who crash. For example, many sober drivers are young males who enjoy risky behavior. This discussion paper debates the question: how much of the alcohol-impaired driving problem is due to alcohol and how much is due to other factors? If the drinking drivers involved in crashes last year had not been drinking, but still drove, what proportion of their crashes still would have occurred?

This paper briefly reviews the major changes and anticipated trends in impaired driving policies, laws, enforcement, and sanctions in the USA. Thus legislation is largely a responsibility of the US states. The US laws prohibit the sale of alcohol to people under 21, but do not apply to drink-driving; however, they have reduced alcohol-related traffic fatalities for people under 21. Blood alcohol content (BAC) limits are being reduced for all drivers, and in some states are even lower in young drivers. In 1988, the Federal Government passed a law with even lower BAC limits for commercial drivers. Licence sanctions are becoming more popular for impaired driving offences, and vehicles sanctions are being tested in various places. Sobriety checkpoints are becoming more popular after their US Supreme Court approval in 1990. All states prohibit driving while impaired by drugs other than alcohol. A Drug Evaluation and Classification (DEC) programme has been developed to help police to test drivers suspected of such impairment. Police have begun to use such procedures in 24 states. Police evidence on drug impairment has been accepted in court. US police are currently faced with increasing demands on their services to address drink-driving and other drug-impaired driving. For the covering abstract, see IRRD 866577.

United States traffic fatalities dropped dramatically from 49,301 in 1981 to an estimated 43,721 in 1982. Fatalities are at their lowest level in 20 yr, and fatalities per mile of travel are the lowest ever recorded. A decrease of similar magnitude occurred only in 1974, when the oil crisis, the national 55 mph speed limit, and depressed economic conditions disrupted the nation's driving habits. In 1982 the potential explanations are more difficult to observe and test. This paper examines several factors which may have contributed to the 1982 changes, including alcohol programs, occupant restraint use, demographic shifts, economic conditions, and travel patterns. Each factor's effect is assessed, though available data do not permit precise quantification. Implications of these findings for 1983 and beyond are discussed.