research papers about drunk driving

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Driving Under the Influence of Alcohol: Findings from the NSDUH, 2002-2017

1 College of Social Work, The Ohio State University, Columbus, OH 43210, United States.

Michael G. Vaughn

2 School of Social Work, College for Public Health and Social Justice, Saint Louis University, St. Louis, MO 63103, United States.

3 Graduate School of Social Welfare, Yonsei University, Seoul, Republic of Korea.

Christopher P. Salas-Wright

4 School of Social Work, Boston University, Boston, MA 02215, United States.

Millan A. AbiNader

5 School of Social Work, Arizona State University, Phoenix, AZ 85006, United States.

Mariana Sanchez

6 Robert Stempel College of Public Health and Social Work, Florida International University, Miami, FL 33199, United States.

Author Statement

Michael G. Vaughn: Conceptualization, Methodology, Writing - review & editing

Christopher P. Salas-Wright: Conceptualization, Methodology, Writing - review & editing

Millan A. AbiNader: Investigation; Writing - review & editing

Mariana Sanchez : Validation; Writing - review & editing

Based on a nationally representative adult sample, the present study examined the prevalence and trends of driving under the influence (DUI) of alcohol in the United States from 2002 to 2017.

Using data from the 2002–2017 National Survey on Drug Use and Health, the prevalence of DUI of alcohol in 2012–2017 were estimated to test for changes in trend and to identify populations at elevated risks of alcohol-involved driving.

Since 2002, the prevalence of DUI of alcohol has gradually decreased from a high of 15.1% in 2002–2004 to 11.8% in 2012–2014 and 8.5% in 2016–2017, indicating percent decreases by 21.6% and 43.7%, respectively. While decreasing trends were observed across all major sociodemographic and criminal justice subgroups (except older adults), men, young adults, Whites, and those with higher household income continued to be associated with greater risks of alcohol-involved driving. Nevertheless, DUI arrests continued to increase among women, narrowing the gender gap.

Discussion:

Despite the decreased alcohol-involved driving over the past decade, there remains worrisome levels among young adult males. This underscores the need for alcohol policies and public awareness campaigns targeting young adult males. Moreover, further research is needed to elucidate the potential differences in the populations who reported driving under any influence of alcohol and who were involved in fatal crashes.

1. Introduction

Driving under the influence (DUI) of alcohol is a significant public health problem. Over 30% of motor vehicle traffic fatalities were caused by alcohol-impaired driving, resulting in 10,874 lives lost and $44 billion costs incurred in 2017 alone ( Naimi et al., 2018 ; National Highway Traffic Safety Administration, 2018 ). Additionally, nearly 1 million arrests were made for DUI during the same year ( The Federal Bureau of Investigation, n.d. ). Several key policies have been implemented to reduce DUI of Alcohol. For instance, by 2004, all states enacted new legal limits of alcohol-impaired driving at a blood alcohol concentration [BAC] of 0.08g/dL. By 2011, 42 states adopted so-called the “Administrative License Revocation” law, which enables states to suspend or revoke driver licenses when a driver was found driving with a BAC of 0.08% or above ( Ying et al., 2013 ).

Despite recent policy changes at the federal and state levels, evidence is limited about how many Americans are involved in drinking and driving and how these rates have changed. NHTSA releases data on drivers’ alcohol involvement, but this data only captures those involved in fatal traffic crashes. Some studies ( Quinlan et al., 2005 ; Schwartz & Beltz, 2018 ) report population-based estimates based on national surveys such as the Behavioral Risk Factor Surveillance System (BRFSS), but these studies also have limitations. For instance, the BRFSS asks whether respondents drove when they have had “perhaps too much” drink during the past month ( Centers for Disease Control and Prevention [CDC], 2018a ). Due to the possibility of subjective interpretation of the question, consistent estimation and comparison of the DUI of alcohol prevalence may not be warranted across respondents and years.

To inform prevention efforts while triangulating existing evidence, further evaluation of trends in the prevalence of DUI of alcohol and identification of populations at heightened risk is critical. Especially, evidence on the scope of the population who drive under any degree of alcohol influence is important to provide insights on more general alcohol-involved driving behaviors and to enable early detection and intervention of problematic driving activities. Moreover, large variations in DUI of alcohol patterns and risks across population subgroups (e.g., age, sex, race/ethnicity, socioeconomic status [SES], criminal justice history) require investigations into identifying those at greatest risk ( Calling et al., 2019 ; Casswell et al., 2003 ; Dickson et al., 2013 ; Impinen et al., 2011 ; Schwartz & Beltz, 2018 ). For instance, Schwartz and Beltz (2018) showed that men’s alcohol-impaired driving rates continue to remain higher than women’ despite an overall decreasing trend. Yet, DUI arrests have increased among women since 1985, narrowing the gender gap ( Schwartz & Beltz, 2018 ; Schwartz & Rookey, 2008 ). In a study examining major racial/ethnic groups, Whites were more likely to be involved in alcohol-impaired driving than African-Americans and Hispanics–though people of color were overrepresented in arrests and crashes ( Romano et al., 2010 ). Studies also point to the different drinking and driving behaviors by prior DUI and other criminal arrests. Labrie and colleagues (2007) found that a history of anti-social behavior and criminal justice system encounters were as important as prior alcohol-related problems in predicting a higher recidivism rate.

The present study addresses prior gaps by examining the prevalence and trends of DUI of alcohol in the United States since 2002 using data from National Survey of Drug Use and Health (NSDUH). We present population-based prevalence estimates for past-year DUI of alcohol among all respondents aged 18 or older and various subgroups by sociodemographic characteristics and criminal justice involvement. Then we tested for changes in trend in DUI of alcohol by comparing with the rates from 2002 to 2017.

2. Material and Methods

2.1. data and sample.

The NSDUH provides nationally representative cross-sectional estimates of substance use and behavioral health outcomes among non-institutionalized civilians aged 12 and older in the United States. In each year, multistage area probability sampling strategy was used to recruit participants, who were interviewed privately at their residence. To reduce socially desirable responding of sensitive behaviors, the interview was carried out using computer-assisted interviewing methodology as a confidential means of reporting. From the 2002–2017 NSDUH data, the present study included an analytic sample of 615,882 adults aged 18 or above (286,562 men and 329,320 women). More detailed descriptions of the NSDUH are available elsewhere ( Center for Behavioral Health Statistics and Quality, 2018 ).

2.2. Measures

2.2.1. dui of alcohol..

All participants were asked: “During the past 12 months, have you driven a vehicle while you were under the influence of alcohol?” Those who reported yes were classified as having involved in DUI of alcohol and were coded as 1, and coded 0 otherwise. While this measure is fully comparable across years from 2002 to 2014, changes in the respondents eligible for DUI questions in 2015 and changes to the drug-related questions in 2016 require caution in comparing estimates between pre-2014 and post-2014 ( Center for Behavioral Health Statistics and Quality, 2016 , 2017 ).

2.2.2. Sociodemographic factors and criminal justice involvement.

In addition to key sociodemographic characteristics including age, sex, race/ethnicity, household income, and urbanicity of residence, three indicators (0=no, 1=yes) of criminal justice system involvement in the past 12 months were also examined. These included: any arrests and booking, not counting minor traffic violations, arrests/booking for DUI, and probation/parole status.

2.3. Statistical Analysis

Using the fully comparable data, we first assessed the prevalence of DUI of alcohol in the early 2000s (2002–2004) and 2010s (2012–2014) for the total sample and sociodemographic and criminal justice involvement subgroups. Samples of three adjacent years were combined to obtain a more stable and consistent estimation. Additionally, the prevalence in years 2016–2017 was examined to provide the most recent rates of DUI of alcohol. Second, annual trends of DUI of alcohol among the whole sample and the trends of DUI arrests and booking among those reporting past-year DUI of alcohol were examined while stratifying by key demographic factors. Third, we tested the significance of the DUI of alcohol trends by including year as a continuous independent variable in multiple logistic regression models (while controlling for the sociodemographic factors) as the CDC (2016) suggests. All estimates were weighted to account for the NSDUH’s stratified cluster sampling design ( Substance Abuse and Mental Health Data Archive, 2014 ). While supplementary analyses including the 2015–2017 data follow similar steps above, adjusted weights were created to account for three additional years of data in consistent with the CDC (2018b) ’s technical guideline.

3.1. Trends in DUI of Alcohol among U.S. Adults

Table 1 displays the prevalence and trends of DUI of alcohol from the early 2000s to 2010s among the full sample and subgroups by demographic characteristics and criminal justice involvement. The prevalence in DUI of alcohol decreased from 15.1% in 2002–2004 to 11.8% in 2012–2014, indicating a 21.6% reduction. This decreasing trends were supported by test of trends for 2002–2014 (AOR = 0.967, 95% CI = 0.963–0.971) and 2002–2017 (AOR = 0.956, 95% CI = 0.953–0.958) as shown in Table A.1 .

Past Year Prevalence of Self-Reported Driving Under the Influence of Alcohol among Adults in the United States, NSDUH 2002–2017

Note: Estimates adjusted for survey design effects. According to SAMHDA, data from 2015–2017 are not fully comparable due to changes in survey design; therefore, we conduct separate supplemental tests. Δ pp = percentage point change from 2002–2004. % change determined by dividing the pp change by the 2002–2004 value.

All major sociodemographic and criminal justice subgroups except older adults aged 65+ showed decline in 2012–2014 and then again in 2016–2017 (see Table 1 ). In 2012–2014, 15.6% (11.1% in 2016–2017) of men and 8.4% (6.1% in 2016–2017) of women reported DUI of alcohol, indicating reductions by 23.2% and 18.9% from 2002–2004, respectively. Declines were gradual and consistent over the study period as shown in the upper chart of Figure 1 . Test of trends supported significant decreases over the past decade for both men (AOR = 0.966, 95% CI = 0.961–0.971) and women (AOR = 0.968, 95% CI = 0.963–0.974).

Prevalence of Driving Under the Influence (DUI) of Alcohol and DUI Arrests among Respondents Who Reported Past-year DUI of Alcohol by Sex in the United States, NSDUH 2002–2017.

Notes. Y-axis displays the survey adjusted prevalence for the corresponding outcome. According to Substance Abuse and Mental Health Services’ Center for Behavioral Health Statistics and Quality (2018) , data for self-reported DUI of alcohol from 2015–2017 are not fully comparable to data prior to 2015 due to changes in survey design.

Additionally, several findings from subgroup analyses are worth noting. First, respondents aged 26–35, due to their slower declining rate than those aged 18–25 (during 2002–2014, AOR = 0.967 for ages 26–34 and AOR = 0.941 for ages 18–25), matched the rates of DUI of alcohol of the youngest age group in 2012–2014. In 2016–2017, 12.1% of respondents aged 26–34 drove under the influence of alcohol, significantly higher than the rates among those aged 18–25 (10.7%). Second, Whites continued to be the racial/ethnic group with the highest prevalence of DUI of alcohol with more than one in every ten adults involved in drunk driving. Third, those with higher SES (i.e., household income of $75,000+ and college education or above) reported the highest prevalence in drunk driving and showed the smallest percent decline over the last decade compared to lower SES groups. Lastly, respondents who encountered the criminal justice system in the past year had greater likelihoods of DUI of alcohol. However, the magnitudes of the decrease in DUI of alcohol prevalence over time were similar to those who were not arrested or booked.

3.2. Trends of DUI Arrests/Booking among Those Engaged in DUI of Alcohol

The lower chart in Figure 1 displays the prevalence of DUI arrests and booking among those reporting DUI of alcohol in the past year. Overall, higher percentages of men reporting DUI of alcohol were more likely to be arrested and booked, ranging between 2.6% and 4.9%, with no significant time trends since 2002 (AOR = 0.999; 95% CI = 0.980–1.018 for 2002–2014). Additionally, significant and gradual increases in women’s DUI arrests and booking were observed from 1.2% in 2002 to 2.3% in 2014 (AOR = 1.055; 95% CI = 1.070–1.082) and 2.5% in 2017 (AOR = 1.040, 95% CI = 1.021–1.059).

4. Discussion

Although we identified decreasing trends in DUI of alcohol (except among older adults), we also found that nearly one in every ten adults in the United States drove under the influence of alcohol. Respondents who were aged 26–34, male, and White, and who reported higher SES as well as those with past-year criminal justice system encounters were more likely to engage in alcohol-involved driving in consistent with prior literature such as Caetano and McGrath (2005) and Labrie et al. (2007) . While greater reductions in the prevalence of DUI of alcohol among those under 26 years old is encouraging, preventive efforts targeting those in their late 20s and early 30s as well as other at-risk sociodemographic subgroups are needed. Moreover, special attention is needed with respect to observed gains in the number of women arrested. Increased alcohol use among women in adolescence and young adulthood as well as a lower legal limit of alcohol-impaired driving are considered important factors underlying the gendered DUI arrest trends ( Robertson et al., 2011 ; Schwartz, 2008 ). Thus, further investigation elucidating who were more affected by the recent alcohol use trends and driving behaviors among women involved in DUI of alcohol is warranted.

Importantly, national reports reveal that the number of alcohol-impaired drivers involved in fatal crashes have started to rise since 2011 in contrast to overall decreases in DUI of alcohol throughout the past decade (see Figure A.1 ). This implies that though fewer Americans drive under any influence of alcohol, the number of alcohol-impaired drivers who are involved in fatal crashes has not subsided since the early 2010s. Thus, it is important to implement measures focused on recalcitrant heavy drinkers who drive that may also have co-existent substance use problems ( Hingson et al., 2008 ). Unfortunately, this may be especially common among young adults who constitutes the largest age group involved in fatal drunk-driving crashes ( National Highway Traffic Safety Administration, 2018 ).

The present study has several limitations. First, data on DUI of alcohol and criminal justice involvement were derived from respondents’ self-reports. Social desirability bias and subjective assessment of intoxication may have affected responses’ accuracy. However, NSDUH’s adoption of the computer-assisted self-interviewing method is considered effective in encouraging honest disclosures. Second, DUI of drugs, an increasingly important part of the DUI problem ( Nochajski & Stasiewicz, 2006 ), was not examined in the study due to multiple changes in the NSDUH’s study designs specific to these questions. Third, DUI trends by different degrees of alcohol influence could not be examined due to lack of BAC information. Data on BAC are needed to better understand the slower reductions in traffic fatalities involving alcohol-impaired drivers than the rates of reductions in DUI of alcohol. Lastly, lack of contextual information limited further investigations into the underlying mechanisms of a higher DUI risk such as higher SES and neighborhood characteristics (e.g., ethnic densities, policing practices). Future research is needed to elucidate the role of salient individual (e.g., affordability, drinking behaviors) and neighborhood factors.

Despite the aforementioned limitations, the present study provides an important triangulation source for existing evidence which largely focuses on driving with BACs of 0.08g/dL or above. While we observed decreasing trends in DUI of alcohol influence among a nationally-representative U.S. adult sample, we also identified target groups for prevention efforts. Specifically, the present investigation points to further division between Americans who drive following heavy drinking episodes and the aggregates who refrain from drinking and driving at all. Alcohol policies and public awareness campaigns need to target young adult males (mostly White) concomitantly with additional research that sheds light on the potential differences in the populations who were involved in fatal crashes and who reported driving under any influence of alcohol.

• About one in ten Americans are driving under the influence of alcohol(DUI-Alcohol).
• Contrary to overall decreases, DUI-Alcohol remained unchanged among older adults.
• The prevalence among those aged 26–34 exceeded the rates among those 25 or under.
• Male, White, and higher income continue to be associated with a greater prevalence.
• DUI arrests increased among Women, narrowing the gender gap.

Acknowledgments

This work was supported by the National Institute on Alcohol Abuse and Alcoholism of the National Institutes of Health [Award Number K01AA026645]. The content is solely the responsibility of the authors and does not necessarily represent the official views of NIAAA or the NIH.

Test of Significance for Trends in Past Year Driving Under the Influence of Alcohol among Adults (Aged 18+) in the United States, NSDUH 2002–2017

Notes. The models were adjusted for sociodemographic factors including sex, age, race/ethnicity, employment status, marital status, educational attainment, annual household income, and urbanicity of residence. Odds ratios and 95% confidence intervals in bold are statistically significant at .05. Caution in interpretation of the supplemental tests is needed due to potential incomparability of DUI data between pre- and post-Year 2015.

Figure A.1.

Prevalence of Driving Under the Influence (DUI) of Alcohol and Number of Alcohol-Impaired Drivers Involved in Fatal Traffic Crashes, 2004–2017

Notes. Data on driving under the influence (DUI) of alcohol and alcohol-impaired drivers were derived from the National Survey on Drug Use and Health and National Highway Traffic Safety Administration’s Fatality Analysis Reporting System, respectively. According to Substance Abuse and Mental Health Services’ Center for Behavioral Health Statistics and Quality (2018) , data for self-reported DUI of alcohol from 2015–2017 are not fully comparable to data prior to 2015 due to changes in survey design.

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• Open access
• Published: 12 March 2015

Driving under the influence of alcohol: frequency, reasons, perceived risk and punishment

• Francisco Alonso 1 ,
• Juan C Pastor 1 ,
• Luis Montoro 2 &
• Cristina Esteban 1  

Substance Abuse Treatment, Prevention, and Policy volume  10 , Article number:  11 ( 2015 ) Cite this article

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The aim of this study was to gain information useful to improve traffic safety, concerning the following aspects for DUI (Driving Under the Influence): frequency, reasons, perceived risk, drivers' knowledge of the related penalties, perceived likelihood of being punished, drivers’ perception of the harshness of punitive measures and drivers’ perception of the probability of behavioral change after punishment for DUI.

A sample of 1100 Spanish drivers, 678 men and 422 women aged from 14 to 65 years old, took part in a telephone survey using a questionnaire to gather sociodemographic and psychosocial information about drivers, as well as information on enforcement, clustered in five related categories: “Knowledge and perception of traffic norms”; “Opinions on sanctions”; “Opinions on policing”; “Opinions on laws” (in general and on traffic); and “Assessment of the effectiveness of various punitive measures”.

Results showed around 60% of respondents believe that driving under the influence of alcohol is maximum risk behavior. Nevertheless, 90.2% of the sample said they never or almost never drove under the influence of alcohol. In this case, the main reasons were to avoid accidents (28.3%) as opposed to avoiding sanctions (10.4%). On the contrary, the remaining 9.7% acknowledged they had driven after consuming alcohol. It is noted that the main reasons for doing so were “not having another way to return home” (24.5%) and alcohol consumption being associated with meals (17.3%).

Another important finding is that the risk perception of traffic accident as a result of DUI is influenced by variables such as sex and age. With regard to the type of sanctions, 90% think that DUI is punishable by a fine, 96.4% that it may result in temporary or permanent suspension of driving license, and 70% that it can be punished with imprisonment.

Conclusions

Knowing how alcohol consumption impairs safe driving and skills, being aware of the associated risks, knowing the traffic regulations concerning DUI, and penalizing it strongly are not enough. Additional efforts are needed to better manage a problem with such important social and practical consequences.

In Europe, traffic accidents are one of the main causes of mortality in people between 15 and 29 years old, and driving under the influence of alcohol (DUI) is a major risk factor in most crashes [ 1 , 2 ].

In the year 2001 in Spain, 40,174 people were treated in public hospitals for traffic injuries. Some 28% of these injuries were serious or very serious and drinking was involved in a high percentage of cases. According to the Spanish Directorate General of Traffic (DGT), alcohol is involved in 30-50% of fatal accidents and in 15 to 35% of crashes causing serious injury, constituting a major risk factor in traffic accidents. This problem is especially important among young people and worsens on weekend nights [ 3 , 4 ].

In more recent years, several studies have shown that more than a third of adults and half of teenagers admit they have driven drunk. We also know that most of them were not detected. Generally, the rate of arrests for driving under the influence is very low and even those drivers who were arrested were mostly “first-time” offenders [ 5 ].

Some studies show that many young people lack information or knowledge about the legislation regulating consumption of alcohol for drivers, as well as the effects of this drug on the user [ 6 - 8 ].

There are also some widespread beliefs and misconceptions regarding the actions the driver can take in order to neutralize the effects of alcohol before driving (for instance drinking coffee, having a cold shower or breathing fresh air). As suggested by Becker’s model of health beliefs [ 9 , 10 ], preventive behavior is unlikely to occur unless the subject considers the action necessary, hence the importance of providing adequate information and disproving false beliefs.

Drivers are not usually aware of the risk they assume when they drive under the influence of alcohol, as they do not suffer a traffic accident every time they drink and drive. Hence they tend to think there is no danger in driving under the influence of alcohol, incurring the same risk behavior once and again.

But the reality is quite different. Alcohol causes very obvious alterations in behavior, as it affects almost all the physical skills we need for safe driving. It can interfere with attention, perceptual functioning and motor skills, as well as in decision making while driving.

Drinking impairs the ability to drive and increases the risk of causing an accident. The effects of alcohol consumption on driving-related functions are modulated by some factors, such as form of consumption (regular or infrequent), expectations about their consumption, expertise in driving and driver’s age. The increased risk of accident starts at a lower blood alcohol level when drivers are inexperienced or they are occasional drinkers, and begins at a higher blood alcohol level when these are more experienced drivers or regular drinkers [ 11 , 12 ].

The BAC represents the volume of alcohol in the blood and is measured in grams of alcohol per liter of blood (g / l) or its equivalent in exhaled air.

Any amount of alcohol in blood, however small, can impair driving, increasing the risk of accident. Therefore, the trend internationally is to lower the maximum rates allowed.

After drinking, the rate of alcohol in blood that a driver is showing can vary widely due to numerous modulating variables. Among them, some important factors are the speed of drinking, the type of alcohol (fermented drinks such as beer or wine, or distilled beverages like rum or whisky) or the fact of having previously ingested some food, as well as the age, sex or body weight. Ideally, if everyone drank alcohol responsibly and never drove after drinking many deaths would be avoided. Accurate information about how driving under the influence effects traffic safety would be a positive step towards this goal.

Study framework

Research on enforcement of traffic safety norms has a long tradition. In 1979, a classic work [ 13 ] showed that increasing enforcement and toughening sanctions can reduce accidents as an initial effect, although the number of accidents tends to normalize later.

Justice in traffic is needed insofar as many innocent people die on the roads unjustly. This is our starting point and our central principle. In order to prevent traffic accidents, a better understanding is needed of the driver’s knowledge, perceptions and actions concerning traffic regulations. Drivers have to be aware of how important rules are for safety. The present study comes from a broader body of research on traffic enforcement, designed to develop a more efficient sanctions system [ 5 , 14 ].

Our research used a questionnaire to gain sociodemographic and psychosocial information about drivers, as well as additional information on enforcement clustered in five related categories: “Knowledge and perception of traffic norms”; “Opinions on sanctions”; “Opinions on policing”; “Opinions on laws” (general ones and traffic laws in particular); and “Assessment of the effectiveness of various punitive measures”.

A number of additional factors were also explored, including: driving too fast or at an improper speed for the traffic conditions, not keeping a safe distance while driving, screaming or verbal abuse while driving, driving under the influence, smoking while driving, driving without a seat belt and driving without insurance. For a more complete review, see the original study [ 14 ].

The aim of this study was to gain useful information to improve traffic safety, concerning the following aspects:

Frequency of driving under the influence of alcohol (DUI).

Reasons for either driving or not driving under the influence (DUI).

Perceived risk of DUI.

Drivers’ knowledge of DUI-related penalties.

The perceived likelihood of being punished for DUI.

Drivers’ perception of the harshness of punitive measures for DUI.

Drivers’ knowledge of the penalties for DUI.

Drivers’ perception concerning the probability of behavior change after punishment for DUI.

Sociodemographic and psychosocial factors related with alcohol consumption and driving.

Participants

The sample consisted of 1100 Spanish drivers: 678 men (61.64%) and 422 women (38.36%), between 14 and 65 years of age. The initial sample size was proportional by quota to segments of Spanish population by gender and age. The number of participants represents a margin of error for the general data of ± 3 with a confidence interval of 95% in the worst case of p = q = 50%; with a significance level of 0.05.

Drivers completed a telephone survey. 1100 drivers answered interviews, and the response rate was 98.5%; as it was a survey on social issues, most people consented to collaborate.

Procedure and design

The survey was conducted by telephone. A telephone sample using random digit dialing was selected. Every phone call was screened to determine the number of drivers (aged 14 or older) in the household. The selection criteria were possession of any type of driving license for vehicles other than motorcycles and driving frequently. Interviewers systematically selected one valid driver per home. The survey was carried out using computer assisted telephone interview (CATI) in order to reduce interview length and minimize recording errors, ensuring the anonymity of the participants at all times and emphasizing the fact that the data would be used only for statistical and research purposes. The importance of answering all the questions truthfully was also stressed.

In this article, we present the data on driving under the influence of alcohol. The first question raised was: How often do you currently drive after drinking any alcoholic beverage? Possible responses were: Almost always, Often, Sometimes, Rarely or Never.

If they answered either Almost always, Often or Sometimes, they were asked: What is the reason that leads you to drive under the influence? If they answered Rarely or Never, they were asked: What is the reason you rarely or never drive under the influence? In both cases, respondents had the option of an open answer.

Later they were asked to rate from 0 to 10 the risk that driving under the influence of alcohol can cause a traffic accident in their opinion (0 being the minimum risk and 10 the maximum risk of crash).

Then they were asked to rate from 0 to 10 the harshness with which they thought DUI sanctions should be administered.

They were also asked: Is driving exceeding alcohol limits punishable? In this case, participants had the chance of answering Yes or No . We would then compare the correct answers with the standard to determine the knowledge.

Drivers who were unaware that DUI is punishable were asked about the probability of being sanctioned for this reason using the following question: When driving exceeding the limits of alcohol, out of 10 times, how many times is it usually sanctioned?

Another question dealt with the type of penalties. The participants were asked if the penalties for DUI consisted of economic fines, imprisonment or license suspension, either temporary or permanent. The question raised was: Have you ever received any penalty for driving under the influence? Possible answers were Yes or No . Those drivers who answered affirmatively were then asked about the harshness of punishment: How do you consider the punishment for DUI? The response options were Hard enough, Insufficient or Excessive. Furthermore, they were asked whether or not they changed their behavior after the punishment.

The questionnaire was used to ascribe drivers to different groups according to demographic and psychosocial characteristics, as well as to identify driving habits and risk factors.

Demographic variables

Gender: male or female.

Age: 14-17, 18-24, 25-29, 30-44, 45-65 and over 65 years old.

Educational level.

Type of driver: professional or non-professional.

Employment status: currently employed, retired, unemployed, unemployed looking for the first job, homemaker or student.

Driving habits

Frequency: the frequency with which the participant drive, the possible choices being Every day, Nearly every day, Just weekends, A few days a week, or A few days per month.

Mileage: the total distance in number of kilometers driven or travelled weekly, monthly or annually.

Route: type of road used regularly, including street, road, highway or motorway, and tollway.

Car use: motives for car use, for instance, to work, to go to work and return home from work or study centre, personal, family, recreational, leisure and others.

Experience/risk

Experience: number of years the participant has held a driver license, grouping them as 2 years or less, 3-6, 7-10, 11-15, 16-20, 21-25, 26-30 and over 30 years.

Traffic offenses. Number of sanctions in the past three years (none, one, two, three or more).

Accidents. Number of accidents as driver throughout life (none, one or more than one), and their consequences (casualties or deaths, or minor damages).

Once data were collected, a number of statistical analyses were performed, using the Statistical Package for the Social Sciences (SPSS), in order to obtain relevant information according to the aims of the study.

74.7% of the sample said that they had never driven under the influence. 15.5% of drivers said they did it almost never, and only the remaining 9.7% (sometimes 9,1%, often 0,2% or always 0,5%) acknowledged that they had driven after consuming alcohol (Figure  1 ).

Frequency of DUI.

Regarding the main reasons that led the drivers to act this way, expressed among drivers who admitted to having driven under the influence of alcoholic beverages, 24.5% of them indicated that it was unavoidable, as “I had to go home and couldn’t do anything else”, while 17.3% claimed that the act of drink-driving was an unintentional consequence or “something associated with meals”, and only 16.4% admitted having done it “intentionally”. In addition, 12.7% considered that “alcohol doesn’t impair driving” anyway (Figure  2 ).

Reasons for DUI.

“In any case, 60% of the interviewees perceived driving under the influence of alcohol as the highest risk factor for traffic accidents.”

Among them, the perception of this risk (or dangerousness of driving under the influence) is greater in women [F (1, 1081) = 41.777 p <0.05], adults aged between 18 and 44 [F (5, 1075) = 4.140 p <0.05], drivers who have never been fined for this infraction [F (2, 1080) = 29.650 p <0.05], drivers who had never committed the offense [F (4, 1077) = 40.489 p <0.05], and drivers who have never been involved in an accident [F (1, 1081) = 12.296 p <0.05]. Table  1 shows the values for this perception by gender and age.

There appears to be no significant relationship between the perceived risk attributed to DUI and other variables such as educational level, type of driver, driving frequency, vehicle use and years of experience.

The main reasons put forward for not drinking and driving included not drinking in any circumstances (50,5%), to avoid accidents (28,3%) as opposed to avoiding sanctions (10,4%) - such as financial penalties (8,4%), withdrawal of driving license (1,8%) or jail (0,2%) - or other reasons related to attitudes to road safety (16,6%).

On a scale of 0-10, participants rated the risk of economic penalties when driving under the influence of the alcohol with an average of 5.2, in other words they estimate the probability of being fined as roughly half of the times one drives drunk.

The perception of this risk (penalty or financial punishment for driving under the influence) is also greater in women [F (1, 1095) = 30,966 p <0.05], drivers who have never been involved in an accident [F (1, 1095) = 8.479 p <0.05], and drivers who had never been fined for this infraction [F (2 1094) = 12.515 p <0.05].

There appears to be no significant relationship between the perceived risk of financial penalty and other variables such as educational level, employment, type of driver, driving frequency, vehicle use and years of experience.

Almost everyone (99.1%) thinks that DUI is punishable and only 0.9% of drivers think it is not.

On a scale of 0-10, participants assigned an average of 9.1 to the need to punish this traffic breach severely. The score is higher in women [F (1, 1086) = 29.474 p <0.05], adults aged 18 to 24 years [F (5, 1089) = 2.699 p <0.05], drivers who have never been involved in an accident [F (1, 1095) = 8.479 p <0.05], and people who had never been fined for this reason [F (2, 1085) = 26,745 p <0.05], which means that these groups are less tolerant of this kind of behavior. By age, college students are the least tolerant and retirees are the most tolerant.

There was no significant relationship between the perceived need to punish this behavior harshly and variables such as type of driver, driving frequency and vehicle use.

Regarding the type of sanctions, 89.5% of drivers think that driving under the influence is subject to an economic fine, almost 70% say it could even be punished by imprisonment, while 96.4% believe it can lead to a temporary or permanent suspension of the license (Figure  3 ).

Type of sanction the driver think DUI is subject to.

Among the drivers who had been fined for DUI, nearly 75% considered that the imposed punishment was adequate, while the remaining 25% saw it as excessive (Figure  4 ). Finally, 91.7% of this group found they had changed their behavior after punishment (Figure  5 ).

Perception of punishment harshness imposed for DUI.

Perception concerning behavior change after punishment for DUI.

Alcohol is a major risk factor in traffic accidents. From the objective standpoint, alcohol interferes with the skills needed to drive safely, as evidenced by numerous studies on driving under the influence of alcohol conducted to date. From the subjective point of view, drivers also perceive it as dangerous, as our study shows.

Around 60% of respondents believe that driving under the influence of alcohol is maximum risk behavior. A smaller percentage compared to those reported by other studies in which the percentage of people that saw drink-driving as a major threat to safety reached 81% [ 15 ].

First, we note a clear correlation between perceived risk and avoidance behavior. In general the higher the perceived risk, the lower the probability of committing the offense, and vice versa: the lower the perceived risk, the greater the likelihood of driving after consuming alcohol.

Thus, drivers who do not commit this offense perceive that the risk of accidents associated with DUI is very high. When it comes to drivers who commit the offense occasionally, the perceived risk is lower, and when it comes to drivers who often drive under the influence of the alcohol, the perception of risk is clearly inferior. Thus, the frequency of DUI and risk perception seem to be inversely related.

These results are related to the hypothesis of optimistic bias, which states that drinkers are overly optimistic about probabilities of adverse consequences from drink. In a study [ 16 ] about overconfidence about consequences of high levels of alcohol consumption, the authors established an alternative to the optimism bias hypothesis that could explain our findings, affirming that persons who drink frequently and consume large amounts of alcohol daily could be more familiar with the risks of such behaviors.

Another important finding is that the risk perception of traffic accident as a result of DUI is influenced by variables such as sex and age. In relation to gender, the perception of risk seems to be higher in women than in men. In relation to age, risk perception is higher in adults between 18 and 44 years old.

The finding about the reason for not drinking and driving supports the already evident need for an integrative approach to developing sustainable interventions, combining a range of measures that can be implemented together. In this way, sustainable measures against alcohol and impaired driving should continue to include a mix of approaches, such as legislation, enforcement, risk reduction and education, but focus efforts more closely on strategies aimed at raising awareness and changing behavior and cultural views on alcohol and impaired driving.

Almost all the drivers surveyed are well aware that driving after drinking any alcoholic beverage is a criminal offense. They also consider that this is a type of infraction that should be punished harshly. In this respect, they assign nine points on a scale of ten possible.

Finally, with regard to the type of sanctions, 90% of drivers think that driving drunk is punishable by a fine. 96.4% consider that it may result in temporary or permanent suspension of driving license, and 70% believe that it can be punished with imprisonment.

In any case, there are several limitations of this study. This was a population-based study of Spanish drivers; there is possibly a lack of generalizability of this population to other settings.

Another possible limitation of this study is the use of self-report questionnaires to derive information rather than using structured interviews. Similarly, self-reported instruments may be less accurate than objective measures of adherence as a result of social desirability bias.

In Spain, various traffic accident prevention programs have been implemented in recent years. Some of them were alcohol-focused, designed to prevent driving under the influence and to inform the Spanish population about the dangers associated with this kind of risk behavior.

As a result, many Spanish drivers seem to be sensitized to the risk of driving drunk. As revealed in our survey, many Spanish drivers never drive under the influence of alcohol, and many of them identify DUI as maximum risk behavior. This shows that a high percentage of the Spanish population know and avoid the risks of DUI.

In any case, the reality is far from ideal, and one out of four drivers has committed this offense at least once. When asked why they did it, the two major risk factors of DUI we identified were the lack of an alternative means of transport and the influence of meals on alcohol consumption. Both situations, especially the latter, occur frequently, almost daily, while it is true that the amount of alcohol consumed in the former is considerably higher and therefore more dangerous.

In addition, most drivers are aware of the dangers of driving under the influence, and they tend to avoid the risk of accident or penalty for this reason. Some drivers never drive under the influence, to avoid a possible accident. To a lesser extent, some do not drive under the influence to avoid a possible fine. They usually think that the possibility of sanction in the event of DUI is so high that they will be fined every two times they risk driving drunk.

Moreover, drivers know the legislation regulating DUI and they believe that the current penalty for DUI is strong enough. Nevertheless, even though almost all the drivers that were fined for this reason say they changed their behavior after the event, nine out of ten drivers would penalize this kind of offense even more strongly.

Knowing how alcohol consumption impairs safety and driving skills, being aware of the associated risks, knowing the traffic regulations concerning DUI and penalizing it strongly are not enough. Many drivers habitually drive after consuming alcohol and this type of traffic infraction is still far from being definitively eradicated.

Additional efforts are needed for better management of a problem with such important social and practical consequences. Efforts should be focused on measures which are complementary to legislation and enforcement, increasing their effectiveness, such as education, awareness and community mobilization; Alcolock™; accessibility to alcohol or brief interventions.

Abbreviations

• Driving under the influence

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Acknowledgements

The authors wish to thank the Audi Corporate Social Responsibility program, Attitudes, for sponsoring the basic research. Also thanks to Mayte Duce for the revisions.

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Francisco Alonso, Juan C Pastor & Cristina Esteban

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All authors contributed to the design of the study and also wrote and approved the final manuscript. FA drew up the design of the study with the help of CE; the rest of the authors also contributed. JCP and LM were in charge of the data revision. JCP and CE also drafted the manuscript. FA performed the statistical analysis. All authors read and approved the final manuscript.

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Alonso, F., Pastor, J.C., Montoro, L. et al. Driving under the influence of alcohol: frequency, reasons, perceived risk and punishment. Subst Abuse Treat Prev Policy 10 , 11 (2015). https://doi.org/10.1186/s13011-015-0007-4

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Evaluating the effect of drunk driving on fatal injuries among vulnerable road users in Taiwan: a population-based study

• Hui-An Lin 1 , 2   na1 ,
• Cheng-Wei Chan 3 , 4 , 5   na1 ,
• Bayu Satria Wiratama 6 ,
• Ping-Ling Chen 2 ,
• Ming-Heng Wang 7 ,
• Chung-Jen Chao 8 ,
• Wafaa Saleh 9 ,
• Hung-Chang Huang 10 &
• Chih-Wei Pai 2  

BMC Public Health volume  22 , Article number:  2059 ( 2022 ) Cite this article

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Most studies have focused on injuries sustained by intoxicated drivers themselves, but few have examined the effect of drunk driving on injury outcomes among VRUs (vulnerable road users) in developing countries. This study aims to evaluate the effect of drunk driving on fatal injuries among VRUs (pedestrians, cyclists, or motorcyclists).

The data were extracted from the National Taiwan Traffic Crash Dataset from January 1, 2011, to December 31, 2019. Crashes involving one motorized vehicle and one VRU were considered. This study examines the effect of drunk driving by estimating multivariate logistic regression models of fatal injuries among VRUs after controlling for other variables.

Among 1,416,168 casualties, the fatality rate of VRUs involved in drunk driving was higher than that of general road users (2.1% vs. 0.6%). Drunk driving was a significant risk factor for fatal injuries among VRUs. Other risk factors for fatal injuries among VRUs included VRU age ≥ 65 years (adjusted odds ratio [AOR]: 5.24, 95% confidence interval [CI]: 5.53–6.07), a nighttime accident (AOR: 4.52, 95% CI: 4.22–4.84), and being hit by a heavy-duty vehicle (AOR: 2.83, 95% CI: 2.26–3.55). Subgroup analyses revealed a linear relationship between driver blood alcohol concentration (BAC) and the risk of fatal injury among motorcyclists. Motorcyclists exhibited the highest fatality rate when they had a BAC ≤ 0.03% (AOR: 3.54, 95% CI: 3.08–4.08).

Drunk driving was associated with a higher risk of fatality for all VRUs. The risk of fatal injury among motorcyclists was linearly related to the BAC of the drunk drivers. Injuries were more severe for intoxicated motorcyclists, even those with BAC ≤ 0.03%, which is within the legal limit.

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Alcohol acts as a central nervous system depressant that alters the level of consciousness [ 1 , 2 ] and reduces the attentional and behavioral control of drivers [ 3 , 4 ]. Drunk driving is a risky behavior; drunk drivers may judge the traffic condition improperly because they exhibit overestimation of personal abilities [ 5 ], excessive bravery [ 6 ], and a tendency to be affected by false memory [ 7 ]. Alcohol also interferes with visual acuity, perception, and psychomotor function; reduces reactions to impulses and environmental vigilance; and impairs the postural control of drivers [ 8 , 9 , 10 , 11 , 12 , 13 ]. Moreover, impaired decision-making [ 14 ] and information processing are evident among drivers with a positive blood alcohol concentration (BAC) [ 15 ]. Simulation studies have also demonstrated negative effects of alcohol on driving speed [ 16 , 17 ], accelerating and braking behavior [ 18 ], and lane positioning [ 19 ].

The positive correlation between drunk driving and motor vehicle crashes (MVCs) has been well documented [ 20 , 21 , 22 , 23 , 24 , 25 , 26 , 27 , 28 , 29 , 30 , 31 , 32 , 33 , 34 ]. Even with a mildly elevated BAC (0.01–0.03%), drunk drivers cause more MVCs than do drivers who have not consumed alcohol [ 35 , 36 , 37 ]. Drunk driving not only increases the MVC risk but also results in more fatal crashes [ 28 , 38 , 39 ]. Zador et al. revealed that drivers with BACs < 0.1% contributed to more fatal injuries to both themselves and other road users [ 40 ]. Reynaud et al. analyzed the French police records through a 5-year period and found that 31.5% of those who died in an accident had a positive BAC, and 9.8% of them had a BAC over the legal limit [ 41 ]. The detrimental effect of alcohol use has also been confirmed in another French study [ 42 ], suggesting that fatigue, when combined with alcohol, presented a particularly high risk of crashes leading to death or serious injuries. Moreover, the victims of alcohol-impaired driving have higher risks of hospitalization, hypotension, Glasgow Coma Scale (GCS) scores, and events of cardiac arrest [ 28 ]. A retrospective analysis of 474 autopsy reports documenting fatalities in traffic crashes revealed 177 victims with a positive BAC [ 39 ]. Substance and alcohol use was also reported to be associated with reduced reaction times [ 43 ], as well as several risky behaviours such as driving without a seatbelt [ 44 ], unlicensed driving [ 45 ], and speeding [ 46 ].

In traffic accidents, vulnerable road users (VRUs)—motorcyclists, bicyclists, and pedestrians—sustain severe injuries and death at a higher rate than motorists. This is because without the protection afforded by a metal structure, VRUs generally sustain more severe injuries than car occupants [ 47 ]. Moreover, car drivers may have difficulty identifying or perceiving VRUs in traffic due to their being poorly visible and having a small size, which may increase the severity of a crash in the event of an accident [ 48 , 49 , 50 , 51 ].

Most studies have focused on injuries sustained by intoxicated drivers themselves, but few have examined the effect of drunk driving towards VRUs (vulnerable road users) in developing countries such as Taiwan. To fill this research gap, we analyzed Taiwan’s national police crash data and investigated the effects of drunk driving with other risk factors on fatal injuries among VRUs.

Study participants and data source

This study analyzed the National Taiwan Traffic Crash Dataset from January 1, 2011, to December 31, 2019. The dataset is administrated by the National Police Agency of Taiwan. Experienced police crash investigators are assigned to arrive at the scene and record the information which includes crash, vehicle, and victim files. Crash files contain data on road traffic crash characteristics such as time of crash, date of crash, weather condition, light condition, and various environmental factors (such as geographic location, speed limit, type and condition of road, and apparent distance). Vehicle files contain data on characteristics of the vehicle involved in the crash, such as first point of impact, type of vehicle, and vehicle maneuver. Furthermore, data on victim characteristics such as age, sex, injury severity level, license status, BAC, travel purpose, and restraint use are contained in the victim files. Similar to those in other countries, the Dataset is considered complete for multi-vehicle crashes but less complete for single-vehicle crashes; such an underreporting problem is less of a concern as the present study focuses on multi-vehicle crashes (i.e., an automobile and a VRU). In addition, variables that contain numerous missing data (e.g., hit-and-run crashes) or are unreliable (e.g., mobile phone use) were not considered in the current research. Every road traffic-related crash reported to the police was recorded in the dataset, which is maintained by the National Police Agency of Taiwan. In this study, we focused on crashes involving one automobile and one VRU (motorcyclist, cyclist, or pedestrian). Figure  1 illustrates the data extraction flowchart for this study. We excluded single-vehicle crashes, multiple-vehicle (> 2) crashes, VRU–VRU crashes, and crashes involving no VRUs from the dataset. Finally, we removed cases with missing data because we used a complete case analysis approach for our data analysis. This study was approved by the Joint Institutional Review Board of Taipei Medical University (number: N202007045). The current research analysed national crash data without individuals’ confidential information such as names or identity numbers. As a result, the Institutional Review Board affiliated with Taipei Medical University waived the informed consent.

Selection of casualties

Study variables

Two injury severity levels were recorded: fatal injury (death within 24 h after crash) and nonfatal injuries (sustained injuries and survived for > 24 h). We also collected basic demographic data such as age, sex, participant’s safety behaviors, including helmet use by motorcyclists and bicyclists, BAC level, and the license status of drivers and motorcyclists. Because bicyclists and pedestrians are not required to be tested for alcohol use in the event of traffic accident, their BAC levels were not included in the present analysis.

Temporal variables included in this research were the time of the crash (rush hour, daytime, night, or early morning) and whether the accident occurred on a weekday or weekend. Rush hour was defined as 07:00 AM to 08:59 AM and 5:00 PM to 7:59 PM, daytime was defined as 09:00 AM to 4:59 PM, evening was defined as 8:00 PM to 11:59 PM, and nighttime was defined as 12:00 AM to 06:59 AM.

The following road and environmental factors were analyzed: weather (fine weather refers to sunny and cloudy days; adverse weather includes rainy, snowy, foggy, or sandy conditions and strong winds), and light conditions (no light at night, illuminated at night, morning or dawn, and daytime with natural light; if the incident was in a tunnel or underpass, the setting was deemed night). Taiwan has six municipalities: Kaohsiung, New Taipei, Taichung, Tainan, Taipei, and Taoyuan. Other regions are defined as counties. Several road conditions were considered in this study, including road type (crossroad or not), road surface conditions (slippery road includes snowy/icy, oily, muddy, or damp road), road defect (intact road surface or a defective road, meaning soft terrain, uneven road, or road with pit or hole), and driver’s sightline (clear sight or obstacle in sight). Speed limit was divided into less than 50 km/h and ≥ 50 km/h. Injured body regions of VRUs were categorized as a head and neck injury and other injuries including the chest, abdomen, back, pelvis, and extremities. Table  1 illustrates variables included in analysis.

Statistical analysis

We first compared the distribution of fatal injuries by demographic factors, behaviors, vehicle attributes, crash characteristics, environmental factors, time factors, and crash types. A p value < 0.2 was used as the cutoff point to incorporate risk factors into multivariate analysis. Multiple logistic regression analysis with backward selection was used to calculate the adjusted odds ratios (AORs). Multicollinearity was assessed using Cramer’s V and the chi-square independent test. A subgroup analysis was conducted separately for motorcyclists, bicyclists, and pedestrians. A full model (automobile VRUs) was first estimated, followed by three additional models: an automobile–motorcycle (A-M) model, an automobile–bicycle (A-B) model, and an automobile–pedestrian (A-P) model. Statistical significance was defined as p  < 0.05. The binary logistic regression model has been broadly utilized in the field of medicine and trauma [ 52 , 53 , 54 ] to identify the significant risk factors of the dichotomous outcome. In binary logistic regression model, the dependent variable is not limited by the assumptions of a continuous or normal distribution.

In the binary logistic regression model, the equation is formulated as follows:

where x j is the value of the jth independent variable, β j is the corresponding coefficient for j = 1, 2, 3,. .., p, and p is the number of independent variables.

The conditional probability of a positive outcome given the independent variable is as follows:

The maximum likelihood method was used to estimate the parameters of the logistic regression model by constructing the likelihood function:

where y i denotes the ith observed outcome with a value of either 0 or 1 and i = 1, 2, 3,. .., n, where n is the number of observations. The best regression estimation of β was determined by maximizing the log-likelihood expression:

The exponentiated coefficient exp( β j ), odds ratio (OR), demonstrates the effect of attributes on the likelihood of fatal injuries in logistic regression model, with a 95% confidence interval (CI) of (exp( β j  − 1.96 sβ j ), exp( β j  + 1.96 sβ j )), where sβ is the standard error of coefficient β . An OR of > 1 indicated a positive association between the target independent variable and fatal injuries, whereas an OR of < 1 indicated a negative association between the interest attribute and fatal injuries. An OR of 1 indicated that no association was found between the interest attributes and outcomes. If there were missing data, we conducted a sensitivity analysis to compare data with and without missing data by using the chi-square test. We used IBM SPSS Statistics for Windows, Version 22.0. Armonk, NY: IBM Corp to perform the statistical analysis.

A total of 5,797,704 victims involved in traffic accidents were documented by police from 2011 to 2019. After applying the exclusion criteria, 2,855,996 casualties remained in the automobile–VRU crash category. Half of the casualties in automobile–VRU crashes were VRUs, and the other half were automobile drivers; accordingly, 1,427,998 VRU casualties were included in our analysis. After excluding missing data, 1,416,168 casualties with intact records were analyzed. Figure 1 illustrates the data extraction flowchart for this study. A total of 5,797,704 victims involved in traffic accidents were documented by police from 2011 to 2019. We excluded single-vehicle crashes, multiple-vehicle (> 2) crashes, VRU–VRU crashes, and crashes involving no VRUs from the dataset. Furthermore, we removed cases with missing data because we used a complete case analysis approach for our data analysis. Finally, 1,416,168 casualties with intact records were analyzed.

Table  2 presents the distribution of injury severity across a set of independent variables. Both being hit by a male driver and being a male VRU were associated with higher rates of fatal injuries to VRUs (both were 0.7%). VRUs aged ≥65 years had a higher mortality rate than other age groups. Higher than at other times, 2.9% of fatal injuries occurred at night. Regions outside a municipality (0.8%) and with a speed limit over 50 km/h (0.6%) were associated with a higher rate of fatal injuries. Nighttime with unlit streets was associated with a higher mortality rate (2.4%) than daytime. Fatal injuries were less prevalent under some road conditions, such as being a crossroad (0.6% vs. not crossroad 0.7%), a slippery road surface (0.5% vs. dry surface 0.6%), and an unobstructed view of the road (0.6% vs. with sight obstacle 1.0%). Weather did not significantly affect fatality rates. A positive BAC and a driver being unlicensed were associated with higher rates of fatal injuries among VRUs. Furthermore, the rates of fatal injuries were higher in crashes with buses and trucks (4.1%) and when the casualties were pedestrians (2.7%); bicyclists (1.6%) and motorcyclists (0.5%) had lower fatality rates. Notably, motorcyclists accounted for 91.8% of all VRUs involved in vehicle–VRU crashes. VRUs who sustained head and neck injuries had higher mortality rates (7.2%) compared with VRUs with other injured regions (0.4%).

Table  3 presents the results of the multivariate logistic models of fatal injuries. Male drivers (AOR: 1.55, 95% confidence interval [CI]: 1.45–1.67) and male VRUs (AOR: 1.63, 95% CI: 1.55–1.72) were both associated with higher risks of fatalities. VRUs aged ≥65 years were over 5 times more likely to sustain fatal injuries (AOR: 5.24, 95% CI: 4.53–6.07) than were younger groups. Fatal injuries among VRUs were more prevalent at nighttime (AOR: 4.52, 95% CI: 4.22–4.84) and in dark environments without illumination (AOR: 2.37, 95% CI: 2.05–2.75). When the travel speed was considered, counties rather than municipalities (AOR: 1.22, 95% CI: 1.16–1.28) and a speed limit ≥50 km/h (AOR: 1.29, 95% CI: 1.21–1.37) both contributed to higher likelihoods of fatal injuries. When the road surface was dry (AOR: 1.34, 95% CI: 1.24–1.44) and driver sight was obstructed (AOR: 1.39, 95% CI: 1.24–1.56), VRUs also had an additional risk of fatal injuries. Road type and road defects were not significant risk factors in multivariate analysis. Alcohol use among drivers was associated with an increased likelihood of fatal injuries to VRUs compared with alcohol nonuse. Drivers with an alcohol level ≥ 0.08% were associated with a higher VRU fatality risk (BAC 0.08–0.11%, AOR: 2.79, 95% CI: 2.14–3.63; BAC ≥ 0.11%, AOR: 2.73, 95% CI: 2.30–3.23). Unlicensed driving (AOR: 2.03, 95% CI: 1.82–2.26) and the accident involving a truck or bus (AOR: 2.82, 95% CI: 2.26–3.55) also appeared to be independent risk factors for deaths. Pedestrians (AOR: 2.17, 95% CI: 2.02–2.32) had a higher mortality rate than did other VRUs. VRUs with head and neck injuries were 12 times more likely to have fatal injuries (AOR: 12.38, 95% CI: 11.78–13.02).

Table  4 presents the results of the subgroup analysis by VRU category. Drivers with a positive BAC were associated with higher odds of fatal injuries in all VRU groups. Driver BAC had a linear relationship with fatality risk among motorcyclists but not among bicyclists or pedestrians. Motorcyclists had the highest risk of death when their alcohol level was as low as 0.01–0.03% (AOR: 3.54, 95% CI: 3.08–4.08). Unlicensed riders also had a higher risk of fatalities (AOR: 1.71, 95% CI: 1.59–1.84). With regard to the effect of unlit darkness, the magnitude of the increased risk of fatal injury was the highest for pedestrians (AOR: 3.57, 95% CI: 2.68–4.76), followed by that for bicyclists (AOR: 2.66, 95% CI: 1.77–3.99) and motorcyclists (AOR: 1.55, 95% CI: 1.27–1.89).

Our study demonstrated that VRUs had additional risks of fatal injuries caused by drunk drivers after controlling for other variables. The higher the alcohol concentration of the driver was, the worse the fatality rates for the VRUs were, and this conclusion is in line with previous research [ 55 , 56 , 57 , 58 ]. A linear relationship was noted between driver BAC and the risk of fatalities among motorcyclists but not among cyclists and pedestrians. Such effects are likely attributed to several dimensions. First, in spite of speed data were not available in the Dataset, motorcyclists are generally moving much faster than those cycling or walking, thereby in turn leading to more devastating crash impacts [ 59 , 60 , 61 , 62 ], less reaction time [ 63 ], and high tendencies to lose control [ 64 ]. High traveling speed of motorcycles, relative to other VRUs, may act synergistically with driver BAC to increase injury severity. Such a linear relationship is likely due to the traffic exposure: fewer cyclists and pedestrians, compared with motorcycles, travel on roadways with higher speed limits. Our conjecture here needs to be ascertained in future research with additional data on crash locations and speed. While drunk driving appeared to be the main risk factors for fatal injuries among vulnerable road users, other studies [ 65 ] pointed out that mobile phone use may compromise pedestrians’ safety. Due to a lack of reliable data on mobile phone use, we identify this as a fruitful area for future studies.

Our data also highlighted that drunk riding increases motorcyclists’ mortality rate, concordant with previous research [ 66 ]. Notably, motorcyclists experienced the highest fatality rate at a legal BAC level (0.01–0.03%). In contrast to drivers, riders had the peak of fatality rate in a relative low BAC, and one early study also concluded that a low BAC level was associated with more crashes in motorcyclists than in drivers [ 67 ]. The relation between the risk of motorcyclists and their low BAC could attribute to the complexity of motorcycling, which requires concentration, balance, control and precision of movement through curves, and familiarity with the operation of the motorcycle [ 68 ]; these skills, especially balance, can be impaired at even a low alcohol concentration [ 69 , 70 ]. Creaser and colleagues suggested that although riders with a low BAC preserved their cognitive and visual ability, they had to concentrate more on maintaining their riding balance, thereby sacrificing attention to cornering and hazard perception [ 68 ].

Traveling at night is generally considered risky due to poor visibility [ 56 , 71 , 72 , 73 , 74 , 75 , 76 ]. In our data, VRUs had the highest risk of fatalities during night hours (00:00 AM to 06:59 AM), and pedestrians exhibited an additional increment in fatalities in this time frame. Compared with motorcycles and bicycles, pedestrians usually have less or no lightning instruments or reflectors, and drivers are prone to miss them in dim light. Furthermore, pedestrians also are smaller in size than other road users (i.e., machines), making them more difficult to be observed at night [ 77 ]. Appropriate measures to prevent crashes in dark environments include enhancing VRUs’ visibility through the use of lighting equipment or reflective clothes.

Head and neck injuries are common in fatal traffic crashes [ 78 , 79 , 80 , 81 , 82 , 83 , 84 ] and were associated with higher risks of death among all VRUs in our study. Helmet use reduced the fatality rate and demonstrated significant protective effects both among motorcyclists and bicyclists. The head is the only region of a rider that can be protected by a device, such as a helmet, and the benefit of a helmet in reducing injury severity and fatalities has been well documented [ 74 , 78 , 79 , 81 , 83 ]. Moreover, riding without a helmet has also been associated with other risky behaviors, such as drunk riding; both risky behaviors may lead to fatalities [ 85 , 86 ]. Motorcyclists have an elevated risk of fatalities when drunk riding without helmets [ 52 ]. Although the number of head injuries in Taiwan has significantly decreased after helmet use by motorcyclists was mandated in 1997 [ 87 ], no legislation mandates the same for cyclists to date. Promoting helmet use among cyclists is clearly a public health issue.

To our knowledge, few studies have focused on the association between alcohol-impaired driving and VRU fatality. We analyzed the effect of alcohol-impaired driving on fatal injuries of VRUs and the individual risk of motorcyclists, bicyclists, and pedestrians. Our research represents to a contribution to profession through the insight that drunk driving among car drivers resulted in additional risks of mortality among all VRUs. Furthermore, a linear relationship was found between driver BAC and motorcyclist fatality rate. Interestingly, intoxicated motorcyclists, even with a BAC within the legal limit of 0.03%, had the highest rate of fatal injuries. Accordingly, we recommend several measures to improve the road safety. First, campaign for alcohol zero tolerance should be promoted to all population. Second, helmet use should not only be mandatory to motorcyclists, but also be promoted to bicyclists to reduce fatal head injuries. Furthermore, the high proportion of fatalities at nights, especially in unlit conditions, underscores the importance to enhance illumination instrument in areas where there are motorcyclists, bicyclists, and pedestrians. Last, VRUs, especially elderly bicyclists and pedestrians, may consider enhancing their own conspicuity at nights by using reflectors. However this paper is not without its limitations. First, vehicle speed was not available from the police crash records. Vehicle speed, instead of the surrogate variable “speed limit” used in the current research, may provide additional insights into fatalities. Second, detailed information on geometric factors, such as curvature or road alignments, that may play a crucial role in fatalities was not readily available from the police crash reports. Third, data on casualties who died at crash scenes were not available, and as a result, their BAC was not measured. These limitations may have underestimated the effect of drunk driving on fatalities among VRUs.

Drunk driving results in additional risks of mortality among all VRUs, and a linear relationship was found between driver BAC and motorcyclist fatality rate. Intoxicated motorcyclists, even with a BAC within the legal limit of 0.03%, had the highest rate of fatal injuries. The results obtained in this current research endorse a tightened legislation for alcohol concentration limit in order to prevent fatal injuries among the vulnerable road users.

Availability of data and materials

The police-reported crash data, which are open to the researchers in Taiwan, are available from the Health and Welfare Data Science Center ( http://dep.mohw.gov.tw/DOS/np-2497-113.html ). Only citizens of Taiwan who fulfill the requirements of conducting research projects are eligible to apply for the police-reported crash dataset. The use of police-reported crash dataset is limited to research purposes only. Applicants must follow the Computer Processed Personal Data Protection Law.

Abbreviations

Blood-alcohol concentration

Motor vehicle crashes

Glasgow Coma Scale

• Vulnerable road user

Adjusted odds ratios

Confidence interval

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Acknowledgements

This manuscript was edited by Wallace Academic Editing.

This study was financially supported by grants from the Ministry of Science and Technology, Taiwan (MOST 110–2410-H-038-016-MY2 and MOST 109–2314-B-038-066-) and New Taipei City Hospital (NTPC111–004). The funders had no role in the design of the study, data collection and analysis, interpretation of data, or preparation of the manuscript.

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Hui-An Lin and Cheng-Wei Chan contributed equally to this work.

Authors and Affiliations

Department of Emergency Medicine, Taipei Medical University Hospital, Taipei City, 110, Taiwan

Graduate Institute of Injury Prevention and Control, College of Public Health, Taipei Medical University, Taipei City, 110, Taiwan

Hui-An Lin, Ping-Ling Chen & Chih-Wei Pai

Department of Emergency Medicine, New Taipei City Hospital, New Taipei City, Taiwan

Cheng-Wei Chan

College of Medicine, Chang Gung University, Taoyuan City, Taiwan

Department of Emergency Medicine, Chang Gung Memorial Hospital, Taoyuan City, Taiwan

Department of Epidemiology, Biostatistics, and Population Health, Faculty of Medicine, Public Health and Nursing, Universitas Gadjah Mada, Yogyakarta City, 55281, Indonesia

Bayu Satria Wiratama

Department of Traffic Management, Taiwan Police College, Taipei City, Taiwan

Ming-Heng Wang

Department of Traffic Science, Central Police University, Kueishan District, Taoyuan City, 33304, Taiwan

Chung-Jen Chao

Transport Research Institute, Edinburgh Napier University, Edinburgh, Scotland

Wafaa Saleh

Division of General Surgery, Department of Surgery, Taiwan Adventist Hospital, Taipei City, Taiwan

Hung-Chang Huang

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HAL was in charge of data analysis, interpretation, reporting, and original draft preparation. CWC reviewed the relevant literature, interpreted and analysed the data, and edited the manuscript. BSW was in charge of data extraction and analysis. PLC provided study conceptualization and supervision. MHW and CJC reviewed the literature and revised the manuscript. WS supported the literature search and quality assessment. HCH reviewed the literature and edited the manuscript. CWP was responsible for study design, data interpretation, drafted the manuscript, and supervision. The final version of the manuscript was read and approved by all contributing authors.

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Lin, HA., Chan, CW., Wiratama, B.S. et al. Evaluating the effect of drunk driving on fatal injuries among vulnerable road users in Taiwan: a population-based study. BMC Public Health 22 , 2059 (2022). https://doi.org/10.1186/s12889-022-14402-3

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14 fascinating teacher interview questions for principals, tips for success if you have a master’s degree and can’t find a job, 14 ways young teachers can get that professional look, which teacher supplies are worth the splurge, 8 business books every teacher should read, conditional admission: everything you need to know, college majors: everything you need to know, 7 things principals can do to make a teacher observation valuable, 3 easy teacher outfits to tackle parent-teacher conferences.

Research Topics About Drunk Driving

• Penalties for Drunk Driving: Criminal Charges for Causing Death While Driving Under the Influence
• Campaigns to Combat Drunk Driving
• Alcohol-Impaired Driving: Cause, Effect, and Control
• The Relationship between Breath Testing and Drunk Driving Demand
• Evidence on Punishment and Deterrence from Drunk Driving
• Seatbelt Use Following More Stringent Drunk Driving Laws
• Managing the Problem of Teenage Drinking and Driving
• The Intentional and Unintentional Consequences of Drunk Driving Policies
• Increase Penalties for Repeated Drunk Driving Offenders
• Preferred Drunk Driving Punishment Structure
• Alcohol and Drunk Driving Are Among the Leading Causes of Death.
• Technology Against Drunk Driving for U.S. Automakers
• Death Penalty for Drunk Driving: Should Drunk Drivers Who Kill Someone Get the Death Penalty?
• Repeat Offenders Can Be Prevented from Drunk Driving
• The Suffering and Pain That Drunk Driving Causes.
• State-Specific Drunk Driving Laws and Penalties in the United States
• The Necessity for More Stringent Drunk Driving Laws
• A View from the Economics of Crime on Preventing Drunk Driving Fatalities
• Evidence from Underage Drunk Driving Laws Concerning Youth Alcohol Use and Risky Sexual Behavior
• The Problem of Teenage Drinking and Driving in the United States: Causes and Solutions

Drunk Driving Essay Titles

• Relationships between Drunk Driving and Traffic Crashes
• Aggressive Strategies to Prevent Drunk Driving
• Impaired Driving Laws and Traffic Fatalities
• The Consequences of Drunk Driving on Society
• Drunk Driving and Drug Use Pose A Substantial Danger to Public Safety
• Deaths from Irresponsible Drinking and Drunk Driving
• Effects and Causes of Drunk Driving
• The Terrible Tragedy That Drunk Driving Has Caused in the United States
• The Reality of Drunk Driving: Why Drunk Driving Laws Should Be Stricter
• Dangers and Need for Preventing Drunk Driving
• Drunk Driving Following the Implementation of Smoking Bans in Bars
• Government and Society Should Collaborate to Eliminate Drunk Driving
• America Needs Better Drunk Driving Laws
• Mothers Against Drunk Driving: from the Ground Up to Policy
• Evidence from Underage Drunk Driving Laws Regarding Heavy Alcohol Use and the Commitment of Nuisance Crime
• Psychological Foundations of Drunk Driving
• Comparison of Mothers Against Drunk Driving and the National Urban League
• Preventing Teen Drinking and Driving
• License Revocation and Impaired Driving
• Drunk Driving Fatalities: Exigent Solution
• What Is Teenage Drunk Driving, and What Happens When the Phrase “Drunk Driving” Is Heard?
• Why Does Drunk Driving Occur?
• Why Should Drunk Driving Laws Be Made Stricter?
• How Has Drinking and Driving Affected A Student?
• Did Ontario’s Zero Tolerance and Graduated Licensing Laws Reduce Drunk Driving Among Teenagers?
• Can Police Deter Drunk Driving?
• What Are the Effects and Cause Essays on Drunk Driving?
• What Is the Issue with Drinking and Driving?
• What Are the Five Telltale Signs of An Impaired Driver?
• What Is the Definition of Drunk Driving?
• Is It A Drunk Driver or A Drunken Driver?
• Why Do Drunk Drivers Manage to Survive?
• Why Are Drunk Drivers Treated So Lightly?
• What Is the Remedy for Drunk Driving?
• How Can You Stop Drinking and Driving?
• What Do Drivers Need Three Seconds to Accomplish?
• How Long After Drinking Is It Safe to Drive?
• What Are the Penalties for A First Offense of Driving Under the Influence?
• Do You Accumulate Points for Drunk Driving?
• What Are Some Common Driving Distractions?
• What Are the Consequences of Drunk Driving?
• How Might One Best Defend Against A Drunk Driving Charge?
• What Do Police Frequently Look for in Drunk Drivers on the Road?
• Why Does America Need to Improve Its Drunk Driving Laws?
• How Do We Tackle the Problem of Teenage Drunk Driving?
• What Are Deterring Drunk Driving Fatalities?
• Did Ontario’s Zero Tolerance and Graduated Licensing Laws Reduce Drunk Driving Among Teens?
• What Are the Psychological Roots of Driving Under the Influence?
• What Are the Argumentative Effects of Free Drunk Driving on Society?
• What Are Effective Punishments for Drunk Driving in Wisconsin?

Research Topics on Domestic Violence

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DRUNK DRIVING RESEARCH PAPER

Every thirty minutes a person dies from an accident caused by a person who is intoxicated behind the wheel of a motor vehicle(NHTSA 2005). Driving under the influence, DUI, is a class A Misdemeanor in Tennessee and has resulted in thousands of deaths in recent years. DUI varies depending on the state or country where a person drives but generally it is the crime of operating a motorized vehicle while a person is impaired by alcohol, drugs, or any substance legal or illegal. This problem of intoxicated driving is both common and misunderstood. Many people driving everyday do not know that the driver of the next to them at the red could be impaired. In order to reduce the number of people who drive impaired in America, the act of DUI driving must be viewed as a crime, penalties for DUI driving must be altered and increased, and American's must look at drugs and alcohol as dangerous substances when used before driving a motor vehicle. DUI driving is completely preventable and with time organizations like Mothers Against Drunk Driving, MADD, have assisted the public in understanding how truly detrimental DUI driving is for all people. What is DUI, for the person who resides, lives, and drives in Tennessee? Driving under the influence is a class A misdemeanor for all DUI convictions with three or fewer previous convictions for DUI. This means for the first three DUI arrests and convictions someone receives in Tennessee it is a Misdemeanor not Felony. The minimum sentencing in Tennessee for a DUI first, second, or third conviction is two, forty­five, or one hundred twenty days in jail, respectively. Once a person is arrested for DUI in Tennessee, he or she is obligated to submit to a blood test to determine the alcoholic and/or drug content of their blood. If one refuses this test, the refusal will result in a license suspension of one to five years, depending on driving history and DUI arrest scenarios, the refusal can be used against the arrestee in court as evidence to their guilt, and the officer may apply for a search warrant to draw the arrestee's blood without his or her consent. Many police and sheriff departments have a policy requiring the police officer or deputy to apply for a search warrant for any and all refusals regardless of prior conviction or circumstances. For someone having a couple drinks and driving two blocks home, this seems a little extreme. How many people have been killed from DUI driving in America? Roughly five thousand American soldiers have died in Afghanistan and Iraq since the 2003 conflict in the middle east started. In 2005, sixteen thousand eight hundred eighty­five people died from an alcohol related crash, alcohol related meaning the driver of a vehicle had alcohol in their system; that is thirty­nine percent of all motor vehicle accident fatalities (NELSON 2015?). In 2004, 1.4 million drivers were arrested for DUI; that is an arrest rate of one out of every one hundred thirty­nine licensed drivers in America(NHTSA NCSA). DUI driving is a common and deadly aspect of driving anywhere. This problem of DUI not only costs lives but avoidable. All DUI's can be prevented and many people choose to drive a small distance even when they know they are impaired and cannot drive safely. The United States has taken several steps to eliminate DUI driving; some of the efforts lawmakers have done to stop DUI driving is raising the drinking age by cutting federal funding for states who do not have a minimum drinking age of twenty­one and enacted statutory blood alcohol levels for states regardless of perceived impairment. The Supreme Court even noted how regular DUI driving occurs in the United States and stated law enforcement has a substantial governmental interest in deterring DUI driving; the same substantial interest is also found at interest patrol checkpoints and airport security, in deterring DUI driving. The DUI driving problem is not going anywhere anytime soon.

Related Papers

Satish Kedia

Journal of Substance Use

Traffic Injury Prevention

Robert Voas

Alcohol research & health: the journal of the National Institute on Alcohol Abuse and Alcoholism

Impaired driving remains a significant public health problem in the United States. Although impressive reductions in alcohol-related fatalities occurred between 1982 and 1997, during which all 50 States enacted the basic impaired-driving laws, progress has stagnated over the last decade. Substantial changes in the laws and policies or funding for the enforcement of the criminal offense of driving while intoxicated (DWI) are needed for further substantial progress in reducing alcohol-related crash injuries. However, research indicates that evidence-based laws in the 50 States and current best practices in DWI enforcement are not being fully adopted or used. It seems, however, that effective operations, such as the low-staff check points that are routinely applied in many communities, could be extended to many more police departments. In addition, several enforcement methods have been proposed but never fully tested.

… .[vp]. 26-30 …

Driving under the influence of alcohol: Frequency, reasons, perceived risk and punishment

Francisco Alonso , Juan C. Pastor , Luis Montoro

Background: The aim of this study was to gain information useful to improve traffic safety, concerning the following aspects for DUI (Driving Under the Influence): frequency, reasons, perceived risk, drivers' knowledge of the related penalties, perceived likelihood of being punished, drivers' perception of the harshness of punitive measures and drivers' perception of the probability of behavioral change after punishment for DUI. Methods: A sample of 1100 Spanish drivers, 678 men and 422 women aged from 14 to 65 years old, took part in a telephone survey using a questionnaire to gather sociodemographic and psychosocial information about drivers, as well as information on enforcement, clustered in five related categories: " Knowledge and perception of traffic norms " ; " Opinions on sanctions " ; " Opinions on policing " ; " Opinions on laws " (in general and on traffic); and " Assessment of the effectiveness of various punitive measures ". Results: Results showed around 60% of respondents believe that driving under the influence of alcohol is maximum risk behavior. Nevertheless, 90.2% of the sample said they never or almost never drove under the influence of alcohol. In this case, the main reasons were to avoid accidents (28.3%) as opposed to avoiding sanctions (10.4%). On the contrary, the remaining 9.7% acknowledged they had driven after consuming alcohol. It is noted that the main reasons for doing so were " not having another way to return home " (24.5%) and alcohol consumption being associated with meals (17.3%). Another important finding is that the risk perception of traffic accident as a result of DUI is influenced by variables such as sex and age. With regard to the type of sanctions, 90% think that DUI is punishable by a fine, 96.4% that it may result in temporary or permanent suspension of driving license, and 70% that it can be punished with imprisonment. Conclusions: Knowing how alcohol consumption impairs safe driving and skills, being aware of the associated risks, knowing the traffic regulations concerning DUI, and penalizing it strongly are not enough. Additional efforts are needed to better manage a problem with such important social and practical consequences.

Evaluation Review

Pedro Ceres García Torres

This article describes the methodology used in the 2007 U.S. National Roadside Survey to estimate the prevalence of alcohol- and drug-impaired driving and alcohol- and drug-involved driving. This study involved randomly stopping drivers at 300 locations across the 48 continental U.S. states at sites selected through a stratified random sampling procedure. Data were collected during a 2-hr Friday daytime session at 60 locations and during 2-hr nighttime weekend periods at 240 locations. Both self-report and biological measures were taken. Biological measures included breath alcohol measurements from 9,413 respondents, oral fluid samples from 7,719 respondents, and blood samples from 3,276 respondents.

Accident Analysis & Prevention

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6.7: A Student Example- “Preventing Drunk Driving by Enforcement” by Daniel Marvins

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• Page ID 6641

• Steven D. Krause
• Eastern Michigan University

The assignment that was the basis for this essay asked students to write a “first person narrative” about the research project they would be working on for the semester. “It was really important to me think about a lot of different ideas and topics because I was worried that I might not be able to find enough research or stick with it,” Marvins said. “This project helped me think this through.”

Preventing Drunk Driving by Enforcement

Despite the fact that Americans are more aware of the problems of drunk driving than we were in the past, it is still a serious problem in the U.S. While educating everyone about the dangers of drunk driving is certainly important, I am interested in researching and writing about different ways to more strictly enforce drunk driving laws.

My working thesis for my research project is “While stronger enforcement measures to control drunk driving might be controversial and a violation of individual rights, they have to be enacted to stop drunk driving deaths.” By “stronger enforcement measures,” I mean things like police check points, lower legal levels of blood-alcohol, required breatholizer tests, less control on police searching cars, and stronger jail sentences.

I got the idea to focus on this topic by working on some of the different brainstorming techniques we talked about in class. I tried several different brainstorming techniques including freewriting and clustering. For me, the most useful technique was making a list of ideas and then talking it over with the other students in my group.

We all agreed that drunk driving would be a good topic, but I thought about writing about other topics too. For example, I think it would also be interesting to write about gun control laws, especially how they might effect deaths with kids and guns. I also thought it might be interesting to do research on the tobacco business and the lawsuits different states are conducting against them.

But I am more interested in exploring issues about drunk driving for a couple of different reasons. First, I think drunk driving is an issue that a lot of people can relate to because most people know that it is dangerous and it is a bad idea. For example, we hear and read messages about not driving drunk in a lot of different advertisements. Still, even though everyone knows it is a bad idea, there are still a lot of deaths and injuries that result from drunk driving.

Second, I’m interested in doing research on stronger enforcement of drunk driving laws because I am not sure I have made my own mind up about it. Like everyone else, I of course think drunk driving is bad and police and society should do everything they can do to prevent people from driving drunk. On the other hand, I also think it’s bad for police to pull over everyone they think might be drunk even when they don’t know for sure. Strong enforcement might stop a lot of drunk driving, but it also gives police more chances to violate individual liberties and rights.

I have done a little bit of research already and I don’t think I’m going to have any problem finding evidence to support my topic. Drunk driving seems to be a pretty common topic with a lot of different things written about it. I did a quick search of the library’s databases and the World Wide Web and I found thousands of different articles. I skimmed the titles and it seemed like a lot of them would be very relevant and useful for my subject.

Drunk driving is a serious problem and everyone agrees that we should do something about it. The question is what should “it” be? My hope is that through my research, I will learn more about how stronger enforcement of drunk driving laws can curtail drunk driving, and I hope to be able to convince my readers of this, too.

Driving Under the Influence of Alcohol Research Paper

Drinking and driving appears to be one of the most troublesome issues for our community to resolve. There are associations such as Mothers against Drunk Driving, Driving under Influence, and many other factions that have done a significant impact on people of all ages in educating them about the existing condition. Sadly, in numerous situations their efforts have not been efficient enough. While a little over eighty percent of drivers have already known about the accepted alcohol level from an educational journal or commercial, nearly twenty percent are familiar with what the extent of the state is.

Substantially, this statistic indicates that the information is not quite absorbed by the consciousness of people. It is a common dispute for a media movement not to be influential; however, the issue of drinking and driving is too critical for becoming cliché. An illustration of driving while intoxicated problem emerges naturally when an individual is not aware of his inability and weak position to drive, and there is not a single person to doubt it and confront him. In general, when people are not affected by the alcohol, an individual is aware of the fact that drinking and driving are two incompatible concepts; nonetheless, the issue comes down to the matter that at the time when this critical resolution has to be made, an individual’s common sense is flawed.

According to the Centers for Disease Control and Prevention, “in 2012, 71% of drivers aged 15 to 20 were killed in motor vehicle crashes after drinking and driving were not wearing a seat belt. In 2013, 51% of teen deaths from motor vehicle crashes occurred between 3 p.m. and midnight and 54% occurred on Friday, Saturday, or Sunday” ( Teen drivers, 2014, para. 4). Moreover, teenage and adult drunk driving up to this day remains the first originator of premature death.

The driving under the influence of alcohol has evolved into one of the most destructive contemporary issues in our community. Along with the extensive agendas towards alcohol alertness, which are accessible to all citizens, most people are aware of the effects of the drinking and driving; however, people are continuing to take the risk. The drunken driving could be provoked by a large number of determinants; though it always results in substantial, psychological, and nervous suffering for not only a person who was the reason for an accident but the blameless uninvolved bystanders as well (Finkelstein, Corso, & Miller, 2006).

The horrifying consequences of driving under the influence of alcohol could be divided into only two groups: death and existence after the incident. One of the implications of the adolescent and adult driving while intoxicated is enduring the life after the occurrence of breaking the law. The person who drinks and drives will not necessarily get into an accident with a fatal outcome; however, his life will assuredly be altered. To be more precise, an individual will be obliged by law to handle the consequences of driving drunk. According to the Office of the Illinois Secretary of State, “if someone under the age of 21 is caught driving with any alcohol in their system, he/she is subject to between 2-5 tears of a suspended license, a $2,500 fine, and possibly up to a year in jail” (White, 2008, para. 2).

Moreover, if a person has already reached the legal age, he or she is obliged to enter his or her arrest and detention on every job application and in every job interview being executed. The article in the Centers for Disease Control and Prevention claims that “six teens die every day in the U.S. in alcohol-related car accidents” ( Teen drivers, 2014, para. 3). If an individual selects to drink and drive, there is a tremendous probability of ending his or her own existence of putting the lives of bystanders in a grave danger. There are absolutely no beneficial and reasonable explanations and outcomes for drinking and driving, and the moments of sudden excitement and adventure do not justify this.

According to the research, which was conducted by the National Highway Traffic Safety Administration, approximately thirty percent of all drivers that were taken into custody or even imprisoned because of driving while intoxicated appear to be reiterated perpetrators. It is crucial to keep in mind that driving under the influence of alcohol is against the law; what is more, it is able to destroy many lives. Drivers that choose to sit behind the wheel under the influence of alcohol should not be treated differently from the burglars, arsonists, and robbers, as they are intentionally committing a crime.

The plurality of population supposes that people who are accused and arrested for driving under the influence of alcohol on the first occasion should obtain an admonition or a nominal fine in a form of a ticket. Nonetheless, drivers that deliberately chose to drive under the influence of alcohol should be detained for their first offense. As the studies have shown, if the case of driving while intoxicated has occurred once, there is a high probability of it to take place again.

According to the Centers for Disease Control and Prevention, “in 2010, 10,228 people were killed in the United States due to alcohol-related crashes. People who drink and drive put everyone on the road in danger because drivers are not in the right state of mind when they are intoxicated. They cannot see, hear, talk, or think correctly. It is wrong for innocent lives to be taken due to the careless mistakes of drunk drivers” ( Traffic safety facts, 2012, para. 6).

As it has already been stated, if a person is arrested while drunken driving, his or her driver license has to be abolished for half a year if this case is the first violation of the law. Nevertheless, it has been stated that nearly seventy percent of drivers still remain on the road without their driver’s license. Taking into consideration the amount of people that have been taken to jail, almost twenty-five percent of them tend to repeat the crime within a year after the incident.

Every driver has an opportunity to drive with responsibility, as the decision to drive under the influence of alcohol is able to have a dreadful influence on the lives of uninvolved entities. According to Mothers Against Drunk Driving, “in the past ten years, more U.S. citizens have died as a result of drunk driving than in the Afghan War, the Iraq War, and Hurricane Katrina combined” ( Drunk driving statistics , 2014, para. 3). However, dissimilar from those interventions of military force and natural catastrophes, driving while intoxicated could be entirely avertable. Putting an end to the dangerous and destructive driving under the influence of alcohol spread is the responsibility of the recent generation.

Drunk driving statistics . (2014). Web.

Finkelstein, E., Corso, P., & Miller, T. (2006). Incidence and economic burden of injuries in the United States . New York, New York: Oxford University Press.

Teen drivers: Get the facts . (2014). Web.

Traffic safety facts . (2012). Web.

White, J. (2008) Use it and lose it. Web.

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IvyPanda. (2024, February 21). Driving Under the Influence of Alcohol. https://ivypanda.com/essays/drunk-driving-problems/

"Driving Under the Influence of Alcohol." IvyPanda , 21 Feb. 2024, ivypanda.com/essays/drunk-driving-problems/.

IvyPanda . (2024) 'Driving Under the Influence of Alcohol'. 21 February.

IvyPanda . 2024. "Driving Under the Influence of Alcohol." February 21, 2024. https://ivypanda.com/essays/drunk-driving-problems/.

1. IvyPanda . "Driving Under the Influence of Alcohol." February 21, 2024. https://ivypanda.com/essays/drunk-driving-problems/.

Bibliography

IvyPanda . "Driving Under the Influence of Alcohol." February 21, 2024. https://ivypanda.com/essays/drunk-driving-problems/.

• The Main Causes of Drunken Driving
• The Arguments by Debra Leach in “Drunken Driving”
• Drunk Driving Problem in the Modern Society
• Mothers Against Drunk Driving
• Driving Under the Influence: US Policies
• Effects of Alcohol. Alcohol-Related Statistics
• Bystanders’ Effects and Minority Victims
• Self-Realization in “Intoxicated by My Illness”, “A Father’s Faith”, “The Seventh Seal”
• Story of Drunken Girlhood
• Teenage Drunk Driving Issue Analysis
• Substance Abuse Disorders and Their Factors
• Employees of Substance Abuse Treatment Facility Needs
• Alcohol Effects on College Learners
• Substance Abusers' Clinical Treatment
• Addiction's Etiology: Models and Theories

This Rare Condition Makes Some People Get Drunk, Even When They Haven’t Touched a Drop of Alcohol

A man in Belgium was acquitted of drunk driving charges this week, after doctors showed he has auto-brewery syndrome, which makes his body produce alcohol

Daily Correspondent

In April 2022, police pulled over a brewery worker in Belgium and found that his blood alcohol level was more than four times the legal limit. He was pulled over again about a month later, with a blood alcohol level more than three times the legal limit.

The most logical explanation? Both times, he’d had too much to drink and decided to get behind the wheel anyway. But that story has one big problem: In each instance, the man hadn’t consumed a drop of alcohol.

Instead, the 40-year-old has a rare medical condition that causes his body to produce its own alcohol. Called auto-brewery syndrome, or ABS for short, the unusual disorder can make life difficult for its sufferers—and get them into sticky situations.

The brewery worker was acquitted of drunk driving charges this week, after three doctors who separately examined him confirmed he has ABS. The man’s lawyer, Anse Ghesquiere, said it was an “unfortunate coincidence” that he worked at a brewery, per Reuters .

In the verdict, the judge noted that even though the man had high levels of alcohol in his body, he did not experience symptoms of intoxication. This is not uncommon among people with ABS, some of whom can tolerate blood alcohol levels that would seriously sicken or even kill others.

“They can function at alcohol levels such as 0.30 and 0.40, when the average person would be comatose or dying,” said Barbara Cordell , a retired dean of nursing at Panola College who founded the nonprofit Auto-Brewery Syndrome Information and Research , to CNN ’s Sandee LaMotte in 2016. “Part of the mystery of this syndrome is how they can have these extremely high levels and still be walking around and talking.”

ABS works like this: When a patient eats food that contains carbohydrates, their gut bacteria and fungi convert the sugars into carbon dioxide and alcohol. This process, known as fermentation, is how beer, wine, mead, hard cider and other types of alcoholic beverages are made—it just happens to be taking place inside a person’s body, instead of in tanks at a brewery or winery.

In two very rare instances, fermentation occurred in one patient’s bladder and in another patient’s mouth, write Cordell and two other researchers in an article shared by the National Library of Medicine.

Small amounts of fermentation occur during normal digestion, but with ABS, gut microbes become harmful pathogens. This extreme fermentation can make some patients show signs of intoxication, even when they haven’t had an alcoholic drink.

People are typically not born with ABS, but they may develop it later in life—especially if they already have other health issues, such as obesity, diabetes or Crohn’s disease. Antibiotics can also disrupt the balance of a person’s gut microbiome.

Patients can often manage the condition by limiting their consumption of high-carbohydrate foods and taking probiotics. In some chronic cases, a doctor may prescribe fecal transplants —that is, a procedure that involves collecting healthy gut bacteria from a donor and transferring them to the patient’s colon.

ABS is “probably underdiagnosed,” the trio of researchers write, but the condition occasionally makes headlines. In December 2014, for instance, a man was driving a tanker truck full of salmon in Oregon when he crashed and spilled the fish all over the highway. His blood alcohol level was more than three times the legal limit, and he was convicted of a DUI. But later, he appealed the decision and claimed to have ABS .

In 2019, doctors published a case report on a 46-year-old man who’d started suffering from depression, brain fog and mental changes after taking antibiotics. Under the supervision of a medical team, he ate a carbohydrate-heavy meal, which caused his blood alcohol level to rise. Weeks later, his condition caused him to fall and get admitted to a hospital, where his blood alcohol level hit 0.40—high enough to cause coma or death .

Another man, Mark Mongiardo, lost his teaching and coaching jobs before being diagnosed with the condition. He shared his story publicly in hopes that “if I could help others understand that this is out there, maybe someone won’t have to go through the same thing I went through,” he told TODAY ’s Meghan Holohan last year.

“It’s devastating for someone to live with this,” he added.

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Sarah Kuta | READ MORE

Sarah Kuta is a writer and editor based in Longmont, Colorado. She covers history, science, travel, food and beverage, sustainability, economics and other topics.