In country after country, including the United States, sharp declines in crash deaths involving alcohol-impaired drivers began to be recorded in the early 1980s. In 1995 the Institute still was reporting that "alcohol involvement in fatal crashes is on the decrease" (see "Highway death toll tops 40,000 for 2nd straight year," Aug. 12, 1995). This progress continued in the United States and elsewhere in the world until about 1997.
Comparison among countries is problematic because of differences including, for example, the blood alcohol concentration (BAC) thresholds specified in DWI laws. What's consistent are the declines in proportions of fatally injured drivers with BACs above some specified threshold. Barry Sweedler, lead author of a 2004 review of trends worldwide, points to declines in Canada, Great Britain, Sweden, the United States, and other countries. Declines also occurred in Australia.
The cornerstone of enforcement is random breath testing. This policy allows police to stop and test any driver for alcohol. In practice police usually set up checkpoints, testing all motorists or a random selection of them. By 1988 this had become "the principal form of enforcement in all Australian states and territories," N.L. Haworth and I.R. Johnston of Monash University report. As random testing increased, there was a big reduction in crashes involving drivers with BACs above 0.05 percent. In Victoria, for example, the proportion of fatally injured drivers with BACs this high was more than halved, from 49 percent in 1977 to 21 percent in 1992.
The maximum permissible BAC is lower than elsewhere at 0.02 percent. Hans Laurell of the Swedish Road Administration reports that a national emphasis on random testing in the 1980s produced a decline in the impaired driving problem. The proportion of fatally injured drivers with any blood alcohol declined from 31 percent in 1989 to a low of 18 percent in 1997.
Considered unreasonable searches, the random breath tests for alcohol that are cornerstones of enforcement in Australia and Sweden aren't conducted in the United States. However, checkpoints at which police screen drivers for alcohol are permitted. These have proved effective even though they don't involve random breath testing.
Besides checkpoints, the main U.S. policies that led to progress against alcohol-impaired driving in the 1980s and 1990s included raising the alcohol purchase age to 21. Laws also have been enacted in most states that provide for administrative revocation of the licenses of drivers who are arrested for alcohol impairment.
Such laws were enacted in large part because of pressure applied to state legislators by MADD and other groups. These grassroots organizations also brought renewed public attention to the problem of impaired driving during the 1980s.
Since then the proportion of fatally injured drivers with BACs of 0.08 percent or more has declined from about half (51 percent in 1982) to about a third by 1997. The biggest improvements were among the youngest drivers (see "Motor vehicle deaths unchanged overall, but important differences still apparent," Oct. 10, 1998).
Random breath tests aren't conducted in Great Britain, but alcohol testing is compulsory after crashes and whenever motorists are stopped for traffic violations. Police began increasing the number of roadside tests, beginning in the early 1980s, and during the ensuing years the proportion of driver deaths involving alcohol over the threshold of 0.08 percent BAC dropped from about one-third in 1992 to about one-fifth beginning in 1989.
Percentages of fatally injured drivers with blood alcohol concentrations in relation to a proscribed threshold
BAC threshold: 0.08% or more
BAC threshold: more than 0.08%
BAC threshold: more than 0.05%
Progress has stalled
Even in Australia, considered a world leader in policies to reduce alcohol-impaired driving, the progress has stalled. Haworth and Johnston report that "the involvement of alcohol in road crashes has not fallen further in the last decade." Since 1992 about 25 to 30 percent of all fatally injured drivers have had BACs higher than 0.05 percent.
This has been a general pattern. In the United States progress also has stalled. Since 1997 about 31-33 percent of fatally injured drivers have had BACs of 0.08 percent or more.
In Sweden the progress hasn't just stalled. It has reversed, going from 18 percent of fatally injured drivers with alcohol in their blood in 1997 to 29 percent in 2003. One reason is that breath testing has declined, Laurell reports. At the same time alcohol consumption has gone up, in part because taxes on alcohol in Sweden and some other European countries have been lowered to comply with E.U. policies. Laurell reports an uptick in annual drinking from 8 liters per adult in 1996, when Sweden joined the European Union, to more than 10 liters in 2004.
In Great Britain adults consume a lesser amount of alcohol per year, on average, at 8.6 liters. However, this represents an increase, especially among young women who now consume about 65 percent more alcohol than they did in 1992.
At the same time, breath testing has declined in Great Britain. Sweedler and his colleagues point to "evidence that reductions in the levels of roadside breath testing are again leading to increased levels of [impaired] driving." The proportion of fatally injured drivers with BACs of more than 0.08 percent has gone up since 1998.
In the United States officials in only a few jurisdictions are conducting sobriety checkpoints on a routine basis. Even though this approach has been shown to deter impaired drivers, it isn't implemented very often or in very many U.S. communities.
Sweedler says "complacency may have set in among policymakers. The level of public awareness and concern seems to have waned" in the United States.
Institute president Brian O'Neill observes, "The complacency isn't justified because the problem is far from solved. Alcohol-impaired driving still is a big concern despite the progress that was achieved during the 1980s and most of the 1990s. In more recent years, this has become an intractable problem. What's needed in the near term is expanded application of sobriety checkpoints. In the longer term, innovative technologies might help to stop driving while impaired by alcohol."