The number of alcohol-impaired driving episodes dropped by 30% from a peak of 161 million in 2006 to 112 million last year, according to a report by the Centers for Disease Control and Prevention.
Although prevalence has declined, alcohol-impaired driving continues to kill thousands of Americans every year. Therefore, continued and strengthened efforts to decrease drinking and driving are essential, CDC officials said at a telebriefing announcing the findings of the report (MMWR 2011 Oct. 4;60[early release]:1-6).
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Prevalence of alcohol-impaired driving episodes has declined 30% over the last 5 years. However, alcohol-impaired driving is responsible for one out of three car crash deaths.
"Every primary care practitioner can help patients realize that car crashes are the leading cause of death for everyone ages 5-34 and that one in three car crash deaths involves someone who is an alcohol-impaired driver," said Dr. Thomas R. Frieden, director of the CDC.
Routinely screen patients for risky drinking patterns, he suggested. Also, "provide a brief intervention, a 10- to 15-minute motivational counseling session, which can substantially reduce the long-term risk of problem drinking and, therefore, of drinking and driving as well," Dr. Frieden said.
Binge drinking was strongly associated with alcohol-impaired driving, according to the report, with binge drinkers accounting for 85% of all episodes of alcohol-impaired driving. A binge drinker was defined as a man who consumes five or more drinks or a woman who consumes four or more drinks on one occasion.
Young men, people who said they do not always wear a seatbelt, and residents of the Midwest also had disproportionately high rates of alcohol-impaired driving. The data were taken from 451,000 responses to the 2010 Behavioral Risk Factor Surveillance System (BRFSS), a nationally representative telephone survey.
A total of 1.8% of respondents reported at least one episode of alcohol-impaired driving in the past 30 days. Extrapolation of monthly figures means more than 4 million adults would report an estimated 112,116,000 episodes of alcohol-impaired driving in 2010.
"There were more than 100 million episodes of alcohol-impaired driving by self-report last year. Each of those episodes could have resulted in the severe injury or death of a pedestrian or a fellow driver or a kid biking to school," Dr. Frieden said. "This is something that is unacceptable."
Men are much more likely than women to drive after drinking, according to the report. A total of 81% of respondents who reported alcohol-impaired driving episodes were men, and men aged 21-34 years may be at especially high risk. Although these younger men account for 11% of the U.S. adult population, they reported 32% of all episodes.
Dr. Frieden said the gender ratio has remained stable over the past few years.
"There is an outstanding question in the field as to whether more women are drinking and driving, but that question is still being researched and there is not a clear answer," said Gwen Bergen, Ph.D., an author of the report and a behavioral scientist at the CDC Division of Unintentional Injury Prevention, National Center for Injury Prevention and Control.
Consider asking patients about seatbelt use as part of a screen, as well. Survey respondents who reported not always wearing a seatbelt were nearly four times more likely to drink and drive, compared with universal seatbelt users.
Geography also was a factor. People surveyed in the Midwest census region had significantly higher rates of annual alcohol-impaired driving episodes (at 643/1,000 population), compared with those living in other regions of the United States. Excluding the District of Columbia and 12 states with small and potentially unstable numbers of respondents, four of the seven states that exceeded the national average for alcohol-impaired driving were in the Midwest.
Midwest residents also reported a significantly higher rate of binge drinking, at 16.5%, compared with 15.1% in the Northeast, 14.3% in the West, and 12.6% in the South.
Reasons for the overall decrease in alcohol-impaired driving are not well understood. However, one possibility is that fewer people are going out to bars and restaurants as a result of the downturn in the U.S. economy, which would decrease the number of impaired drivers, he said.
"While we’ve made progress, this is still a huge problem that is a threat to everyone who uses the road, with often tragic consequences," Dr. Frieden said.
The CDC offered several recommendations to help further decrease drinking and driving rates. More widespread use of sobriety checkpoints, greater enforcement of laws concerning blood alcohol concentrations and minimum drinking age, and ignition interlock programs for all convicted alcohol-impaired driving offenders are among the effective, evidence-based strategies, Dr. Frieden said. He added that public support for these and other proven strategies is strong.