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Binge Drinkers are Responsible for Most Alcohol-Impaired Driving on American Roads

January 4, 2008
Nicole T. Flowers, Timothy S. Naimi, Robert D. Brewer, Randy W. Elder, Ruth A. Shults, Ruth Jiles

Nicole T. Flowers, Timothy S. Naimi, Robert D. Brewer, Randy W. Elder, Ruth A. Shults, Ruth Jiles. (April 2008). Patterns of alcohol consumption and alcohol-impaired driving in the United States.  Alcoholism: Clinical and Experimental Research (ACER).  32(4): 639–644.

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  • Self-reported alcohol-impaired (AI) driving has increased in the United States during the last decade.
  • New findings show that most AI driving is due to binge drinkers rather than heavy or alcohol-dependent drinkers.
  • Researchers say effective strategies must address both excessive drinking as well as impaired driving.

Motor-vehicle crashes that are alcohol-related in nature kill approximately 17,000 Americans per year and, in the year 2000, cost more than $51 billion in related damages.  A new study of the drinking patterns of alcohol-impaired (AI) drivers in the United States has found that most AI driving is performed by binge drinkers.

Results are published in the April issue of Alcoholism: Clinical & Experimental Research.

“Previous research had found the number of self-reported AI driving episodes was increasing over the last eight years, especially among binge drinkers,” said Nicole T. Flowers, medical epidemiologist at the Centers for Disease Control and Prevention and corresponding author for the study.  “Many current policies have focused on discouraging people from operating a vehicle while intoxicated instead of trying to prevent people from becoming intoxicated.  Furthermore, when people are arrested for driving under the influence of alcohol the punitive measures frequently involve alcohol-treatment programs suitable for alcoholics but not necessarily suitable for non-alcohol dependent binge drinkers.”

“Although AI driving fatalities – as one measure of AI driving – have declined in the United States over the past 30 years, the reduction has been far less in the United States than in other highly motorized Western countries such as Canada, Australia, Japan, or Germany,” added David E. Nelson, senior scientific advisor with the Alcohol Team at the Centers for Disease Control and Prevention. 

Flowers and her colleagues analyzed data from the 2006 Behavioral Risk Factor Surveillance System (BRFSS), the largest telephone health survey in the world with more than 350,000 adults interviewed each year.  Established in 1984, BRFSS data is collected monthly from all 50 states, the District of Columbia, Puerto Rico, the U.S. Virgin Islands and Guam, and used to track tobacco use, cardiovascular disease, dietary habits, weight changes, immunization status, and screening for high blood pressure, high cholesterol and cancer. 

For this study, alcohol-consumption patterns of self-reported AI-drivers among U.S. adults 18 years and older for all states were divided into four categories: non-binge/non-heavy, non-binge/heavy, binge/non-heavy, and binge/heavy.  (Binge drinking was defined as 5+ drinks for men or 4+ drinks for women on one or more occasions in the previous month; heavy drinking was defined as more than two drinks per day for men or more than one drink per day for women.)

The results showed that approximately 84 percent of AI drivers were binge drinkers, and 88 percent of AI-driving episodes involved binge drinkers.

“We were surprised that binge drinkers who were not heavy drinkers made up 50 percent of all the self-reported AI drivers,” said Flowers.  “We thought it would be a large percentage but didnt know it would be that high.”

Both Flowers and Nelson noted that these findings demonstrate the need for effective interventions to change their focus.

“AI driving is both a drinking problem and a driving problem,” said Flowers.  “A large number of AI drivers are probably not alcohol dependent, and the population of people who sit down once a month and have four or five drinks at one time must be taken into account when developing interventions to decrease the prevalence of impaired driving.  Policies should deter both driving intoxicated and the behavior of becoming intoxicated.”

Both Flowers and Nelson recommended strategies that include sobriety checkpoints, lowering blood alcohol concentrations, license-revocation laws to reduce AI driving, as well as policies to reduce excessive drinking, such as an increase in alcohol-excise taxes, enforcement of the minimal legal drinking age, a reduction in alcohol-outlet density and business hours, and restriction of happy hours.  “Both kinds of efforts should be widely distributed to decrease the excessive drinking behavior that is strongly associated with impaired driving,” said Flowers.

The bottom line, added Flowers, is that drinking to get drunk is a risky behavior.  “Although 2.6 million Americans may not identify themselves as problem drinkers, drinking more than four or five drinks at a time is contributing to over 56 million episodes of AI driving per year.  Binge drinking is a wide-spread and dangerous behavior.”  She and her colleagues have plans to continue using BRFSS data to examine the demographics of people who drink certain types and quantities of alcohol, as well as the association between intimate partner violence and binge drinking.