In 2017, 10,874 people were killed in alcohol-impaired traffic crashes, a 1.1% decrease from 2016, according to NHTSA, and comprising 29% of all traffic fatalities. Of those fatalities, there were 6,618 drivers (61%) who had a blood alcohol content (BAC) of 0.08 or higher, while the remainder were 3,057 (28%) motor vehicle occupants and 1,181 (11%) nonoccupants.
Although there was a slight decrease in alcohol-impaired driving fatalities in 2017, impaired driving remains a major traffic safety and public health issue for states. NHTSA’s data shows that in 2017, an average of one alcohol-impaired-driving fatality occurred every 48 minutes. The annual cost of alcohol-related crashes is more than $44 billion, which includes costs such as lost productivity, legal and court expenses, medical costs and property damage, among other costs.
Table 2. Alcohol-Impaired Traffic Fatalities, 2017
State/Jurisdiction |
Total Traffic Fatalities |
Alcohol-Impaired Driving Fatalities (BAC ≥ 0.08) |
Percentage Alcohol-Impaired |
Alabama
|
948
|
268
|
28
|
|
Alaska
|
79
|
22
|
28
|
|
Arizona
|
1,000
|
278
|
28
|
|
Arkansas
|
493
|
140
|
28
|
|
California
|
3,602
|
1,120
|
31
|
|
Colorado
|
648
|
177
|
27
|
|
Connecticut
|
278
|
120
|
43
|
|
Delaware
|
119
|
32
|
27
|
|
Florida
|
3,112
|
839
|
27
|
|
Georgia
|
1,540
|
366
|
24
|
|
Hawaii
|
107
|
42
|
39
|
|
Idaho
|
244
|
60
|
24
|
|
Illinois
|
1,097
|
349
|
32
|
|
Indiana
|
914
|
220
|
24
|
|
Iowa
|
330
|
88
|
27
|
|
Kansas
|
461
|
102
|
22
|
|
Kentucky
|
782
|
181
|
23
|
|
Louisiana
|
760
|
212
|
28
|
|
Maine
|
172
|
50
|
29
|
|
Maryland
|
550
|
186
|
34
|
|
Massachusetts
|
350
|
120
|
34
|
|
Michigan
|
1,030
|
311
|
30
|
|
Minnesota
|
357
|
85
|
24
|
|
Mississippi
|
690
|
148
|
21
|
|
Missouri
|
930
|
254
|
27
|
|
Montana
|
186
|
56
|
30
|
|
Nebraska
|
228
|
67
|
29
|
|
Nevada
|
309
|
89
|
29
|
|
New Hampshire
|
102
|
27
|
26
|
|
New Jersey
|
624
|
125
|
20
|
|
New Mexico
|
379
|
120
|
32
|
|
New York
|
999
|
295
|
30
|
|
North Carolina
|
1,412
|
413
|
29
|
|
North Dakota
|
115
|
46
|
40
|
|
Ohio
|
1,179
|
333
|
28
|
|
Oklahoma
|
655
|
165
|
25
|
|
Oregon
|
437
|
137
|
31
|
|
Pennsylvania
|
1,137
|
314
|
28
|
|
Rhode Island
|
83
|
34
|
41
|
|
South Carolina
|
988
|
313
|
32
|
|
South Dakota
|
129
|
35
|
27
|
|
Tennessee
|
1,040
|
251
|
24
|
|
Texas
|
3,722
|
1,468
|
39
|
|
Utah
|
273
|
53
|
19
|
|
Vermont
|
69
|
18
|
26
|
|
Virginia
|
839
|
246
|
29
|
|
Washington
|
565
|
178
|
32
|
|
West Virginia
|
303
|
72
|
24
|
|
Wisconsin
|
613
|
190
|
31
|
|
Wyoming
|
123
|
44
|
36
|
|
District of Columbia
|
31
|
16
|
51
|
|
United States
|
37,133
|
10,874
|
29
|
|
Puerto Rico
|
290
|
96
|
33
|
|
To better understand public opinions and behaviors regarding traffic safety, AAA publishes an annual Traffic Safety Culture Index. The 2017 index reveals that 94.3% of surveyed drivers ages 16 and older believe that drivers who have consumed alcohol pose a threat to their personal safety. Among survey participants who consume alcohol, 20.7% reported driving when they thought they had consumed too much alcohol to drive safely in the past year. Survey participants ages 25 to 39 made up the highest proportion—18.2%—of drivers of any age range who perceived that their alcohol level might have been close or possibly over the legal limit during the past year.
Traffic safety organizations are actively examining interventions to combat alcohol-impaired driving. NHTSA released a study in June 2017 that examines the Feasibility of Voluntary Ignition Interlocks as a Prevention Strategy for Young Drivers. Although ignition interlock devices (IID) are commonly used as a deterrent for alcohol-impaired driving offenders, NHTSA examined the idea of using IIDs to prevent young people from driving drunk. Researchers spoke with ignition interlock companies and discovered that only a small number of individuals in the U.S. had voluntarily signed up for an interlock program; most were court-ordered to install the device in their vehicles. Researchers also spoke with car insurance companies who said they would consider offering discounted premiums and other incentives for drivers who use ignition interlock devices. They would need more research, however, showing the devices lower driving risks, change behaviors and make younger drivers safer. Parents and teens shared that the device could be helpful in preventing drunk driving, but it could result in teens using drugs instead of alcohol and finding ways to circumvent the interlock devices. Parents and teens also felt the device may be too invasive and that its reputation as a method of punishment would need to change before voluntary installation of these devices becomes acceptable.
NHTSA published a study in 2017 that explores how ignition interlock data is being used to monitor offenders and offender-related programs and whether this data can be used to reduce alcohol-related recidivism. Researchers found that automatically uploading interlock data makes it easier to track program statistics and success, but there is no definitive answer about the data’s effect on evaluating alcohol-impaired driving recidivism. The study shows that while offenders use an interlock device, they are not actually dealing with their underlying drinking problem or reducing alcohol consumption. Researchers concluded that this may mean a combination of treatment for alcohol use disorders and interlock programs may be needed. However, issues around cost, privacy laws and technological impediments have led to a lack of coordination of treatment programs between states, courts and probation offices.
With sponsorship from NHTSA, the National Academies Press (NAP) published a report in 2018 that offers recommendations to strengthen alcohol-impaired driving interventions. NAP convened a committee to examine data on alcohol-impaired driving, evidence for interventions and their impact on public health, and methods to monitor the progress of these interventions. Committee members approached their evaluation from the perspective that each alcohol-impaired driving crash represents a failure in the system. They analyzed NHTSA’s data on alcohol-impaired driving as well as a broad range of interventions used by other countries. Their final recommendations include:
- Increasing alcohol excise taxes.
- Lowering state laws for alcohol-impaired driving to .05 percent BAC.
- Preventing illegal alcohol sales to underage persons and already-intoxicated adults.
- Strengthening regulation of alcohol marketing.
- Implementing policies to reduce the physical availability of alcohol.
State Legislation
Lawmakers in 43 states considered approximately 240 bills related to alcohol-impaired driving in 2018. At least 49 bills were enacted by 27 states. Laws addressing alcohol-impaired driving included ignition interlock installation requirements and compliance, ignition interlock indigent programs, implied consent and refusal of alcohol concentration tests, higher penalties for offenders and sobriety monitoring programs.
Ignition Interlock Installation Requirements
IIDs are installed in motor vehicles to prevent the car from being started if a set level of alcohol, usually a BAC of .02 or .025, is detected on the driver’s breath. Most devices require random retesting while the car is running to ensure that the driver is not drinking once the car is started. Many courts require the use of IIDs when sentencing offenders convicted of driving under the influence (DUI.) (It is understood that while many states refer to impaired driving as “driving while impaired,” “operating while impaired” or “operating under the influence,” the term “DUI” will be used for this document.) During sentencing, an offender whose driver's license has been suspended or revoked can be granted limited driving privileges if an ignition interlock device is installed on the vehicle(s) they use. All 50 states have passed legislation that allows or requires use of ignition interlocks for certain drunken driving offenders.
In 2005, New Mexico became the first state to require IIDs for all convicted drunk drivers, including first-time offenders. As of December 2018, 28 additional states require IIDs for all convicted drunk driving offenders. Those states are Alabama, Alaska, Arizona, Arkansas, Connecticut, Delaware, Hawaii, Idaho, Illinois, Iowa, Kansas, Louisiana, Maine, Maryland, Mississippi, Nebraska, Nevada, New Hampshire, New Mexico, New York, Oregon, Tennessee, Texas, Utah, Vermont, Virginia, Washington and West Virginia, plus the District of Columbia. Most states set the BAC limit at .08 or greater. Although Pennsylvania is not an all-offender ignition interlock state, its law is unique because it requires interlocks for first-time offenders if they had a BAC of .10 or greater. Colorado and Maine’s ignition interlock laws do not make installation of the device’s mandatory for first-time offenders, but they provide strong incentives for installation on the first conviction.
Iowa and Idaho became the latest states to require all alcohol-impaired driving offenders to install IIDs upon first offense. Iowa’s legislation (HF 2238) requires a person whose license is revoked for a BAC over .08 to install an IID in order to obtain a restricted license. The device is required for the period in which the temporary restricted license is issued.
Idaho’s (HB 551) new law requires DUI offenders to install an IID for a period of one year following the end of the license suspension period without driving privileges. If an offender refuses to be tested for alcohol at the time of arrest and does not prevail at a court hearing, the court will require an IID for one year. If an offender has committed two refusals of evidentiary testing within 10 years, an IID installation is required for two years
Alabama’s law (SB 1) expands its all-offender ignition interlock law to include offenders in pretrial diversion programs. These programs offer an alternative to prosecution by diverting offenders from the traditional criminal justice process and placing them into a probation supervised program. The new law requires DUI offenders who enter a pretrial diversion program to install an IID for at least six months or until they complete the program.
Arizona’s legislation (SB 1502) reduces the amount of time a person is required to have an IID installed by the length of a time a person was incarcerated in jail or prison.
Ignition Interlock Compliance Laws
Some states are revising their ignition interlock laws to include compliance-based removal provisions. To attain compliance-based removal, an offender must use the interlock device and not fail any tests for a set amount of time prior to removal. Washington, for example, revised its law in 2011, stipulating that when the compliance period is over, the offender can have the device removed if he or she has not:
- Tried to start the vehicle with a BAC of .04 or more.
- Failed to take or pass any required retests.
- Failed to obtain scheduled maintenance, repairs, calibration, monitoring, inspection or replacement of the device.
Arizona enacted legislation (SB 1401) in 2018 that requires the IID to produce a notification to the Department of Public Safety each time a person fails to properly perform three consecutive rolling retests during a drive cycle. Tampering with an IID can result in a six-month extension of the device period and a restricted or limited driver's license. Arizona’s new law also requires IIDs to be equipped with a camera (see below for more information on camera-based compliance laws).

Ignition Interlock Indigent Programs
Indigent IID programs reduce the cost of the devices for participating offenders who qualify for financial assistance. As IID programs have expanded, states are faced with opposition over the financial burden they place on low-income offenders. IID installations are associated with administrative costs as well as the cost of purchasing the device. To alleviate this cost barrier, states have established indigent programs to aid in the widespread implementation of IID programs. While other phrases are used in some states, “indigent fund” is used for consistency in this document.
Alabama, Delaware and Connecticut enacted legislation relating to ignition interlock indigent programs in 2018. Alabama’s new law (SB 1) requires ignition interlock companies to provide a minimum number of indigent offenders with free services including installation, lease, calibration and removal. The minimum number of indigent offenders who receive the free service is equal to 5% of total installations provided by the manufacturer during the prior calendar year. The state’s previous law required offenders to pay one-half the cost of installation. In addition, the law reduces the fee non-indigent offenders are required to pay into an indigent fund, from $300 to $200.
Delaware expanded its indigent program (HB 132) to allow all applicants who are required to participate in the IID program to apply for an indigent plan. The state’s prior indigent plan offered devices on a lottery basis, limiting access to offenders in need of financial assistance.
Connecticut’s legislation (HB 5579) allows IID service providers to reduce or eliminate charges associated with installing and operating the devices for indigent offenders who qualify for financial assistance. The law applies to indigent offenders whose IID is required because of convictions such as driving under the influence or having their license suspended. To qualify for the program, offenders may provide proof of their participation in various federal financial assistance programs in order to indicate indigence.
Implied Consent, Blood Alcohol Testing and Test Refusals
All driver’s license applicants agree to comply with requests by law enforcement officers to take breath or blood samples to determine BAC when they sign their driver’s license application forms. A breath test can be administered roadside or at any location; blood and urine testing can only be performed at a medical or detention facility. These laws, called implied consent laws, are based on the premise that driving is a privilege and not a right. Offenders who refuse will still face administrative penalties, like having their driver’s license suspended. Every state has some sort of implied consent law, but the penalties vary.
States "such as Alabama" and Mississippi require a 90-day license suspension for a first time BAC refusal. Other states such as Arizona require a six-month or even a year suspension. Some suspected DUI offenders will refuse to take BAC tests and take a license suspension to avoid or reduce the chance of facing more serious criminal sanctions. NHTSA research indicates about 20% of people arrested for drunk driving refuse to submit to a BAC test. In response to high refusal rates, at least 12 states currently criminalize the refusal to consent to a BAC. Criminal penalties typically include fines and jail time.
Over the years, questions arose about whether these laws violated the Fourth Amendment. The Supreme Court ruled in Birchfield v. North Dakota in 2016 that police have to obtain a warrant to test the blood of an individual suspected of impaired driving, but a warrant is not required for a breath test. States may criminalize an arrestee’s refusal to take a warrantless breath test. If states criminalize the refusal to take a blood test, police must obtain a warrant. Per the search-incident-to-arrest exception, police officers can search an arrestee’s person, without first obtaining a warrant, to protect officer safety or evidence. To determine if this exception applies, the court weighed the degree to which the search “could intrude upon an individual’s privacy” with the need to promote “legitimate government interests.” The court concluded the privacy intrusion of breath tests was minimal, but the privacy intrusion of blood tests was not because “while humans exhale air from their lungs many times per minute, humans do not continually shed blood.” For this reason, the court concluded that police must obtain a warrant if states criminalize the refusal to take a blood test.
Since the 2016 ruling, nine states—Arkansas, California, Minnesota, North Dakota, Pennsylvania, Rhode Island, Tennessee, Virginia and Washington—have enacted legislation to align state law with the court’s decision. California (AB 2717) was the only state to repeal criminal penalties for the refusal by a person to submit or complete a blood test for determining BAC in 2018.
Enhanced Criminal Penalties for Offenders
Pennsylvania and Rhode Island enacted legislation in 2018 to increase criminal penalties for DUI convictions for certain offenders. Pennsylvania (SB 961) now fines offenders who drive during a time when the person’s driving privilege is suspended or revoked. Upon a first conviction, offenders are fined $500 with up to 90 days in jail. A second violation results in a fine of $1,000 and a minimum of 90 days in jail. A third violation constitutes a fine of $2,500 and imprisonment for six months or longer.
Rhode Island’s new law (HB 7223, SB 2867) provides that any person over the age of 18 who is convicted of a DUI while a child under 13 is present in the vehicle is subject to potential jail time and a fine of up to $1,000. Any person convicted of a subsequent offense is guilty of a felony, may be sentenced to imprisonment of up to five years and a fine of up to $5,000.
Treatment Programs and 24/7 Sobriety Monitoring Programs
DUI recidivism is a significant concern for lawmakers and enforcement officials. To address this issue, states have debated and enacted legislation that requires using treatment programs and sobriety monitoring programs. Judges have always had the option to use court-mandated treatment, which requires impaired driving offenders to participate in evaluation and treatment for their substance abuse issues. However, recent interest includes combining behavioral treatment with more punitive sanctions, leading to a more comprehensive approach to dealing with impaired driving offenders and those who have committed other offenses while impaired. One of these programs is called a “24/7 sobriety program.”
In 2007, South Dakota became the first state to pass a statewide program of this kind. The pretrial program emphasizes offender sobriety and requires repeat and high-BAC DUI offenders to submit to a breath or urine test twice a day at a local sheriff’s office or other designated site. Breathalyzers, transdermal alcohol monitoring devices (ankle bracelets) and drug monitoring patches also may be used to monitor an offender’s sobriety. If the offender fails or does not appear for a test, the offender’s bond, parole or probation may be immediately revoked and, in most cases, the infraction will result in immediate incarceration.
In 2013, the RAND Corporation published the first peer-reviewed evaluation of whether 24/7 sobriety monitoring programs improved public health in South Dakota. Key findings indicated that between 2005 and 2010, more than 10% of men ages 18 to 40 in some counties participated in a 24/7 program. At the county level, researchers indicated a 12% reduction in repeat DUI arrests and a 9% reduction in domestic violence arrests following adoption of the program. Evidence pertaining to traffic crashes was mixed.
The RAND Corporation’s 2018 study on 24/7 sobriety monitoring programs in South Dakota shows that between 2005 and February 2017, more than 30,000 South Dakotans participated in a 24/7 program. The results show that over 12 months, 24/7 participants were rearrested or had their probation revoked 49% less than non-program participants. These reductions continued at 24 months, with a 35% reduction in rearrests and license revocations, and at 36 months, with a 26% reduction.
To isolate the effects of 24/7, Beau Kilmer, a co-author of the study, examined county-level program implementation outcomes, such as traffic crashes involving men ages 18 to 40. Results reveal there is no evidence the program affected the number of total traffic crashes.
Lastly, the study uses the 24/7 model to support the hypothesis that it is possible to create an effective deterrent program on a large scale. It works by prioritizing actions that are swift, certain and with a moderate sanction, such as a night or two in jail, as is the case with 24/7 programs.
A 2015 study by the Upper Great Plains Institute at North Dakota studied the deterrent effect on that state’s 24/7 program offenders. Researchers found that among DUI offenders in this sample, positive behavioral improvements were made upon enrolling in the program. The program appears to have more of a deterrent effect on women than men. The mandatory 12-month enrollment period has a stronger deterrent effect than did prior sentences, which generally were left to judicial discretion. Nonetheless, for the group of high-risk offenders who likely have alcohol abuse problems, the program was found to have little deterrent effect.
Other states have used South Dakota’s model and Alaska, Hawaii, Idaho, Iowa, Montana, North Dakota, Utah, Washington and Wyoming have enacted statewide legislation to set up 24/7 monitoring programs.
No states enacted laws directly related to 24/7 sobriety monitoring in 2018. However, Delaware and Oklahoma enacted laws that focus on alcohol and drug rehabilitation or monitoring of DUI offenders. Delaware’s new legislation (HB 294) requires the Division of Substance Abuse and Mental Health to establish rehabilitation programs for drivers whose licenses have been revoked for driving under the influence of alcohol, any drug or both.
Oklahoma removed a provision (HB 2643) that requires the district attorney to pursue enhanced punishment for an individual convicted of driving under the influence before the individual is required to participate in additional assessments. The state’s new law requires offenders to initially participate in an alcohol and drug substance abuse evaluation and assessment program conducted by a certified assessor to evaluate an offender’s receptivity to treatment.
Other 2018 Impaired Driving Legislation
Hawaii enacted legislation (HB 2003) in 2018 that authorizes permits for a DUI offender to operate an employer’s vehicle during the period of license revocation. To receive a permit, the employer is required to attest to the offender’s need to drive the vehicle for the purpose of employment and report on the employee’s assigned work hours.