title: Alcohol-impaired driving in the United States: contributors to the problem and effective countermeasures.
abstract: OBJECTIVE
  To review the effectiveness of current countermeasures in alcohol-impaired driving.
  
  
  METHODS
  This article provides an overview of the contributors to the alcohol-impaired driving problem in the United States and reviews the effectiveness of alcohol-impaired driving countermeasures.
  
  
  RESULTS
  Many effective countermeasures have been used during the past few decades both to deter drivers from driving when they are over the legal limit for alcohol and to discourage driving while intoxicated (DWI) offenders from reoffending once they have been caught and convicted. In recent years, greater attention has been given to the problem of "hardcore" drinking drivers, a term coined to refer to those who repeatedly drive with high blood alcohol concentrations and are resistant to changing their behavior. Although such individuals are a legitimate target for attention, focusing predominantly on this group will result in missed opportunities to address a large portion of alcohol-impaired driving crashes. This article provides a review of the primary countermeasures that have been used to reduce alcohol-impaired driving and summarizes evidence for their effectiveness. It asks the question of where, in an environment of limited resources, attention should be focused.
  
  
  CONCLUSIONS
  General deterrent approaches, such as frequent and highly publicized sobriety checkpoints, have the greatest potential to save lives and should be the mainstay of state and local efforts. Specific deterrent approaches, aimed at deterring DWI offenders from reoffending, such as alcohol ignition interlocks, should be applied to all apprehended drivers, whatever their drinking history. Evidence suggests that they could benefit from them. In the future, advanced in-vehicle technologies that would prevent vehicles from being driven when their drivers are over the legal limit may hold the key to drastically reducing the alcohol-impaired driving problem.
authors.affiliation: Ferguson International LLC, Naples, Florida 34108, USA. fergsusan@gmail.com
authors.forename: Susan A
authors.initials: SA
authors.lastname: Ferguson
mesh_terms: D000435:Alcoholic Intoxication / Q000453:epidemiology* / Q000517:prevention & control; D001334:Automobile Driving / Q000331:legislation & jurisprudence / Q000706:statistics & numerical data*; D000431:Ethanol / Q000097:blood; D006801:Humans; D035846:Law Enforcement; D011482:Protective Devices; D014481:United States / Q000453:epidemiology
chemical_list: D000431:Ethanol