Decades of education, advocacy for legislative changes, improved vehicle safety systems and increased enforcement significantly cut the percentage of fatal car crashes that involve alcohol since about 1970.
In the mid-1970s more than 60% of fatal car crashes involved alcohol, while in 2022 it was about 30%, according to the National Institutes for Health.
Yet for the last decade, progress has stalled, and advocates are quickly turning their attention to a new tool that they believe will again dramatically decrease alcohol-related traffic deaths: technology.
“We’ve done what we can, and law enforcement has done what they could, now we need the technology,” said Rebecca Green, executive director of Mothers Against Drunk Driving Colorado. “We are still seeing 10,000 to 13,000 lives lost nationally every year.
“But we have done all we can to teach people to behave differently when consuming those substances. We need another tool to save lives.”
In 2023, 12,429 people died in the United States in alcohol-impaired traffic crashes, according to the National Highway Traffic Safety Administration. That’s about 42 people every day. And, an estimated 360,441 people were injured.
Drug-related traffic fatalities are on the increase, and a University of California study said there were nearly 11,000 traffic deaths nationwide in 2021 that involved one or more drugs – illegal, prescription and over-the-counter. And often, drug- and alcohol-related traffic deaths and injuries overlap.
While awaiting the installation of technology in vehicles, MADD and other organizations will continue to push their education campaigns and assure the cultural shifts among young people who increasingly rely on ride shares or public transportation continue.
NHTSA’s latest education campaign to halt that bad behavior is “If you feel different, you drive different.”
And by different they mean you’re less alert and have slower reflexes and poor judgment.
With a blood alcohol content of .02 – well below the .05 for impaired and .08 for drunken driving – drivers have less visual ability and are less able to perform two tasks at the same time. And as the blood alcohol increases, all abilities decrease.
The Colorado State Patrol consistently delivers information on the cost of driving while impaired, either by drugs or alcohol, telling drivers that it will cost more than $13,000 if they get a driving under the influence ticket. And their license gets suspended for a year to boot.
Green said the monetary penalties do seem to deter some first-time offenders from repeating their expensive illegal behavior.
“It’s hit or miss,” she said when asked whether the financial penalties were a deterrent. “There’s a certain portion of the population that is walking a path that involves substance use. They are still consuming and driving – technology helps prevent those people from driving while impaired.”
And that doesn’t mean there will be a breath test that every driver must take before turning on the ignition.
Seeing Machines, an Australia-based company, uses technology that literally watches a driver to detect cognitive impairment, for example.
At MADD’s 45th anniversary gathering in September 2025, Seeing Machines demonstrated its detection system.
“For years our technology, now in over 3.7 million cars and over 60,000 trucks today, has been capable of detecting and preventing distracted and drowsy driving,” Seeing Machines Chief Safety Officer Mike Lenne said in a news release.
And now it can detect alcohol impairment.
The European Union has required some driver detection systems in new vehicles since 2022, and those requirements were expanded in 2024. This year (2026) the systems must detect alcohol impairment.
The HALT Drunk Driving Act that was part of the Infrastructure and Jobs Act approved by Congress in 2021 has yet to be implemented. The NHTSA asked for an extension last year to make the rules for implementation.
Still, Green said, there the auto industry has the technology and could implement without finalization of the law that will force them to do it.
The Insurance Institute for Highway Safety is pushing for such systems, too, and announced at the MADD gathering that it plans to add them to the criteria for its Top Safety Pick awards in coming years.
The detection systems are similar to what many drivers already experience – a warning sound or light – when they stray toward another vehicle or the edge of the road.
An impairment system would first alert a driver that it has detected impairment and urge the driver to pull off the road. If that doesn’t happen, the alert would become more visible – like an alarm clock you can’t shut off.
Finally, the system would have the ability to restrict the vehicle’s speed and turn off such things as infotainment systems, entering what Seeing Machines calls a “limp home mode.”
Even if every new vehicle was equipped with such driver detection systems today, it will take an estimated 20 to 25 years for most cars on the road to have them, Green said.
Researched and written by Sue McMillin