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Traffic crashes are the cause of more fatal and debilitating traumatic injuries than any other modern activity in the United States, and today few are blind to the fact that alcohol-impaired drivers pose a significant risk to themselves and others. The deaths and injuries that drunk driving causes are frequently inflicted upon innocent victims; as there is no justification for drunk driving, these are particularly pointless and tragic occurrences. But broad recognition of the problems drunk drivers cause has not led to an easy crafting of effective strategies to combat them; indeed, the path remains contentious. Even fundamental issues, such as defining the term drunk driving, spark sometimes-heated battles among researchers, activists, industry, and the government. Nonetheless, great strides have occurred in preventing deaths from drunk driving. Of concern, though, is the apparent recent stall in the decline in drunk driving and the identification of tools for further prevention success.

Drunk driving is the act of driving after being impaired by alcohol, placing the driver at a higher risk of crashing than normal, given the same driving conditions. This is a more general term than a legal definition, which requires impairment to be identifiable by an enforcement officer, or a per se definition of driving under the influence (DUI) based on a specific blood alcohol concentration (BAC). States vary in their definitions of DUI and driving while impaired (DWI). Further, the U.S. National Highway Traffic Safety Administration (NHTSA) uses the term alcohol related to mean a crash that occurs where at least one driver, pedestrian, or pedalcyclist has a BAC greater than or equal to .01 (g/dL). To avoid confusion, statistics in this entry include the terms and definitions of the statistic's source.

The NHTSA compiles alcohol-related traffic fatalities within a database, the Fatality Analysis Reporting System (EARS), formerly known as the Fatal Accident Reporting System. EARS is a valuable resource for understanding the prevalence of drunk driving within the United States. Each state reports to this system its fatal road crashes, along with important details about the drivers, other vehicle occupants, the vehicles, and the crash itself. Included within the driver data set are the results of any alcohol level testing. The NHTSA uses an imputing scheme to replace missing data from states' reports.

According to the NHTSA analysis, in 2005, 16,885 fatalities stemmed from alcohol-related crashes. Most of these crashes (85.3 percent) involved drivers whose BAC was .08 (g/dL) or greater. In fact, more than half of the crashes (57.6 percent) involved a driver with a BAC of .15 (g/dL) or greater. Relative to their risk of being in any fatal crash, males and those between ages 20 and 39 are at a disproportionate risk of being in an alcohol-related fatal crash. Motorcyclists are also disproportionately involved in alcohol-related crashes.

Physiology

Alcohol is usually absorbed quickly through the stomach and intestines and thus enters the bloodstream within 20 minutes of consumption. Food in the stomach acts to slow this absorption. The concentration of alcohol within the blood is usually measured in the proportion of grams of alcohol per deciliter of blood (g/dL). This fraction is often referred to as blood alcohol concentration (BAC). A number of formulas can estimate the resulting BAC from the consumption of varying amounts of alcohol. The actual attained BAC that results from consumption is a function of the drinker's physiology (including weight and sex), the quantity of alcohol consumed, and the time over which the consumption occurred. Time plays two roles: latency of absorption and time that it takes for removal of the alcohol by the liver.

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