Drinking and Driving – A Fatal Combination

There is irreconcilable conflict between liquor/alcohol and safe driving. The result is fatal. The cost of this conflict is very high and its greater impact is on young generation. According to studies, drunken driving is a leading cause of death and disability among young people. Conservative estimate suggests that thousands of people die and tens of thousands are injured annually as result of drunken driving. It is accounted as the major and leading cause of road related accidents.


Worldwide, the number of people killed in road traffic accidents each year is estimated at almost 1.2 million, while the number injured could be as high as 50 million.

More than 1000 children and young adults under the age of 25 years are killed in road traffic accidents every day.

More than half of all road traffic deaths occur among young adults between 15 and 44 years of age.

73% of all road traffic fatalities are male.

Road traffic injuries are the leading cause of death for 10-24 year olds.

Speeding is the single most common traffic rule violation committed by young, male drivers and contributes to up to one third of all road traffic crashes.

Inexperienced young adults driving with blood alcohol concentration levels above 0.05g/dl have a 2.5 times higher risk of a crash compared with older, more experienced drivers.

Wearing a helmet is the single most effective way of reducing head injuries and fatalities resulting from motorcycle crashes.

Globally, road traffic injuries are the leading cause of death among young people aged 10-24 years. Each year nearly 400 000 people under 25 years of age die on the world’s roads – an average of 1049 a day. Most of these deaths occur in low- and middle-income countries and among vulnerable road users – pedestrians, cyclists, motorcyclists and those using public transport.

Road traffic injuries can be prevented. A number of targeted interventions have proved to be effective in addressing these risk factors and reducing road traffic injuries among young people.This note is aimed at addressing drinking and driving among drivers. Commercial drivers are an especially important group to address in terms of drinking and driving because of the large number of passengers they can carry and/or the number of kilometres they are likely to travel.

The public must know why drinking and driving is both unsafe and anti-social. Public education has an important role to play in road safety.


In order to know this, it is essential to understand how alcohol affects our body system. Alcohol is a toxic substance (ethyl alcohol), intoxicating, and depressant in nature that slows down the activity of the brain. Alcohol needs no digestion and is observed by the stomach and small intestines instantly. After absorption the alcohol enters the blood stream and can reach to the brain within one minute. The blood carries the alcohol through out body. Alcohol acts primarily on the nerve cells within the brain, interferes with communication between nerve cell and all other cells.


There are a number of factors that increase the risk of road accidents involving drinking and driving. For example, young male drivers are at a high risk of such accidents, and accidents involving alcohol are more frequent at night.

The consumption of alcohol, even in relatively small amounts, increases the risk of being involved in a crash for motorists and pedestrians. Not only does alcohol impair processes critical to safe road use, such as vision and reaction time, it is also associated with impaired judgement and so is often linked to other high-risk road use behaviours such as speeding or not using seat-belts. The immediate effects of alcohol on the brain are either depressing or stimulating in nature, depending on the quantity consumed. Either way, alcohol results in impairment which increases the likelihood of an accident since it produces poor judgement, increased reaction time, lower vigilance and decreased visual perception. Not only do judgement and reaction time suffer, but vision also deteriorates. Apart from its direct impact on crash outcomes, alcohol is believed to affect other aspects of driver safety such as seat-belt wearing, helmet use, and speed choice. Physiologically, alcohol also lowers blood pressure and depresses consciousness and respiration.


Slows brain functions so that you can’t respond to situations, make decisions or react quickly.

Reduces your ability to judge how fast you are moving or your distance from other cars, people or objects.

Gives you false confidence – you may take greater risks because you think your driving is better than it really is.

Makes it harder to do more than one thing at a time – while you concentrate on steering, you could miss seeing a red light, cars entering from side streets or pedestrians.

Makes you feel sleepy or fatigued.

Decades of research have shown that drunken drivers have a significantly higher risk of being involved in a road crash than drivers who have not consumed alcohol.


Drivers who have been drinking have a much higher risk of involvement in accident than those with no alcohol in their blood, and this risk increases rapidly with increasing Blood Alcohol Content (BAC).

Increasing blood alcohol levels are also associated with an increase in the severity of injury incurred in a road crash. This is particularly true for the risk of death: an alcohol-impaired driver has 17 times the risk of being involved in a fatal crash than an unimpaired driver.

Alcohol is a risk factor for many pedestrians who are involved in road crashes. A study in the United Kingdom found that 48% of pedestrians killed in road crashes had been drinking alcohol. In South Africa, alcohol was found to contribute to 61% of fatalities among pedestrians.

Any drug that affects the central nervous system has the potential for driver impairment.

Motorcycle riders are at even greater risk from drink riding because alcohol affects sense of balance. As balance plays a direct role in controlling a motorcycle, the consequences of consuming alcohol before riding are severe. Drivers who have been drinking have a much higher risk of involvement in accidents than those with no alcohol in their blood, and this risk grows rapidly with increasing blood alcohol concentration

BAC (g/100ml) Effects on the body
0.01 – 0.05

Increase in heart and respiration rates

Decrease in various brain centre functions

Inconsistent effects on behavioural task performances

Decrease in judgment and inhibitions

Mild sense of elation, relaxation and pleasure

0.06 – 0.10

Physiological sedation of nearly all systems

Decreased attention and alertness, slowed reactions, impaired coordination, and reduced muscle strength

Reduced ability to make rational decisions or exercise good judgment

Increase in anxiety and depression

Decrease in patience

0.10 – 0.15

Dramatic slowing of reactions

Impairment of balance and movement

Impairment of some visual functions

Slurred speech

Vomiting, especially if this BAC is reached rapidly

0.16 – 0.29

Severe sensory impairment, including reduced awareness of external stimulation

Severe motor impairment, e.g. frequently staggering or falling

0.30 – 0.39

Non-responsive stupor

Loss of consciousness

Anaesthesia comparable to that for surgery

Death (for many)

0.40 & greater


Cessation of breathing

Death, usually due to respiratory failure

Alcohol compromises driving performance and thus increases the risk of a road traffic collision.

Young adults in the 20–29 years age group were estimated to have three times the risk compared with drivers aged 30 years and above, at all BAC levels. Teenage drivers had more than five times the risk of a fatal crash compared with drivers aged 30 and above, at all levels of blood-alcohol content.The risk of a road accident when a driver is alcohol impaired varies with age. Teenagers are significantly more likely to be involved in a fatal crash than older drivers. At almost every blood alcohol content level, the risk of accident fatality decreases with increasing driver age and experience.

Apart from the adverse influence of alcohol as a contributor to road crashes, the presence of alcohol in the body of a road crash victim adversely affects the diagnosis, management, and treatment of injuries.

Unfortunately, the scale of the problem is not well understood, there is little public awareness of the problem. Road traffic injuries are a major but neglected global public health problem, requiring concerted efforts for effective and sustainable prevention.

Drinking and driving interventions that are undertaken by and involve the local community can be an effective means of both educating the public about the risks involved in drinking and driving and preventing it from taking place. Road safety is a shared responsibility.




Issued in Public Interest.