The New York Times (Well blog), 18 October 2011

On Sept. 15, Matthew Grape, 21, got into the passenger seat of a car with one of his Duke University fraternity brothers. The driver hit a tree, escaping with minor injuries, but killing his dear friend. According to local press reports, the driver was charged with impaired driving.

Nearly 11,000 deaths related to alcohol-impaired driving still occur each year in the United States, despite a three-decade surge in anti-drunken driving activism, stricter laws and clever slogans like “Friends don’t let friends drive drunk.” There are more than 110 million instances of impaired driving each year, according to data from the 2010 Behavioral Risk Factor Surveillance System Survey and summarized in a new report from the Centers for Disease Control and Prevention.

How can this still be occurring, and what can be done about it?

Back in 1980, when Candy Lightner’s 13-year-old daughter, Cari, was killed in California by a drunken driver with several previous arrests for driving while intoxicated, including one only two days earlier, there was little public discussion of the topic, even though drunken drivers killed 25,000 Americans annually. Crashes were called “accidents,” and victims were characterized as having been “in the wrong place at the wrong time.” Police and prosecutors routinely allowed drunken drivers to plead to lesser offenses, and few served any time in prison. Officials politely told the families of victims to “get on with their lives.”

When a police officer told Ms. Lightner that the man who had killed her daughter would probably receive only a slap on the wrist, she was incredulous and livid. She formed Mothers Against Drunk Driving, or MADD, one of the first citizen groups devoted to the issue. Within five years, the organization had more than 300 chapters and 600,000 members. Its relentless lobbying efforts and publicity campaigns helped lead to the passage of 700 new drunken driving laws and the passage of the National Minimum Drinking Age Act.

MADD unabashedly heaped criticism on people who willfully drank and drove without regard to the threat they caused. The connection of alcohol and driving, formerly celebrated on television, in movies and in advertising, became stigmatized. Drunken driving deaths began to decline.

Too many young people still climb into cars after drinking, despite hearing countless admonitions against drunken driving in health classes in high school and from their parents and friends.

Adolescent feelings of invulnerability no doubt play a role. But other, more subtle reasons probably contribute as well.

Binge drinking at colleges remains a huge problem. Despite public health campaigns to eliminate drinking on campuses, the alcohol industry continues to sponsor events, and provocative advertisements persist. Men ages 21 to 34 and binge drinkers of all ages are those most likely to drive while drunk.

In addition, scientifically proven methods for lowering drunken driving deaths are being underused, as the C.D.C. report points out. These include sobriety checkpoints, in which drivers are stopped to assess their level of alcohol impairment. Twelve states don’t use them at all, while many others underuse them. Ignition interlocks, which prevent those who have been drinking from starting their cars, are used for only one in five persons convicted of driving while intoxicated, although they lower the rate of subsequent arrests by two-thirds. Designated drivers have become more commonplace, but they are much more socially accepted in other countries like Sweden and Australia.

Finally, and ironically, the recent focus on distracted driving, in which drivers text or speak on their cellphones, may have distracted our attention from drunken driving. Both are enormous public health problems.

Some might argue that measures to control drunken driving in the United States have been remarkably successful. After all, the number of people who will die because of alcohol-related crashes this year is less than half what it was 30 years ago.

But it is unlikely that the families of thousands of other victims of drunken driving would agree. Drunken driving remains among the most preventable of violent injuries. Every time we lose a young person — or an old person — to this crime, it is as tragic as it was in 1980.