Drunk driving in the United States

Drunk driving is the act of operating or driving a motor vehicle while under the influence of alcohol or drugs to the degree that mental and motor skills are impaired. It is illegal in all jurisdictions within the United States, though enforcement varies widely between and within states/territories.

The specific criminal offense is usually called driving under the influence (DUI), and in some states 'driving while intoxicated' (DWI), 'operating while impaired' (OWI), or 'operating a vehicle under the influence' (OVI). Such laws may also apply to boating or piloting aircraft. Vehicles can include farm machinery and horse-drawn carriages.

In the United States the National Highway Traffic Safety Administration (NHTSA) estimates that 17,941 people died in 2006 in alcohol-related collisions, representing 40% of total traffic deaths in the US. NHTSA states 275,000 were injured in alcohol-related accidents in 2003. The Bureau of Justice Statistics estimated that in 1996 local law enforcement agencies made 1,467,300 arrests nationwide for driving under the influence of alcohol, 1 out of every 10 arrests for all crimes in the U.S., compared to 1.9 million such arrests during the peak year in 1983, accounting for 1 out of every 80 licensed drivers in the U.S.

NHTSA defines fatal collisions as "alcohol-related" if they believe the driver, a passenger, or non-motorist (such as a pedestrian or pedal cyclist) had a blood alcohol content (BAC) of 0.01% or greater. NHTSA defines nonfatal collisions as alcohol-related if the accident report indicates evidence of alcohol present. NHTSA specifically notes that alcohol-related does not necessarily mean a driver or non occupant was tested for alcohol and that the term does not indicate a collision or fatality was caused by the presence of alcohol. On average, about 60% of the BAC values are missing or unknown. To analyze what they believe is the complete data, statisticians simulate BAC information. Drivers with a BAC of 0.10% are 6 to 12 times more likely to get into a fatal crash or injury than drivers with no alcohol.

Laws and regulations
For the most part, DUI or DWI are synonymous terms that represent the criminal offense of operating (or in some jurisdictions merely being in physical control of) a motor vehicle while being under the influence of alcohol or drugs or a combination of both. All states in the U.S. designate a per se blood or breath alcohol level as the threshold point for an independent criminal offense. A second criminal offense of driving "under the influence" or "while impaired" is also usually charged in most states, with a permissive presumption of guilt where the person's BAC is 0.08% or greater (units of milligrams per deciliter, representing 8 g of alcohol in 10 liters of blood). Some states (e.g., Colorado) include a lesser charge, sometimes referred to as driving while ability impaired that may apply to individuals with a 0.05% or above, but less than the 0.08% per se limit for the more serious charge. Wisconsin, however, is the only state that continues to regard first offense drunk driving arrests as a forfeiture.

The amount of alcohol intake to reach a BAC of 0.08% may vary with the individual's body composition and state of health.

Prior to increased emphasis on drinking and driving in the 1980s, standards of 0.10%-0.15% were in place. The legal limit for commercial drivers in New York is set at 0.04%.

Driving under the influence of drugs
The key inquiry focuses on whether the driver's faculties were impaired by the substance that was consumed. The detection and successful prosecution of drivers impaired by prescription medication or illegal drugs can therefore be difficult. Breathalyzers have been developed for the purpose of administering roadside or laboratory tests that can detect the actual level of a controlled substance in an individual's body.

Physician reporting
Six states require physicians to report patients who drive while impaired. Another 25 states permit physicians to violate doctor-patient confidentiality to report impaired drivers, if they so choose. The American Medical Association endorsed physician reporting in 1999, but deferred to the states on whether such notification should be mandatory or permissive. An authority on professional confidentiality, Jacob Appel of New York University, has written that physician reporting is a double-edged sword, because it may deter some patients from seeking care. According to Appel, "Reporting may remove some dangerous drivers from the roads, but if in doing so it actually creates other dangerous drivers, by scaring them away from treatment, then society has sacrificed confidentiality for no tangible return in lives saved."

Penalties
Many jurisdictions require more such as jail time, larger fines, longer DUI programs, the installation of ignition interlock devices) in cases where the driver's BAC is over 0.20%, or 0.15% in some places. These additional sanctions are an attempt to deter and punish the operation of a vehicle at extremely high BAC levels and the concomitant danger posed to the safety of persons and property by heavily impaired drivers. As of July 1, 2010, California implemented a pilot project for DUI sentencing. In two counties, Los Angeles and Alameda, first offenders convicted of drunk driving are required to install an ignition interlock device in their car for a period of five months. Previously, this requirement was only mandated for second offenders and then for a three year period. California DMV has now written guidelines to clear up any ambiguities in the law.

Compared to many other countries, penalties for drunk driving in the United States are light, unless alcohol is involved in an incident causing injury or death of others, in which case they are very heavy compared to other nations. See Driving under the influence. Some states, such as Wisconsin, do not permanently revoke driving permits even if the offender is convicted multiple times.

DUI plates
In 1967, Ohio began to issue special license plates to DUI offenders who are granted limited driving privileges such as work-related driving until a court can rule that they can have full privileges back. However, judges rarely enforced the plates, so in 2004, the plates became mandated by state law to all DUI offenders. Unlike Ohio's standard-issue plates (which as of 2008 have a picture of the Ohio country side), the DUI plates are yellow with red writing with no registration stickers or graphics. They are sometimes known as "party plates".

Minnesota has a similar program, where the plates are white with either blue or black text. The plate number is a "W", followed by a letter and four numbers. These plates may be issued to drivers with at least 2 DUIs in a ten-year period. In Minnesota, DUI plates are referred to as "whiskey plates", whiskey being the name of the letter W in the NATO phonetic alphabet.

Restricted Licenses
Most states do allow certain DUI offenders (usually first-time) to obtain a restricted or hardship license while on suspension. This license permits them to drive to and from work or school. Currently only Alabama, Kansas, New Hampshire, New Jersey and Vermont do not allow for this type of license.

Flying while drunk and related laws
Federal Aviation Regulation 91.17 (14 CFR 91.17) prohibits pilots from flying aircraft with an alcohol level of 0.04% or more, or within eight hours of consuming alcohol, or while under the impairing influence of any drug. The same prohibition applies to any other crew members on duty aboard the aircraft (flight attendants, etc.). Some airlines impose additional restrictions, and many pilots also impose stricter standards upon themselves. Commercial pilots found to be in violation of regulations are typically fired or resign voluntarily, and they may lose their pilot certificates and be subject to criminal prosecution under Federal or State laws, effectively ending their careers.

Similar laws apply to other activities involving transportation; Michigan prohibits intoxicated bicycling, horseback riding, buggy driving, use of motorized farm implements, or boating, the latter whether a pilot or passenger, with much the same threshold of intoxication.

Driving While Impaired courts
These innovative courts use substance abuse intervention with repeat offenders who plead guilty to driving while intoxicated. Those accepted into the diversionary program are required to abstain from alcohol. Some are required to wear a device that monitors and records any levels of alcohol detected in their bloodstreams.

SR-22
An SR-22 is an administrative form that attests to an insurance company's coverage, or the posting of a personal public bond in the amount of the state's minimum liability coverage for the licensed driver/ or vehicle registration. The SR in SR-22 stands for Safety Responsibility, and it's needed to reinstate a suspended driver's license after a DUI conviction. It is submitted to the state by an auto insurance company to serve as proof that a driver has the minimum liability insurance that the states requires. SR-22s are typically filed with the respective State's DMV, and in some States must be carried by the licensed driver, or in the registered vehicle (particularly if the licensee has been cited for coverage lapses, DUI or other administrative infractions). SR-22s may attest coverage for a vehicle regardless of operator (owner liability coverage), or cover a specific person regardless of the specific vehicle operated (operator liability coverage).

The form is required in 49 States and the US District of Columbia in order to register a vehicle for usage on public roads (with the notable exception being New Hampshire). (You need an SR-22 for 3 years after being convicted of DWI in New Hampshire ) It is also required to redeem a license which has been suspended due to coverage lapse in these required States. These States also, generally, require that the issuing insurance company provide the relevant State's DMV with timely updates as to the status of such coverage. If the policy with the SR22 cancels, a form called an SR26 is issued and sent to the state DMV. Upon notice that there has been a laspe in coverage, the state will suspend the driver's license again. Another SR-22 Filing will need to be submitted to regain driving privileges.

History of drunk driving laws
The first jurisdiction in the United States of America to adopt laws against drunk driving was New York in 1910, with California and others following. Early laws simply prohibited driving while intoxicated, requiring proof of a state of intoxication with no specific definition of what level of inebriation qualified. The first generally-accepted legal BAC limit was 0.15%.

In 1938, the American Medical Association created a "Committee to Study Problems of Motor Vehicle Accidents". At the same time, the National Safety Council set up a "Committee on Tests for Intoxication".

In the US, most of the laws and penalties were greatly enhanced starting in the late 1970s, and through the 1990s, largely due to pressure from groups like Mothers Against Drunk Driving (MADD) and Students Against Destructive Decisions (SADD) and leaders like Candy Lightner. Significantly, zero tolerance laws were enacted which criminalized driving a vehicle with 0.01% or 0.02% BAC for drivers under 21. This is true even in Puerto Rico, despite maintaining a legal drinking age of 18.

Statistics
In the United States the National Highway Traffic Safety Administration (NHTSA) estimates that 17,941 people died in 2006 in alcohol-related collisions, representing 40% of total traffic deaths in the US. NHTSA states 275,000 were injured in alcohol-related accidents in 2003. The Bureau of Justice Statistics estimated that in 1996 local law enforcement agencies made 1,467,300 arrests nationwide for driving under the influence of alcohol, 1 out of every 10 arrests for all crimes in the U.S., compared to 1.9 million such arrests during the peak year in 1983, accounting for 1 out of every 80 licensed drivers in the U.S. This represented a 220% increase in DUI arrests from 1970 to 1986, while the number of licensed drivers increased by just 42% in the same period. The arrest rate for alcohol-related offenses among American Indians was more than double that for the total population during 1996, and almost 4 in 10 American Indians held in local jails had been charged with a public order offense, most commonly driving while intoxicated. In 1997 an estimated 513,200 DUI offenders were under correctional supervision, down from 593,000 in 1990 and up from 270,100 in 1986.

NHTSA defines fatal collisions as "alcohol-related" if they believe the driver, a passenger, or non-motorist (such as a pedestrian or pedal cyclist) had a BAC of 0.01% or greater. NHTSA defines nonfatal collisions as alcohol-related if the accident report indicates evidence of alcohol present. NHTSA specifically notes that alcohol-related does not necessarily mean a driver or non occupant was tested for alcohol and that the term does not indicate a collision or fatality was caused by the presence of alcohol. On average, about 60% of the BAC values are missing or unknown. To analyze what they believe is the complete data, statisticians simulate BAC information. Drivers with a BAC of 0.10% are 6 to 12 times more likely to get into a fatal crash or injury than drivers with no alcohol.

The NHTSA maintains a Digest of Impaired Driving and Select Beverage Control Laws.

Typical DUI investigation and arrest
Following are common procedures when a law enforcement officer has reason to suspect a driver is intoxicated.

Reasonable suspicion to stop
There are several situations in which the officer will come into contact with a driver, some examples are:
 * The driver has been involved in an automobile accident; the officer has responded to the scene and is conducting an investigation.
 * The driver has been stopped at a sobriety checkpoint (also known as roadblocks).
 * The police have received a report, possibly from an anonymous citizen, that a described car has been driving erratically. The officer should verify the erratic driving before pulling the driver over. In some cases, the driver will no longer be in the vehicle.
 * The officer on patrol has observed erratic, suspicious driving, or a series of traffic infractions indicating the possibility that the driver may be impaired. This is by far the most common reason for stopping a suspect.
 * A police officer has stopped a vehicle for a lesser traffic offense, notices the signs of intoxication, and begins the DUI investigation.

The following list of DUI symptoms, from a publication issued by the National Highway Traffic Safety Administration (DOT HS-805-711), is widely used in training officers to detect drunk drivers. After each symptom is a percentage figure which, according to NHTSA, indicates the statistical chances through research, that a driver is over the legal limit.

If the officer observes enough to have a reasonable suspicion to legally justify a further detention and investigation, they will ask the driver to step out of the vehicle.

Reasonable suspicion requires less evidence than probable cause, but more than a mere hunch. A rule of thumb is that reasonable suspicion requires 25 % proof, and probable cause requires more than 50 % statistical chance. Therefore, if there is probable cause for arrest for DWI, as suggested by the research and examples used above, then there is reasonable suspicion to stop a driver.

Investigation
The officer will typically approach the driver's window and ask some preliminary questions. During this phase of the stop the officer will note if they detect any of the following indicators of intoxication
 * odor of an alcoholic beverage on the driver's breath or in the car generally
 * slurred speech in response to the questioning
 * watery, blood shot, or reddish eyes
 * flushed face
 * droopy eyelids
 * difficulty in understanding and responding intelligently to question
 * fumbling with his or her driver's license and registration
 * the plain-view presence of containers of alcoholic beverages in the vehicle.
 * admission of consumption of alcoholic beverage

If the officer observes enough to have a reasonable suspicion to legally justify a further detention and investigation, they will ask the driver to step out of the vehicle.

Field sobriety tests
One of the most controversial aspects of a DUI stop is the field sobriety test (FSTs). The National Highway Traffic Safety Administration (NHTSA) has developed a model system for managing Standardized Field Sobriety Test (SFST) training. They have published numerous training manuals associated with FSTs. As a result of the NHTSA studies, the walk-and-turn test was determined to be 68% accurate, and the one-leg stand test is only 65% accurate when administered to people within the study parameters. The tests were not validated for people with medical conditions, injuries, 65 years or older, and 50 pounds or greater overweight. The officer will administer one or more field sobriety tests. FSTs are "divided attention tests" that test the suspect's ability to perform the type of mental and physical multitasking that is required to operate an automobile. However, these tests can be problematic for people with nonobvious disabilities affecting proprioception, such as Ehlers-Danlos syndrome. The three validated tests by NHTSA are: Alternative tests, which have not been scientifically validated, include:
 * horizontal gaze nystagmus test, which involves following an object with the eyes (such as a pen) to determine characteristic eye movement reaction.
 * walk-and-turn (heel-to-toe in a straight line). This test is designed to measure a person's ability to follow directions and remember a series of steps while dividing attention between physical and mental tasks.
 * one-leg-stand.
 * modified-position-of-attention (feet together, head back, eyes closed for thirty seconds; also known as the Romberg test).
 * finger-to-nose (tip head back, eyes closed, touch the tip of nose with tip of index finger).
 * recite part of the alphabet
 * (finger count) touch each finger of hand to thumb counting with each touch (1, 2, 3, 4, 4, 3, 2, 1).
 * count backwards from a number ending in a number other than 5 or 0 and stopping at a number ending other than 5 or 0. The series of numbers should be more than 15.
 * breathe into a "portable or preliminary breath tester" or PBT.

Although most law enforcement agencies continue to use a variety of these FSTs, increasingly a 3-test battery of standardized field sobriety tests (SFSTs) is being adopted. The NHTSA-approved battery of tests consists of the horizontal gaze nystagmus test, the walk-and-turn test, and the one-leg-stand. In some states, such as Ohio, only the standardized tests will be admitted into evidence, provided they were administered and objectively scored "in substantial compliance" with NHTSA standards (ORC 4511.19(D)(4)(b)).

According to original studies conducted by NHTSA, these tests are not designed to detect impairment, but rather give a probability that a driver is at or a above a 0.08% BAC. However, studies throw doubt on the tests' usefulness in helping an officer to judge either. In 1991, Dr. Spurgeon Cole of Clemson University conducted a study of the accuracy of FSTs. His staff videotaped people performing six common field sobriety tests, then showed the tapes to 14 police officers and asked them to decide whether the suspects had "had too much to drink and drive" (sic). The blood-alcohol concentration of each of the 21 DUI subjects was 0.00, unknown to the officers. The result: the officers gave their opinion that 46% of these innocent people were too drunk to be able to drive. This study showed the possible inaccuracy of FSTs.

An increasingly used field sobriety test involves having the suspect breathe into a small, handheld breath testing device. Called variously a PAS ("preliminary alcohol screening") or PBT ("preliminary breath test"), the units are small, inexpensive versions of the larger, more sophisticated instruments at the police stations, the EBTs ("evidentiary breath test"). Whereas the EBTs usually employ infrared spectroscopy, the PAS units use a relatively simple electrochemical (fuel cell) technology. Their purpose, along with other FSTs, is to assist the officer in determining probable cause for arrest. Although, because of their relative inaccuracy, they were never intended to be used in court for proving actual blood-alcohol concentration, some courts have begun to admit them as evidence of BAC.

Probable cause to arrest
If the officer has sufficient probable cause that the suspect has been driving under the influence of alcohol, they will make the arrest, handcuff the suspect and transport them to the police station. En route, the officer may advise them of their Miranda rights and their legal implied consent obligation to submit to an evidentiary chemical test of blood, breath or possibly urine.

Laws relating to what exactly constitutes probable cause vary from state to state. In California it is a refutable presumption that a person with a BAC of 0.08% or higher is driving under the influence. However, section 23610(a)(2) of the California Vehicle Code states that driving with a BAC between 0.05% and 0.08% "shall not give rise to any presumption that the person was or was not under the influence of an alcoholic beverage".

Chemical test
At the police station, the arrest will be offered a chemical test of breath, blood or, much less frequently, urine. Breath test results are usually available immediately; urine and blood samples are sent to a lab for later analysis to determine the BAC or possible presence of drugs.

If the arrestee refuses to submit to chemical testing, they will usually be booked for driving under the influence; there will be no evidence for filing the second charge of driving with 0.08% BAC. In some cases the arrest may be charged with DUI even after passing a breathalyzer test if he or she refuses also to take subsequent urine or blood tests. However, the refusal will carry increased penalties on the driving under the influence charge (typically a longer license suspension or an increased jail sentence), and the act of refusing may be admissible in court as evidence of "consciousness of guilt". In some states, refusal to submit to a chemical test can result in an automatic suspension of driving privileges, regardless of whether the suspect is convicted of DUI. In an increasing number of jurisdictions, if the suspect refuses to take a chemical test the police in some states may seek a search warrant to draw a sample of blood. This is particularly common in situations involving an accident with injury or death. In common law jurisdictions this requires obtaining a search warrant from a criminal magistrate. Some states have 'implied consent' laws, agreed to when applied for a driver's license. By signing the driver's license application, consent is implied to allow a law enforcement officer to direct a medical professional to draw blood for the purpose of determining the BAC, in case of be arrest on suspicion of DUI. Even if a breath test is refused, because of the 'implied consent', officers can still seek a search warrant to draw a blood sample for BAC determination.

Some commentators, such as Brown University's Jacob Appel, have criticized the role of medical personnel in this process. According to Appel, "If physicians acquiesce today in the removal of a resistant patient's blood, soon they may be called upon to pump the contents of an unwilling patient's stomach or even to perform involuntary surgery to retrieve an evidential bullet".

While chemical tests are used to determine the driver's BAC, they do not determine the driver's level of impairment. However, state laws usually provide for a rebuttable legal presumption of intoxication at a BAC of 0.08% or higher (see blood alcohol test assumptions).

Booking and charging
If it is determined after arrest that the person's BAC is not at or above the legal limit of 0.08%, they will probably be released without any charges. One may, however, still be charged with driving under the influence of alcohol on the basis of driving symptoms, observed impairment, admissions or performance on the field sobriety tests. And if there is suspicion of drug usage, a blood or urine test is likely, or at least the testimony of a specially-trained officer called a Drug Recognition Expert (DRE). Assuming sufficient evidence of impaired driving from drugs, the arrested may face charges of driving under the influence of drugs or the combined influence of alcohol and drugs.

Most of the time, the driver will either be kept in a holding cell (sometimes referred to as the "drunk tank") until they are deemed sober enough to be released on bail or on his "own recognizance" ("O.R."). A date to appear in court for an arraignment will be given to them. If they cannot make bail or is not granted O.R., they will be kept in jail to wait for the arraignment on remand.

Interventions
Drunk driving is a public health concern in the United States, and reducing its frequency may require an integrated community-based approach utilizing sanctions and treatments. Several intervention programs have been developed, such as the Paradigm Developmental Model of Treatment (PDMT), a program encouraging a paradigm shift in the offender's view of oneself and the world.

The National Institute for Alcohol Abuse and Alcoholism suggests environmental interventions to help eliminate drinking and driving all together. To date, the most successful law in combating drinking and driving has been raising the minimum drinking age to 21 (NIAAA, 2011). NHTSA estimates that a legal drinking age of 21 saves 700 to 1,000 lives annually. Since 1976, these laws have prevented more than 21,000 traffic deaths. Other suggestions include raising taxes, enacting zero-tolerance laws, stepping up enforcement, school-based prevention programs, and family based prevention programs (NIAAA).

International comparisons
In countries such as the United Kingdom and Australia drunk driving and deaths caused by drunk driving are considerably lower than the USA. Drunk driving deaths in the UK (population 61 million, 31 million cars) were 380 in 2010 (12% of all fatal accidents). In California (population 36 million, 32 million cars) there were 1,489 deaths from traffic accidents related to "alcohol or other drugs" in 2007 (22% of all fatal accidents). Alcohol consumption per capita in the UK and Australia is higher than the US and the legal age for drinking lower. 

Research in the United Kingdom has shown that the danger group for drunk driving is young men in their early 20s rather than teenagers. It is not uncommon for police forces in Australia to randomly stop motorists and submit them to a Random breath test. This test involves speaking or blowing into a hand held device to give a reading. Refusing a roadside test is an offense, and is subject to the same penalty as high range drunk driving. This detection method is not employed in the UK, and it is not an offence for a fully licenced driver to drive with a BAC of less than 0.08% (which it is in Australia). Also in Australia it is an offence for any person driving on Learner or probationary ('P1 or P2') plates (aged under 20years) to drive with any alcohol at all in your system. The BAC must be 0.00% and still remains under 0.05% for an "instructing a learner".

Unlike the USA these countries do not see restricting access to alcohol as having any useful role to play in reducing drunk driving. Their experience is that random breath tests, severe penalties, including imprisonment for a first offense (in UK), combined with blanket public service broadcasting are a more effective strategy.

Australian and British Law also does not recognize the crime of DUI Manslaughter and sentences for causing death by drunk driving are much lower than the USA. In the UK, a judge makes a sentencing decision based on the amount of alcohol present. This can lead to imprisonment for a first offence. In Australia, while they differ slightly from state to state, the penalties are more or less set depending on the range of BAC detected. For example over 0.05% and under 0.08% BAC does not lead to any licence restriction for any period of time(fine only). Over 0.08% means at least 3 month driving ban and fine for a first offence (this climbs as the BAC reading climbs). Over 0.15% is at least 6 months driving ban and larger fine(over $1000) for a first offence. In the latter case the drivers licence is revoked and they must re sit a driving test (after the ban is completed) and provide liver function test (LFT's) results that show that they are not consuming alcohol above a low range.

In Germany, a legal limit of 0.05% lowers to 0.03% if found to be at fault in a traffic accident and 0.00% is the standard for those who are under 21 years of age.