Alcohol and Highway Safety: Screening and Brief Intervention for Alcohol Problems as a Community Approach to Improve Traffic Safety [Traffic Tech]

NHTSA · 2013 · ROSA P / United States. National Highway Traffic Safety Administration

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Summary

This report, published by the National Highway Traffic Safety Administration (NHTSA) in 2013, addresses the challenge of reducing alcohol-involved motor vehicle crashes by targeting at-risk drinkers who are rarely apprehended through traditional law enforcement. The authors highlight that only a small fraction of impaired drivers are arrested; estimates suggest the probability of arrest for driving with a blood alcohol concentration over .10 g/dL is approximately 1 in 200, and only 23% of drivers admitted to trauma units after alcohol-involved crashes are convicted of Driving While Intoxicated (DWI). Consequently, the paper advocates for Screening and Brief Intervention (SBI) as a community-based countermeasure to identify and assist high-risk drivers outside the criminal justice system. The report defines SBI as a methodology adapted from primary medical care, originally used to assist patients in quitting smoking. The process involves two main components: screening and brief intervention. Screening utilizes clinical examinations, biological markers, or self-report questionnaires to identify individuals at risk for substance abuse or dependence. Widely used instruments include the Michigan Alcohol Screening Task (MAST), CAGE, and the Alcohol Use Disorders Identification Test (AUDIT), which is noted for its high sensitivity and specificity. Once identified, individuals receive brief interventions, which may consist of a single session involving personalized feedback, motivational dialogue, and medical advice to reduce or quit drinking. This approach targets the "harmful and hazardous" drinking group, which comprises approximately 25% of the population and accounts for a disproportionate share of alcohol-related injuries, rather than focusing solely on the smaller group of alcohol-dependent individuals. The review synthesizes findings from more than 50 randomized controlled trials conducted over two decades, demonstrating that SBI is effective in reducing alcohol consumption and related harms. Evidence indicates that SBI delivered in primary care settings significantly reduces motor vehicle crashes and the frequency of crashes involving nonfatal injuries. In emergency departments and trauma centers, SBI implementation has been associated with reductions in excessive alcohol consumption, motor vehicle violations, arrests, and crash involvement. Due to these positive outcomes and associated healthcare cost savings, the Committee on Trauma of the American College of Surgeons mandated that Level I and II trauma centers utilize the "teachable moment" following alcohol-involved injuries to implement SBI. While studies in college settings and web-based programs show promise, they require more rigorous evaluation. The significance of this research lies in its recommendation to integrate traffic safety goals into healthcare and public health policies. The authors argue that healthcare organizations often overlook their role in reducing impaired driving. To maximize impact, the report calls for broad dissemination of SBI across healthcare, law enforcement, and criminal justice institutions. It emphasizes the need for policy changes that promote education on SBI utility, foster inter-agency collaboration, and develop efficient training methods. By addressing the large population of risky drinkers through medical and community interventions, SBI offers a viable strategy to improve traffic safety and reduce unintentional injuries associated with alcohol use.

Key finding

Screening and Brief Intervention delivered in primary care, emergency departments, and trauma centers is associated with statistically significant reductions in excessive alcohol consumption, motor vehicle violations, and involvement in motor vehicle crashes.

Methodology

review

Provenance

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Summary generated by qwen3.6-27b-prismaquant on 2026-06-10; verification: verified.

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• dui enforcement

Information type

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• Applied Guidance: countermeasure evaluation