Impaired driving is dangerous. It's the cause of more than half of all car crashes. It means operating a motor vehicle while you are affected by:

• Alcohol
• Legal or illegal drugs
• Sleepiness
• Distractions, such as using a cell phone or texting
• Having a medical condition which affects your driving

For your safety and the safety of others, do not drive while impaired. Have someone else drive you or take public transportation when you cannot drive. If you need to take a call or send a text message, pull over.

Every day, 29 people in the United States die in motor vehicle crashes that involve an alcohol-impaired driver. This is one death every 50 minutes. The annual cost of alcohol-related crashes totals more than $44 billion.

Thankfully, there are effective measures that can help prevent injuries and deaths from alcohol-impaired driving.

How big is the problem?

• In 2016, 10,497 people died in alcohol-impaired driving crashes, accounting for 28% of all traffic-related deaths in the United States.
• Of the 1,233 traffic deaths among children ages 0 to 14 years in 2016, 214 (17%) involved an alcohol-impaired driver.
• In 2016, more than 1 million drivers were arrested for driving under the influence of alcohol or narcotics. That’s one percent of the 111 million self-reported episodes of alcohol-impaired driving among U.S. adults each year (figure below).
• Drugs other than alcohol (legal and illegal) are involved in about 16% of motor vehicle crashes.
• Marijuana use is increasing and 13% of nighttime, weekend drivers have marijuana in their system.
• Marijuana users were about 25% more likely to be involved in a crash than drivers with no evidence of marijuana use, however other factors–such as age and gender–may account for the increased crash risk among marijuana users.

Annual Self-reported Alcohol-impaired Driving Episodes among U.S. Adults, 1993–2014

Source: CDC. Behavioral Risk Factor Surveillance System (BRFSS), 1993–2014. Available at https://www.cdc.gov/brfss
Note: The annual estimated alcohol-impaired driving episodes were calculated using BRFSS respondents’ answers to this question: “During the past 30 days, how many times have you driven when you’ve had perhaps too much to drink?” Annual estimates per respondent were calculated by multiplying the reported episodes during the preceding 30 days by 12. These numbers were summed to obtain the annual national estimates (see https://www.cdc.gov/mmwr/preview/mmwrhtml/mm6430a2.htm).

Who is most at risk?

Young people:

• At all levels of blood alcohol concentration (BAC), the risk of being involved in a crash is greater for young people than for older people.
• Among drivers with BAC levels of 0.08% or higher involved in fatal crashes in 2016, nearly three in 10 were between 25 and 34 years of age (27%). The next two largest groups were ages 21 to 24 (26%) and 35 to 44 (22%).

Motorcyclists:

• Among motorcyclists killed in fatal crashes in 2016, 25% had BACs of 0.08% or greater.
• Motorcyclists ages 35-39 have the highest percentage of deaths with BACs of 0.08% or greater (38% in 2016).

Drivers with prior driving while impaired (DWI) convictions:

• Drivers with a BAC of 0.08% or higher involved in fatal crashes were 4.5 times more likely to have a prior conviction for DWI than were drivers with no alcohol in their system. (9% and 2%, respectively).

What are the effects of blood alcohol concentration (BAC)?

Information in this table shows the blood alcohol concentration (BAC) level at which the effect usually is first observed.

*Blood Alcohol Concentration Measurement

The number of drinks listed represents the approximate amount of alcohol that a 160-pound man would need to drink in one hour to reach the listed BAC in each category.

**A Standard Drink Size in the United States

A standard drink is equal to 14.0 grams (0.6 ounces) of pure alcohol. Generally, this amount of pure alcohol is found in

• 12-ounces of beer (5% alcohol content)
• 8-ounces of malt liquor (7% alcohol content)
• 5-ounces of wine (12% alcohol content)
• 1.5-ounces or a “shot” of 80-proof (40% alcohol content) distilled spirits or liquor (e.g., gin, rum, vodka, whiskey)

Adapted from The ABCs of BAC, National Highway Traffic Safety Administration, 2005, and How to Control Your Drinking, WR Miller and RF Munoz, University of New Mexico, 1982.

How can deaths and injuries from impaired driving be prevented?

Effective measures include:

• Actively enforcing existing 0.08% BAC laws, minimum legal drinking age laws, and zero tolerance laws for drivers younger than 21 years old in all states.
• Requiring ignition interlocks for all offenders, including first-time offenders.
• Using sobriety checkpoints.
• Putting health promotion efforts into practice that influence economic, organizational, policy, and school/community action.
• Using community-based approaches to alcohol control and DWI prevention.
• Requiring mandatory substance abuse assessment and treatment, if needed, for DWI offenders.
• Raising the unit price of alcohol by increasing taxes.

What safety steps can individuals take?

Make plans so that you don’t have to drive while impaired by alcohol and/or drugs. For example:

• Before drinking, designate a non-drinking driver when with a group.
• Don’t let your friends drive while impaired.
• If you have been drinking alcohol and/or using drugs, get a ride home, use a ride share service, or call a taxi.
• If you’re hosting a party where alcohol will be served, remind your guests to plan ahead and designate a sober driver. Offer alcohol-free beverages, and make sure all guests leave with a sober driver.

Nine people in the United States are killed every day in crashes that are reported to involve a distracted driver.

Distracted driving is doing another activity that takes the driver’s attention away from driving. Distracted driving can increase the chance of a motor vehicle crash.

There are three types of driving distractions

Anything that takes your attention away from driving can be a distraction. Sending a text message, talking on a cell phone, using a navigation system, and eating while driving are a few examples of distracted driving. Any of these distractions can endanger you, your passengers, and others on the road.

There are three main types of distraction:

• Visual: taking your eyes off the road
• Manual: taking your hands off the wheel
• Cognitive: taking your mind off driving

Distracted driving impacts thousands of Americans each year

• In the United States, over 3,100 people were killed and about 424,000 were injured in crashes involving a distracted driver in 2019.
• About 1 in 5 of the people who died in crashes involving a distracted driver in 2019 were not in vehicles―they were walking, riding their bikes, or otherwise outside a vehicle.

Sources: National Highway Traffic Safety Administration, 2010-2013, 2014–2018 and 2019

Some groups are more at risk for distracted driving

Young adult and teen drivers

• Among fatal crashes involving distracted drivers in the U.S. in 2019:
  • A higher percentage of drivers ages 15–20 were distracted than drivers age 21 and older.
  • Among these younger drivers, 9% of them were distracted at the time of the crash.
• A 2019 survey of U.S. high school students found:
  • 39% of high school students who drove in the past 30 days texted or emailed while driving on at least one of those days.
  • Texting or emailing while driving was more common among older students than younger students (see figure below) and more common among White students (44%) than Black (30%) or Hispanic students (35%).
  • Texting or emailing while driving was as common among students whose grades were mostly As or Bs as among students with mostly Cs, Ds, or Fs.
  • Students who texted or emailed while driving were also more likely to report other transportation risk behaviors. They were:
    • more likely to not always wear a seat belt;
    • more likely to ride with a driver who had been drinking alcohol; and
    • more likely to drive after drinking alcohol.

Source: National Highway Traffic Safety Administration, 2019

Source: Transportation Risk Behaviors Among High School Students — Youth Risk Behavior Survey, United States, 2019

Distracted driving is preventable

What drivers can do

• Do not multitask while driving. Whether it’s adjusting your mirrors, selecting music, eating, making a phone call, or reading a text or email―do it before or after your trip, not during.
• You can use apps to help you avoid cell phone use while driving. Consider trying an app to reduce distractions while driving.

What passengers can do

• Speak up if you are a passenger in a car with a distracted driver. Ask the driver to focus on driving.
• Reduce distractions for the driver by assisting with navigation or other tasks.

What parents can do

• Talk to your teen or young adult about the rules and responsibilities involved in driving. Share stories and statistics related to teen/young adult drivers and distracted driving.
  • Remind them driving is a skill that requires the driver’s full attention.
  • Emphasize that texts and phone calls can wait until arriving at a destination.

• Familiarize yourself with your state’s graduated driver licensing system and enforce its guidelines for your teen.
• Know your state’s laws on distracted driving. Many states have novice driver provisions in their distracted driving laws. Talk with your teen about the consequences of distracted driving and make yourself and your teen aware of your state’s penalties for talking or texting while driving.
• Set consequences for distracted driving. Fill out CDC’s Parent-Teen Driving Agreement together to begin a safe driving discussion and set your family’s rules of the road. Your family’s rules of the road can be stricter than your state’s law. You can also use these simple and effective ways to get involved with your teen’s driving: Parents Are the Key.
• Set an example by keeping your eyes on the road and your hands on the wheel while driving.

Drive alert—protect yourself and others on the road! Learn the risks of drowsy driving and how to prevent it.

Drowsy driving is the dangerous combination of driving when sleepy. This usually happens when a driver has not slept enough, but it can also happen because of untreated sleep disorders or shift work. Prescription and over-the-counter medications can also cause drowsiness, and alcohol can interact with sleepiness to increase both impairment and drowsiness.

No one knows the exact moment when sleep will come over their body. Falling asleep at the wheel is clearly dangerous, but being sleepy also affects your ability to drive safely, even if you don’t fall asleep. Drowsiness:

• Makes you less able to pay attention to the road.
• Slows your reaction time if you must brake or steer suddenly.
• Affects your ability to make good decisions.

Did You Know?

• In a CDC survey, an estimated 1 in 25 adult drivers (aged 18 years or older) reported having fallen asleep while driving in the previous 30 days.
• In the same CDC survey, adult drivers who snore or usually sleep 6 or fewer hours per day were more likely to report falling asleep while driving than drivers who do not snore or usually sleep 7 or more hours per day, respectively.
• Drowsy driving was involved in 91,000 crashes in 2017—resulting in 50,000 injuries and nearly 800 deaths. In 2020, there were 633 deaths based on police reports. However, these numbers are underestimated, and over 6,000 fatal crashes each year may involve a drowsy driver.

Who’s at greater risk of drowsy driving and related crashes and deaths?

• Teen and young adult drivers.
• Drivers on the road between midnight and 6 a.m. or in the later afternoon.
• Drivers who don’t get enough sleep.
• Commercial truck drivers.
• Drivers who work the night shift or long shifts.
• Drivers with untreated sleep disorders—like sleep apnea, where breathing repeatedly stops and starts.
• Drivers who use medicines that make them sleepy.

Learn the warning signs of drowsy driving:

• Yawning or blinking frequently.
• Trouble remembering the past few miles driven.
• Missing your exit.
• Drifting from your lane.
• Hitting a rumble strip on the side of the road.

If you have any of these warning signs, pull over to rest or let someone else drive. Simply turning up the radio or opening the window are not effective ways to keep you alert.

Prevent drowsy driving before taking the wheel

• Get enough sleep! Most adults need at least 7 hours of sleep a day, and teens need at least 8 hours.
• Develop good sleeping habits, such as sticking to a sleep schedule.
• If you have a sleep disorder or have symptoms of a sleep disorder such as snoring or feeling sleepy during the day, talk to your doctor about treatment options.
• Before you drive, avoid taking medicines that make you sleepy. Be sure to check the label on any medicines you take or talk to your pharmacist.
• Before you drive, avoid drinking alcohol. Alcohol impairs the skills needed for driving and increases drowsiness.

If you’re taking a medication, is it safe to drive?

Most likely, yes. Still, the U.S. Food and Drug Administration (FDA) advises you to make sure before operating any type of vehicle, whether a car, bus, train, plane, or boat.

Although most medications won’t affect your ability to drive, some prescription and nonprescription medicines (also called over-the-counter, or OTC) can have side effects and cause reactions that may make it unsafe to drive. Side effects can include:

• sleepiness/drowsiness
• blurred vision
• dizziness
• slowed movement
• fainting
• inability to focus or pay attention
• nausea
• excitability

Some medicines can affect your driving for a short time after you take them. For others, the effects can last for several hours, and even the next day. And some medicines have a warning to not operate heavy machinery — this includes driving a car.

Medicines That Might Affect Driving

Knowing how your medications — or any combination of them — affect your ability to drive is a safety measure. Some drugs that could make it dangerous to drive include:

• opioid pain relievers
• prescription drugs for anxiety (for example, benzodiazepines)
• anti-seizure drugs (antiepileptic drugs)
• antipsychotic drugs
• some antidepressants
• products containing codeine
• some cold remedies and allergy products, such as antihistamines (both prescription and OTC)
• sleeping pills
• muscle relaxants
• medicines that treat or control symptoms of diarrhea
• medicines that treat or prevent symptoms of motion sickness
• diet pills, “stay awake” drugs, and other medications with stimulants (e.g., caffeine, ephedrine, pseudoephedrine)

Also, taking cannabidiol (CBD) products and driving can be dangerous. CBD can cause sleepiness, sedation, and lethargy. Because of these side effects, consumers should use caution if planning on operating a motor vehicle after consuming any CBD products.

Some Sleep Medicines Can Impair You, Even the Next Morning

People with insomnia have trouble falling or staying asleep. Many take medicines to help sleep. Come morning, though, some sleep medicines could make you less able to perform activities for which you must be fully alert, including driving.

A common ingredient in a widely prescribed sleep medication is zolpidem, which belongs to a class of medications called sedative-hypnotics. The FDA has found that medicines containing zolpidem, especially extended release forms, can impair driving ability and other activities the next morning.

Zolpidem immediate and extended-release forms are marketed as generic drugs and under these brand names:

• Ambien and Ambien CR (oral tablet)
• Edluar (tablet placed under the tongue)
• Intermezzo (tablet placed under the tongue)
• Zolpimist (oral spray)

People who take sleep medicines should talk to their health care professional about ways to take the lowest effective dose. Don’t assume that non-prescription sleep medicines are necessarily safer alternatives. The FDA is also evaluating the risk of next-day impairment with other insomnia drugs, both prescription and OTC versions.

Allergy Medicines Can Affect Your Ability to Drive

For allergy sufferers, medications containing antihistamines can help relieve many different types of allergies, including hay fever. But these medicines may interfere with driving and operating heavy machinery (including driving a car). Antihistamines can slow your reaction time, make it hard to focus or think clearly, and may cause mild confusion even if you don’t feel drowsy.

Read the OTC Drug Facts label of your medicine and understand the warnings before using it. Also, avoid drinking alcohol or taking sleep medications while using some antihistamines. Those combinations can increase the sedative effects of antihistamines.

How to Avoid Driving Impaired

You can still drive safely while taking most medications. Talk to your health care provider about possible side effects. For example, some antihistamines and sleep medications work for longer periods than others. You might feel the sedating effects of these medications for some time after you’ve taken them, and maybe even into the next day.

Doctors and pharmacists can tell you about known side effects of medications, including those that interfere with driving. You can also request printed information about the side effects of any new medicine.

To manage or minimize side effects while driving, your health care provider may be able to adjust your dose, adjust the timing of when you take the medicine, or change the medicine to one that causes fewer side effects for you.

Here are some more tips:

• Always follow directions for use and read warnings on medication packaging, or handouts provided by the pharmacy.
• Don’t stop using your medicine unless your prescriber tells you to.
• Tell your health care provider about all the products you are taking, including prescription, OTC, and herbal products. Also, let them know about any reactions you experience.

Is it safe to drink alcohol and drive?

No. Alcohol use slows reaction time and impairs judgment and coordination, which are all skills needed to drive a car safely. The more alcohol consumed, the greater the impairment.

What does it mean to be above the legal limit for drinking?

The legal limit for drinking is the alcohol level above which a person is subject to legal penalties (e.g., arrest or loss of a driver’s license).

• Legal limits are measured using either a blood alcohol test or a breathalyzer.
• Legal limits are typically defined by state law, and may vary according to individual characteristics, such as age and occupation.

All states in the United States have adopted 0.08% (80 mg/dL) as the legal limit for operating a motor vehicle for drivers aged 21 years or older (except for Utah, which adopted a 0.05% legal limit in 2018). However, drivers younger than 21 are not allowed to operate a motor vehicle with any level of alcohol in their system.

Note: Legal limits do not define a level below which it is safe to operate a vehicle or engage in some other activity. Impairment due to alcohol use begins to occur at levels well below the legal limit.

Drugged driving is driving a vehicle while impaired due to the intoxicating effects of recent drug use. It can make driving a car unsafe—just like driving after drinking alcohol. Drugged driving puts the driver, passengers, and others who share the road at serious risk.

Why is drugged driving dangerous?

The effects of specific drugs on driving skills differ depending on how they act in the brain. For example, marijuana can slow reaction time, impair judgment of time and distance, and decrease coordination. Drivers who have used cocaine or methamphetamine can be aggressive and reckless when driving. Certain kinds of prescription medicines, including benzodiazepines and opioids, can cause drowsiness, dizziness, and impair cognitive functioning (thinking and judgment). All of these effects can lead to vehicle crashes.

Research studies have shown negative effects of marijuana on drivers, including an increase in lane weaving, poor reaction time, and altered attention to the road. Use of alcohol with marijuana makes drivers more impaired, causing even more lane weaving. Some studies report that opioids can cause drowsiness and impair thinking and judgment. Other studies have found that being under the influence opioids while driving can double your risk of having a crash.

It is difficult to determine how specific drugs affect driving because people tend to mix various substances, including alcohol. But we do know that even small amounts of some drugs can have a measurable effect. As a result, some states have zero-tolerance laws for drugged driving. This means a person can face charges for driving under the influence (DUI) if there is any amount of drug in the blood or urine. Many states are waiting to develop laws until research can better define blood levels that indicate impairment, such as those they use with alcohol.

How many people take drugs and drive?

According to the 2021 National Survey on Drug Use and Health (NSDUH), in 2021, 13.5 million people aged 16 or older drove under the influence of alcohol in the past year and 11.7 million drove under the influence of selected illicit drugs, including marijuana (2021 DT 8.33A).

The survey also showed that men are more likely than women to drive under the influence of drugs or alcohol. A higher percentage of adults aged 21 to 25 (15.0%) drive after taking drugs or drinking than do young adults aged 16 to 20 (7.5%) or adults 26 or older (7.7%) (2021 DT 8.33B).

Which drugs are linked to drugged driving?

After alcohol, marijuana is the drug most often found in the blood of drivers involved in crashes. Tests for detecting marijuana in drivers measure the level of delta-9-tetrahydrocannabinol (THC), marijuana’s mind-altering ingredient, in the blood. But the role that marijuana plays in crashes is often unclear. THC can be detected in body fluids for days or even weeks after use, and it is often combined with alcohol. The vehicle crash risk associated with marijuana in combination with alcohol, cocaine, or benzodiazepines appears to be greater than that for each drug by itself.

Several studies have shown that drivers with THC in their blood were roughly twice as likely to be responsible for a deadly crash or be killed than drivers who hadn't used drugs or alcohol. However, a large NHTSA study found no significant increased crash risk traceable to marijuana after controlling for drivers’ age, gender, race, and presence of alcohol. More research is needed.

Along with marijuana, prescription drugs are also commonly linked to drugged driving crashes. In 2016, 19.7 percent of drivers who drove while under the influence tested positive for some type of opioid.

How often does drugged driving cause crashes?

It's hard to measure how many crashes are caused by drugged driving. This is because:

• a good roadside test for drug levels in the body doesn't yet exist
• some drugs can stay in your system for days or weeks after use, making it difficult to determine when the drug was used, and therefore, how and if it impaired driving
• police don't usually test for drugs if drivers have reached an illegal blood alcohol level because there's already enough evidence for a DUI charge
• many drivers who cause crashes are found to have both drugs and alcohol or more than one drug in their system, making it hard to know which substance had the greater effect

However, according to the Governors Highway Safety Association, 43.6 percent of fatally injured drivers in 2016 tested positive for drugs and over half of those drivers were positive for two or more drugs.

Effects of Commonly Misused Drugs on Driving

Marijuana affects psychomotor skills and cognitive functions critical to driving including vigilance, drowsiness, time and distance perception, reaction time, divided attention, lane tracking, coordination, and balance.

Opioids can cause drowsiness and can impair cognitive function.

Alcohol can reduce coordination, concentration, ability to track moving objects and reduce response to emergency driving situations as well as difficulty steering and maintaining lane position. It can also cause drowsiness.

What populations are especially affected by drugged driving?

Teen and older adult drivers are most often affected by drugged driving. Teens are less experienced and are more likely than other drivers to underestimate or not recognize dangerous situations. They are also more likely to speed and allow less distance between vehicles. When lack of driving experience is combined with drug use, the results can be tragic. Car crashes are the leading cause of death among young people aged 16 to 19 years.

A study of college students with access to a car found that 1 in 6 had driven under the influence of a drug other than alcohol at least once in the past year. Marijuana was the most common drug used, followed by cocaine and prescription pain relievers.

Mental decline in older adults can lead to taking a prescription drug more or less often than they should or in the wrong amount. Older adults also may not break down the drug in their system as quickly as younger people. These factors can lead to unintended intoxication while behind the wheel of a car.

What steps can people take to prevent drugged driving?

Because drugged driving puts people at a higher risk for crashes, public health experts urge people who use drugs and alcohol to develop social strategies to prevent them from getting behind the wheel of a car while impaired. Steps people can take include:

• offering to be a designated driver
• appointing a designated driver to take all car keys
• getting a ride to and from parties where there are alcohol and/or drugs.
• discussing the risks of drugged driving with friends in advance

Points to Remember

• Use of illicit drugs or misuse of prescription drugs can make driving a car unsafe—just like driving after drinking alcohol.
• In 2018, 20.5 million people aged 16 or older drove under the influence of alcohol in the past year and 12.6 million drove under the influence of illicit drugs.
• It's hard to measure how many crashes are caused by drugged driving, but estimates show that almost 44 percent of drivers in fatal car crashes tested positive for drugs.
• Driving under the influence of marijuana, opioids and alcohol can have profound effects on driving.
• People who use drugs and alcohol should develop social strategies to prevent them from getting behind the wheel of a car while impaired.

What You Need To Know About Marijuana Use and Driving

Driving under the influence (DUI) laws are not just for alcohol. Driving under the influence of drugs, including marijuana, is also dangerous and illegal. Driving is a complex task that requires your full attention to stay safe and alert. Marijuana affects areas of the brain that control your body’s movements, balance, coordination, memory, and judgment. Marijuana use can impair important skills required for safe driving by:

• slowing your reaction time and ability to make decisions,
• impairing coordination, and
• distorting perception.

Studies have shown an association between acute marijuana use and car crashes, but more research is needed. It is difficult to connect the presence of marijuana or concentration of tetrahydrocannabinol (THC), the compound responsible for marijuana’s psychoactive properties (the “high”), to impairment in driving performance for an individual person. Studies have shown that the use of multiple substances (such as marijuana and alcohol) at the same time can increase impairment.

What you can do to help prevent impaired driving

If you intend to drive, the safest option is not to use any alcohol or drugs, including marijuana. Here are steps you can take to help prevent impaired driving if you plan to use, are using, or have used alcohol or drugs, including marijuana:

• Choose not to drive and remind your friends and family to do the same.
• Assign a trusted designated driver who will not drink or use drugs when you are going out with a group of people you know.
• Plan on getting a ride home from someone who has not been drinking alcohol and/or using drugs, using a rideshare service, or calling a taxi.

All of the following are methods that can help any driver drive safely, and they are especially important to help older drivers continue to drive safely

• always wear your seat-belt
• continuously move your eyes and observe all traffic
• look for vehicles that enter the highway from curbs, driveways and businesses
• be alert for parked cars, pedestrians and cyclists
• frequently check both your inside and outside rearview mirrors
• check for traffic behind you - turn your head and neck and look over your shoulder before you turn or change traffic lanes
• do not expect that you will be given the right of way, even if you know it ought to be given to you
• make sure that it is safe to pass or change traffic lanes before you do so
• keep a minimum three-second following distance - start your count when the car ahead passes a fixed point
• when you drive in rain or winter weather, reduce your speed and increase your following distance
• make sure there is a safe amount of space on all sides of your vehicle
• plan all your trips so you can use routes you know well - stay away from highways with heavy traffic and high traffic speeds
• try not to drive at dusk or dawn when you cannot see as well
• do not drive for extended periods of time without rest
• keep windshields and rear windows clean on the inside and the outside
• avoid looking at the headlights of vehicles that approach you
• concentrate on your driving and be prepared for events you do not expect
• do not drive if you are emotionally upset
• reduce background noise - keep your air conditioning or heater and the volume of your radio, on lower settings.
• never drive after you consume alcohol or drugs (including prescription drugs).
• also read the labels on over-the-counter medications - these medications can also affect your ability to drive
• take a driver improvement course.

It is important for older drivers to retain or improve their driving skills and judgment. Older drivers can help maintain safe driving skills and extend their years of driving if they

• have their driving abilities assessed frequently
• attend driver safety courses to help renew driving knowledge and skills
• recognize vision changes and see their eye care specialist
• keep active to maintain quick reflexes and remain flexible
• when required, get physical therapy and medical rehabilitation