Analysis of Drunk vs. Drugged Driving Fatal Crashes

On November 22, 2020, a driver ran a red light in Atlanta, Georgia, and slammed into a car, killing a 25-year-old, and injuring several others. The driver had taken a combination of drugs and had a blood alcohol concentration of 0.12 – way above the legal limit of 0.08.

On December 13, 2020, a driver caused a four-car crash that injured three people in Portland, Oregon. The driver admitted to alcohol and cocaine use before driving.

Individually, driving while drugged or drunk has been proven to be dangerous, but their combined effects are more catastrophic.

Given the consequences of drunk driving and drugged driving, we worked with the data visualization agency, 1Point21 Interactive, to analyze fatal crash data from 2000-2019. The objective was to compare fatal crashes caused by drunk driving with drugged driving – and also the combined effects of drugs and alcohol in fatal crashes.

During our time period, there were a total of 691,605 fatal crashes. 29 percent of crashes (204,010) involved one or more drivers with a blood alcohol concentration level above 0.08, while 9.1 percent of crashes (63,157) involved one or more drivers who tested positive for a drug. Only 4.5 percent of crashes (31,434) involved drivers who combined drugs and alcohol.

Interactive Map: Alcohol and Drug Related Fatal Crashes

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For this study, our definition for a drunk driver was anyone with an actual or estimated blood alcohol concentration (BAC) level above the legal limit of 0.08, and our definition for a drugged driver was anyone who tested positive for one or more drugs.

Drug testing and reporting across the U.S. isn’t standardized. Therefore, our data is incomplete and is impacted by the following factors:

• How often states drug test drivers in fatal crashes
• How accurate and complete the drug tests are. The more drugs someone is tested for, the more likely at least one result could be positive.

Which Crashes Are More Prevalent: Drunk or Drugged Driving?

Based on our study, people are the most likely to drive drunk and the least likely to drive while both drugged and drunk. The data shows that drunk driving crashes are more than three times as likely to occur than drugged crashes and more than six times as likely as crashes involving both drugged and drunk drivers.

Where Are Drugged/Drunk Driving Crashes Most Common?

As the map shows, high rates of combined drunk and drugged driving are concentrated in West Virginia, the Mountain West, and Alaska. In the northern plains states, drunk driving is common, but not drugged driving. In the South and Rust Belt, drugged driving is seen at higher rates than drunk driving in fatal crashes. In Utah, the majority of the population is of Mormon faith, which prohibits drinking. This may contribute to the low number of fatal crashes in Utah involving drunk or drugged driving.

Top 25 Counties With the Highest Percentages of Drugged and Drunk Driving Crashes (Population > 25k)

Orleans, Vermont – 18 percent

Abbeville, South Carolina – 16.5 percent

Logan, Illinois – 16 percent

Cheshire, New Hampshire – 15.3 percent

Hawaii, Hawaii 15.2 percent

Lewis and Clark, Montana – 15.1 percent

Franklin, Vermont – 14.8 percent

Washington, Rhode Island – 14.4 percent

Lake, Montana – 14.3 percent

Thurston, Washington – 13.5 percent

Belknap, New Hampshire – 13.5 percent

Island, Washington – 13.5 percent

Maui, Hawaii – 13.4 percent

Wakulla, Florida – 13.3 percent

Lexington, South Carolina – 13.2 percent

Carroll, New Hampshire – 13.1 percent

Fulton, Illinois – 12.8 percent

Stevens, Washington – 12.8 percent

St. Clair, Illinois – 12.6 percent

Madison, Illinois – 12.6 percent

Kershaw, South Carolina – 12.5 percent

Flathead, Montana – 12.4 percent

Preble, Ohio – 12.4 percent

Adams, Ohio – 12.3 percent

Gallatin, Montana – 12.3 percent

Top 25 Counties With the Highest Percentages of Drugged Driving Crashes (Population > 25k)

Hawaii, Hawaii – 40.2 percent

Pike, Kentucky – 38.2 percent

Floyd, Kentucky – 37.7 percent

Island, Washington – 35.6 percent

Brown, Ohio – 35.0 percent

Orleans, Vermont – 34.8 percent

Skagit, Washington – 34.7 percent

Harlan, Kentucky – 34.0 percent

Snohomish, Washington – 34.0 percent

Clermont, Ohio – 34.0 percent

Stevens, Washington – 33.6 percent

Flathead, Montana – 33.3 percent

Logan, Illinois – 33.0 percent

Perry, Kentucky – 32.6 percent

Mason, Washington – 32.3 percent

Madison, Ohio – 32.2 percent

Belknap, New Hampshire – 32.1 percent

Lake, Montana – 31.9 percent

Maui, Hawaii – 31.6 percent

Merrimack, New Hampshire – 31.5 percent

Preble, Ohio – 31.5 percent

Loudon, Tennessee – 31.4 percent

Cheshire, New Hampshire – 31.3 percent

Mingo, West Virginia – 31.3 percent

Kitsap, Washington – 31.2 percent

Top 25 Counties With the Highest Percentages of Drunk Driving Crashes (Population > 25k)

Fremont, Wyoming – 47.2 percent

Wakulla, Florida – 46.7 percent

Marinette, Wisconsin – 46.6 percent

Okanogan, Washington – 45.9 percent

Abbeville, South Carolina – 45.9 percent

Oconto, Wisconsin – 45.6 percent

Kent, Rhode Island – 45.2 percent

Cascade, Montana – 45.1 percent

Monroe, Illinois – 45.1 percent

Lake, Montana – 45.1 percent

Charlottesville, Virginia – 45.0 percent

Washington, Rhode Island – 44.9 percent

Trempealeau, Wisconsin – 44.3 percent

Clinton, Illinois – 44.3 percent

Dickinson, Michigan – 44.2 percent

Bristol, Rhode Island – 44.1 percent

Rio Arriba, New Mexico – 43.9 percent

Becker, Minnesota – 43.8 percent

Taos, New Mexico – 43.8 percent

Lexington, South Carolina – 43.5 percent

Douglas, Wisconsin – 43.3 percent

Houghton, Michigan – 43.1 percent

Camden, Missouri – 43.0 percent

Galveston, Texas – 42.9 percent

Cameron – 42.8 percent

Which Drugs Are Most Commonly Mixed With Alcohol?

According to our fatal crash data, cocaine is the drug most likely to be combined with alcohol, followed by marijuana. Amphetamines and opioids are the least likely. One reason people mix cocaine and alcohol is that they believe doing so will help them perpetuate their high and avoid withdrawal. However, alcohol increases cravings for cocaine as well as the risk for stroke, heart-related issues, and other toxic effects.

Cocaine + Alcohol

Top 25 Counties With the Highest Percentages of Cocaine + Alcohol Crashes (Population > 25k):

Wakulla, Florida – 5.7 percent

Berkeley, West Virginia – 5.4 percent

Charlottesville, Virginia – 5.0 percent

Taos, New Mexico – 4.7 percent

Madison, Illinois – 4.7 percent

Washington, Rhode Island – 4.6 percent

Rio Arriba, New Mexico – 4.6 percent

Portsmouth, Virginia – 4.5 percent

Lexington, South Carolina – 4.4 percent

Sullivan, New York – 4.2 percent

Grundy, Illinois – 4.1 percent

Vermilion, Illinois – 4.1 percent

Aiken, South Carolina – 4.1 percent

Kershaw, South Carolina – 4.0 percent

Putnam, Florida – 3.9 percent

Jefferson, West Virginia – 3.9 percent

York, South Carolina – 3.8 percent

Orangeburg, South Carolina – 3.8 percent

St. Mary’s, Maryland – 3.8 percent

Winnebago, Illinois – 3.8 percent

Will, Illinois – 3.8 percent

Carroll, New Hampshire – 3.8 percent

Leon, Florida – 3.7 percent

St. Clair, Illinois – 3.7 percent

Douglas, Washington – 3.7 percent

Marijuana + Alcohol

Top 25 Counties With the Highest Percentages of Marijuana + Alcohol Crashes (Population > 25k):

Logan, Illinois – 13 percent

Cheshire, New Hampshire – 12 percent

Franklin, Vermont – 11.7 percent

Lake, Montana – 11 percent

Stevens, Washington – 10.7 percent

Maui, Hawaii – 10.6 percent

Abbeville, South Carolina – 10.6 percent

Island, Washington – 10.6 percent

Hawaii, Hawaii – 10.5 percent

Franklin, Illinois – 9.9 percent

Gladwin, Michigan – 9.8 percent

Thurston, Washington – 9.7 percent

Belknap, New Hampshire – 9.6 percent

Fulton, Illinois – 9.6 percent

Highland, Ohio – 9.2 percent

Knox, Ohio – 9.1 percent

Clallam, Washington – 9.1 percent

Kauai, Hawaii – 9.0 percent

Orleans, Vermont – 9.0 percent

Lewis and Clark, Montana – 8.9 percent

Missoula, Montana – 8.8 percent

Pierce, Washington – 8.8 percent

Gallatin, Montana – 8.6 percent

St. Clair, Illinois – 8.6 percent

Hamilton, Ohio – 8.6 percent

Benzodiazepines + Alcohol

Top 25 Counties With the Highest Percentages of Benzodiazepines + Alcohol Crashes (Population > 25k):

Oconee, South Carolina – 5.6 percent

Lawrence, Tennessee – 4.9 percent

Perry, Kentucky – 4.8 percent

Abbeville, South Carolina – 4.7 percent

Cabell, West Virginia – 4.6 percent

Pike, Kentucky – 4.3 percent

Carter, Kentucky – 4.3 percent

Lincoln, Tennessee – 4.3 percent

Graves, Kentucky – 4.2 percent

Logan, Illinois – 4.0 percent

Franklin, Tennessee – 3.8 percent

Jefferson, Tennessee – 3.8 percent

Roane, Tennessee – 3.7 percent

Coshocton, Ohio – 3.7 percent

Clermont, Ohio – 3.5 percent

Spartanburg, South Carolina – 3.5 percent

Bell, Kentucky – 3.4 percent

Boyd, Kentucky – 3.4 percent

Orleans, Vermont – 3.4 percent

Highland, Ohio – 3.4 percent

Jackson, Ohio – 3.3 percent

Obion, Tennessee – 3.3 percent

Logan, West Virginia – 3.2 percent

Glynn, Georgia – 3.2 percent

Orangeburg, South Carolina – 3.2 percent

Amphetamines + Alcohol

Top 25 Counties With the Highest Percentages of Amphetamines + Alcohol Crashes (Population > 25k):

Orleans, Vermont – 3.4 percent

Lewis, Washington – 3.1 percent

McCracken, Kentucky – 2.9 percent

Lake, Montana – 2.7 percent

Lewis and Clark, Montana – 2.7 percent

Grand Forks, North Dakota – 2.7 percent

Bennington, Vermont – 2.5 percent

Greenwood, South Carolina – 2.5 percent

Douglas, Washington – 2.5 percent

Fremont, Wyoming – 2.4 percent

Kitsap, Washington – 2.4 percent

Natrona, Wyoming – 2.4 percent

Abbeville, South Carolina – 2.4 percent

Elk, Pennsylvania – 2.3 percent

Ripley, Indiana – 2.3 percent

Geary, Kansas – 2.3 percent

Umatilla, Oregon – 2.3 percent

Vermilion, Illinois – 2.3 percent

Williamson, Illinois – 2.3 percent

Becker, Minnesota – 2.2 percent

Polk, Minnesota – 2.2 percent

Yellowstone, Montana – 2.2 percent

San Jacinto, Texas – 2.2 percent

Jefferson, Missouri – 2.2 percent

Coos, Oregon – 2.2 percent

Who Tends to Drive Drunk/Drugged/Both?

In fatal crashes, male drivers ages 20-60 are the most likely to drive drunk, drugged, or a combination of both. In contrast, female drivers over the age of 50 are the most likely to be sober during a fatal crash.

Across all demographics, drunk driving is more common than drugged driving, and combined drunk and drugged driving is the least common.

Has Drugged/Drunk/Both Driving Changed Over Time?

While drunk driving fatal crashes are on a downward trend in the U.S., fatal crashes resulting from drugged drivers or the combination of drugged and drunk drivers are on a rise. However, it is unclear if this change is due to increased and improved testing, or a higher number of people driving under the influence.

Preventing Drugged and Drunk Driving

Many combine alcohol with drugs in an attempt to maintain their high and to fight withdrawal. But this actually intensifies the drug cravings and any other negative effects on your brain and body, impairing your judgment and reflexes. The combination of alcohol and marijuana isn’t considered to be as serious, but studies have shown that drinking alcohol before smoking marijuana heightens the effects of marijuana, altering the driver’s concentration and ability to perceive time and distance. For these reasons, practice the following safety tips before driving:

• Always plan for a designated driver if there is even the slightest chance you will be under the influence of alcohol, drugs, or both.
• Avoid combining alcohol and drugs; it may seem innocuous at the moment, but the consequences can be life-altering.
• Do not let someone you love drive under the influence under any circumstance.
• If you see someone on the road driving impaired, contact law enforcement.

Methodology and Fair Use

For this study, we analyzed 2000-2019 fatal crash data from the National Highway Traffic Safety Administration (NHTSA). This data includes any driver who tested positive for drug tests or had a blood alcohol concentration level (actual or estimated) above the legal limit of 0.08. Drivers who were not given drug tests following the crash are excluded.

If you would like to report or republish our findings, please link to this page to provide a citation for our work.